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Refractory epilepsy

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https://www.readbyqxmd.com/read/28432961/diurnal-patterns-and-relationships-between-physiological-and-self-reported-stress-in-patients-with-epilepsy-and-psychogenic-non-epileptic-seizures
#1
Barbora Novakova, Peter R Harris, Markus Reuber
PURPOSE: Patients with epilepsy and those with psychogenic non-epileptic seizures (PNES) experience high levels of stress and stress is one of the most frequently self-identified seizure precipitants. Although stress is a multifaceted phenomenon, few studies have systematically examined its different components in patients with seizures. The aim of this study was therefore to describe diurnal patterns of psychological and physiological measures of stress in patients with epilepsy and patients with PNES, and explore their relationships to each other in order to improve our understanding of the mechanisms underlying stress and seizure occurrence in these patients...
April 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28428738/improved-localization-of-seizure-onset-zones-using-spatiotemporal-constraints-and-time-varying-source-connectivity
#2
Juan D Martinez-Vargas, Gregor Strobbe, Kristl Vonck, Pieter van Mierlo, German Castellanos-Dominguez
Presurgical evaluation of brain neural activity is commonly carried out in refractory epilepsy patients to delineate as accurately as possible the seizure onset zone (SOZ) before epilepsy surgery. In practice, any subjective interpretation of electroencephalographic (EEG) recordings is hindered mainly because of the highly stochastic behavior of the epileptic activity. We propose a new method for dynamic source connectivity analysis that aims to accurately localize the seizure onset zones by explicitly including temporal, spectral, and spatial information of the brain neural activity extracted from EEG recordings...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28427564/inflammation-in-epileptic-encephalopathies
#3
Oleksii Shandra, Solomon L Moshé, Aristea S Galanopoulou
West syndrome (WS) is an infantile epileptic encephalopathy that manifests with infantile spasms (IS), hypsarrhythmia (in ~60% of infants), and poor neurodevelopmental outcomes. The etiologies of WS can be structural-metabolic pathologies (~60%), genetic (12%-15%), or of unknown origin. The current treatment options include hormonal treatment (adrenocorticotropic hormone and high-dose steroids) and the GABA aminotransferase inhibitor vigabatrin, while ketogenic diet can be given as add-on treatment in refractory IS...
2017: Advances in Protein Chemistry and Structural Biology
https://www.readbyqxmd.com/read/28427025/psychiatric-symptoms-after-temporal-epilepsy-surgery-a-one-year-follow-up-study
#4
Carmen Iranzo-Tatay, Teresa Rubio-Granero, Antonio Gutierrez, Mercedes Garcés, Rebeca Conde, Asier Gómez-Ibáñez, Sergio Arques-Egea, Lucia Sancho-Miñana, David Hervas-Marín, Vicente Villanueva
Psychiatric symptoms must be considered in patients with refractory temporal lobe epilepsy after epilepsy surgery. The main objectives of our study were to describe clinical and socio-demographical characteristics of a cohort of patients with pharmacoresistant temporal lobe epilepsy who underwent temporal lobe epilepsy surgery, and moreover, to evaluate possible risk factors for developing psychiatric symptoms. In order to achieve those goals, we conducted a prospective evaluation of psychopathology throughout the first year after surgery in a clinical sample of 72 patients, by means of three clinical rated measures; the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS), and the Brief Psychiatric Rating Scale (BPRS)...
April 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28424599/electrophysiological-sequelae-of-hemispherotomy-in-ipsilateral-human-cortex
#5
Ammar H Hawasli, Ravi Chacko, Nicholas P Szrama, David T Bundy, Mrinal Pahwa, Chester K Yarbrough, Brian J Dlouhy, David D Limbrick, Dennis L Barbour, Matthew D Smyth, Eric C Leuthardt
Objectives: Hemispheric disconnection has been used as a treatment of medically refractory epilepsy and evolved from anatomic hemispherectomy to functional hemispherectomies to hemispherotomies. The hemispherotomy procedure involves disconnection of an entire hemisphere with limited tissue resection and is reserved for medically-refractory epilepsy due to diffuse hemispheric disease. Although it is thought to be effective by preventing seizures from spreading to the contralateral hemisphere, the electrophysiological effects of a hemispherotomy on the ipsilateral hemisphere remain poorly defined...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28419330/seizure-outcomes-in-occipital-lobe-and-posterior-quadrant-epilepsy-surgery-a-systematic-review-and-meta-analysis
#6
Stephen C Harward, William C Chen, John D Rolston, Michael M Haglund, Dario J Englot
BACKGROUND: Occipital lobe epilepsy (OLE) is an uncommon but debilitating focal epilepsy syndrome with seizures often refractory to medical management. While surgical resection has proven a viable treatment, previous studies examining postoperative seizure freedom rates are limited by small sample size and patient heterogeneity, thus exhibiting significant variability in their results. OBJECTIVE: To review the medical literature on OLE so as to investigate rates and predictors of both seizure freedom and visual outcomes following surgery...
