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Refractory epilepsy

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https://www.readbyqxmd.com/read/28104438/safety-of-externally-stimulated-intracranial-electrodes-during-functional-mri-at-1-5t
#1
Pallab K Bhattacharyya, Jeffery Mullin, Bryan S Lee, Jorge A Gonzalez-Martinez, Stephen E Jones
Surgical resection of the epileptogenic zone (EZ) is a potential cure for medically refractory focal epilepsy. Proper identification of the EZ is essential for such resection. Synergistic application of functional magnetic resonance imaging (fMRI) simultaneously with stimulation of a single externalized intracranial stereotactic EEG (SEEG) electrode has the potential to improve identification of the EZ. While most EEG-fMRI studies use the electrodes passively to record electrical activity, it is possible to stimulate the brain using the electrodes by connecting them with conducting cables to the stimulation hardware...
January 16, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28104084/access-to-vagal-projections-via-cutaneous-electrical-stimulation-of-the-neck-fmri-evidence-in-healthy-humans
#2
Eleni Frangos, Barry R Komisaruk
BACKGROUND: Stimulation of the vagus nerve via implanted electrodes is currently used to treat refractory epilepsy and depression. Recently, a non-invasive approach to vagal stimulation has demonstrated similar beneficial effects, but it remains unclear whether these effects are mediated via activation of afferent vagal fibers. OBJECTIVE: The present study was designed to ascertain whether afferent vagal projections can be accessed non-invasively by transcutaneous electrical stimulation of the antero-lateral surface of the neck, which overlies the course of the vagus nerve...
January 2017: Brain Stimulation
https://www.readbyqxmd.com/read/28103894/impacts-of-caring-for-a-child-with-the-cdkl5-disorder-on-parental-wellbeing-and-family-quality-of-life
#3
Yuka Mori, Jenny Downs, Kingsley Wong, Barbara Anderson, Amy Epstein, Helen Leonard
BACKGROUND: Although research in this area remains sparse, raising a child with some genetic disorders has been shown to adversely impact maternal health and family quality of life. The aim of this study was to investigate such impacts in families with a child with the CDKL5 disorder, a newly recognised genetic disorder causing severe neurodevelopmental impairments and refractory epilepsy. METHODS: Data were sourced from the International CDKL5 Disorder Database to which 192 families with a child with a pathogenic CDKL5 mutation had provided data by January 2016...
January 19, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28101481/evaluation-of-ictal-consciousness-in-temporal-and-extra-temporal-epilepsy-observations-from-a-tertiary-care-hospital-in-india
#4
Rima M Chaudhari, Deepa Dash, Bhargavi Ramanujam, Manit K Rana, Renjith Appukuttan, Anubha Sharma, Yuvraj Kunwar, Gaurav Tejaniya, Vasantha Padma, Sarat P Chandra, Manjari Tripathi
BACKGROUND AND PURPOSE: Differences in consciousness during seizures depend on the location of the seizure onset. METHODS: The present study evaluates ictal consciousness using the ictal consciousness inventory (ICI) in drug refractory mesial temporal (MTLE), neocortical temporal (NTLE) and extra temporal epilepsy (ETLE). This was a cross sectional cohort study with 45 patients with mesial temporal epilepsy, 47 with extra temporal and 11 patients with neocortical temporal epilepsy...
December 2016: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/28101477/change-of-patient-selection-strategy-and-improved-surgical-outcome-in-mri-negative-neocortical-epilepsy
#5
Hye-Jin Moon, Dong Wook Kim, Chun-Kee Chung, Jung-Won Shin, Jangsup Moon, Bong Su Kang, Soon-Tae Lee, Keun-Hwa Jung, Kon Chu, Ki-Young Jung, Yong Won Cho, Sang Kun Lee
BACKGROUND AND PURPOSE: It is crucial to make selection strategy to identify surgical candidates among medically refractory MRI-negative neocortical epilepsy patients. In our previous study, we suggested two or more concordance between noninvasive studies (EEG, ictal scalp EEG, interictal FDG-PET, and SPECT) as a new patient selection strategy for MRI-negative neocortical epilepsy surgery. The objective of this study was to evaluate the surgical outcomes of MRI-negative neocortical epilepsy patients before and after the implementation of a new selection strategy...
