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Pharmacoresistant epilepsy

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https://www.readbyqxmd.com/read/28632525/clozapine-safety-and-efficacy-for-interictal-psychotic-disorder-in-pharmacoresistant-epilepsy
#1
Vincent Jetté Pomerleau, François Dubeau, Simon Ducharme
Since the middle of the 19th century, both neurologists and psychiatrists have linked psychosis and epilepsy. Clozapine, the most effective antipsychotic drug, alters electroencephalographic activity and carries a significant risk of causing seizures. Unfortunately, this risk limits the drug's potential use in treating pharmacoresistant psychosis in patients with epilepsy. We present a unique case in which we used clozapine successfully as a last resort treatment for chronic interictal psychosis in a 43-year-old woman with severe pharmacoresistant epilepsy and recurrent status epilepticus...
June 2017: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
https://www.readbyqxmd.com/read/28624720/retention-of-perampanel-in-adults-with-pharmacoresistant-epilepsy-at-a-single-tertiary-care-center
#2
Tim Wehner, Shahidul Mannan, Sanchit Turaga, Kirtana Vallabhaneni, Hao Meng Yip, Carys Wiggans, Rohit Shankar, John S Duncan, Josemir W Sander
RATIONALE: Observational data on antiepileptic drugs (AEDs) inform about their use in clinical practice. We describe our clinical experience with perampanel (PER) in a large UK tertiary epilepsy center. METHODS: Adults initiated on PER between October 2012 and March 2015 were followed until they discontinued PER or 10 September 2016. Data on epilepsy syndrome, duration, seizure types, concomitant and previous AED use, PER dosing, efficacy and side effects were recorded...
June 15, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28602600/influence-of-the-dual-combination-of-silymarin-and-epigallocatechin-gallate-natural-dietary-flavonoids-on-the-pharmacokinetics-of-oxcarbazepine-in-rats
#3
Ana Ferreira, Márcio Rodrigues, Alexandre Marques, Amílcar Falcão, Gilberto Alves
Considering the potential of flavonoids in reversing the P-glycoprotein (P-gp)-mediated multidrug resistance, this work aimed to assess the combined effects of silymarin and (-)-epigallocatechin gallate (EPG) on the pharmacokinetics of the P-gp substrates oxcarbazepine (OXC) and licarbazepine (LIC). Rats were pre-treated intraperitoneally with silymarin (25 mg/kg), EPG (25 mg/kg), silymarin/EPG (12.5/12.5 mg/kg; 6.25/18.75 mg/kg; 18.75/6.25 mg/kg) or verapamil (25 mg/kg, reference P-gp inhibitor) before the intraperitoneal administration of OXC (50 mg/kg)...
June 8, 2017: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/28595975/brain-molecular-imaging-in-pharmacoresistant-focal-epilepsy-current-practice-and-perspectives
#4
A Verger, S Lagarde, L Maillard, F Bartolomei, E Guedj
This review aims to synthesize all the available data on brain molecular imaging, such as single-photon emission computed tomography (SPECT) and interictal fluorodeoxyglucose positron emission tomography (FDG-PET), in focal epilepsies. SPECT imaging is able to measure regional cerebral blood flow and its major innovation remains its ictal imaging value. On the other hand, FDG-PET, which has higher spatial resolution and lower background activity than SPECT, enables glycolytic metabolism to be identified in interictal states...
June 5, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28590300/18f-fdopa-pet-imaging-in-prolactinoma
#5
Merwan Ginet, Thomas Cuny, Emmanuelle Schmitt, Pierre-Yves Marie, Antoine Verger
Pituitary macroadenoma constitutes a frequently misdiagnosed benign tumor. We report herein a case where such macroadenoma, a prolactinoma, was incidentally discovered in a 63-year-old man who had been referred to F-FDG PET and F-FDOPA PET imaging for a pharmacoresistant epilepsy. An increased uptake was documented for both radiotracers within the sellar region, although with a much higher contrast for F-FDOPA than for F-FDG. This case presents an increased uptake documented within a prolactinoma owing to the high contrast and image quality provided by F-FDOPA PET...
