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Refractory epilepsy

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https://www.readbyqxmd.com/read/29137921/intraoperative-definition-of-bottom-of-sulcus-dysplasia-using-intraoperative-ultrasound-and-single-depth-electrode-recording-a-technical-note
#1
Dorothea Miller, Patrick Carney, John S Archer, Gregory J Fitt, Graeme D Jackson, Kristian J Bulluss
Bottom of sulcus dysplasias (BOSDs) are localized focal cortical dysplasias (FCDs) centred on the bottom of a sulcus that can be highly epileptogenic, but difficult to delineate intraoperatively. We report on a patient with refractory epilepsy due to a BOSD, successfully resected with the aid of a multimodal surgical approach using neuronavigation based on MRI and PET, intraoperative ultrasound (iUS) and electrocorticography (ECoG) using depth electrodes. The lesion could be visualized on iUS showing an increase in echogenicity at the grey-white matter junction...
November 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29133176/effect-of-zonisamide-on-refractory-epilepsy-during-pregnancy-in-lamotrigine-resistant-kindled-rats
#2
Reza Narenji Sani, Keivan Keramati, Niloufar Saberi, Melika Moezifar, Ali Mahdavi
Drug-resistant epilepsy with uncontrolled severe seizures despite state-of-the-art medical treatment continues to be a major clinical problem. Pregnancy is a state where drug pharmacokinetic changes are more pronounced and more rapid than any other period of life. The current study investigated the effect of zonisamide (ZNS) on refractory epilepsy during pregnancy in lamotrigine-resistant kindled rats. Fifty-six lamotrigine (LTG)-resistant kindled Wistar rats were divided into five experimental (four pregnant and one non-pregnant) and 2 positive controls (pregnant and non-pregnant) groups and eight intact Wistar rats were put in the negative pregnant control group...
November 11, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29130289/development-and-pilot-testing-of-a-parent-reported-health-related-quality-of-life-measure-for-children-on-the-ketogenic-diet-the-ketoqol
#3
Katie Barwick, Tamara Parker, Nicole Murphy, Alwyn Todd, Michael Leveritt, Shelley A Wilkinson
AIM: The aim of the present study was to develop a parent-reported tool that will measure health-related quality of life (HRQoL) in children following ketogenic diet (KD) therapies for refractory epilepsy once it has been pilot tested and analysed. METHODS: Parents of children following KD therapies for epilepsy were recruited through a public hospital in Queensland, Australia, in 2012 and 2014. Qualitative semistructured interviews were conducted in 2012 with 13 parents who described changes seen in their child's HRQoL while on the KD...
November 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/29129763/mammillothalamic-and-mammillotegmental-tracts-as-new-targets-for-dementia-and-epilepsy-treatment
#4
REVIEW
Naci Balak, Ece Balkuv, Ali Karadag, Recep Basaran, Huseyin Biceroglu, Buruç Erkan, Necmettin Tanriover
Very recently, neuromodulation through deep brain stimulation (DBS) has appeared as a new surgical procedure in the treatment of some types of dementia and epilepsy. The mammillothalamic and the mammillotegmental tracts are involved among the new targets. To our knowledge, a review article focused specifically on these mammillary body efferents is lacking in the medical literature. Their contribution to memory is, regrettably, often overlooked. There is evidence that mammillary bodies can contribute to memory independently from hippocampal formation, but the mechanism is not yet known...
November 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29128679/early-onset-epileptic-encephalopathy-with-de-novo-scn8a-mutation
#5
Yangyang Xiao, Jie Xiong, Ding'an Mao, Lingjuan Liu, Jian Li, Xingfang Li, Haiyan Luo, Liqun Liu
Early-onset epileptic encephalopathies (EOEEs) are clinically and genetically heterogeneous disorders characterized by intractable seizures and unremitting interictal paroxysmal epileptiform activity. Consequently, these syndromes impair neurodevelopment during the first year of life. Currently, the etiology of these disorders is largely unknown. In this study, Childhood-Onset Epilepsy Gene Panel Testing (containing 511 epilepsy-related genes) was performed in a parent-offspring trio. In this family, the son had refractory seizures, intellectual disability, and motor abnormalities, and he was diagnosed with EOEE...
