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https://www.readbyqxmd.com/read/28644682/management-of-severe-bupropion-poisoning-with-intravenous-lipid-emulsion
#1
Neeraj Chhabra, Carol DesLauriers, Michael Wahl, Sean M Bryant
BACKGROUND: Bupropion toxicity is characterized by central nervous system and cardiovascular toxicity. Intravenous lipid emulsion (ILE) has been suggested as a treatment by some for the treatment of refractory bupropion toxicity. This recommendation is based largely on published case reports and cases presented at scientific meetings. The objective of this study is to characterize the outcomes of patients with suspected bupropion toxicity in which ILE was administered and the indications for its use...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28644097/thirty-day-postoperative-morbidity-and-mortality-after-temporal-lobectomy-for-medically-refractory-epilepsy
#2
Panagiotis Kerezoudis, Brandon McCutcheon, Meghan E Murphy, Kenan R Rajjoub, Daniel Ubl, Elizabeth B Habermann, Gregory Worrell, Mohamad Bydon, Jamie J Van Gompel
OBJECTIVE Temporal lobectomy is a well-established treatment modality for the management of medically refractory epilepsy in appropriately selected patients. The aim of this study was to assess 30-day morbidity and mortality after temporal lobectomy in cases registered in a national database. METHODS A retrospective cohort analysis was conducted using a multiinstitutional surgical registry compiled between 2006 and 2014. The authors identified patients who underwent anterior temporal lobectomy and/or amygdalohippocampectomy for a primary diagnosis of intractable epilepsy...
June 23, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28637943/stereoelectroencephalography-indication-and-efficacy
#3
Koji Iida, Hiroshi Otsubo
Stereoelectroencephalography (SEEG) is a method for invasive study of patients with refractory epilepsy. Localization of the epileptogenic zone in SEEG relied on the hypothesis of anatomo-electro-clinical analysis limited by X-ray, analog electroencephalography (EEG), and seizure semiology in the 1950s. Modern neuroimaging studies and digital video-EEG have developed the hypothesis aiming at more precise localization of the epileptic network. Certain clinical scenarios favor SEEG over subdural EEG (SDEEG). SEEG can cover extensive areas of bilateral hemispheres with highly accurate sampling from sulcal areas and deep brain structures...
June 20, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28637175/multiple-subpial-transections-for-medically-refractory-epilepsy-a-disaggregated-review-of-patient-level-data
#4
John D Rolston, Hansen Deng, Doris D Wang, Dario J Englot, Edward F Chang
BACKGROUND: Multiple subpial transections (MST) are a treatment for seizure foci in nonresectable eloquent areas. OBJECTIVE: To systematically review patient-level data regarding MST. METHODS: Studies describing patient-level data for MST procedures were extracted from the Medline and PubMed databases, yielding a synthetic cohort of 212 patients from 34 studies. Data regarding seizure outcome, patient demographics, seizure type, surgery type, and complications were extracted and analyzed...
June 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28628235/expanded-phenotypes-and-outcomes-among-256-lgi1-caspr2-igg-positive-patients
#5
Avi Gadoth, Sean J Pittock, Divyanshu Dubey, Andrew McKeon, Jeff W Britton, John E Schmeling, Aurelia Smith, Amy L Kotsenas, Robert E Watson, Daniel H Lachance, Eoin P Flanagan, Vanda A Lennon, Christopher J Klein
OBJECTIVE: To describe an expanded phenotypic spectrum and longitudinal outcome in 256 LGI1-IgG or CASPR2-IgG seropositive patients. METHODS: Patients were identified through service neural autoantibody evaluation. Ninety-five had longitudinal follow-up (7-456 months; median 35). RESULTS: Among 3,910 patients tested, 196 were LGI1-IgG-positive; 51 were CASPR2-IgG-positive and 9 were dual-positive. CSF-testing was less sensitive than serum-testing, detecting only 24/38 LGI1-IgG-positive (63%) and 5/6 CASPR2-IgG-positive (83%)...
