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https://www.readbyqxmd.com/read/29671293/surgical-treatment-for-refractory-epilepsy
#1
Johannes Herta, Christian Dorfer
The goal of any epilepsy surgery is to improve patient ́s quality of life by achieving seizure freedom or by reducing the frequency of severely debilitating seizures. To achieve this goal, non-invasive and invasive diagnostic methods must precisely delineate the epileptogenic zone (EZ), which is defined as the area that needs to be resected to obtain seizure freedom. At the same time, the correct identification of eloquent brain areas is inevitable to avoid new neurological deficits from surgery. In recent years, the technical advances in diagnostics have enabled us to achieve these goals in an increasing number of cases...
April 18, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29649700/detailed-spectral-profile-analysis-of-electrocorticograms-during-freezing-against-penicillin-induced-epileptiform-discharges-in-the-anesthetized-rat
#2
Tatsuji Tokiwa, Lev Zimin, Takao Inoue, Sadahiro Nomura, Michiyasu Suzuki, Takeshi Yamakawa
OBJECTIVES: Cryosurgery is an alternative technique for minimally invasive treatment of lesions. We have recently examined cryosurgery for epilepsy in animal models, and found that penicillin G (PG)-induced epileptiform discharges (EDs) mostly vanished after freezing. However, EDs were provoked again after insufficient freezing. Inadequate freezing is not visually detectable during and just after freezing and is not predictable beforehand. To manage this problem, we examined whether intraoperative monitoring of electrocorticograms (ECoGs) can predict recurrence of EDs after cryosurgery...
March 29, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29574299/deep-facial-analysis-a-new-phase-i-epilepsy-evaluation-using-computer-vision
#3
David Ahmedt-Aristizabal, Clinton Fookes, Kien Nguyen, Simon Denman, Sridha Sridharan, Sasha Dionisio
Semiology observation and characterization play a major role in the presurgical evaluation of epilepsy. However, the interpretation of patient movements has subjective and intrinsic challenges. In this paper, we develop approaches to attempt to automatically extract and classify semiological patterns from facial expressions. We address limitations of existing computer-based analytical approaches of epilepsy monitoring, where facial movements have largely been ignored. This is an area that has seen limited advances in the literature...
March 22, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29563872/the-metabotropic-purinergic-p2y-receptor-family-as-novel-drug-target-in-epilepsy
#4
REVIEW
Mariana Alves, Edward Beamer, Tobias Engel
Epilepsy encompasses a heterogeneous group of neurological syndromes which are characterized by recurrent seizures affecting over 60 million people worldwide. Current anti-epileptic drugs (AEDs) are mainly designed to target ion channels and/or GABA or glutamate receptors. Despite recent advances in drug development, however, pharmacoresistance in epilepsy remains as high as 30%, suggesting the need for the development of new AEDs with a non-classical mechanism of action. Neuroinflammation is increasingly recognized as one of the key players in seizure generation and in the maintenance of the epileptic phenotype...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29560754/precipitation-and-inhibition-of-seizures-in-focal-epilepsies
#5
Rūta Mameniškienė, Peter Wolf
There is growing awareness that reflex epileptic seizures offer unique insight into natural seizure generation in humans. In the last years, focus has mostly been on reflex seizures in generalized epilepsies whereas a comprehensive review of their role in focal epilepsies has been missing. Areas covered: This paper reviews reflex seizures strictly in focal epilepsies, not including focal reflex seizures in system epilepsies that also exist. They were categorized according to their triggers which can be sensory or cognitive, simple or complex...
March 21, 2018: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/29560450/integration-of-stationary-wavelet-transform-on-a-dynamic-partial-reconfiguration-for-recognition-of-pre-ictal-gamma-oscillations
#6
N Jmail, M Zaghdoud, A Hadriche, T Frikha, C Ben Amar, C Bénar
To define the neural networks responsible of an epileptic seizure, it is useful to perform advanced signal processing techniques. In this context, electrophysiological signals present three types of waves: oscillations, spikes, and a mixture of both. Recent studies show that spikes and oscillations should be separated properly in order to define the accurate neural connectivity during the pre-ictal, seizure and inter-ictal states. Retrieving oscillatory activity is a sensitive task due to the frequency overlap between oscillations and transient activities...