April 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28416069/-dietary-treatment-of-medically-refractory-epilepsy-in-children-and-adolescents
#7
Frederikke Høgsbro-Rode, Katrine M Harris Johannesen, Vibeke Stubbings, Helle Hjalgrim
Ketogenic diet (KD) is used worldwide in the treatment of medically refractory epilepsy. Since the introduction of KD in the early 1900s, new approaches such as medium-chain triglyceride ketogenic diet, modified Atkins diet and low glycaemic index treatment have been suggested as alternative treatments. Several studies have documented significant seizure reduction from all four diets. The aim of this article is to give an overview of the effect of dietary treatment and to discuss advantages in initiating dietary treatment as an early treatment instead of as a last option...
April 3, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28414968/investigating-the-correlation-between-short-term-effectiveness-of-vns-therapy-in-reducing-the-severity-of-seizures-and-long-term-responsiveness
#8
Maryam Ravan
VNS (Vagus Nerve Stimulation) Therapy(®) is an adjunctive therapy for patients with medically refractory epilepsy. The primary metric used to assess response to any treatment for epilepsy is seizure frequency reduction as measured using seizure diaries. In addition to seizure frequency, reduction in seizure severity is clinically meaningful to patients and can be measured objectively. Analysis of electro-encephalographic (EEG) signals has revealed that seizures are accompanied by spatial synchronization of EEG electrodes that may persist for several minutes after the seizure...
April 11, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28414967/pharmacodynamics-of-remifentanil-induced-intracranial-spike-activity-in-mesial-temporal-lobe-epilepsy
#9
Troels Wesenberg Kjaer, Hans Hogenhaven, Andrea P Lee, Flemming Find Madsen, Bo Jespersen, Jannick Brennum, Lennart Derm, Finn Borgbjerg Moltke
Patients with medically refractory epilepsy may benefit from resective epilepsy surgery. However even the best centers experience surgical failures. It is therefore important to find techniques that may aid in neurosurgical planning of epileptic focus resection. Recordings of electrical brain activity with EEG during seizures reveal abnormal cortical hypersynchronization. Between seizures the EEG often shows interictal depolarizing phenomena such as spikes reflecting an irritable focus of the brain. In the present study we investigated the effect of intravenous remifentanil on the spike activity in the temporal neocortex and hippocampus...
March 31, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28412918/neurological-aspects-of-medical-use-of-cannabidiol
#10
Carmen Mannucci, Michele Navarra, Fabrizio Calapai, Elvira Ventura Spagnolo, Francesco Paolo Busardò, Roberto Da Cas, Francesca Menniti Ippolito, Gioacchino Calapai
BACKGROUND: Cannabidiol (CBD) is among the major secondary metabolites of Cannabis devoid of the delta-9-tetra-hydrocannabinol psychoactive effects. It is a resorcinol-based compound with a broad spectrum of potential therapeutic properties, including neuroprotective effects in numerous pathological conditions. CBD neuroprotection is due to its antioxidant and antiinflammatory activi-ties and the modulation of a large number of brain biological targets (receptors, channels) involved in the development and maintenance of neurodegenerative diseases...
