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https://www.readbyqxmd.com/read/28937549/electroconvulsive-therapy-for-super-refractory-status-epilepticus
#1
Jayme Ahmed, Michael Metrick, Anne Gilbert, Anita Glasson, Ranjeet Singh, Wayne Ambrous, Lori Brown, Laura Aykroyd, Karen Bobel
OBJECTIVES: Super refractory status epilepticus (SRSE) is a stage beyond refractory status that requires general anesthesia as management. Electroconvulsive therapy (ECT) is recommended only as a potential treatment option beyond general anesthesia and after all other options have been exhausted. Its effect on aborting status has been minimally researched. We present the largest case series to our knowledge exploring the effect of ECT on SRSE. METHODS: Eight adults hospitalized for SRSE received ECT in an attempt to abort status after other treatment modalities were exhausted...
September 20, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28929472/-ivermectin-as-an-adjunct-in-the-treatment-of-refractory-epilepsy
#2
J A Diazgranados-Sanchez, J L Mejia-Fernandez, L S Chan-Guevara, M H Valencia-Artunduaga, J L Costa
INTRODUCTION: Ivermectin, a 22'23 dihydro derivative of avermectins beta-1a, is a highly effective veterinary and human anti parasitic, used to treat endoparasites of difficult control such as filariasis and onchocerciasis, with a median plasma life of at least of 16 hours. The recommended therapeutic doses range from 0.05 to 0.40 mg/kg, without undesirable effects or risk to human life. It went from being a great success in animal health to its application in humans, where it has had great impact...
October 1, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28927557/cacna1a-related-early-onset-encephalopathy-with-myoclonic-epilepsy-a-case-report
#3
Takuya Hayashida, Yoshiaki Saito, Atsushi Ishii, Hiroyuki Yamada, Ayako Itakura, Toshinori Minato, Tetsuhiro Fukuyama, Yoshihiro Maegaki, Shinichi Hirose
We report a one-year-old boy with early-onset myoclonic epilepsy, developmental arrest, and hyperekplexia during early infancy. He presented with refractory myoclonic/tonic seizures since birth. Electroencephalography revealed multifocal spikes, and rhythmic activities that occurred simultaneous with aggravation of myoclonus accompanied by tonic upper limb elevation. Brain magnetic resonance imaging revealed progressive cerebral atrophy with periventricular signal change and thin corpus callosum at one year of age...
September 16, 2017: Brain & Development
https://www.readbyqxmd.com/read/28926830/a-distinctive-ictal-amplitude-integrated-electroencephalography-pattern-in-newborns-with-neonatal-epilepsy-associated-with-kcnq2-mutations
#4
Ana Vilan, José Mendes Ribeiro, Pasquale Striano, Sarah Weckhuysen, Lauren C Weeke, Eva Brilstra, Linda S de Vries, Maria Roberta Cilio
BACKGROUND: Recurrent and prolonged seizures are harmful for the developing brain, emphasizing the importance of early seizure recognition and effective therapy. Amplitude-integrated electroencephalography (aEEG) has become a valuable tool to diagnose epileptic seizures, and, in parallel, genetic etiologies are increasingly being recognized, changing the paradigm of the workup and management of neonatal seizures. OBJECTIVE: To report the ictal aEEG pattern in neonates with KCNQ2-related epilepsy...
September 20, 2017: Neonatology
https://www.readbyqxmd.com/read/28923014/scn8a-mutations-in-chinese-patients-with-early-onset-epileptic-encephalopathy-and-benign-infantile-seizures
#5
Jiaping Wang, Hua Gao, Xinhua Bao, Qingping Zhang, Jiarui Li, Liping Wei, Xiru Wu, Yan Chen, Shujie Yu
BACKGROUND: SCN8A mutations have recently been associated with epilepsy and neurodevelopmental disorders. This study aimed to broaden the phenotypic-spectrum of disease related with SCN8A mutations. METHODS: To identify the pathogenic gene of a Chinese family, in which six members suffered from epilepsy, whole-exome sequencing was performed. In addition, target next-generation sequencing (NGS) was performed on 178 sporadic patients, who had epilepsy of unknown etiology within 6 months after birth...