October 28, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29127345/the-synthetic-neuroactive-steroid-sge-516-reduces-seizure-burden-and-improves-survival-in-a-dravet-syndrome-mouse-model
#6
Nicole A Hawkins, Michael Lewis, Rebecca S Hammond, James J Doherty, Jennifer A Kearney
Dravet syndrome is an infant-onset epileptic encephalopathy with multiple seizure types that are often refractory to conventional therapies. Treatment with standard benzodiazepines like clobazam, in combination with valproate and stiripentol, provides only modest seizure control. While benzodiazepines are a first-line therapy for Dravet syndrome, they are limited by their ability to only modulate synaptic receptors. Unlike benzodiazepines, neuroactive steroids potentiate a wider-range of GABAA receptors. The synthetic neuroactive steroid SGE-516 is a potent positive allosteric modulator of both synaptic and extrasynaptic GABAA receptors...
November 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29126704/decreased-neurite-density-within-frontostriatal-networks-is-associated-with-executive-dysfunction-in-temporal-lobe-epilepsy
#7
Anny Reyes, Vedang S Uttarwar, Yu-Hsuan A Chang, Akshara R Balachandra, Chris J Pung, Donald J Hagler, Briana M Paul, Carrie R McDonald
OBJECTIVE: Executive dysfunction is observed in a sizable number of patients with refractory temporal lobe epilepsy (TLE). The frontostriatal network has been proposed to play a significant role in executive functioning, however, because of the complex architecture of these tracts, it is difficult to generate measures of fiber tract microstructure using standard diffusion tensor imaging. To examine the association between frontostriatal network compromise and executive dysfunction in TLE, we applied an advanced, multishell diffusion model, restriction spectrum imaging (RSI), that isolates measures of intraaxonal diffusion and may provide better estimates of fiber tract compromise in TLE...
November 8, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29122302/multiple-subpial-transections-and-magnetic-resonance-imaging
#8
P Finet, C Grandin, G Vaz, K Van Rijckevorsel, C Raftopoulos
INTRODUCTION: Multiple subpial transection (MST) has been applied to the treatment of refractory epilepsy when epileptogenic zone involves eloquent areas since 1989. However, there is a lack of data evaluating the effect of this surgical technique on the cortex as measured by Magnetic Resonance Imaging (MRI). PATIENTS AND METHODS: Ten consecutive patients (3F/7M, average age: 18.5 years) were operated on using radiating MST (average: 39; min: 19, max: 61) alone (n=3) or associated with another technique (n=7)...
November 6, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/29118737/a-case-series-of-adult-onset-rasmussen-s-encephalitis-diagnostic-and-therapeutic-challenges
#9
James Francis Castellano, Jenny A Meyer, Fred Alexander Lado
Rasmussen's encephalitis (RE) is a rare neurologic disorder characterized by progressive cerebral hemiatrophy and medically refractory epilepsy. The majority of current literature on this topic is focused on the pediatric population. In this case series, we will review three cases of adult-onset RE, as defined by fulfillment of the 2005 Bien criteria. The diagnostic challenge of characterizing this rare disease will be highlighted by the extensive serum, CSF, and pathologic sampling in all three patients. MR imaging and EEG data will be examined over time to characterize hallmark findings as well as progression...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29115760/efficacy-and-safety-of-cannabis-for-treating-children-with-refractory-epilepsy
#10
Michelle Neale
The aim of this literature review was to examine the evidence base for the safety and efficacy of cannabis in treating children with refractory epilepsy. Clinical and medical databases were searched and four articles were included in the final analysis, which included retrospective reviews and open-label trials with a total sample size of 424. One clinical trial included administration of cannabidiol, the non-psychoactive compound of cannabis, while the other three articles stated that the compound administered to participants contained tetrahydrocannabidiol, the psychoactive constituent of cannabis...
