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https://www.readbyqxmd.com/read/27924180/magnetic-resonance-spectroscopy-and-single-photon-emission-computed-tomography-in-the-evaluation-of-cerebral-tumors-a-case-report
#1
Ioannis Siasios, Varvara Valotassiou, Eftychia Kapsalaki, Ioannis Tsougos, Panagiotis Georgoulias, Aggeliki Fotiadou, Maria Ioannou, Georgios Koukoulis, Vassilios Dimopoulos, Kostas Fountas
In their daily clinical practice, physicians have to confront diagnostic dilemmas which cannot be resolved by the application of only one imaging technique. In this case report, we present a 66-year-old woman who was admitted to our institution for the surgical resection of a recently diagnosed brain tumor. The patient had a history of epileptic seizures and was hospitalized in the past for anti-phospholipid syndrome related to a non-Hodgkin lymphoma in remission. Magnetic resonance imaging (MRI) examination revealed an enhancing right parasagittal lesion with significant edema suggestive of a high grade glioma...
January 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27923187/sleep-eeg-patterns-in-infants-with-congenital-zika-virus-syndrome
#2
Maria Durce Costa Gomes Carvalho, Demócrito de Barros Miranda-Filho, Vanessa van der Linden, Paula Fabiana Sobral, Regina Coeli Ferreira Ramos, Maria Ângela Wanderley Rocha, Marli Tenório Cordeiro, Sarah Pinheiro de Alencar, Magda Lahorgue Nunes
OBJECTIVES: To describe sleep EEG patterns of neonates, and infants with microcephaly due to congenital Zika virus (ZikV) syndrome. METHODS: A descriptive case series of EEGs performed in a cohort of neonates with microcephaly monitored from October 2015 to February 2016 at a University Hospital in Northeast Brazil. Infants were investigated following an established protocol that includes EEG, neuroimaging studies, PCR and specific antibodies for ZikV detection...
November 14, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27922474/embracing-a-nurse-driven-alcohol-withdrawal-protocol-through-quality-improvement
#3
John Barrett, Maria Jansen, April Cooper, Matthew Felbinger, Faith Waters
BACKGROUND: Alcohol withdrawal can lead to severe complications including seizures, delirium tremens, and death if not treated appropriately. Nurses are critical to the safety and outcomes of these patients. OBJECTIVE: The objective of this retrospective study was to determine if nursing education on a community hospital's alcohol withdrawal protocol led to improved nursing compliance. METHODS: This is a quality improvement project involving a two-part retrospective review-an initial needs assessment followed by nursing education and a subsequent posteducation retrospective review...
October 2016: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/27912111/can-ictal-meg-obviate-the-need-for-phase-ii-monitoring-in-people-with-drug-refractory-epilepsy-a-prospective-observational-study
#4
Bhargavi Ramanujam, Kamal Bharti, Vibhin Viswanathan, Ajay Garg, Madhavi Tripathi, Chandrashekhar Bal, P Sarat Chandra, Manjari Tripathi
PURPOSE: To determine if ictal-magnetoencephalography (ictal-MEG) source localization (SL) added information towards delineating the ictal-onset zone (IOZ), whether and how it helped final decision-making in epilepsy-surgery. METHODS: Definite focal clusters on ictal-MEG were available for 32 DRE-patients, data was analyzed (single equivalent current dipole (ECD) model), SL done. Clinical history, long-term video-EEG (VEEG) monitoring, epilepsy-protocol MRI, FDG-PET, ictal-SPECT and interictal-MEG were discussed at the multispeciality Epilepsy Surgery Case-conference (ESC)...
October 31, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27911366/a-multimodal-imaging-and-stimulation-based-method-of-evaluating-connectivity-related-brain-excitability-in-patients-with-epilepsy
#5
Mouhsin M Shafi, Susan Whitfield-Gabrieli, Catherine J Chu, Alvaro Pascual-Leone, Bernard S Chang
Resting-state functional connectivity MRI (rs-fcMRI) is a technique that identifies connectivity between different brain regions based on correlations over time in the blood-oxygenation level dependent signal. rs-fcMRI has been applied extensively to identify abnormalities in brain connectivity in different neurologic and psychiatric diseases. However, the relationship among rs-fcMRI connectivity abnormalities, brain electrophysiology and disease state is unknown, in part because the causal significance of alterations in functional connectivity in disease pathophysiology has not been established...
