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Refractory epilepsy

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https://www.readbyqxmd.com/read/29350262/vagal-nerve-stimulation-for-medically-refractory-epilepsy-in-angelman-syndrome-a-series-of-three-cases
#1
REVIEW
Krystal L Tomei, Christine Y Mau, Michael Ghali, Jayoung Pak, Ira M Goldstein
BACKGROUND: We describe three children with Angelman syndrome and medically refractory epilepsy. METHODS: Case series of three pediatric patients with Angelman syndrome and medically refractory epilepsy. All three patients failed medical treatment and were recommended for vagal nerve stimulator (VNS) implantation. RESULTS: Following VNS implantation, all three patients experienced reduction in seizure frequency greater than that afforded by medication alone...
January 19, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29349679/autoimmune-encephalitis-associated-with-glutamic-acid-decarboxylase-antibodies-a-case-series
#2
Faruk Incecik, Ozlem M Herguner, Seyda Besen, Mustafa Yılmaz
Antibodies against glutamic acid decarboxylase (GAD) are associated with various neurologic conditions described in patients including stiff person syndrome, cerebellar ataxia, refractory epilepsy, limbic and extralimbic encephalitis. GAD antibodies-related limbic encephalitis cases are well described; reports of extralimbic involvement are limited. We describe four cases of GAD antibody-related autoimmune encephalitis. Three of them had extralimbic involvement and only one had limbic encephalitis.
January 18, 2018: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29344469/successful-use-of-therapeutic-hypothermia-for-refractory-nonconvulsive-status-epilepticus
#3
Do-Hyung Kim, Hye-Hoon Kang, Minjung Kim, Tae-Won Yang, Oh-Young Kwon, Jung Sook Yeom, Bong Su Kang, Yong Hwan Kim, Young-Soo Kim
Therapeutic hypothermia (TH) has rarely been utilized as an adjunct to anticonvulsants in treating patients with refractory convulsive status epilepticus (CSE). However, determining the effectiveness of TH in CSE is difficult due to the unavoidable use of sedative drugs to manage hypothermia. Additionally, the effectiveness of TH has not been studied in patients with refractory non-convulsive status epilepticus (NCSE). Here, we report the successful use of TH without additional sedative drugs in a patient with temporal lobe epilepsy and refractory NCSE...
December 2017: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/29344466/comparison-of-autonomic-function-before-and-after-surgical-intervention-in-patients-with-temporal-lobe-epilepsy
#4
Navita Choudhary, Kishore K Deepak, Poodipedi S Chandra, Shalini Bhatia, Rajesh Sagar, Ashok K Jaryal, Ravindra M Pandey, Manjari Tripathi
Background and Purpose: Refractory temporal lobe epilepsy (TLE) is commonly associated with imbalances in cardiovascular (CV) parasympathetic and sympathetic functions, which are treated using TLE surgery. We investigated the effect of hemispheric lateralization of seizure foci on autonomic CV functions before and after TLE surgery. Methods: The study was conducted on patients with left TLE (LTLE, n = 23) and right TLE (RTLE, n = 30) undergoing unilateral TLE surgery...
December 2017: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/29344464/cannabinoids-in-the-treatment-of-epilepsy-hard-evidence-at-last
#5
REVIEW
Emilio Perucca
The interest in cannabis-based products for the treatment of refractory epilepsy has skyrocketed in recent years. Marijuana and other cannabis products with high content in Δ(9) - tetrahydrocannabinol (THC), utilized primarily for recreational purposes, are generally unsuitable for this indication, primarily because THC is associated with many undesired effects. Compared with THC, cannabidiol (CBD) shows a better defined anticonvulsant profile in animal models and is largely devoid of adverse psychoactive effects and abuse liability...