September 18, 2017: BMC Medical Genetics
https://www.readbyqxmd.com/read/28921161/deep-brain-stimulation-for-refractory-temporal-lobe-epilepsy-a-systematic-review-and-meta-analysis-with-an-emphasis-on-alleviation-of-seizure-frequency-outcome
#6
Bowen Chang, Jiwen Xu
OBJECTIVE: Conflicting conclusions have been reported regarding predictors of deep brain stimulation (DBS) outcome in patients with refractory temporal lobe epilepsy (TLE). The main goal of this meta-analysis study was to identify possible predictors of remarkable seizure reduction (RSR). METHODS: We conducted a comprehensive search of English-language literature published since 1990 and indexed in PubMed, Embase, and the Cochrane Library that addressed seizure outcomes in patients who underwent DBS for refractory TLE...
September 18, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28920893/a-functional-genetic-scheme-for-seizure-forecasting-in-canine-epilepsy
#7
E Bou Assi, D K Nguyen, S Rihana, M Sawan
OBJECTIVE: The objective of this work is the development of an accurate seizure forecasting algorithm that considers brain's functional connectivity for electrode selection. METHODS: We start by proposing Kmeans-directed transfer function, an adaptive functional connectivity method intended for seizure onset zone localization in bilateral intracranial EEG recordings. Electrodes identified as seizure activity sources and sinks are then used to implement a seizure-forecasting algorithm on long-term continuous recordings in dogs with naturallyoccurring epilepsy...
September 13, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28920564/intentional-overdose-of-the-novel-anti-epileptic-drug-eslicarbazepine-presenting-with-recurrent-seizures-and-ventricular-dysrhythmias
#8
Jesse Thompson, James D Powell, Daniel H Ovakim
Eslicarbazepine is a novel anti-epileptic agent indicated for the treatment of partial-onset seizures. We present the case of an 18 year old female that presented to the Emergency Department four hours after a reported intentional ingestion of an estimated 5600 mg of eslicarbazepine. Although initially hemodynamically stable and neurologically normal, shortly after arrival she developed confusion, rigidity and clonus, followed by recurrent seizures, hypoxemia and cardiac arrest which responded to cardiopulmonary resuscitation and wide complex tachycardia requiring defibrillation...
September 18, 2017: CJEM
https://www.readbyqxmd.com/read/28919768/ictal-heart-rate-changes-and-the-effects-of-vagus-nerve-stimulation-for-patients-with-refractory-epilepsy
#9
Wei Chen, Fan-Gang Meng
Vagus nerve stimulation (VNS) shows long-term efficiency worldwide in most pharmacoresistant patients with epilepsy; however, there are still a small number of patients who are non-responders to VNS therapy. It has been shown that VNS treatment outcomes for drug-resistant epilepsy may be predicted by preoperative heart-rate variability measurements and that patients with epilepsy with ictal tachycardia (IT) during seizures have good responses to VNS. However, few studies have reported the efficacy of VNS in patients with epilepsy with ictal bradycardia (IB) or normal heart rate (HR), and none have explored the possible mechanisms of VNS efficacy based on different HR types...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28915401/the-modified-ketogenic-diet-for-adults-with-refractory-epilepsy-an-evaluation-of-a-set-up-service
#10
Kirsty J Martin-McGill, Michael D Jenkinson, Catrin Tudur Smith, Anthony G Marson
PURPOSE: The ketogenic diet (KD) has been proven to be effective in children with refractory epilepsy and is recommended by the National Institute of Health and Care Excellence (NICE). There is no randomised control trial (RCT) evidence for the clinical or cost effectiveness of KD in adults, for whom the KD is not currently recommended. We assessed the feasibility of the modified ketogenic diet (MKD) in adults with refractory epilepsy along with the willingness of patients to participate in a future RCT...