November 13, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27897304/-the-role-of-diffusion-tensor-imaging-in-the-pre-surgical-study-of-temporal-lobe-epilepsy
#6
M A Garcia-Pallero, C V Torres, R Manzanares-Soler, E Camara, R G Sola
INTRODUCTION: Diffusion tensor imaging (DTI) is a non-invasive technique that can be used to assess the integrity of the white matter in the brain. AIMS: To investigate the usefulness of DTI in patients with temporal lobe epilepsy (TLE) and to observe its relationship with lateralisation of the epileptogenic focus in these patients. PATIENTS AND METHODS: We analysed 11 patients diagnosed with TLE in accordance with the pre-surgical protocol of our epilepsy unit, and who were seizure-free two years after performing a temporal lobectomy plus amygdalohippocampectomy (Spencer technique)...
December 16, 2016: Revista de Neurologia
https://www.readbyqxmd.com/read/27891419/evaluation-of-hospitalized-intractable-epileptic-children-with-spect-scan-in-ahvaz-south-west-of-iran
#7
Ali Akbar Momen, Faramarz Ahmadi, Arash Malekian, Hannaneh Davoodzadeh, Hossein Kabirinia
INTRODUCTION: Seizures are the most frequent neurologic disorder seen in childhood. Epilepsy is a group of disorders that includes an abnormally increased susceptibility to seizures. AIM: To examine the effectiveness of SPECT (Single Photon Emission Computerized Tomography) in detecting seizure foci in 21 Iranian children who had medically refractory epilepsy. MATERIALS AND METHODS: Children between 2 to 15 years of age with uncontrolled seizures were investigated using SPECT scan as a standardized protocol...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27889312/efficacy-safety-and-tolerability-of-lacosamide-monotherapy-versus-controlled-release-carbamazepine-in-patients-with-newly-diagnosed-epilepsy-a-phase-3-randomised-double-blind-non-inferiority-trial
#8
Michel Baulac, Felix Rosenow, Manuel Toledo, Kiyohito Terada, Ting Li, Marc De Backer, Konrad J Werhahn, Melissa Brock
BACKGROUND: Further options for monotherapy are needed to treat newly diagnosed epilepsy in adults. We assessed the efficacy, safety, and tolerability of lacosamide as a first-line monotherapy option for these patients. METHODS: In this phase 3, randomised, double-blind, non-inferiority trial, patients from 185 epilepsy or general neurology centres in Europe, North America, and the Asia Pacific region, aged 16 years or older and with newly diagnosed epilepsy were randomly assigned in a 1:1 ratio, via a computer-generated code, to receive lacosamide monotherapy or controlled-release carbamazepine (carbamazepine-CR) twice daily...
November 23, 2016: Lancet Neurology
https://www.readbyqxmd.com/read/27876397/efficacy-of-sodium-channel-blockers-in-scn2a-early-infantile-epileptic-encephalopathy
#9
Robertino Dilena, Pasquale Striano, Elena Gennaro, Laura Bassi, Sara Olivotto, Laura Tadini, Fabio Mosca, Sergio Barbieri, Federico Zara, Monica Fumagalli
BACKGROUND: Recent clinical evidence supports a targeted therapeutic approach for genetic epileptic encephalopathies based on the molecular dysfunction. PATIENT DESCRIPTION: A 2-day-old male infant presented with epileptic encephalopathy characterized by burst-suppression EEG background and tonic-clonic migrating partial seizures. The condition was refractory to phenobarbital, pyridoxine, pyridoxal phosphate and levetiracetam, but a dramatic response to an intravenous loading dose of phenytoin was documented by video-EEG monitoring...
November 19, 2016: Brain & Development
https://www.readbyqxmd.com/read/27824913/treatment-trials-for-neonatal-seizures-the-effect-of-design-on-sample-size
#10
Nathan J Stevenson, Geraldine B Boylan, Lena Hellström-Westas, Sampsa Vanhatalo
Neonatal seizures are common in the neonatal intensive care unit. Clinicians treat these seizures with several anti-epileptic drugs (AEDs) to reduce seizures in a neonate. Current AEDs exhibit sub-optimal efficacy and several randomized control trials (RCT) of novel AEDs are planned. The aim of this study was to measure the influence of trial design on the required sample size of a RCT. We used seizure time courses from 41 term neonates with hypoxic ischaemic encephalopathy to build seizure treatment trial simulations...