December 2016: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/28098941/posterior-cortex-epilepsy-surgery-in-childhood-and-adolescence-predictors-of-long-term-seizure-outcome
#6
Georgia Ramantani, Angeliki Stathi, Armin Brandt, Karl Strobl, Susanne Schubert-Bast, Gert Wiegand, Rudolf Korinthenberg, Vera van Velthoven, Josef Zentner, Andreas Schulze-Bonhage, Thomas Bast
OBJECTIVE: We aimed to investigate the long-term seizure outcome of children and adolescents who were undergoing epilepsy surgery in the parietooccipital cortex and determine their predictive factors. METHODS: We retrospectively analyzed the data of 50 consecutive patients aged 11.1 (mean) ± 5.1 (standard deviation) years at surgery. All patients but one had a magnetic resonance imaging (MRI)-visible lesion. Resections were parietal in 40%, occipital in 32%, and parietooccipital in 28% cases; 24% patients additionally underwent a resection of the posterior border of the temporal lobe...
January 18, 2017: Epilepsia
https://www.readbyqxmd.com/read/28096104/recent-developments-in-the-surgical-management-of-paediatric-epilepsy
#7
REVIEW
Vijay M Ravindra, Matthew T Sweney, Robert J Bollo
Among the 1% of children affected by epilepsy, failure of pharmacological therapy and early age of seizure onset can lead to worse long-term cognitive outcomes, mental health disorders and impaired functional status. Surgical management often improves functional and cognitive outcomes in children with medically refractory epilepsy, especially when seizure remission is achieved. However, surgery remains underused in children with drug-resistant epilepsy, creating a large treatment gap. Several recent innovations have led to considerable improvement in surgical technique, including the recent development of minimally invasive diagnostic and therapeutic techniques such as stereotactic EEG, transcranial magnetic stimulation, MRI-guided laser ablation, as well as novel paradigms of neurostimulation...
January 17, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28088680/the-influence-of-patient-caregiver-and-family-factors-on-symptoms-of-anxiety-and-depression-in-children-and-adolescents-with-intractable-epilepsy
#8
Klajdi Puka, Elysa Widjaja, Mary Lou Smith
OBJECTIVE: The objective was to evaluate the association of caregiver and family factors with symptoms of anxiety and depression in children and adolescents with medically refractory localization-related epilepsy (i.e., failed at least two epilepsy medications). METHOD: Forty-four children (ages 6-11years) and 65 adolescents (ages 12-18years) and their parents participated in this multicentered, observational, cross-sectional study. Univariable and multivariable linear regressions were used to evaluate the influence of multiple patient, caregiver, and family characteristics on self-reported symptoms of anxiety and depression in the children and adolescents...
January 12, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28088049/sudden-unexpected-death-in-epilepsy-sudep-disclosure-in-pediatric-epilepsy-an-italian-survey-on-to-tell-or-not-to-tell
#9
Galli Federica, Vignoli Aglaia, Canevini Maria Paola, Cerioli Gabriele, Vegni Elena
BACKGROUND AND OBJECTIVES: Although there has recently been significant debate regarding the importance of disclosing the risk of SUDEP, professional societies and clinical practice guidelines currently recommend that the risk of SUDEP be disclosed as part of a comprehensive epilepsy education program. Therefore, the primary aim of the present study was to examine whether healthcare providers treating pediatric patients with epilepsy in Italy would disclose the risk of SUDEP to the parents of children with epilepsy...
January 11, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28079471/pre-implant-modeling-of-depth-lead-placement-in-white-matter-for-maximizing-the-extent-of-cortical-activation-during-direct-neurostimulation-therapy
#10
Leopoldo Cendejas Zaragoza, Richard W Byrne, Marvin A Rossi
INTRODUCTION: The objective of this work was to predict preoperatively the maximum extent to which direct stimulation therapy can propagate through an epileptic circuit for stabilizing refractory focal-onset epilepsy. A pre-surgical workflow is presented which comprises a computationally intensive process for calculating the volume of cortical activation (VOCA) surrounding cylindrical depth contacts virtually placed in white matter. The process employs an activation function (AF) derived from cable modeling of an axon...
January 12, 2017: Neurological Research
https://www.readbyqxmd.com/read/28079250/use-of-the-ketogenic-diet-in-the-neonatal-intensive-care-unit-safety-and-tolerability
#11
Lindsey Thompson, Erin Fecske, Mohammad Salim, Ara Hall
Drug-resistant epilepsy poses a challenge in neonatal patients, especially those in the neonatal intensive care unit (NICU), who have various secondary comorbidities. We present results of four children with a history of drug-resistant epilepsy for whom a ketogenic diet was initiated and used in the NICU. A nonfasting induction into ketosis over 1-2 weeks was utilized, with gradual increases in the ketogenic ratio every 2-3 days. Data were collected retrospectively from a database, which included medical history, daily progress notes, relevant laboratory data, and imaging and diagnostic information...
