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https://www.readbyqxmd.com/read/29161897/status-epilepticus-and-multiple-sclerosis-a-case-presentation-and-literature-review
#1
Murat Mert Atmaca, Candan Gurses
PURPOSE: To search the literature for the frequency, pathogenesis, prognosis, and treatment of seizures and status epilepticus (SE) in patients with multiple sclerosis (MS). METHODS: We report 2 patients with MS who presented with SE and review the literature. RESULTS: Seizures and SE episodes worsened during MS relapses in the first patient. SE episodes and MS relapses significantly decreased after initiation of natalizumab treatment but she still had seizures and was taking 4 antiepileptic drugs (AEDs)...
January 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/29160210/exceptional-response-to-brivaracetam-in-a-patient-with-refractory-idiopathic-generalized-epilepsy-and-absence-seizures
#2
Alberto Grande-Martín, David Sopelana-Garay, José Manuel Pardal-Fernández, Rosa María Sánchez-Honrubia, Álvaro Abelardo Sánchez-Larsen
Brivaracetam is currently indicated as adjunctive therapy for patients with focal-onset seizures with or without secondary generalization. However, it has been suggested that it could provide broad-spectrum efficacy given its similarity to levetiracetam and based on the results from preclinical studies and others of patients with generalized epilepsy. We present the case of a woman with refractory idiopathic generalized epilepsy and absence seizures with dramatic response to brivaracetam. Our report supports a consideration of treatment with this new antiepileptic drug on a case-by-case basis in patients with refractory generalized epilepsy, while we await further studies on this topic...
November 21, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/29159426/an-initial-cost-effectiveness-analysis-of-intraoperative-magnetic-resonance-imaging-imri-in-pediatric-epilepsy-surgery
#3
Matthew F Sacino, Sean S Huang, Robert F Keating, William D Gaillard, Chima O Oluigbo
PURPOSE: Previous studies have illustrated the clinical utility of the addition of intraoperative magnetic resonance imaging (iMRI) to conventional microsurgical resection. While iMRI requires initial capital cost investment, long-term reduction in costly follow-up management and reoperation costs may prove economically efficacious. The objective of this study is to investigate the cost-effectiveness of the addition of iMRI utilization versus conventional microsurgical techniques in focal cortical dysplasia (FCD) resection in pediatric patients with medically refractory epilepsy...
November 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29159065/train-of-four-stimulation-artifact-mimicking-a-seizure-during-computerized-automated-icu-eeg-monitoring
#4
Laxmi P Dhakal, William O Tatum, William D Freeman
A 54-year-old man was admitted to the intensive care unit with an aneurysmal subarachnoid hemorrhage and subsequently underwent mechanical ventilation and received neuromuscular blocking drugs to control refractory elevated intracranial pressure. During quantitative EEG monitoring, an automated alert was triggered by the train of four peripheral nerve stimulation artifacts. Real-time feedback was made possible due to remote monitoring. This case illustrates how computerized, automated artificial intelligence algorithms can be used beyond typical seizure detection in the intensive care unit for remote monitoring to benefit patient care...
2017: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/29140935/cerebral-infarction-and-refractory-seizures-in-a-neonate-with-suspected-zika-virus-infection
#5
Adam Raymond, Jonathan Jakus
Congenital Zika syndrome is a set of congenital anomalies associated with Zika virus infection during pregnancy. We present the unique case of a neonate born to a suspected Zika virus positive mother that developed an embolic stroke and medication resistant seizures. This report may impact the evolving definition of congenital Zika syndrome.
November 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29137921/intraoperative-definition-of-bottom-of-sulcus-dysplasia-using-intraoperative-ultrasound-and-single-depth-electrode-recording-a-technical-note
#6
Dorothea Miller, Patrick Carney, John S Archer, Gregory J Fitt, Graeme D Jackson, Kristian J Bulluss
Bottom of sulcus dysplasias (BOSDs) are localized focal cortical dysplasias (FCDs) centred on the bottom of a sulcus that can be highly epileptogenic, but difficult to delineate intraoperatively. We report on a patient with refractory epilepsy due to a BOSD, successfully resected with the aid of a multimodal surgical approach using neuronavigation based on MRI and PET, intraoperative ultrasound (iUS) and electrocorticography (ECoG) using depth electrodes. The lesion could be visualized on iUS showing an increase in echogenicity at the grey-white matter junction...