2016: PloS One
https://www.readbyqxmd.com/read/27809868/efficacy-of-naloxone-in-reducing-postictal-central-respiratory-dysfunction-in-patients-with-epilepsy-study-protocol-for-a-double-blind-randomized-placebo-controlled-trial
#11
Sylvain Rheims, Luc Valton, Véronique Michel, Louis Maillard, Vincent Navarro, Philippe Convers, Fabrice Bartolomei, Arnaud Biraben, Arielle Crespel, Philippe Derambure, Bertrand de Toffol, Edouard Hirsch, Philippe Kahane, Martine Lemesle Martin, Didier Tourniaire, Sébastien Boulogne, Catherine Mercier, Pascal Roy, Philippe Ryvlin
BACKGROUND: Generalized tonic-clonic seizures (GTCSs) are the main risk factor for sudden unexpected death in epilepsy (SUDEP). Experimental and clinical data strongly suggest that the majority of SUDEP results from a postictal respiratory dysfunction progressing to terminal apnea. Postictal apnea could partly derive from a seizure-induced massive release of endogenous opioids. The main objective of this study is to evaluate the efficacy of an opioid antagonist, naloxone, administered in the immediate aftermath of a GTCS, in reducing the severity of the postictal central respiratory dysfunction...
November 3, 2016: Trials
https://www.readbyqxmd.com/read/27803505/outcomes-after-implementation-of-an-alcohol-withdrawal-protocol-at-a-single-institution
#12
Mary E Eberly, Anna G Lockwood, Sean Lockwood, Kelly W Davis
Background: There are varying dosing strategies for the administration of benzodiazepines in the setting of alcohol withdrawal. In October 2014, a symptom-based alcohol withdrawal protocol (AWP) using the Clinical Institute Withdrawal Assessment of Alcohol, Revised (CIWA-Ar) scale was implemented at one institution. Objective: To evaluate the safety and efficacy of the AWP. Methods: Retrospective chart review was completed, including patients receiving at least one dose of diazepam for alcohol withdrawal pre- and post-protocol...
October 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27798055/exercise-induced-syncope-in-a-22-year-old-man
#13
Colin Yeo, Vern Hsen Tan, Kelvin Ck Wong
A 22-year-old man was referred to us for syncope during a game of Captain's ball. There was no prodrome. His friends did not notice any ictal movements. He was otherwise well prior to passing out. He was not taking any medications or supplements. He was not usually physically active, but was otherwise well with no significant medical history. This is his first episode of syncope. There was no history of cardiac arrest or seizures. There is no family history of premature sudden cardiac death.Physical examination was normal...
October 25, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27774585/the-importance-of-people-compliance-social-desirability-bias-in-the-assessment-of-epilepsy-prevalence-in-rural-areas-of-developing-countries-results-of-the-atahualpa-project
#14
Oscar H Del Brutto, Robertino M Mera
Epilepsy is a major health issue in rural areas of developing countries. However, heterogeneity of epilepsy prevalence in different studies precludes assessment of the magnitude of the problem. Using similar protocols, two population-based surveys were conducted 12 years apart (2003 and 2015) in a rural Ecuadorian village (Atahualpa). The only difference was a higher people compliance with interviewers during the second survey. Epilepsy prevalence in the 2003 survey was 13.5 per 1,000 (18/1,332) in villagers aged ≥20 years...
October 24, 2016: Epilepsia
https://www.readbyqxmd.com/read/27771234/comparison-of-conscious-sedation-and-asleep-awake-asleep-techniques-for-awake-craniotomy
#15
Ozlem Korkmaz Dilmen, Eren Fatma Akcil, Abdulvahap Oguz, Hayriye Vehid, Yusuf Tunali
Since awake craniotomy (AC) has become a standard of care for supratentorial tumour resection, especially in the motor and language cortex, determining the most appropriate anaesthetic protocol is very important. The aim of this retrospective study is to compare the effectiveness of conscious sedation (CS) to "awake-asleep-awake" (AAA) techniques for supratentorial tumour resection. Forty-two patients undergoing CS and 22 patients undergoing AAA were included in the study. The primary endpoint was to compare the CS and AAA techniques with respect to intraoperative pain and agitation in patients undergoing supratentorial tumour resection...