September 11, 2017: Nursing Children and Young People
https://www.readbyqxmd.com/read/29115482/reactive-astrocytes-increase-the-expression-of-p%C3%A2-gp-and-mrp1-via-tnf%C3%A2-%C3%AE-and-nf%C3%A2-%C3%AE%C2%BAb-signaling
#11
Xueying Wang, Shaoping Huang, Yongsheng Jiang, Yu Liu, Tingting Song, Dan Li, Lin Yang
To understand multidrug resistance gene expression in reactive astrocytes, the present study involved stimulated astrocytes with tumor necrosis factor (TNF)‑α and determined gene expression by reverse transcription‑quantitative polymerase chain reaction and western blot analysis. Stimulation induced P‑glycoprotein (gp) and multidrug resistance‑associated protein (MRP0) 1 expression, which peaked by 24 h. Interestingly, the expression of P‑gp and Mrp1 correlated with cell proliferation. Therefore, reactivation of astrocytes may increase P‑gp and Mrp1 expression through TNF‑α and nuclear factor (NF)‑κB signaling...
November 2, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29111296/a-neurosurgeon-s-view-laser-interstitial-thermal-therapy-of-mesial-temporal-lobe-structures
#12
Yarema B Bezchlibnyk, Jon T Willie, Robert E Gross
Stereotactic laser ablation of mesial temporal structures is a promising new surgical intervention for patients with mesial temporal lobe epilepsy (MTLE). Since this procedure was first used to treat MTLE in 2010, the literature contains reports of 37 patients that underwent MR-guided stereotactic laser amygdalohippocampotomy (SLAH) using Laser Interstitial Thermal Therapy (LITT) with at least 1year of follow-up. This early body of data suggests that SLAH is a safe and effective treatment for MTLE in properly selected patients...
October 27, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29105058/verbal-memory-decline-from-hippocampal-depth-electrodes-in-temporal-lobe-surgery-for-epilepsy
#13
Hanna Ljung, Arto Nordlund, Maria Strandberg, Johan Bengzon, Kristina Källén
OBJECTIVE: To explore whether patients with refractory mesial temporal lobe epilepsy risk aggravated verbal memory loss from intracranial electroencephalography (EEG) recording with longitudinal hippocampal electrodes in the language-dominant hemisphere. METHODS: A long-term neuropsychological follow-up (mean 61.5 months, range 22-111 months) was performed in 40 patients after ictal registration with left hippocampal depth electrodes (study group, n = 16) or no invasive EEG, only extracranial registration (reference group, n = 24)...
November 3, 2017: Epilepsia
https://www.readbyqxmd.com/read/29104044/calcitonin-potentiates-the-anticonvulsant-and-antinociceptive-effects-of-valproic-acid-and-pregabalin-in-pentylenetetrazole-kindled-mice
#14
Nada M Hamada, Rehab H Ashour, Amany A Shalaby, Hussien M El-Beltagi
Antiepileptic drugs are the backbone for epilepsy management. Epilepsy may be accompanied by decreased pain threshold. Thus, anticonvulsant agents with antinociceptive properties are of great importance. This study investigated the possible anticonvulsant and antinociceptive effects of calcitonin in combination with either valproic acid or pregabalin and whether these effects might occur through γ-aminobutyric acid (GABA) modulation. Eighty-four male Balb/C mice were divided into 7 groups: control-naïve, pentylenetetrazole (PTZ)-induced seizures, PTZ-calcitonin, PTZ-valproic acid, PTZ-pregabalin, PTZ-calcitonin-valproic acid (PCV) combination, and PTZ-calcitonin-pregabalin (PCP) combination...
November 2, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29101860/correlation-between-extreme-fear-and-focal-cortical-dysplasia-in-anterior-cingulate-gyrus-evidence-from-a-surgical-case-of-refractory-epilepsy
#15
Liang Qiao, Tao Yu, Duanyu Ni, Xueyuan Wang, Cuiping Xu, Chang Liu, Guojun Zhang, Yongjie Li
Localizing the semiology of ictal fear and seizure onset in epilepsy patients is commonly challenging due to limited value of routine electroencephalography (EEG) and very few surgical attempts. Here we reported a case of refractory epilepsy characterized by aura of extreme fear and hypermotor seizures, in which the left (dominant hemisphere) anterior cingulate gyrus (ACG) was determined to be the epileptogenic zone (EZ) through multiple modalities of presurgical evaluation including analysis of high frequency oscillation on intracranial EEG...
