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Refractory epilepsy

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https://www.readbyqxmd.com/read/28334226/loss-of-cannabinoid-cb-1-receptors-induces-cortical-migration-malformations-and-increases-seizure-susceptibility
#1
Javier Díaz-Alonso, Adán de Salas-Quiroga, Juan Paraíso-Luna, Daniel García-Rincón, Patricia P Garcez, Maddy Parsons, Clara Andradas, Cristina Sánchez, François Guillemot, Manuel Guzmán, Ismael Galve-Roperh
Neuronal migration is a fundamental process of brain development, and its disruption underlies devastating neurodevelopmental disorders. The transcriptional programs governing this process are relatively well characterized. However, how environmental cues instruct neuronal migration remains poorly understood. Here, we demonstrate that the cannabinoid CB 1 receptor is strictly required for appropriate pyramidal neuron migration in the developing cortex. Acute silencing of the CB 1 receptor alters neuronal morphology and impairs radial migration...
October 5, 2016: Cerebral Cortex
https://www.readbyqxmd.com/read/28327467/automated-detection-of-epileptic-ripples-in-meg-using-beamformer-based-virtual-sensors
#2
Carolina Migliorelli, Joan Alonso, Sergio Romero, Rafal Nowak, Antonio Russi, Miguel Mananas
OBJECTIVE: In epilepsy, high-frequency oscillations (HFOs) are considered events highly linked to the seizure onset zone (SOZ). The detection of HFOs in noninvasive signals such as scalp EEG and MEG is still a challenging task. The aim of this study was to automatize the detection of ripples in MEG signals reducing the high-frequency noise using beamformer-based virtual sensors (VS) and applying an automatic procedure exploring the time-frequency content of the detected events. APPROACH: 200 seconds of MEG signals and simultaneous iEEG were selected in nine patients with refractory epilepsy...
March 22, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28324881/optic-radiation-tractography-and-visual-field-deficits-in-laser-interstitial-thermal-therapy-for-amygdalohippocampectomy-in-patients-with-mesial-temporal-lobe-epilepsy
#3
Dali Yin, John A Thompson, Cornelia Drees, Steven G Ojemann, Lidia Nagae, Victoria S Pelak, Aviva Abosch
BACKGROUND/AIMS: Laser interstitial thermal therapy (LITT) has become an alternative to open-resective surgery for refractory mesial temporal lobe epilepsy (MTLE). Occurrence of visual field defects (VFDs) following open surgery for MTLE is reported at 52-100%. We examined the rate of VFDs following LITT for amygdalohippocampectomy (AHE) and correlated the occurrence of VFDs with damage to the optic radiations, assessed by diffusion tensor tractography (DTI). METHODS: We performed a retrospective analysis of 5 patients who underwent LITT-AHE for medically refractory MTLE...
March 22, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28324765/hd-tdcs-in-refractory-lateral-frontal-lobe-epilepsy-patients
#4
Sanaz Ahmadi Karvigh, Mahmoud Motamedi, Mahsa Arzani, Javad Hasan Nia Roshan
PURPOSE: To evaluate the anticonvulsant effect of the novel high definition transcranial direct current stimulation (HD-tDCS) method on patients with refractory lateral frontal lobe epilepsy. The effects of HD-tDCS on working memory were also examined. METHOD: 10 adult patients with intractable lateral frontal lobe epilepsy were studied. A central cathode electrode was placed on the epileptogenic zone according to LTM, and 20-min sessions of 2mA HD-tDCS were applied for 10 consecutive days...
March 14, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28324681/morphometric-mri-features-are-associated-with-surgical-outcome-in-mesial-temporal-lobe-epilepsy-with-hippocampal-sclerosis
#5
Maria Teresa Fernandes Castilho Garcia, Larissa Botelho Gaça, Gabriel Barbosa Sandim, Idaiane Batista Assunção Leme, Henrique Carrete, Ricardo Silva Centeno, João Ricardo Sato, Elza Márcia Targas Yacubian
PURPOSE: Corticoamygdalohippocampectomy (CAH) improves seizure control, quality of life, and decreases mortality for refractory mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). One-third of patients continue having seizures, and it is pivotal to determine structural abnormalities that might influence the postoperative outcome. Studies indicate that nonhippocampal regions may play a role in the epileptogenic network in MTLE-HS and could generate seizures postoperatively...