December 2017: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/29340584/long-interval-intracortical-inhibition-as-biomarker-for-epilepsy-a-transcranial-magnetic-stimulation-study
#6
Prisca R Bauer, Annika A de Goede, William M Stern, Adam D Pawley, Fahmida A Chowdhury, Robert M Helling, Romain Bouet, Stiliyan N Kalitzin, Gerhard H Visser, Sanjay M Sisodiya, John C Rothwell, Mark P Richardson, Michel J A M van Putten, Josemir W Sander
Cortical excitability, as measured by transcranial magnetic stimulation combined with electromyography, is a potential biomarker for the diagnosis and follow-up of epilepsy. We report on long-interval intracortical inhibition data measured in four different centres in healthy controls (n = 95), subjects with refractory genetic generalized epilepsy (n = 40) and with refractory focal epilepsy (n = 69). Long-interval intracortical inhibition was measured by applying two supra-threshold stimuli with an interstimulus interval of 50, 100, 150, 200 and 250 ms and calculating the ratio between the response to the second (test stimulus) and to the first (conditioning stimulus)...
January 11, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29338667/docosahexaenoic-acid-prevents-resistance-to-antiepileptic-drugs-in-two-animal-models-of-drug-resistant-epilepsy
#7
Melika Moezifar, Mohammad Sayyah, Morteza Zendehdel, Hakimeh Gavzan
OBJECTIVES: One-third of epileptic patients are resistant to antiepileptic drugs. Few clinical studies with small sample size indicate that polyunsaturated fatty acids could control drug-resistant epilepsy. We examined the efficacy of acute and chronic administration of docosahexaenoic acid (DHA) in two animal models of drug-resistant epilepsies, i.e. 6-Hz psychomotor seizures in mice and lamotrigine (LTG)-resistant kindled rats. METHODS: Mice received a single injection of DHA (300 µM, i...
January 16, 2018: Nutritional Neuroscience
https://www.readbyqxmd.com/read/29336393/cardiac-surgery-in-a-patient-with-implanted-vagal-nerve-stimulator
#8
Aashish Jain, Dheeraj Arora, Yatin Mehta
The prevalence of epilepsy worldwide is around 0.5%-2% of the population. Antiepileptic medications are the first line of treatment in most of the cases but approximately 25%-30% epilepsy patients are refractory to the single or combination therapy. The surgical option for temporal lobe epilepsy is temporal lobectomy, which has its inherent risk of neurological deficits after the surgery. Patients who are either refractory to combination therapy or do not want surgical temporal lobectomy are the candidates for electrical stimulation therapy...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29336297/add-on-perampanel-and-aggressive-behaviour-in-severe-drug-resistant-focal-epilepsies
#9
S Juhl, G Rubboli
This study aimed to investigate the incidence of aggressiveness in patients with severe drug-refractory focal epilepsy (DRE) who started perampanel (PER) as add-on treatment, and to identify possible predisposing factors. Data on 49 consecutive patients with severe DRE who initiated PER were retrospectively collected. Twelve of the 49 patients experienced aggressiveness as adverse event related to PER treatment, one third of them on low (2-4 mg/day) PER dosages. PER was discontinued in 10/12 patients because of aggressive behaviors...
October 2017: Functional Neurology
https://www.readbyqxmd.com/read/29336017/long-term-surveillance-of-sudep-in-drug-resistant-epilepsy-patients-treated-with-vns-therapy
#10
Philippe Ryvlin, Elson L So, Charles M Gordon, Dale C Hesdorffer, Michael R Sperling, Orrin Devinsky, Mark T Bunker, Bryan Olin, Daniel Friedman
OBJECTIVE: Limited data are available regarding the evolution over time of the rate of sudden unexpected death in epilepsy patients (SUDEP) in drug-resistant epilepsy. The objective is to analyze a database of 40 443 patients with epilepsy implanted with vagus nerve stimulation (VNS) therapy in the United States (from 1988 to 2012) and assess whether SUDEP rates decrease during the postimplantation follow-up period. METHODS: Patient vital status was ascertained using the Centers for Disease Control and Prevention's National Death Index (NDI)...