January 12, 2017: Epilepsia
https://www.readbyqxmd.com/read/28074282/unique-findings-of-subependymal-giant-cell-astrocytoma-within-cortical-tubers-in-patients-with-tuberous-sclerosis-complex-a-histopathological-evaluation
#12
Joel S Katz, Hyman Frankel, Tracy Ma, David Zagzag, Benjamin Liechty, Bruria Ben Zeev, Michal Tzadok, Orrin Devinsky, Howard L Weiner, Jonathan Roth
INTRODUCTION: Tuberous sclerosis is associated with three central nervous system pathologies: cortical/subcortical tubers, subependymal nodules (SENs), and subependymal giant cell astrocytomas (SEGAs). Tubers are associated with epilepsy, which is often medication-resistant and often leads to resective surgery. Recently, mammalian target of rapamycin inhibitors (mTORi) have been shown to be effective reducing seizure burden in some patients with tuberous sclerosis complex (TSC)-related refractory epilepsy...
January 10, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28073789/dynamics-of-convulsive-seizure-termination-and-postictal-generalized-eeg-suppression
#13
Prisca R Bauer, Roland D Thijs, Robert J Lamberts, Demetrios N Velis, Gerhard H Visser, Else A Tolner, Josemir W Sander, Fernando H Lopes da Silva, Stiliyan N Kalitzin
It is not fully understood how seizures terminate and why some seizures are followed by a period of complete brain activity suppression, postictal generalized EEG suppression. This is clinically relevant as there is a potential association between postictal generalized EEG suppression, cardiorespiratory arrest and sudden death following a seizure. We combined human encephalographic seizure data with data of a computational model of seizures to elucidate the neuronal network dynamics underlying seizure termination and the postictal generalized EEG suppression state...
January 10, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28070485/vagus-nerve-stimulation-for-genetic-epilepsy-with-febrile-seizures-plus-gefs-accompanying-seizures-with-impaired-consciousness
#14
Ryosuke Hanaya, Fajar H Niantiarno, Yumi Kashida, Hiroshi Hosoyama, Shinsuke Maruyama, Toshiaki Otsubo, Kazumi Tanaka, Atsushi Ishii, Shinichi Hirose, Kazunori Arita
Genetic epilepsy with febrile seizures plus (GEFS(+)) is characterized by childhood-onset epilepsy syndrome. It involves febrile seizures and a variety of afebrile epileptic seizure types within the same pedigree with autosomal-dominant inheritance. Approximately 10% of individuals with GEFS(+) harbor SCN1A, a gene mutation in one of the voltage-gated sodium channel subunits. Considerably less common are focal epilepsies including complex partial seizures. We report vagus nerve stimulation (VNS) in a 6-year-old girl with GEFS(+) who exhibited refractory generalized tonic-clonic seizures and complex partial seizures...
2017: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/28069460/epilepsy-and-exercise-an-experimental-study-in-female-rats
#15
Diego Vannucci Campos, Glauber Menezes Lopim, Daiana Aparecida da Silva, Alexandre Aparecido de Almeida, Debora Amado, Ricardo Mario Arida
OBJECTIVE: Epilepsy is the most common neurological chronic condition worldwide, affecting about 2% of world population. Temporal lobe epilepsy (TLE) reaches 40% of all cases of this condition, and it is highly refractory to pharmacological treatment. Physical activity has been suggested as complementary therapy for epilepsy. However, there is no consistent information whether all these effects are plenty applicable to females, since clinical and experimental studies concerning physical exercise and epilepsy are largely performed in males...