March 1, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28324680/somatic-complications-of-epilepsy-surgery-over-25-years-at-a-single-center
#6
Inuka K Gooneratne, Shahidul Mannan, Jane de Tisi, Juan C Gonzalez, Andrew W McEvoy, Anna Miserocchi, Beate Diehl, Tim Wehner, Gail S Bell, Josemir W Sander, John S Duncan
INTRODUCTION: Epilepsy surgery is an effective treatment for refractory focal epilepsy. Risks of surgery need to be considered when advising individuals of treatment options. We describe the frequency and nature of physical adverse events associated with epilepsy surgery in a single center. MATERIAL AND METHODS: We reviewed the prospectively maintained records of adults who underwent epilepsy surgery at our center between 1990 and 2014 to identify peri/postsurgical adverse events...
March 1, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28322853/the-role-of-histopathologic-subtype-in-the-setting-of-hippocampal-sclerosis-associated-mesial-temporal-lobe-epilepsy
#7
Jordan M Gales, Lara Jehi, Amy Nowacki, Richard A Prayson
Hippocampal sclerosis (HS) and focal cortical dysplasia (FCD) are among the most common neuropathological findings in those undergoing surgery for refractory mesial temporal lobe epilepsy (MTLE). Existing data regarding differences among the most recent International League Against Epilepsy (ILAE) HS subtypes remains limited. This study sought to characterize the roles of HS subtype and coexistent FCD. Epilepsy surgery pathologic specimens in 307 cases of temporal lobe epilepsy with HS were reviewed (mean age ± SD, 37 ± 15 years, 56% women)...
March 17, 2017: Human Pathology
https://www.readbyqxmd.com/read/28318732/paroxysmal-events-during-prolonged-video-video-electroencephalography-monitoring-in-refractory-epilepsy
#8
A Sanabria-Castro, F Henríquez-Varela, C Monge-Bonilla, S Lara-Maier, M Sittenfeld-Appel
INTRODUCTION: Given that epileptic seizures and non-epileptic paroxysmal events have similar clinical manifestations, using specific diagnostic methods is crucial, especially in patients with drug-resistant epilepsy. Prolonged video electroencephalography monitoring during epileptic seizures reveals epileptiform discharges and has become an essential procedure for epilepsy diagnosis. The main purpose of this study is to characterise paroxysmal events and compare patterns in patients with refractory epilepsy...
March 16, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28318128/proton-mr-spectroscopy-in-patients-with-nonlesional-insular-cortex-epilepsy-confirmed-by-invasive-eeg-recordings
#9
Yasmine Aitouche, Steve A Gibbs, Guillaume Gilbert, Olivier Boucher, Alain Bouthillier, Dang Khoa Nguyen
BACKGROUND AND PURPOSE: Recent studies suggest that a nonnegligible proportion of drug-resistant epilepsy surgery candidates have an epileptogenic zone that involves the insula. We aimed to examine the value of proton magnetic resonance spectroscopy ((1) H-MRS) in identifying patients with insular cortex epilepsy. METHODS: Patients with possible nonlesional drug-refractory insular epilepsy underwent a voxel-based (1) H-MRS study prior to an intracranial electroencephalographic (EEG) study...
March 20, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28300952/the-individual-with-epilepsy-perceptions-about-the-disease-and-implications-on-quality-of-life
#10
Christiane Del Claro Hopker, Ana Paula Berberian, Gisele Massi, Mariluci Hautsch Willig, Rita Tonocchi
Purpose: The present study aims to analyze the perceptions of individuals with epilepsy about the disease and its impact in their quality of life (QoL). Methods: This is a cross-sectional, qualitative and quantitative study conducted in a tertiary referral hospital associated with the Brazilian National Health System (SUS). Data were collected from 30 individuals with diagnosis of refractory temporal lobe epilepsy (RTLE). The study participants responded to a questionnaire to collect sociodemographic and clinical data, as well as their perceptions about the disease...