January 16, 2018: Epilepsia
https://www.readbyqxmd.com/read/29334039/refractory-epilepsy-the-role-of-positron-emission-tomography
#11
Tommy L H Chan, Jonathan Romsa, David A Steven, Jorge G Burneo
RATIONALE: Presurgical localization of the epileptogenic focus is critical to successful surgery. Traditionally, localization of the epileptogenic focus depends on seizure semiology, scalp video-electroencephalography (vEEG), magnetic resonance imaging (MRI), neuropsychological assessment, and, when needed, intracranial EEG (iEEG). We aimed to explore the role of positron emission tomography (PET) in the presurgical evaluation of patients with refractory epilepsy. METHODS: A retrospective review was conducted on patients from London Health Sciences Centre (London, Ontario) with refractory epilepsy who underwent PET from September of 2011 to April of 2016...
January 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29332084/thalamic-deep-brain-stimulation
#12
Benjamin B Whiting, Alexander C Whiting, Donald M Whiting
The use of deep brain stimulation (DBS) of the thalamus has been proven to be a safe and efficacious treatment for the management of many diseases. The most common indication for thalamic DBS remains essential tremor (ET), one of the most common movement disorders in the world. ET patients should be considered for surgical intervention when their tremor has demonstrated to be refractory to medication, a characteristic estimated to be present in roughly 50% of ET cases. Advantages of DBS over thalamotomy include its reversibility, the ability to adjust stimulation settings to optimize efficacy and minimize side effects, the ability to perform bilateral procedures safely, and an association with a lower risk of postoperative cognitive problems...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29321970/deepied-an-epileptic-discharge-detector-for-eeg-fmri-based-on-deep-learning
#13
Yongfu Hao, Hui Ming Khoo, Nicolas von Ellenrieder, Natalja Zazubovits, Jean Gotman
Presurgical evaluation that can precisely delineate the epileptogenic zone (EZ) is one important step for successful surgical resection treatment of refractory epilepsy patients. The noninvasive EEG-fMRI recording technique combined with general linear model (GLM) analysis is considered an important tool for estimating the EZ. However, the manual marking of interictal epileptic discharges (IEDs) needed in this analysis is challenging and time-consuming because the quality of the EEG recorded inside the scanner is greatly deteriorated compared to the usual EEG obtained outside the scanner...
2018: NeuroImage: Clinical
https://www.readbyqxmd.com/read/29318974/-understanding-the-role-of-hypoxia-inducible-factor-during-neurodegeneration-for-new-therapeutics-opportunities
#14
Amalia Merelli, Julio Cesar Garcia Rodriguez, Jaume Folch, Marcelo R Regueiro, Antoni Camins, Lazarowski Alberto
Neurodegeneration (NDG) is linked with the progressive loss of neural function with intellectual and/or motor impairment. Several diseases affecting older individuals, including Alzheimer's disease, Amyotrophic Lateral Sclerosis, Huntington's disease, Parkinson's disease, stroke, Multiple Sclerosis and many others, are the most relevant disorders associated with NDG. Since other pathologies such as refractory epilepsy, brain infections, or hereditary diseases such as "neurodegeneration with brain iron accumulation", also lead to chronic brain inflammation with loss of neural cells, NDG can be said to affect all ages...
January 10, 2018: Current Neuropharmacology
https://www.readbyqxmd.com/read/29318116/expression-of-multidrug-resistance-genes-in-peripheral-blood-of-patients-with-refractory-epilepsy-and-the-reverse-effect-of-oxcarbazepine-on-its-expression
#15
Jinming Ji, Gang Li, Yunxia Ma, Shuangshuang Pan, Rongrong Yuan
Background: We aimed to investigate the expression levels of multidrug resistance gene 1 (MDR1), multidrug resistance-associated protein 1 (MRP1) and multidrug resistance P-glycoprotein (P-gp) in peripheral blood of patients with refractory epilepsy. Methods: Patients with epilepsy (n=24) and those with refractory epilepsy (n=24) were selected, and 30 normal volunteers were enrolled as control. The expression level of MDR1 genes was detected using semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR)...