June 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28585349/csnk2b-splice-site-mutations-in-patients-cause-intellectual-disability-with-or-without-myoclonic-epilepsy
#6
Karine Poirier, Laurence Hubert, Géraldine Viot, Marlène Rio, Pierre Billuart, Claude Besmond, Thierry Bienvenu
De novo mutations are a frequent cause of disorders related to brain development. We report the results from the screening of two patients diagnosed with intellectual disability (ID) using exome sequencing to identify new causative de novo mutations. Exome sequencing was conducted in two patient-parent trios to identify de novovariants. In silico and expression studies were also performed to evaluate the functional consequences of these variants.The two patients presented developmental delay with minor facial dysmorphy...
June 6, 2017: Human Mutation
https://www.readbyqxmd.com/read/28582572/surgical-treatment-of-mesiotemporal-lobe-epilepsy-which-approach-is-favorable
#7
Barbara Schmeiser, Kathrin Wagner, Andreas Schulze-Bonhage, Irina Mader, Anne-Sophie Wendling, Bernhard Jochen Steinhoff, Marco Prinz, Christian Scheiwe, Astrid Weyerbrock, Josef Zentner
BACKGROUND: Mesiotemporal lobe epilepsy is one of the most frequent causes for pharmacoresistant epilepsy. Different surgical approaches to the mesiotemporal area are used. OBJECTIVE: To analyze epileptological and neuropsychological results as well as complications of different surgical strategies. METHODS: This retrospective study is based on a consecutive series of 458 patients all harboring pharmacoresistant mesiotemporal lobe epilepsy...
June 2, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28567171/a-functional-mri-based-model-for-individual-memory-assessment-in-patients-eligible-for-anterior-temporal-lobe-resection
#8
Maria Strandberg, Peter Mannfolk, Lars Stenberg, Hanna Ljung, Ia Rorsman, Elna-Marie Larsson, Danielle van Westen, Kristina Källén
TITLE: A functional (f) MRI-based model for individual memory assessment in patients eligible for temporal lobe resection. AIM: To investigate if pre-operative fMRI memory paradigms, add predictive information with regard to post-surgical memory deficits. METHODS: Fourteen pharmacoresistant Temporal Lobe Epilepsy (TLE) patients accepted for Anterior Temporal Lobe Resection (ATLR) were included. A clinical risk assessment score (RAS 0-3) was constructed from structural MRI, neuropsychological testing and hemisphere dominance...
2017: Open Neuroimaging Journal
https://www.readbyqxmd.com/read/28555776/concurrent-mood-and-anxiety-disorders-are-associated-with-pharmacoresistant-seizures-in-patients-with-mtle
#9
Mateus H Nogueira, Clarissa L Yasuda, Ana C Coan, Andres M Kanner, Fernando Cendes
OBJECTIVE: To investigate whether mood disorders (MD) and anxiety disorders (AD) are associated with seizure control in patients with mesial temporal lobe epilepsy (MTLE). We compared patients without any current psychiatric disorder, patients with current MD and/or AD, patients with subsyndromic depression episodes (SSDE) and anxiety episodes (SSAE), and patients with family psychiatric history. METHODS: In a cross-sectional study, we included 144 consecutive patients with MTLE (82 pharmacoresistant and 62 treatment-responsive patients)...
May 26, 2017: Epilepsia
https://www.readbyqxmd.com/read/28527108/increased-expression-of-brain-derived-neurotrophic-factor-transcripts-i-and-vi-camp-response-element-binding-and-glucocorticoid-receptor-in-the-cortex-of-patients-with-temporal-lobe-epilepsy
#10
G A Martínez-Levy, L Rocha, F Rodríguez-Pineda, M A Alonso-Vanegas, A Nani, R M Buentello-García, M Briones-Velasco, D San-Juan, J Cienfuegos, C S Cruz-Fuentes
A body of evidence supports a relevant role of brain-derived neurotrophic factor (BDNF) in temporal lobe epilepsy (TLE). Magnetic resonance data reveal that the cerebral atrophy extends to regions that are functionally and anatomically connected with the hippocampus, especially the temporal cortex. We previously reported an increased expression of BDNF messenger for the exon VI in the hippocampus of temporal lobe epilepsy patients compared to an autopsy control group. Altered levels of this particular transcript were also associated with pre-surgical use of certain psychotropic...