November 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29133176/effect-of-zonisamide-on-refractory-epilepsy-during-pregnancy-in-lamotrigine-resistant-kindled-rats
#7
Reza Narenji Sani, Keivan Keramati, Niloufar Saberi, Melika Moezifar, Ali Mahdavi
Drug-resistant epilepsy with uncontrolled severe seizures despite state-of-the-art medical treatment continues to be a major clinical problem. Pregnancy is a state where drug pharmacokinetic changes are more pronounced and more rapid than any other period of life. The current study investigated the effect of zonisamide (ZNS) on refractory epilepsy during pregnancy in lamotrigine-resistant kindled rats. Fifty-six lamotrigine (LTG)-resistant kindled Wistar rats were divided into five experimental (four pregnant and one non-pregnant) and 2 positive controls (pregnant and non-pregnant) groups and eight intact Wistar rats were put in the negative pregnant control group...
November 11, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29131676/incidence-of-postoperative-neurologic-complications-in-pugs-following-portosystemic-shunt-attenuation-surgery
#8
Mandy L Wallace, Catriona M MacPhail, Eric Monnet
Postoperative seizures occur in 5-12% of dogs following surgical attenuation of congenital extrahepatic portosystemic shunts (CEPSS) and are often refractory to treatment. Because pugs are predisposed to necrotizing meningoencephalitis, they may be at higher risk of developing neurologic complications after CEPSS attenuation. We hypothesized that pugs have a higher prevalence of postoperative neurologic complications and that pugs who died due to neurologic complications would have evidence of encephalitis at necropsy...
November 13, 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/29129763/mammillothalamic-and-mammillotegmental-tracts-as-new-targets-for-dementia-and-epilepsy-treatment
#9
REVIEW
Naci Balak, Ece Balkuv, Ali Karadag, Recep Basaran, Huseyin Biceroglu, Buruç Erkan, Necmettin Tanriover
Very recently, neuromodulation through deep brain stimulation (DBS) has appeared as a new surgical procedure in the treatment of some types of dementia and epilepsy. The mammillothalamic and the mammillotegmental tracts are involved among the new targets. To our knowledge, a review article focused specifically on these mammillary body efferents is lacking in the medical literature. Their contribution to memory is, regrettably, often overlooked. There is evidence that mammillary bodies can contribute to memory independently from hippocampal formation, but the mechanism is not yet known...
November 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29128679/early-onset-epileptic-encephalopathy-with-de-novo-scn8a-mutation
#10
Yangyang Xiao, Jie Xiong, Ding'an Mao, Lingjuan Liu, Jian Li, Xingfang Li, Haiyan Luo, Liqun Liu
Early-onset epileptic encephalopathies (EOEEs) are clinically and genetically heterogeneous disorders characterized by intractable seizures and unremitting interictal paroxysmal epileptiform activity. Consequently, these syndromes impair neurodevelopment during the first year of life. Currently, the etiology of these disorders is largely unknown. In this study, Childhood-Onset Epilepsy Gene Panel Testing (containing 511 epilepsy-related genes) was performed in a parent-offspring trio. In this family, the son had refractory seizures, intellectual disability, and motor abnormalities, and he was diagnosed with EOEE...
October 28, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29127848/influence-of-titration-schedule-and-maintenance-dose-on-the-tolerability-of-adjunctive-eslicarbazepine-acetate-an-integrated-analysis-of-three-randomized-placebo-controlled-trials
#11
Gregory Krauss, Victor Biton, Jay H Harvey, Christian Elger, Eugen Trinka, Patrício Soares da Silva, Helena Gama, Hailong Cheng, Todd Grinnell, David Blum
OBJECTIVE: To examine the influence of titration schedule and maintenance dose on the incidence and type of treatment-emergent adverse events (TEAEs) associated with adjunctive eslicarbazepine acetate (ESL). METHODS: Data from three randomized, double-blind, placebo-controlled trials were analyzed. Patients with refractory partial-onset seizures were randomized to maintenance doses of ESL 400, 800, or 1200mg QD (dosing was initiated at 400 or 800mg QD) or placebo...