March 9, 2017: CoDAS
https://www.readbyqxmd.com/read/28298036/efficacy-and-safety-of-corpus-callosotomy-after-vagal-nerve-stimulation-in-patients-with-drug-resistant-epilepsy
#11
Jennifer Hong, Atman Desai, Vijay M Thadani, David W Roberts
OBJECTIVE Vagal nerve stimulation (VNS) and corpus callosotomy (CC) have both been shown to be of benefit in the treatment of medically refractory epilepsy. Recent case series have reviewed the efficacy of VNS in patients who have undergone CC, with encouraging results. There are few data, however, on the use of CC following VNS therapy. METHODS The records of all patients at the authors' center who underwent CC following VNS between 1998 and 2015 were reviewed. Patient baseline characteristics, operative details, and postoperative outcomes were analyzed...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28293101/new-developments-in-the-management-of-partial-onset-epilepsy-role-of-brivaracetam
#12
REVIEW
Giangennaro Coppola, Giulia Iapadre, Francesca Felicia Operto, Alberto Verrotti
Currently, a number of novel anticonvulsant drugs, the so-called third generation, are in various stages of development. Several of them are already available or in ongoing clinical trials. These new compounds should take advantage of new insights into the basic pathophysiology of epileptogenesis, drug metabolism and drug interactions. Many of them still need to be further evaluated mainly in real-world observational trials and registries. Among newer anticonvulsant drugs for partial-onset seizures (POSs), rufinamide, lacosamide, eslicarbazepine and perampanel are those new treatment options for which more substantial clinical evidence is currently available, both in adults and, to some extent, in children...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28287071/auditory-seizures-in-autoimmune-epilepsy-a-case-with-anti-thyroid-antibodies
#13
Claudia Varrasi, Domizia Vecchio, Luca Magistrelli, Gionata Strigaro, Laura Tassi, Roberto Cantello
In its classic presentation, Hashimoto's encephalopathy is an acute-subacute complex neuropsychiatric syndrome with cognitive impairment, hallucinations, myoclonus, tremor or ataxia, associated with elevated anti-thyroid antibodies. Corticoids and immunotherapy are dramatically effective. However, in some cases, not all the associated features are presented and this delays diagnosis and appropriate treatment. We describe a man with abrupt onset of recurrent auditory seizures resulting in refractory non-convulsive status epilepticus...
March 8, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28284396/pyridoxal-phosphate-supplementation-in-neuropediatric-disorders
#14
Elisenda Cortès-Saladelafont, Marta Molero-Luis, Hsjd Working Group, Rafael Artuch, Àngels García-Cazorla
Pyridoxal phosphate (PLP) is the active form of vitamin B6 and a cofactor in many enzyme reactions including neurotransmitter metabolism. PLP metabolism disturbances may mostly lead to refractory seizures. In this report, we review the main pathophysiological factors related with PLP deficiency and our experience in PLP treatment in pediatric patients with low-normal cerebrospinal fluid PLP values who presented epilepsy. Only one case had a definite diagnosis (Phelan-McDermid syndrome). The results of extensive metabolic workups and targeted genetic studies were normal for all patients...
November 2016: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/28284049/significance-of-mdr1-gene-c3435t-polymorphism-in-predicting-childhood-refractory-epilepsy
#15
Rui-Juan Lv, Xiao-Qiu Shao, Tao Cui, Qun Wang
The association between the MDR1 gene C3435T polymorphism and childhood intractable epilepsy remains controversial. In this study, we performed a meta-analysis to clarify this issue. We searched the PubMed, Medline, Embase and CNKI databases for studies published through October 2016 that evaluated the association between the MDR1 C3435T polymorphism and childhood refractory epilepsy. Eleven studies involving 863 cases in the group with drug-resistant epilepsy and 915 cases in the group with drug-responsive epilepsy were included in this systematic review and meta-analysis...