September 1, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28914199/clinical-applications-of-intravenous-immunoglobulins-in-child-neurology
#11
Maria Gogou, Efimia Papadopoulou-Alataki, Martha Spilioti, Sofia Alataki, Athanasios Evangeliou
BACKGROUND: While there are guidelines for the use of intravenous immunoglobulins in children with Guillain-Barre syndrome and myasthenia gravis based on high-level evidence studies, data is fewer for the majority of neurologic disorders in this age group. Neuronal antibodies are detected in children with seizures of autoimmune etiology. Intravenous immunoglobulins with their broad immunomodulatory mechanism of action could be ideally effective in different forms of immune-dysregulated intractable epilepsies such as autoimmune epilepsy and autoimmune Rasmussen encephalitis...
September 15, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28904568/pediatric-autoimmune-encephalitis
#12
REVIEW
Massimo Barbagallo, Giovanna Vitaliti, Piero Pavone, Catia Romano, Riccardo Lubrano, Raffaele Falsaperla
Autoimmune (antibody mediated) encephalitis (AE) is emerging as a more common cause of pediatric encephalopathy than previously thought. The autoimmune process may be triggered by an infection, vaccine, or occult neoplasm. In the latter case, onconeural autoantibodies are directed against intracellular neuronal antigens, but a recent heterogeneous group of encephalitic syndromes has been found not to have underlying tumor but is associated with autoantibodies to the neuronal surface or synaptic antigens. Neuropsychiatric symptoms are very common in autoimmune encephalopathy; as a result, affected children may be initially present to psychiatrists...
April 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28898171/febrile-infection-related-epilepsy-syndrome-fires-a-literature-review-and-case-study
#13
Kristy Fox, Mary Ellen Wells, Michael Tennison, Bradley Vaughn
Febrile infection-related epilepsy syndrome (FIRES) is a catastrophic epileptic syndrome that strikes previously healthy children aged 3-15 years and has an unknown pathogenesis and few treatments. These children experience a nonspecific febrile illness that is followed by prolonged refractory status epilepticus. Although the etiology is unknown, FIRES has a biphasic presentation, with the acute phase beginning as seizure activity lasting 1-12 weeks, then followed by the chronic phase, which is characterized by refractory seizures that cluster every 2-4 weeks, and may continue to be multifocal and independent...
2017: Neurodiagnostic Journal
https://www.readbyqxmd.com/read/28892425/laparoscopic-resection-of-a-pancreatic-%C3%AE-cell-tumor-in-a-dog
#14
Janet Kovak Mcclaran, Philippa Pavia, Anthony J Fischetti, Taryn A Donovan
Laparoscopic partial pancreatectomy has been performed in experimental canine studies and has been evaluated in human medicine but has not been reported in a clinical veterinary case. The authors present a 9 yr old field spaniel with weakness and hypoglycemia with insulin levels and Amended Insulin: Glucose Ratio results equivocal for a pancreatic insulinoma. Multiple abdominal ultrasounds did not detect the tumor, yet dual-phase computed tomographic angiography revealed the presence of a focal hypoattenuating nodule in the left lobe of the pancreas...
September 11, 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28891483/emergency-surgery-for-refractory-status-epilepticus
#15
Abhijeet Botre, Vrajesh Udani, Neelu Desai, Spoorthy Jagadish, Milind Sankhe
BACKGROUND: Management of refractory status epilepticus in children is extremely challenging. CASE CHARACTERISTICS: Two children with medically refractory status epilepticus, both of whom had lesional pathology on MRI and concordant data on EEG and PET scan. INTERVENTION: Emergency hemispherotomy performed in both patients. A complete, sustained seizure freedom obtained postoperatively. MESSAGE: Emergency surgery is a treatment option in selected cases of drug refractory status epilepticus with lesional pathology and concordant data...