June 19, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28628018/autoimmune-limbic-encephalitis-case-reports
#6
K Kobaidze, A Harrison, Y Burklin, V Patidar, M Riccardi
Limbic encephalitis (LE) is an autoimmune or paraneoplastic disease that affects the medial temporal lobes. The patient will usually present with cognitive impairment, psychiatric changes, and seizures. Autoimmune limbic encephalitis (LE) is a challenging diagnosis as it is not always included in the typical paraneoplastic/autoimmune panels. Anti-GAD antibodies are associated with various disease including type I diabetes mellitus, various autoimmune processes, some neoplastic and infectious diseases. Thus, it is not as specific as some of the antibodies causing LE...
May 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28624183/the-neuroprotective-effect-of-perampanel-in-lithium-pilocarpine-rat-seizure-model
#7
Ting Wu, Katsutoshi Ido, Yoshihide Osada, Sadaharu Kotani, Akira Tamaoka, Takahisa Hanada
PURPOSE: Status epilepticus (SE) causes irreversible neurodegeneration if not terminated quickly. Perampanel (PER), a potent AMPA receptor antagonist, has previously been shown to terminate seizures in the lithium-pilocarpine SE model. In the present study, we assessed whether PER would also prevent neuronal damage in this model. METHODS: SE was induced in rats using lithium chloride and pilocarpine. Initiation of SE was defined as continuous seizures that exhibited as rearing accompanied by bilateral forelimb clonus (Racine score 4)...
June 14, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28621626/a-multimodal-concept-for-invasive-diagnostics-and-surgery-based-on-neuronavigated-voxel-based-morphometric-mri-postprocessing-data-in-previously-nonlesional-epilepsy
#8
Daniel Delev, Carlos M Quesada, Alexander Grote, Jan P Boström, Christian Elger, Hartmut Vatter, Rainer Surges
OBJECTIVE Diagnosis and surgical treatment of refractory and apparent nonlesional focal epilepsy is challenging. Morphometric MRI voxel-based and other postprocessing methods can help to localize the epileptogenic zone and thereby support the planning of further invasive electroencephalography (EEG) diagnostics, and maybe resective epilepsy surgery. METHODS The authors developed an algorithm to implement regions of interest (ROI), based on postprocessed MRI data, into a neuronavigation tool. This was followed by stereotactic ROI-guided implantation of depth electrodes and ROI-navigated resective surgery...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28619068/late-onset-jaw-and-teeth-pain-mimicking-trigeminal-neuralgia-associated-with-chronic-vagal-nerve-stimulation-case-series-and-review-of-the-literature
#9
Gabriela Timarova, Andrej Šteňo
BACKGROUND: Vagal nerve stimulation (VNS) for refractory epilepsy is well established. Trigeminal neuralgia itself is a common disease in adults, and thus, late-onset pain in the trigeminal region under VNS, which is extremely rare, may not be recognized as caused by VNS. CASE PRESENTATION: Two patients with drug-resistant symptomatic epilepsy treated with chronic VNS experienced stimulation-related pain in the lower and upper jaw and teeth on the side of stimulation...
June 15, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28615895/study-of-refractory-status-epilepticus-from-a-tertiary-care-center
#10
Sahil Kohli, Suresh Babu Pasangulapati, Sangeetha Yoganathan, Gideon Lyngsyun Rynjah, A T Prabhakar, Sanjith Aaron, Mathew Alexander, Vivek Mathew
OBJECTIVES: To determine the proportion of refractory status epilepticus (RSE) and super-RSE (SRSE) among patients with status epilepticus (SE) and to analyze RSE and non-RSE (NRSE) in terms of etiology and predictors for RSE. MATERIALS AND METHODS: Patients were identified from discharge summaries database with keywords of SE and records of the portable electroencephalogram (EEG) machine from January 2011 to March 2016. RESULTS: Two hundred and eighteen events were included in the study with 114 (52...