November 4, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29127345/the-synthetic-neuroactive-steroid-sge-516-reduces-seizure-burden-and-improves-survival-in-a-dravet-syndrome-mouse-model
#12
Nicole A Hawkins, Michael Lewis, Rebecca S Hammond, James J Doherty, Jennifer A Kearney
Dravet syndrome is an infant-onset epileptic encephalopathy with multiple seizure types that are often refractory to conventional therapies. Treatment with standard benzodiazepines like clobazam, in combination with valproate and stiripentol, provides only modest seizure control. While benzodiazepines are a first-line therapy for Dravet syndrome, they are limited by their ability to only modulate synaptic receptors. Unlike benzodiazepines, neuroactive steroids potentiate a wider-range of GABAA receptors. The synthetic neuroactive steroid SGE-516 is a potent positive allosteric modulator of both synaptic and extrasynaptic GABAA receptors...
November 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29127224/clinical-prediction-rule-for-neurological-sequelae-due-to-acute-encephalopathy-a-medical-community-based-validation-study-in-harima-japan
#13
Kaori Sasaki, Hiroaki Nagase, Azusa Maruyama, Kyoko Fujita, Masahiro Nishiyama, Tsukasa Tanaka, Sadayuki Nukina, Toru Takumi, Kanae Takenaka, Yoshinobu Oyazato, Atsushi Nishiyama, Tomoko Kawata, Keisuke Saeki, Yuichi Takami, Eriko Satake-Inoue, Kazumoto Iijima, Ichiro Morioka, Yoshiyuki Uetani
OBJECTIVES: This study aimed to verify the screening performance of our clinical prediction rule for neurological sequelae due to acute encephalopathy (NSAE-CPR), which previously identified the following three variables as predictive of poor outcomes: (1) refractory status epilepticus; (2) consciousness disturbance and/or hemiplegia at 6 hours from onset and (3) aspartate aminotransferase >90 IU/L within 6 hours of onset. DESIGN: Medical community-based multicentre retrospective cohort study...
November 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/29115760/efficacy-and-safety-of-cannabis-for-treating-children-with-refractory-epilepsy
#14
Michelle Neale
The aim of this literature review was to examine the evidence base for the safety and efficacy of cannabis in treating children with refractory epilepsy. Clinical and medical databases were searched and four articles were included in the final analysis, which included retrospective reviews and open-label trials with a total sample size of 424. One clinical trial included administration of cannabidiol, the non-psychoactive compound of cannabis, while the other three articles stated that the compound administered to participants contained tetrahydrocannabidiol, the psychoactive constituent of cannabis...
September 11, 2017: Nursing Children and Young People
https://www.readbyqxmd.com/read/29111296/a-neurosurgeon-s-view-laser-interstitial-thermal-therapy-of-mesial-temporal-lobe-structures
#15
Yarema B Bezchlibnyk, Jon T Willie, Robert E Gross
Stereotactic laser ablation of mesial temporal structures is a promising new surgical intervention for patients with mesial temporal lobe epilepsy (MTLE). Since this procedure was first used to treat MTLE in 2010, the literature contains reports of 37 patients that underwent MR-guided stereotactic laser amygdalohippocampotomy (SLAH) using Laser Interstitial Thermal Therapy (LITT) with at least 1year of follow-up. This early body of data suggests that SLAH is a safe and effective treatment for MTLE in properly selected patients...