February 2018: Heliyon
https://www.readbyqxmd.com/read/29556176/conflicting-effects-of-methylglyoxal-and-potential-significance-of-mirnas-for-seizure-treatment
#7
REVIEW
Hua Tao, Xu Zhou, Bin Zhao, Keshen Li
According to an update from the World Health Organization, approximately 50 million people worldwide suffer from epilepsy, and nearly one-third of these individuals are resistant to the currently available antiepileptic drugs, which has resulted in an insistent pursuit of novel strategies for seizure treatment. Recently, methylglyoxal (MG) was demonstrated to serve as a partial agonist of the gamma-aminobutyric acid type A (GABAA ) receptor and to play an inhibitory role in epileptic activities. However, MG is also a substrate in the generation of advanced glycation end products (AGEs) that function by activating the receptor of AGEs (RAGE)...
2018: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/29540143/the-management-of-epilepsy-in-children-and-adults
#8
Piero Perucca, Ingrid E Scheffer, Michelle Kiley
The International League Against Epilepsy has recently published a new classification of epileptic seizures and epilepsies to reflect the major scientific advances in our understanding of the epilepsies since the last formal classification 28 years ago. The classification emphasises the importance of aetiology, which allows the optimisation of management. Antiepileptic drugs (AEDs) are the main approach to epilepsy treatment and achieve seizure freedom in about two-thirds of patients. More than 15 second generation AEDs have been introduced since the 1990s, expanding opportunities to tailor treatment for each patient...
March 19, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29536948/optogenetic-dissection-of-ictogenesis-in-search-of-a-targeted-anti-epileptic-therapy
#9
Kyle P Lillis, Kevin J Staley
For over a century, epileptic seizures have been characterized as a state of pathological, hypersynchronous brain activity. Anti-epileptic therapies have been developed largely based on the dogma that the altered brain rhythms result from an overabundance of glutamatergic activity or insufficient GABAergic inhibition. The most effective drugs in use today act to globally decrease excitation, increase inhibition, or decrease all activity. Unfortunately, such broad alterations to brain activity often lead to impactful side effects such as mood disordersdrowsiness, cognitive impairment, and sleep disruption...
March 14, 2018: Journal of Neural Engineering
https://www.readbyqxmd.com/read/29526428/-status-epilepticus-recent-advances
#10
REVIEW
William Szurhaj, Nicolas Engrand
About half of status epilepticus (SE) occur in patients without epilepsy. An EEG has to be performed quickly in any patient who remains unconscious after the end of convulsions with the aim to detect a subtle status. An EEG should be performed as soon as possible in case of suspicion of non-convulsive status epilepticus, or in case of a confusional state whose origin remains unknown. The realization of a cerebral imaging is very often necessary in case of inaugural SE, as soon as the patient's condition allow it...
March 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29519472/parietal-lobe-epilepsy
#11
Vicenta Salanova
There are few reports of patients with parietal lobe epilepsy. One of the largest series, from the Montreal Neurological Institute (MNI), reported that patients with epileptogenic areas in the parietal cortex behind the postcentral gyrus comprised 6% of patients with refractory focal epilepsy treated surgically at the MNI between 1929 and 1988. Since then several other institutions have reported their experience with the evaluation and treatment of patients with parietal lobe epilepsy. This chapter reviews the functional anatomy of the parietal lobe, electroclinical manifestations and surgical outcome of parietal lobe epilepsy, and recent advances in the evaluation of patients with refractory focal epilepsy...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29506031/cognition-and-dementia-in-older-patients-with-epilepsy
#12
Arjune Sen, Valentina Capelli, Masud Husain
With advances in healthcare and an ageing population, the number of older adults with epilepsy is set to rise substantially across the world. In developed countries the highest incidence of epilepsy is already in people over 65 and, as life expectancy increases, individuals who developed epilepsy at a young age are also living longer. Recent findings show that older persons with epilepsy are more likely to suffer from cognitive dysfunction and that there might be an important bidirectional relationship between epilepsy and dementia...
February 28, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29433116/-mr-guided-focused-ultrasound
#13
Hideki Mochizuki, Noriaki Hattori
Since the middle of the 20th century and in order to treat neurological diseases, clinicians have proposed the use of ultrasound, instead of skin incision or trepanation, when performing intracranial thermocoagulation. However, focusing ultrasound intracranially with high precision was technically difficult until recent technological developments. Specifically, advancements in ultrasound phased-array transducers have eliminated the need for a craniotomy, and progress in magnetic resonance (MR) imaging has allowed the real-time measurement of intracranial temperature...
February 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/29426807/neonatal-epilepsy-genetics
#14
REVIEW
Erika J T Axeen, Heather E Olson
Neonatal epilepsy genetics is a rapidly expanding field with recent technological advances in genomics leading to an expanding list of genetic disorders associated with neonatal-onset epilepsy. The genetic causes of neonatal epilepsy can be grouped into the following categories: (i) malformations of cortical development, (ii) genetic-metabolic, (iii) genetic-vascular, (iv) genetic-syndromic, and (v) genetic-cellular. Clinically, epilepsy in the neonate shows phenotypic overlap with pathogenic variants in unrelated genes causing similar clinical presentation (locus heterogeneity) and variants in the same gene leading to a wide clinical spectrum ranging from benign familial neonatal seizures to more severe epileptic encephalopathies (variable expressivity)...