February 28, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28284046/breaking-the-cycle-a-comparison-between-intravenous-immunoglobulins-and-high-dosage-prednisone-in-the-treatment-of-medically-intractable-epilepsy-in-children
#16
Richard Tang-Wai, Janette Mailo, Bernard Rosenblatt
PURPOSE: Because immune mediated mechanisms are suspected in epileptogenesis, IVIg and corticosteroids have been used as alternatives to treat refractory seizures. We present our experience treating intractable epileptic children with IVIg and prednisone. METHODS: Children with intractable epilepsy treated with prednisone or IVIg between 2005-2016 were reviewed retrospectively. Children with infantile spasms and autoimmune epilepsy were excluded. Data analyzed include epilepsy type and etiology, duration of epilepsy prior to treatment, seizure outcome, time to best seizure outcome, and adverse effects...
March 6, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28281498/from-resection-to-ablation-a-review-of-resective-surgical-options-for-temporal-lobe-epilepsy-and-rationale-for-an-ablation-based-approach
#17
REVIEW
Anne Coyle, Jonathan Riley, Chengyuan Wu, Ashwini Sharan
Surgical intervention is of proven benefit in an appropriately selected subset of patients with medically refractory temporal lobe epilepsy. In these patients, a surgical cure both provides the quality of life improvement that comes from seizure freedom as well as a survival benefit. However, patients who undergo open surgical intervention may have a worsening in neurobehavioral outcomes. Laser interstitial thermal therapy (LITT) represents a minimally invasive surgical intervention that has shown promise in improving post-operative neurobehavioral outcomes...
2017: Neurology India
https://www.readbyqxmd.com/read/28281497/management-of-brain-tumor-related-epilepsy
#18
REVIEW
Neil V Klinger, Aashit K Shah, Sandeep Mittal
Seizures are common in both primary and metastatic brain tumors, although the rate of seizures differ significantly between the different types of neoplasms. Patients with brain tumor-associated seizures need treatment with antiepileptic drugs (AEDs) to prevent recurrence, whereas strong clinical data exists to discourage routine prophylaxis in patients who have not had seizures. The newer AEDs, such as levetiracetam, lamotrigine, lacosamide, topiramate, or pregabalin, are preferable for various reasons, primarily related to the side-effect profile and limited interactions with other drugs...
2017: Neurology India
https://www.readbyqxmd.com/read/28281493/use-of-resting-state-fmri-in-planning-epilepsy-surgery
#19
REVIEW
Sharon Chiang, Zulfi Haneef, John M Stern, Jerome Engel
Epileptic seizures result from abnormal neuronal excitability and synchronization, affecting 0.5-1% of the population worldwide. Although anti-seizure drugs are often effective, a significant number of patients with epilepsy continue to experience refractory seizures and are candidates for surgical resection. Whereas standard presurgical evaluation has relied on intracranial electroencephalography (icEEG) and direct cortical stimulation to identify epileptogenic tissue and areas of cortex for which resection would produce clinical deficits, the invasive nature and limited spatial extent of icEEG has led to the investigation of less invasive imaging modalities as adjunctive tools in the presurgical workup...
2017: Neurology India
https://www.readbyqxmd.com/read/28281491/status-epilepticus-refractory-and-super-refractory
#20
REVIEW
Deepanshu Dubey, Jayantee Kalita, Usha K Misra
Status epilepticus (SE) is an important neurological emergency. It is defined as seizures lasting for 5 minutes or more or recurrent seizures without recovery of consciousness to baseline between the attacks. Refractory SE (RSE) is defined as SE persisting despite sufficient dose of benzodiazepines and at least one antiepileptic drug (AED), irrespective of time. Super refractory SE (SRSE) is defined as SE that continues for 24 hours or more after the use of anesthetic therapy, including cases that recur on weaning of the anesthestic agent...
2017: Neurology India
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