April 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28605011/use-of-the-ketogenic-diet-to-manage-refractory-epilepsy-in-cdkl5-disorder-experience-of-100-patients
#11
Zhan Lim, Kingsley Wong, Heather E Olson, Ann M Bergin, Jenny Downs, Helen Leonard
OBJECTIVE: Pathogenic variants involving the CDKL5 gene result in a severe epileptic encephalopathy, often later presenting with features similar to Rett syndrome. Cardinal features of epilepsy in the CDKL5 disorder include early onset at a median age of 6 weeks and poor response to antiepileptic drugs. The ketogenic diet (KD) was first introduced in the 1920s as a treatment option for refractory epilepsy in children. This study investigated use of the KD in the CDKL5 disorder and its influences on seizures...
June 12, 2017: Epilepsia
https://www.readbyqxmd.com/read/28604555/immune-related-neurological-symptoms-in-an-adolescent-patient-receiving-the-checkpoint-inhibitor-nivolumab
#12
Dmitry Tchapyjnikov, Alexandra J Borst
Immune checkpoint inhibitors are a novel group of immunotherapeutic agents for the treatment of cancer. Immune-related adverse events, including neurological symptoms, have been associated with these agents. We present the case of an adolescent with refractory Hodgkin lymphoma treated with nivolumab, a PD1 inhibitor, who developed Hashimoto thyroiditis, posterior reversible encephalopathy syndrome causing seizures, as well as urinary retention, truncal/appendicular spasticity, dysphagia, and a progressive encephalopathy that was clinically consistent with a diagnosis of progressive encephalopathy with rigidity and myoclonus, a stiff-person-syndrome spectrum disorder...
June 9, 2017: Journal of Immunotherapy
https://www.readbyqxmd.com/read/28602933/familial-epilepsy-with-anterior-polymicrogyria-as-a-presentation-of-col18a1-mutations
#13
Mark A Corbett, Samantha J Turner, Alison Gardner, Jeremy Silver, Jim Stankovich, Richard J Leventer, Christopher P Derry, Renée Carroll, Thuong Ha, Ingrid E Scheffer, Melanie Bahlo, Graeme D Jackson, David A Mackey, Samuel F Berkovic, Jozef Gecz
Knobloch syndrome [OMIM: (KNO1) #267750] is a rare and clinically heterogeneous autosomal recessive disorder caused by mutations in COL18A1. Knobloch syndrome is characterised by abnormalities of the eye and occipital skull defects however the full phenotypic spectrum is yet to be defined. This report describes a family of four affected sisters with polymicrogyria, refractory seizures, and intellectual impairment of varying severity with a Lennox-Gastaut phenotype, and complex eye abnormalities where a syndromic diagnosis was not initially made...
June 8, 2017: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/28601603/enhanced-classical-complement-pathway-activation-and-altered-phagocytosis-signaling-molecules-in-human-epilepsy
#14
Season K Wyatt, Thomas Witt, Nicholas M Barbaro, Aaron A Cohen-Gadol, Amy L Brewster
Microglia-mediated neuroinflammation is widely associated with seizures and epilepsy. Although microglial cells are professional phagocytes, less is known about the status of this phenotype in epilepsy. Recent evidence supports that phagocytosis-associated molecules from the classical complement (C1q-C3) play novel roles in microglia-mediated synaptic pruning. Interestingly, in human and experimental epilepsy, altered mRNA levels of complement molecules were reported. Therefore, to identify a potential role for complement and microglia in the synaptodendritic pathology of epilepsy, we determined the protein levels of classical complement proteins (C1q-C3) along with other phagocytosis signaling molecules in human epilepsy...
June 7, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28597112/serial-magnetic-resonance-study-in-super-refractory-status-epilepticus-progressive-involvement-of-striatum-and-pallidus-is-a-possible-predictive-marker-of-negative-outcome
#15
Alessandra Ferrari, Paolo Renzetti, Carlo Serrati, Roberto Fancellu
Super refractory status epilepticus (SRSE) is a life-threatening condition in which seizures do not respond to third-line anticonvulsant drug therapy. SRSE is associated with high mortality. How often SRSE occurs, what are the risk factors leading to this condition, and what is the effect on clinical outcome of failure to control seizures are poorly defined. Several studies have evaluated magnetic resonance imaging (MRI) findings in status epilepticus (SE), confirming that SE may directly cause selective neuronal necrosis due to excitotoxic mechanisms, as described in clinical case reports and experimental models...