October 27, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29111096/multinodular-and-vacuolating-neuronal-tumor-of-the-cerebrum-a-rare-entity-new-case-and-review-of-the-literature
#16
Lain Hermes Gonzalez-Quarante, Fernando Ruiz-Juretschke, Emma Sola Vendrell, Oscar Lucas Gil de Sagredo Del Corral, Vijay Agarwal, Roberto Garcia-Leal
BACKGROUND: Multinodular and vacuolating neuronal tumor has been recently described and included in the World Health Organization Classification of Tumors of The Central Nervous System, even though its consideration as a true tumor is controversial. Patients with these lesions usually present with refractory seizures and inconclusive imaging findings that may be confused with other more common diagnoses such as dysembryoplastic neuroepithelial tumors or low-grade gliomas. Therefore, surgical resection is warranted to reach a pathologic diagnosis and seizure control...
October 28, 2017: Neurocirugía
https://www.readbyqxmd.com/read/29108913/development-and-content-validation-of-a-preliminary-core-set-of-patient-and-caregiver-relevant-outcomes-for-inclusion-in-a-potential-composite-endpoint-for-dravet-syndrome
#17
Rima Nabbout, Stephane Auvin, Catherine Chiron, John Irwin, Arun Mistry, Nicola Bonner, Nicola Williamson, Bryan Bennett
BACKGROUND: Dravet Syndrome (DS) is a rare developmental and epileptic encephalopathy characterized by multiple seizures, frequently prolonged and treatment refractory, with significant developmental disabilities and behavioral and psychiatric disorders. Patients with DS require intensive support and supervision from a caregiver, impacting significantly on both patients' and caregivers' lives. This study aimed to identify core concepts to measure the impact on both patients and caregivers in future DS clinical trials...
November 3, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29105058/verbal-memory-decline-from-hippocampal-depth-electrodes-in-temporal-lobe-surgery-for-epilepsy
#18
Hanna Ljung, Arto Nordlund, Maria Strandberg, Johan Bengzon, Kristina Källén
OBJECTIVE: To explore whether patients with refractory mesial temporal lobe epilepsy risk aggravated verbal memory loss from intracranial electroencephalography (EEG) recording with longitudinal hippocampal electrodes in the language-dominant hemisphere. METHODS: A long-term neuropsychological follow-up (mean 61.5 months, range 22-111 months) was performed in 40 patients after ictal registration with left hippocampal depth electrodes (study group, n = 16) or no invasive EEG, only extracranial registration (reference group, n = 24)...
November 3, 2017: Epilepsia
https://www.readbyqxmd.com/read/29104044/calcitonin-potentiates-the-anticonvulsant-and-antinociceptive-effects-of-valproic-acid-and-pregabalin-in-pentylenetetrazole-kindled-mice
#19
Nada M Hamada, Rehab H Ashour, Amany A Shalaby, Hussien M El-Beltagi
Antiepileptic drugs are the backbone for epilepsy management. Epilepsy may be accompanied by decreased pain threshold. Thus, anticonvulsant agents with antinociceptive properties are of great importance. This study investigated the possible anticonvulsant and antinociceptive effects of calcitonin in combination with either valproic acid or pregabalin and whether these effects might occur through γ-aminobutyric acid (GABA) modulation. Eighty-four male Balb/C mice were divided into 7 groups: control-naïve, pentylenetetrazole (PTZ)-induced seizures, PTZ-calcitonin, PTZ-valproic acid, PTZ-pregabalin, PTZ-calcitonin-valproic acid (PCV) combination, and PTZ-calcitonin-pregabalin (PCP) combination...
November 2, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29101860/correlation-between-extreme-fear-and-focal-cortical-dysplasia-in-anterior-cingulate-gyrus-evidence-from-a-surgical-case-of-refractory-epilepsy
#20
Liang Qiao, Tao Yu, Duanyu Ni, Xueyuan Wang, Cuiping Xu, Chang Liu, Guojun Zhang, Yongjie Li
Localizing the semiology of ictal fear and seizure onset in epilepsy patients is commonly challenging due to limited value of routine electroencephalography (EEG) and very few surgical attempts. Here we reported a case of refractory epilepsy characterized by aura of extreme fear and hypermotor seizures, in which the left (dominant hemisphere) anterior cingulate gyrus (ACG) was determined to be the epileptogenic zone (EZ) through multiple modalities of presurgical evaluation including analysis of high frequency oscillation on intracranial EEG...
October 31, 2017: Clinical Neurology and Neurosurgery
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