October 31, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29092962/multiple-endocrine-neoplasia-type-1-presenting-with-refractory-seizures
#16
Banshi Lal Kumawat, Chandramohan Sharma, Mohit Janakkumar Shah, Maulik Panchal
We report a case of 29-year-old woman referred to us for management of refractory epilepsy. Under observation, she was detected to have recurrent hypoglycaemia during the episodes of seizures. On investigation, she was found to have hyperinsulinemic hypoglycaemia. Her triple-phase CT scan of abdomen showed neuroendocrine tumour of pancreatic head, with bilateral renal calculi. Screening of other endocrine glands revealed pituitary microadenoma and parathyroid adenoma on imaging, which was also supported by biochemical and hormonal profile...
November 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29091250/functional-hemispherectomy-for-adult-rasmussen-encephalitis-a-case-report-and-literature-review
#17
Qun Wang, Zhanpeng Zhu, Guangming Wang, Lichao Sun, Jiqing Qiu
BACKGROUND: Rasmussen encephalitis (RE) is a rare and severe brain disorder associated with unilateral hemispheric atrophy, manifesting as severe refractory epilepsy, hemiplegia, defects of motor and speech functions, and cognitive impairment. Treatment of RE, especially in adult patients, is extremely challenging. Herein, we report the case of an adult patient with RE who was treated with a functional hemispherectomy and achieved a favorable prognosis. CASE REPORT: A 29-year-old woman presented with a 24-year history of epileptic seizures...
September 26, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29089769/identification-of-a-novel-cacna1a-mutation-in-a-chinese-family-with-autosomal-recessive-progressive-myoclonic-epilepsy
#18
Yudan Lv, Zan Wang, Chang Liu, Li Cui
BACKGROUND: Progressive myoclonic epilepsy (PME) is a heterogeneous neurodegenerative disorder, which is commonly manifested with refractory seizures and neurologic deterioration. The prognosis of PME is poor, so early diagnosis of PME is critical. The aim of our study is to identify the novel pathogenic gene in a Chinese family with PME, which may be helpful in future. SUBJECTS AND METHODS: A three-generation consanguineous Chinese Han family with PME was recruited...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29089238/-clinical-and-pathological-definition-of-temporal-medium-epilepsy-subtypes-with-hypocampic-sclerosis
#19
Gonzalo Olivares-Granados, Rosa María Ríos-Pelegrina, Jesús Ruiz-Giménez, Alberto Galdón-Castillo, Teresa Escobar-Delgado, Raimundo García Del Moral
BACKGROUND AND OBJECTIVE: Mesial temporal lobe epilepsy with hippocampal sclerosis is the most common cause of refractory epilepsy, and the most common indication for surgery. Although effective, surgery fails in up to 40% of patients. The objective of our study was to establish a correlation between the different histological subtypes of mesial temporal lobe epilepsy with hippocampal sclerosis and the prognosis, seizures control, side effects and anticonvulsivant drug withdrawal in patients with refractory epilepsy...
October 28, 2017: Neurocirugía
https://www.readbyqxmd.com/read/29083341/a-case-of-refractary-epilepsy-and-related-pain-due-to-dysmenorrhea-solved-with-loading-dose-of-lacosamide-clinical-and-neurophysiological-correlates
#20
Nicolino Marchitto, Umberto Ceratti, Serenella Dalmaso, Gianfranco Raimondi
 In most cases, the etiology of epilepsy is unknown, although some individuals may develop epilepsy as a result of certain brain injuries, following a stroke, a brain tumor or because of drugs and alcohol. Even some rare genetic mutations may be related to the onset of the condition. Seizures are the result of excessive and abnormal activity of neurons in the cerebral cortex. In this case report we show a clinical case of refractory epilepsy due to pain related to uncontrolled dysmenorrhea. The patient, 43 yrs old, had a history of epilepsy of 20 years and ovarian cancer...
October 23, 2017: Acta Bio-medica: Atenei Parmensis
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