August 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28886496/convulsive-status-epilepticus-in-a-quaternary-hospital-paediatric-intensive-care-unit-picu-in-south-africa-an-8-year-review
#16
Yavini Reddy, Yusentha Balakrishna, Lawrence Mubaiwa
PURPOSE: Convulsive status epilepticus (CSE) is associated with a high morbidity and mortality. This study aimed to describe the clinical profile, aetiology, neuroimaging and EEG findings as well as outcome of children with CSE in Sub-Saharan Africa. METHODS: This was a retrospective analysis of electronic records of children with CSE admitted to the Paediatric Intensive Care Unit (PICU) over an 8-year period from January 2007 to December 2014. RESULTS: Seventy six patients were admitted to the PICU with CSE and 55(72%) had refractory status epilepticus...
August 2, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28884208/lacosamide-treatment-of-childhood-refractory-focal-epilepsy-the-first-reported-side-effect-in-paediatric-patients
#17
Edibe Pembegul Yildiz, Melis Ulak Ozkan, Gonca Bektas, Tuğçe Aksu Uzunhan, Nur Aydinli, Mine Caliskan, Meral Ozmen
PURPOSE: Lacosamide (LCM) is an effective antiepileptic drug (AED) approved for the treatment of focal epilepsy in both children and adults. The aim of this observational study was to review our centre's experience with LCM and to characterise its efficacy and tolerability as an adjunct therapy in children with refractory focal epilepsy. METHODS: We retrospectively reviewed the medical records of 12 paediatric patients who underwent treatment with LCM from January 2014 to December 2015...
September 7, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28878524/a-microbial-old-friend-with-a-new-face-a-rare-case-of-pyrexia-of-unknown-origin-and-leukemoid-reaction
#18
Sumeet P Mirgh, Virti D Shah, Jehangir S Sorabjee
We present a case of a young male, who presented to us with high-grade fever for more than four weeks, refractory seizures, multiple subcutaneous palpable lumps, and evidence of leukocytosis with predominant left shift on the peripheral smear. The classic "starry-sky" appearance on imaging, generalized muscular uptake on positron emission tomography-computerized tomography scan, and positive serology led to a diagnosis of disseminated cysticercosis. He responded to oral steroids. To the best of our knowledge, disseminated cysticercosis presenting as pyrexia of unknown origin and with a leukemoid reaction has never been reported in literature...
July 2017: Journal of Global Infectious Diseases
https://www.readbyqxmd.com/read/28873364/refractory-spasms-of-focal-onset-a-potentially-curable-disease-that-should-lead-to-rapid-surgical-evaluation
#19
Mathilde Chipaux, Georg Dorfmüller, Martine Fohlen, Nathalie Dorison, Marie-Astrid Metten, Olivier Delalande, Sarah Ferrand-Sorbets, Delphine Taussig
PURPOSE: Infantile spasms (IS) can occur as the only seizure type in children with surgically amenable epilepsies. Although early surgery has shown positive effects, little is known regarding outcomes. METHODS: We retrospectively reviewed all children with IS referred to our tertiary center between 2002 and 2014 and try to define factors of outcome. RESULTS: Sixty-eight children with focal onset seizures were referred: twenty children with a hemispheric implication and 48 with one or more lobes involved...
August 31, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28870844/inhibitory-synapse-deficits-caused-by-familial-%C3%AE-1-gabaa-receptor-mutations-in-epilepsy
#20
Xiumin Chen, Nela Durisic, Joseph W Lynch, Angelo Keramidas
Epilepsy is a spectrum of neurological disorders with many causal factors. The GABA type-A receptor (GABAAR) is a major genetic target for heritable human epilepsies. Here we examine the functional effects of three epilepsy-causing mutations to the α1 subunit (α1(T10'I), α1(D192N) and α1(A295D)) on inhibitory postsynaptic currents (IPSCs) mediated by the major synaptic GABAAR isoform, α1β2γ2L. We employed a neuron - HEK293 cell heterosynapse preparation to record IPSCs mediated by mutant-containing GABAARs in isolation from other GABAAR isoforms...
September 1, 2017: Neurobiology of Disease
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