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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/29348993/delayed-presentation-of-cerebral-air-embolism-from-a-left-atrial-esophageal-fistula-a-case-report-and-review-of-the-literature
#2
Catherine Peterson, Clay Elswick, Vicki Diaz, R Shane Tubbs, Marc Moisi
Air embolism developing from an atrial-esophageal fistula that was created as a complication from an atrial ablation procedure is a rare, yet usually fatal diagnosis. Neurologic manifestations such as meningitis, altered mental status, seizures, strokes, transient ischemic attacks (TIAs), psychiatric changes, and coma can ensue. Imaging of the brain might reveal infarcts, cerebral edema, as well as signs of pneumocephalus. This case describes a 42-year-old male with recent cardiac ablation procedure at an outside hospital for refractory atrial fibrillation (A-fib) who presented with altered mental status, dyspnea and diaphoresis...
November 15, 2017: Curēus
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/29338667/docosahexaenoic-acid-prevents-resistance-to-antiepileptic-drugs-in-two-animal-models-of-drug-resistant-epilepsy
#6
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/29337452/-neurology
#7
Isabelle Chopard, David Benninger, Jean-François Demonet, Renaud Du Pasquier, Lorenz Hirt, Thierry Kuntzer, Patrik Michel, Bernard Nater, Jan Novy, Andrea Rossetti, Olivier Rouaud, Philippe Ryvlin, Myriam Schluep, Marie Theaudin
Ocrelizumab (Ocrevus), an anti-CD20 monoclonal antibody, has been approved for the treatment of multiple sclerosis. Eculizumab (Soliris) has been approved in several countries for refractory forms of generalized seropositive severe myasthenia gravis. A form of gene therapy, patisiran, has shown positive results in transthyretin familial amyloidosis. In the treatment of headaches, particularly migraines, non-pharmacological approaches have shown some interesting results. The criteria for Lewy body dementia have been revised...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29336839/effect-of-thymectomy-on-refractory-autoimmune-status-epilepticus
#8
Alberto Vogrig, Giada Pauletto, Enrico Belgrado, Enrico Pegolo, Carla Di Loreto, Veronique Rogemond, Jerome Honnorat, Roberto Eleopra
Refractory status epilepticus (RSE) is an increasingly recognized manifestation of autoimmune encephalitis, which can occur either as a paraneoplastic or non-paraneoplastic disorder. The effect of tumor removal in paraneoplastic status epilepticus has never been explored systematically, although early tumor treatment is usually recommended. In this study, we report clinical, pathological and EEG findings of a patient who developed RSE as one of multiple paraneoplastic manifestations of thymoma and the effect of thymectomy on seizure outcome...
January 9, 2018: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/29334039/refractory-epilepsy-the-role-of-positron-emission-tomography
#9
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/29331846/functional-neuroimaging-in-rasmussen-syndrome
#10
Ichiro Kuki, Kazumi Matsuda, Yuko Kubota, Tetsuhiro Fukuyama, Yukitoshi Takahashi, Yushi Inoue, Haruo Shintaku
PURPOSE: For a diagnosis of Rasmussen syndrome (RS), clinical course together with electroencephalography (EEG) and magnetic resonance imaging (MRI) findings are considered important, but there are few reports on functional neuroimaging. This study investigated cerebral blood flow (CBF)-single photon emission computed tomography (SPECT), central benzodiazepine receptor (BZR)-SPECT, and fluorine-18 fluorodeoxy glucose-positron emission tomography (FDG-PET) in RS patients, and correlated neuroimaging results with MRI and pathological findings...
January 5, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29327953/multicentric-cryptococcosis-in-a-congo-african-grey-parrot-psittacus-erithacus-erithacus
#11
Raina S K Schunk, Nicholas E Sitinas, Katherine E Quesenberry, Jessica L Grodio
An approximately 10-year-old, female Congo African grey parrot ( Psittacus erithacus erithacus) developed progressive, unilateral exophthalmos and buphthalmos. Survey radiographs revealed a large, coelomic, soft tissue mass, which was confirmed on computed tomography scan. Aspirates of both the contents of the buphthalmic globe and coelomic mass were consistent with Cryptococcus species. Initial results were later confirmed with serum antigen latex agglutination and polymerase chain reaction testing, and the organism was then identified as Cryptococcus neoformans with DNA sequencing...