June 8, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28595534/a-review-of-levetiracetam-in-neonates
#16
Amit Agrawal, Anita Banergee
BACKGROUND: Neonatal seizures are the most common clinical manifestation of central nervous system (CNS) dysfunction and are associated with various neurological sequelae. There are currently no evidence-based guidelines for the management of neonatal seizures and currently used drugs such as phenobarbital, and phenytoin have limited efficacy and potential toxicities. Newer second line anticonvulsant, levetiracetam, has been used in refractory neonatal seizures despite limited data and off-label use...
June 6, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28591480/laser-interstitial-thermal-therapy-a-first-line-treatment-for-seizures-due-to-hypothalamic-hamartoma
#17
Victor X Du, Shashank V Gandhi, Harold L Rekate, Ashesh D Mehta
Successful treatment of hypothalamic hamartoma (HH) can result in the resolution of its sequelae including epilepsy and rage attacks. Risks and morbidity of open surgical management of this lesion have motivated the development of laser interstitial thermal therapy (LITT) as a less invasive treatment approach to the disease. Although overall morbidity and risk would appear to be lower, complications related to LITT therapy have been reported, and the longer-term follow-up that is now possible after initial experience helps address the question of whether LITT provides equivalent efficacy compared to other treatment options...
June 2017: Epilepsia
https://www.readbyqxmd.com/read/28590988/seizures-after-pediatric-vilazodone-ingestion-a-case-series
#18
Jeannine Del Pizzo, Elon K Fernandez, Kathryn T Kopec, Jesse Wenger, Erin M Noyes, Matthew Salzman, Fred M Henretig
Vilazodone hydrochloride is the first member in a new class of antidepressants called indolealkylamines and was approved for use in the United States in 2011 for major depressive disorder. It has a combined mechanism of action of a selective serotonin reuptake inhibitor and a partial agonist of serotonin 5-HT1A receptors. It has not been approved for use in the pediatric population, and toxicity from exploratory vilazodone ingestion has been rarely described to date. We describe 2 children with laboratory-confirmed vilazodone ingestions that led to significant toxicity including refractory status epilepticus in 1 patient and likely transient seizure activity in the other...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590911/effect-of-%C3%AE-ethyl-%C3%AE-phenyl-butyrolactone-efbl-anticonvulsant-and-hypnotic-drug-on-mouse-brain-catecholamine-levels
#19
Lourdes A Vega Rasgado, Iván Villanueva, Fernando Vega Díaz
γ-Ethyl-γ-phenyl-butyrolactone (EFBL) is a structural combination of the anticonvulsant γ-hydroxy-γ-ethyl-γ-phenylbutyramide (HEPB) and the hypnotic γ-butyrolactone (GBL), which inherits both properties. To clarify its mechanism of action, the effects of EFBL, GBL and HEPB on dopamine (DA) and noradrenaline (NA) brain levels were investigated. Influences of chlorpromazine, phenelzine and aminooxyacetic acid were also studied. EFBL increased DA in a dose-dependent manner, remaining enhanced by 80 % over a period of 24 h and augmented NA by 54 % one hour after treatment...
June 27, 2017: Acta Pharmaceutica
https://www.readbyqxmd.com/read/28589521/strengthening-the-case-for-epilepsy-drug-development-bridging-experiences-from-the-alzheimer-s-disease-field-an-opinion
#20
Roy E Twyman
Given the sheer number of drugs (over 20!) available for treatment of seizures, epilepsy can be considered one of the most successful areas in pharmaceutical development and especially for neuroscience. However, despite the large number of drug treatment options available for managing patients with epilepsy, there remains considerable unmet need. For example, the overall impact on seizure control has not been substantial with approximately 30% of patients remaining refractory or their seizures not adequately controlled...
June 7, 2017: Neurochemical Research
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