April 13, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28411558/sporadic-periventricular-nodular-heterotopia-classification-phenotype-and-correlation-with-filamin-a-mutations
#11
Wenyu Liu, Bo Yan, Dongmei An, Jiahe Xiao, Fayun Hu, Dong Zhou
OBJECTIVE: The purpose of this study was to better delineate the clinical spectrum of periventricular nodular heterotopia (PNH) in a large patient population after long term follow up. Specifically, this study aimed to relate PNH subtypes to clinical or epileptic outcomes, epileptic discharges and underlying Filamin A (FLNA) mutations by analyzing anatomical features. METHODS: The study included 100 patients with radiologically confirmed nodular heterotopia. Patients' FLNA gene sequences and medical records were analyzed...
April 4, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28410885/successful-implantation-and-immediate-activation-of-vagus-nerve-stimulation-vns-during-pregnancy-in-a-patient-with-intractable-epilepsy-a-case-illustration-and-review-of-the-literature
#12
N Jazebi, N Moghimi, R Lall, E Osadebey, J Ortega-Barnett, T Masel
While Vagus Nerve Stimulation (VNS) is proven to be a safe and effective adjunctive therapy in the general population with medically intractable seizures, little is published about its implantation during pregnancy. Here we illustrate the case of a 21year old primigravid woman with medically refractory seizures who underwent safe and successful VNS implantation and immediate activation of the device in her 32nd week of pregnancy, resulting in dramatically improved seizure control and subsequent delivery of a healthy baby...
April 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28410487/structural-brain-changes-in-medically-refractory-focal-epilepsy-resemble-premature-brain-aging
#13
Heath R Pardoe, James H Cole, Karen Blackmon, Thomas Thesen, Ruben Kuzniecky
OBJECTIVE: We used whole brain T1-weighted MRI to estimate the age of individuals with medically refractory focal epilepsy, and compared with individuals with newly diagnosed focal epilepsy and healthy controls. The difference between neuroanatomical age and chronological age was compared between the three groups. METHODS: Neuroanatomical age was estimated using a machine learning-based method that was trained using structural MRI scans from a large independent healthy control sample (N=2001)...
April 3, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28405902/mitophagy-in-refractory-temporal-lobe-epilepsy-patients-with-hippocampal-sclerosis
#14
Mengqian Wu, Xinyu Liu, Xiaosa Chi, Le Zhang, Weixi Xiong, Siew Mun Vance Chiang, Dong Zhou, Jinmei Li
This study aimed to determine if there is an association between mitophagy and refractory temporal lobe epilepsy (rTLE) with hippocampal sclerosis. During epilepsy surgery, we collected tissue samples from the hippocampi and temporal lobe cortexes of rTLE patients with hippocampal sclerosis (as diagnosed by a pathologist). Transmission electron microscopy (TEM) was used to study the ultrastructural features of the tissue. To probe for mitophagy, we used fluorescent immunolabeling to determine if mitochondrial and autophagosomal markers colocalized...
April 12, 2017: Cellular and Molecular Neurobiology
https://www.readbyqxmd.com/read/28399932/guideline-recommendations-for-diagnosis-and-clinical-management-of-ring14-syndrome-first-report-of-an-ad-hoc-task-force
#15
REVIEW
Berardo Rinaldi, Alessandro Vaisfeld, Sergio Amarri, Chiara Baldo, Giuseppe Gobbi, Pamela Magini, Erto Melli, Giovanni Neri, Francesca Novara, Tommaso Pippucci, Romana Rizzi, Annarosa Soresina, Laura Zampini, Orsetta Zuffardi, Marco Crimi
BACKGROUND: Ring chromosome 14 syndrome is a rare chromosomal disorder characterized by early onset refractory epilepsy, intellectual disability, autism spectrum disorder and a number of diverse health issues. RESULTS: The aim of this work is to provide recommendations for the diagnosis and management of persons affected by ring chromosome 14 syndrome based on evidence from literature and experience of health professionals from different medical backgrounds who have followed for several years subjects affected by ring chromosome 14 syndrome...