October 19, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27740984/imaging-for-adults-with-seizures-and-epilepsy
#16
Samuel Lapalme-Remis, Gregory D Cascino
PURPOSE OF REVIEW: This article discusses structural and functional neuroimaging findings in patients with seizures and epilepsy. The indications for neuroimaging in these patients and the potential diagnostic utility of these studies are presented. RECENT FINDINGS: Patients presenting with new seizures typically require urgent imaging to rule out a critical underlying cause. MRI is the structural neuroimaging procedure of choice in individuals with epilepsy. Specific epilepsy protocols should be considered to increase the diagnostic yield of neuroimaging in patients with structural lesions associated with focal or generalized seizures...
October 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27737654/effectiveness-and-cost-effectiveness-of-routine-third-trimester-ultrasound-screening-for-intrauterine-growth-restriction-study-protocol-of-a-nationwide-stepped-wedge-cluster-randomized-trial-in-the-netherlands-the-iris-study
#17
Jens Henrichs, Viki Verfaille, Laura Viester, Myrte Westerneng, Bert Molewijk, Arie Franx, Henriette van der Horst, Judith E Bosmans, Ank de Jonge, Petra Jellema
BACKGROUND: Intrauterine growth retardation (IUGR) is a major risk factor for perinatal mortality and morbidity. Thus, there is a compelling need to introduce sensitive measures to detect IUGR fetuses. Routine third trimester ultrasonography is increasingly used to detect IUGR. However, we lack evidence for its clinical effectiveness and cost-effectiveness and information on ethical considerations of additional third trimester ultrasonography. This nationwide stepped wedge cluster-randomized trial examines the (cost-)effectiveness of routine third trimester ultrasonography in reducing severe adverse perinatal outcome through subsequent protocolized management...
October 13, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27736225/use-of-propofol-for-induction-and-maintenance-of-anesthesia-in-a-king-penguin-aptenodytes-patagonicus-undergoing-magnetic-resonance-imaging
#18
Sarah E Bigby, Jennifer E Carter, Sébastien Bauquier, Thierry Beths
Anesthesia protocols for patients with intracranial lesions need to provide hemodynamic stability, preserve cerebrovascular autoregulation, avoid increases in intracranial pressure, and facilitate a rapid recovery. Propofol total intravenous anesthesia (TIVA) maintains cerebral blood flow autoregulation and is considered superior to inhalant agents as an anesthetic protocol for patients with intracranial lesions. A propofol-based TIVA subsequent to premedication with medetomidine and diazepam was used in a king penguin ( Aptenodytes patagonicus ) undergoing magnetic resonance imaging of the brain after a new onset of seizures...
September 2016: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/27730770/desensitization-to-oxcarbazepine-long-term-efficacy-and-tolerability
#19
Jiwon Lee, Eu Gene Park, Munhyang Lee, Jeehun Lee
BACKGROUND AND PURPOSE: Antiepileptic drug (AED)-associated cutaneous adverse drug reactions can lead to the discontinuation of medications. The aim of this study was to determine the long-term efficacy and safety of performing desensitization to oxcarbazepine. METHODS: This study involved 20 patients who exhibited cutaneous adverse drug reactions associated with oxcarbazepine use between July 2009 and March 2016 at Samsung Medical Center. All of the participants had to discontinue oxcarbazepine despite presenting initially positive responses...
October 7, 2016: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/27723498/alcohol-withdrawal-in-epileptic-rats-effects-on-postictal-depression-respiration-and-death
#20
Srinivasa P Kommajosyula, Marcus E Randall, Srinivasan Tupal, Carl L Faingold
Patients with epilepsy are at risk of sudden unexpected death in epilepsy (SUDEP). The most common series of events in witnessed cases of SUDEP is a generalized convulsive seizure followed by terminal apnea. Risk factors for SUDEP include prolonged postictal depression (PID), as well as alcohol abuse. The present study examined these issues in a genetic epilepsy model that exhibits generalized convulsive audiogenic seizures (AGSz) but rarely exhibits seizure-induced death, the genetically epilepsy-prone rats (GEPR-9s)...
October 7, 2016: Epilepsy & Behavior: E&B
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