December 2017: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/29317669/selective-targeting-of-scn8a-prevents-seizure-development-in-a-mouse-model-of-mesial-temporal-lobe-epilepsy
#12
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
#13
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
#14
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/29313881/stiripentol-for-the-treatment-of-super-refractory-status-epilepticus-with-cross-sensitivity
#15
Y Uchida, K Terada, Y Madokoro, T Fujioka, M Mizuno, T Toyoda, D Kato, N Matsukawa
BACKGROUND: Cross-sensitivity of rash has been reported between various antiepileptic drugs (AEDs). However, few studies have determined the frequency and management of cross-sensitivity in patients with super-refractory status epilepticus (SRSE). AIMS OF THE STUDY: To examine the optimal AED for treating SRSE with cross-sensitivity. METHODS: We performed a retrospective review of adult patients with SRSE treated at Nagoya City University Hospital, in which we investigated the frequency of cross-sensitivity among patients with SRSE and their clinical and medical profiles...
January 3, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29313510/need-for-surgical-treatment-of-epilepsy-and-excision-of-tumors-and-post-traumatic-epileptogenic-lesions-in-kinshasa-rdc
#16
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/29306558/high-dose-phenobarbitone-coma-in-pediatric-refractory-status-epilepticus-a-retrospective-case-record-analysis-a-proposed-protocol-and-review-of-literature
#17
Sheffali Gulati, Vishal Sondhi, Biswaroop Chakrabarty, Prashant Jauhari, Rakesh Lodha, Jhuma Sankar
BACKGROUND: Ongoing refractory status epilepticus is associated with significant morbidity and mortality. Therapeutic coma induction with midazolam, thiopentone, phenobarbitone or propofol is indicated when conventional antiepileptics fail to abort seizure. Of these, the most extensively studied is midazolam. Amongst the remaining three, phenobarbitone has the most favourable pharmacological profile, but has not been studied adequately, more so in the pediatric age group. The current retrospective case records analysis is an attempt to describe use of phenobarbitone coma in pediatric refractory status epilepticus...
January 3, 2018: Brain & Development
https://www.readbyqxmd.com/read/29305185/predictors-of-outcome-after-surgery-in-134-children-with-drug-resistant-tle
#18
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
https://www.readbyqxmd.com/read/29296617/flupirtine-and-diazepam-combination-terminates-established-status-epilepticus-results-in-three-rodent-models
#19
Terry Zhang, Marko S Todorovic, John Williamson, Jaideep Kapur
Objective: Status epilepticus (SE) is a neurological emergency requiring rapid termination of seizures. New treatment choices are needed for benzodiazepine-refractory SE or established SE (ESE). Previous studies have demonstrated that the potassium-channel opener flupirtine terminates seizures in neonatal animals. However, its effectiveness in adult ESE has not been tested. We tested whether flupirtine alone or in combination with the benzodiazepine diazepam would terminate ESE in three animal models...
December 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29291456/does-age-affect-response-to-quinidine-in-patients-with-kcnt1-mutations-report-of-three-new-cases-and-review-of-the-literature
#20
Elie Abdelnour, William Gallentine, Marie McDonald, Monisha Sachdev, Yong-Hui Jiang, Mohamad A Mikati
PURPOSE: Gain-of-function mutations in the KCNT1 gene have been reported in a number of drug resistant epilepsy syndromes including Epilepsy of Infancy with Migrating Focal Seizures. Quinidine, a potassium channel blocker, has been proposed as a potential therapeutic agent with only a few patients reported in the literature to have received it. Here we report 3 additional children, with such KCNT1 mutations and refractory seizures, who received quinidine therapy. METHODS: Retrospective chart review of 3 children with KCNT1 mutations, of ages 3 months, 9 years and 13 years old...
December 23, 2017: Seizure: the Journal of the British Epilepsy Association
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