January 6, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28067423/current-standards-of-neuropsychological-assessment-in-epilepsy-surgery-centers-across-europe
#16
Viola Lara Vogt, Marja Äikiä, Antonio Del Barrio, Paul Boon, Csaba Borbély, Ema Bran, Kees Braun, Evelien Carette, Maria Clark, Judith Helen Cross, Petia Dimova, Daniel Fabo, Nikolaos Foroglou, Stefano Francione, Anna Gersamia, Antonio Gil-Nagel, Alla Guekht, Sue Harrison, Hrvoje Hecimovic, Einar Heminghyt, Edouard Hirsch, Alena Javurkova, Reetta Kälviäinen, Nicole Kavan, Anna Kelemen, Vasilios K Kimiskidis, Margarita Kirschner, Catherine Kleitz, Teia Kobulashvili, Mary H Kosmidis, Selin Yagci Kurtish, Mathieu Lesourd, Sofia Ljunggren, Morten Ingvar Lossius, Kristina Malmgren, Ruta Mameniskiené, Patricia Martin-Sanfilippo, Petr Marusic, Marijke Miatton, Çiğdem Özkara, Federica Pelle, Guido Rubboli, Sarah Rudebeck, Philippe Ryvlin, Monique van Schooneveld, Elisabeth Schmid, Pia-Magdalena Schmidt, Margitta Seeck, Bernhard J Steinhoff, Sara Shavel-Jessop, Oana Tarta-Arsene, Eugen Trinka, Gerd Viggedal, Anne-Sophie Wendling, Juri-Alexander Witt, Christoph Helmstaedter
We explored the current practice with respect to the neuropsychological assessment of surgical epilepsy patients in European epilepsy centers, with the aim of harmonizing and establishing common standards. Twenty-six epilepsy centers and members of "E-PILEPSY" (a European pilot network of reference centers in refractory epilepsy and epilepsy surgery), were asked to report the status of neuropsychological assessment in adults and children via two different surveys. There was a consensus among these centers regarding the role of neuropsychology in the presurgical workup...
January 9, 2017: Epilepsia
https://www.readbyqxmd.com/read/28063856/effectiveness-of-deferoxamine-on-ferric-chloride-induced-epilepsy-in-rats
#17
Xiang Zou, Shize Jiang, Zehan Wu, Yimin Shi, Shengyong Cai, Renqing Zhu, Liang Chen
Iron overload has been regarded as a common cause for refractory epilepsies in patients after hemorrhagic strokes. This study is to examine the potential epilepsy control effect of deferoxamine (DFO), an iron chelator, on a ferric chloride-induced epilepsy rat model. Twenty four rats were divided into 4 groups: group I is blank control group, group II is sham group with intracortical injection of saline, group III is epilepsy group with intracortical injection of iron and saline treatment, group IV is treatment group with intracortical injection of iron and DFO treatment...
January 4, 2017: Brain Research
https://www.readbyqxmd.com/read/28061418/memory-and-mood-outcomes-after-anterior-thalamic-stimulation-for-refractory-partial-epilepsy
#18
Alexander I Tröster, Kimford J Meador, Christopher P Irwin, Robert S Fisher
PURPOSE: Bilateral deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) reduces seizures and is relatively safe but may be accompanied by complaints of memory problems and depression. This study examined incidence of memory and depression adverse events (AE) in the SANTE study blinded phase and their relationship to objective neurobehavioral measures, baseline characteristics, quality of life and long-term neurobehavioral outcome. METHOD: The neurobehavioral AE and neuropsychological data from a previously reported prospective randomized trial (SANTE) were analyzed...
December 23, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28060326/network-analysis-of-foramen-ovale-electrode-recordings-in-drug-resistant-temporal-lobe-epilepsy-patients
#19
Ancor Sanz-García, Lorena Vega-Zelaya, Jesús Pastor, Cristina V Torres, Rafael G Sola, Guillermo J Ortega
Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control seizures. However, a significant minority of patients continues to exhibit post-operative seizures, even in those cases in which the suspected source of seizures has been correctly localized and resected. The protocol presented here combines a clinical procedure routinely employed during the pre-operative evaluation of temporal lobe epilepsy (TLE) patients with a novel technique for network analysis...
December 18, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28060325/interictal-high-frequency-oscillations-detected-with-simultaneous-magnetoencephalography-and-electroencephalography-as-biomarker-of-pediatric-epilepsy
#20
Christos Papadelis, Eleonora Tamilia, Steven Stufflebeam, Patricia E Grant, Joseph R Madsen, Phillip L Pearl, Naoaki Tanaka
Crucial to the success of epilepsy surgery is the availability of a robust biomarker that identifies the Epileptogenic Zone (EZ). High Frequency Oscillations (HFOs) have emerged as potential presurgical biomarkers for the identification of the EZ in addition to Interictal Epileptiform Discharges (IEDs) and ictal activity. Although they are promising to localize the EZ, they are not yet suited for the diagnosis or monitoring of epilepsy in clinical practice. Primary barriers remain: the lack of a formal and global definition for HFOs; the consequent heterogeneity of methodological approaches used for their study; and the practical difficulties to detect and localize them noninvasively from scalp recordings...
December 6, 2016: Journal of Visualized Experiments: JoVE
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