January 31, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29425906/effects-of-vagal-neuromodulation-on-feeding-behavior
#15
Nicole A Pelot, Warren M Grill
Implanted vagus nerve stimulation (VNS) for obesity was recently approved by the FDA. However, its efficacy and mechanisms of action remain unclear. Herein, we synthesize clinical and preclinical effects of VNS on feeding behavior and energy balance and discuss engineering considerations for understanding and improving the therapy. Clinical cervical VNS (≤30 Hz) to treat epilepsy or depression has produced mixed effects on weight loss as a side effect, albeit in uncontrolled, retrospective studies. Conversely, preclinical studies (cervical and subdiaphragmatic VNS) mostly report decreased food intake and either decreased weight gain or weight loss...
February 6, 2018: Brain Research
https://www.readbyqxmd.com/read/29414561/a-modern-epilepsy-surgery-treatment-algorithm-incorporating-traditional-and-emerging-technologies
#16
REVIEW
Dario J Englot
Epilepsy surgery has seen numerous technological advances in both diagnostic and therapeutic procedures in recent years. This has increased the number of patients who may be candidates for intervention and potential improvement in quality of life. However, the expansion of the field also necessitates a broader understanding of how to incorporate both traditional and emerging technologies into the care provided at comprehensive epilepsy centers. This review summarizes both old and new surgical procedures in epilepsy using an example algorithm...
February 1, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29393419/hmgb1-mediates-microglia-activation-via-the-tlr4-nf-%C3%AE%C2%BAb-pathway-in-coriaria-lactone-induced-epilepsy
#17
Yunbo Shi, Lingli Zhang, Junfang Teng, Wang Miao
Epilepsy is a chronic and recurrent disease of the central nervous system, with a complex pathology. Recent studies have demonstrated that the activation of glial cells serve an important role in the development of epilepsy. The objective of the present study was to investigate the role of high‑mobility group box‑1 (HMGB1) in mediating the activation of glial cells through the toll‑like receptor 4 (TLR4)/nuclear factor (NF)‑κB signaling pathway in seizure, and the underlying mechanism. The brain tissue of post‑surgery patients with intractable epilepsy after resection and the normal control brain tissue of patients with craniocerebral trauma induced intracranial hypertension were collected...
January 25, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29369115/are-the-days-of-counting-seizures-numbered
#18
Philippa Karoly, Daniel M Goldenholz, Mark Cook
PURPOSE OF REVIEW: The estimation of seizure frequency is a cornerstone of clinical management of epilepsy and the evaluation of new therapies. Current estimation approaches are significantly limited by several factors. Comparing patient diaries and objective estimates (through both inpatient video-EEG monitoring of and long-term ambulatory EEG studies) reveal that patients document seizures inaccurately. So far, few practical alternative methods of estimation have been available. RECENT FINDINGS: We review the systems of counting currently utilized and their limitations, as well as the limitations imposed by problems defining clinical events...
April 2018: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29359340/review-mechanistic-target-of-rapamycin-mtor-pathway-focal-cortical-dysplasia-and-epilepsy
#19
REVIEW
E Marsan, S Baulac
Over the last decade, there has been increasing evidence that hyperactivation of the mechanistic target of rapamycin (mTOR) pathway is a hallmark of malformations of cortical development such as focal cortical dysplasia (FCD) or hemimegalencephaly. The mTOR pathway governs protein and lipid synthesis, cell growth and proliferation as well as metabolism and autophagy. The molecular genetic aetiology of mTOR hyperactivation has only been recently clarified. This article will review the current and still evolving genetic advances in the elucidation of the molecular basis of FCD...
February 2018: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/29355038/the-future-of-type-1-cannabinoid-receptor-allosteric-ligands
#20
Mariam Alaverdashvili, Robert B Laprairie
Allosteric modulation of the type 1 cannabinoid receptor (CB1R) holds great therapeutic potential. This is because allosteric modulators do not possess intrinsic efficacy, but instead augment (positive allosteric modulation) or diminish (negative allosteric modulation) the receptor's response to endogenous ligand. Consequently, CB1R allosteric modulators have an effect ceiling which allows for the tempering of CB1R signaling without the desensitization, tolerance, dependence, and psychoactivity associated with orthosteric compounds...
February 2018: Drug Metabolism Reviews
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