April 11, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28396650/new-onset-refractory-status-epilepticus-with-claustrum-damage-definition-of-the-clinical-and-neuroimaging-features
#16
Stefano Meletti, Giada Giovannini, Giuseppe d'Orsi, Lisa Toran, Giulia Monti, Rahul Guha, Andreas Kiryttopoulos, Maria Grazia Pascarella, Tommaso Martino, Haris Alexopoulos, Martha Spilioti, Jana Slonkova
New-onset refractory status epilepticus (NORSE) is a rare but challenging condition occurring in a previously healthy patient, often with no identifiable cause. We describe the electro-clinical features and outcomes in a group of patients with NORSE who all demonstrated a typical magnetic resonance imaging (MRI) sign characterized by bilateral lesions of the claustrum. The group includes 31 patients (12 personal and 19 previously published cases; 17 females; mean age of 25 years). Fever preceded status epilepticus (SE) in 28 patients, by a mean of 6 days...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28395287/interleukin-1%C3%AE-plays-a-pivotal-role-via-the-pi3k-akt-mtor-signaling-pathway-in-the-chronicity-of-mesial-temporal-lobe-epilepsy
#17
Zhaohua Xiao, Jing Peng, Na Gan, Ahmed Arafat, Fei Yin
OBJECTIVE: Mesial temporal lobe epilepsy (MTLE) is the most common type of refractory epilepsy. It is often associated with hippocampal sclerosis, which is histopathologically characterized by selective neuron loss, mossy fiber sprouting, and synapse reconstruction, and is the primary cause of refractory epilepsy. Its mechanism has not been fully elucidated. Substantial evidence now supports that inflammatory pathways are activated in epilepsy foci. We have confirmed that the interleukin-1β (IL-1β) level is involved in the epileptogenesis of MTLE, and we further investigated how it works in its chronicity in this study...
April 11, 2017: Neuroimmunomodulation
https://www.readbyqxmd.com/read/28392943/report-from-a-survey-of-parents-regarding-the-use-of-cannabidiol-medicinal-cannabis-in-mexican-children-with-refractory-epilepsy
#18
Carlos G Aguirre-Velázquez
Structured online surveys were used to explore the experiences of the parents of children with refractory epilepsy using medicinal cannabis in Mexico during September 2016. The surveys, which were completed in full, were reviewed, and 53 cases of children aged between 9 months and 18 years were identified. Of these, 43 cases (82%) were from Mexico and 10 (18%) were from Latin American countries. Of the 43 Mexican cases, the diagnoses were as follows: 20 cases (47%) had Lennox-Gastaut syndrome (LGS); 13 cases (30%) had unspecified refractory epilepsy (URE); 8 cases (19%) had West syndrome (WS); 1 case (2%) had Doose syndrome (DS); and 1 case (2%) had Ohtahara syndrome (OS)...
2017: Neurology Research International
https://www.readbyqxmd.com/read/28390806/the-vagal-nerve-stimulation-outcome-and-laryngeal-effect-otolaryngologists-roles-and-perspective
#19
Ahmad I Al Omari, Firas Q Alzoubi, Mohammad M Alsalem, Samah K Aburahma, Diala T Mardini, Paul F Castellanos
INTRODUCTION: Epilepsy is one of the most common neurologic disorders. Vagus nerve stimulation (VNS), first investigated in 1938 and subsequently studied as a potential therapy for epilepsy. The FDA approved the use of VNS in 1997 as an adjunctive non-pharmacologic symptomatic treatment option for refractory epilepsy for adults and adolescents over 12years. VNS can cause laryngeal and voice side effects that can be managed by otolaryngologists safely and effectively. OBJECTIVES: This study is to review the outcomes of vagal nerve stimulator (VNS) implantation in terms of the surgical procedures, complications, seizure frequency, and the clinical effect on larynx and vocal folds motion...
April 4, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28388656/integrated-network-analysis-reveals-potentially-novel-molecular-mechanisms-and-therapeutic-targets-of-refractory-epilepsies
#20
Hongwei Chu, Pin Sun, Jiahui Yin, Guangming Liu, Yiwei Wang, Pengyao Zhao, Yizhun Zhu, Xiaohan Yang, Tiezheng Zheng, Xuezhong Zhou, Weilin Jin, Changkai Sun
Epilepsy is a complex neurological disorder and a significant health problem. The pathogenesis of epilepsy remains obscure in a significant number of patients and the current treatment options are not adequate in about a third of individuals which were known as refractory epilepsies (RE). Network medicine provides an effective approach for studying the molecular mechanisms underlying complex diseases. Here we integrated 1876 disease-gene associations of RE and located those genes to human protein-protein interaction (PPI) network to obtain 42 significant RE-associated disease modules...
2017: PloS One
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