January 2018: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/29317669/selective-targeting-of-scn8a-prevents-seizure-development-in-a-mouse-model-of-mesial-temporal-lobe-epilepsy
#16
Jennifer C Wong, Christopher D Makinson, Tyra Lamar, Qi Cheng, Jeffrey C Wingard, Ernest F Terwilliger, Andrew Escayg
We previously found that genetic mutants with reduced expression or activity of Scn8a are resistant to induced seizures and that co-segregation of a mutant Scn8a allele can increase survival and seizure resistance of Scn1a mutant mice. In contrast, Scn8a expression is increased in the hippocampus following status epilepticus and amygdala kindling. These findings point to Scn8a as a promising therapeutic target for epilepsy and raise the possibility that aberrant overexpression of Scn8a in limbic structures may contribute to some epilepsies, including temporal lobe epilepsy...
January 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29317649/synchrotron-generated-microbeams-induce-hippocampal-transections-in-rats
#17
Erminia Fardone, Benoît Pouyatos, Elke Bräuer-Krisch, Stefan Bartzsch, Hervè Mathieu, Herwig Requardt, Domenico Bucci, Giacomo Barbone, Paola Coan, Giuseppe Battaglia, Geraldine Le Duc, Alberto Bravin, Pantaleo Romanelli
Synchrotron-generated microplanar beams (microbeams) provide the most stereo-selective irradiation modality known today. This novel irradiation modality has been shown to control seizures originating from eloquent cortex causing no neurological deficit in experimental animals. To test the hypothesis that application of microbeams in the hippocampus, the most common source of refractory seizures, is safe and does not induce severe side effects, we used microbeams to induce transections to the hippocampus of healthy rats...
January 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29315734/molecular-characteristics-of-long-term-epilepsy-associated-tumours-leats-and-mechanisms-for-tumour-related-epilepsy-tre
#18
Thomas J Stone, Rachel Rowell, Bodiabaduge Ashan Prasanna Jayasekera, Mark O Cunningham, Thomas S Jacques
Brain tumours are the second most common cause of seizures identified in epilepsy surgical series. While any tumour involving the brain has the potential to cause seizures, specific subtypes are more frequently associated with epilepsy. Tumour-related epilepsy has a profound impact on patients with brain tumours and these seizures are often refractory to anti-epileptic treatments, resulting in long-term disability and patient morbidity. Despite the drastic impact epilepsy-associated tumours have on patients, they have not traditionally enjoyed as much attention as more malignant neoplasms...
January 6, 2018: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/29313510/need-for-surgical-treatment-of-epilepsy-and-excision-of-tumors-and-post-traumatic-epileptogenic-lesions-in-kinshasa-rdc
#19
G Ntsambi-Eba, A Beltchika Kalubye, J P Kalala Okito
Surgery is a treatment to consider in epilepsy when the condition is refractory or epileptic events are related to a clearly identified brain abnormality. The tropical climate of the DRC explains the high risk of epilepsy and the potentially large number of refractory cases. The number of patients with epilepsy in Kinshasa is estimated to be at least 120 000, and almost one third may be refractory. Hence, the need to integrate the use of surgery in the treatment of this disease. Most neurosurgical techniques used for treating epilepsy are practiced with a neurosurgical microscope and neuronavigation...
November 1, 2017: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/29305185/predictors-of-outcome-after-surgery-in-134-children-with-drug-resistant-tle
#20
Ashalatha Radhakrishnan, Ramshekhar Menon, Mathew Abraham, George Vilanilam, Suvasini Sharma, Bejoy Thomas, Chandrashekharan Kesavadas, Ajith Cherian, Raviprasad Varma, Sanjeev V Thomas
PURPOSE: To determine the factors predicting seizure outcome in children who underwent anterior temporal lobectomy (ATL) for drug-resistant temporal lobe epilepsy (TLE). METHODS: Among the 664 patients who underwent ATL for TLE from 1995 to 2008, there were 134 children. "Excellent" outcome in them was defined as seizure freedom during the entire follow-up (Engel class I a); "good outcome", if in remission last 2 years, and the rest as "unfavorable outcome". To identify the potential predictors of seizure recurrence, the attributes of recurred and non-recurred groups was compared by univariate and multivariate analysis...
January 2, 2018: Epilepsy Research
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