May 19, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28502217/hippocampal-low-frequency-stimulation-inhibits-afterdischarge-and-increases-gaba-a-receptor-expression-in-amygdala-kindled-pharmacoresistant-epileptic-rats
#11
Guofeng Wu, Likun Wang, Zhen Hong, Siying Ren, Feng Zhou
OBJECTIVE: The purpose of the present study was to observe the effects of hippocampal low-frequency stimulation (Hip-LFS) on amygdala afterdischarge and GABA (A) receptor expression in pharmacoresistant epileptic (PRE) rats. METHODS: A total of 110 healthy adult male Wistar rats were used to generate a model of epilepsy by chronic stimulation of the amygdala. Sixteen PRE rats were selected from 70 amygdala-kindled rats by testing their response to Phenytoin and Phenobarbital, and they were randomly assigned to a pharmacoresistant stimulation group (PRS group, 8 rats) or a pharmacoresistant control group (PRC group, 8 rats)...
May 14, 2017: Neurological Research
https://www.readbyqxmd.com/read/28495218/effects-of-hippocampal-low-frequency-stimulation-in-idiopathic-non-human-primate-epilepsy-assessed-via-a-remote-sensing-enabled-neurostimulator
#12
Thomas A Wozny, Witold J Lipski, Ahmad Alhourani, Efstathios D Kondylis, Arun Antony, R Mark Richardson
Individuals with pharmacoresistant epilepsy remain a large and under-treated patient population. Continued technologic advancements in implantable neurostimulators have spurred considerable research efforts directed towards the development of novel antiepileptic stimulation therapies. However, the lack of adequate preclinical experimental platforms has precluded a detailed understanding of the differential effects of stimulation parameters on neuronal activity within seizure networks. In order to chronically monitor seizures and the effects of stimulation in a freely-behaving non-human primate with idiopathic epilepsy, we employed a novel simultaneous video-intracranial EEG recording platform using a state-of-the-art sensing-enabled, rechargeable clinical neurostimulator with real-time seizure detection and wireless data streaming capabilities...
August 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28468530/the-epigenetics-of-epilepsy-and-its-progression
#13
Rebecca M Hauser, David C Henshall, Farah D Lubin
Epilepsy is a common and devastating neurological disorder characterized by recurrent and unprovoked spontaneous seizures. One leading hypothesis for the development and progression of epilepsy is that large-scale changes in gene transcription and protein expression contribute to aberrant network restructuring and hyperexcitability, resulting in the genesis of repeated seizures. Current research shows that epigenetic mechanisms, including posttranslational alterations to the proteins around which DNA is coiled, chemical modifications to DNA, and the activity of various noncoding RNA molecules exert important influences on these gene networks in experimental epilepsy...
May 1, 2017: Neuroscientist: a Review Journal Bringing Neurobiology, Neurology and Psychiatry
https://www.readbyqxmd.com/read/28449218/development-and-pharmacologic-characterization-of-the-rat-6-hz-model-of-partial-seizures
#14
Cameron S Metcalf, Peter J West, Kyle E Thomson, Sharon F Edwards, Misty D Smith, H Steve White, Karen S Wilcox
OBJECTIVE: The mouse 6 Hz model of psychomotor seizures is a well-established and commonly used preclinical model for antiseizure drug (ASD) discovery. Despite its widespread use both in the identification and differentiation of novel ASDs in mice, a corresponding assay in rats has not been developed. We established a method for 6 Hz seizure induction in rats, with seizure behaviors similar to those observed in mice including head nod, jaw clonus, and forelimb clonus. METHODS: A convulsive current that elicits these seizure behaviors in 97% of rats (CC97 ) was determined using a Probit analysis...
June 2017: Epilepsia
https://www.readbyqxmd.com/read/28441636/psychological-features-and-quality-of-life-in-50-adult-patients-with-epilepsy-and-their-caregivers-from-the-lecco-epilepsy-center-italy
#15
Alessandra Petruzzi, Andrea Rigamonti, Claudia Yvonne Finocchiaro, Paolo Borelli, Elena Lamperti, Antonio Silvani, Rossana Regazzoni, Lorenzo Stanzani, Andrea Salmaggi
Epilepsy is one of the most common neurological disorders. To the best of our knowledge, in Italy, the relationship between patients' and caregivers' psychological state has rarely been analyzed. Thus, we sought to evaluate both the psychological state of patients with epilepsy and that of their caregivers and the interrelationship between them. We also assessed the existing relation between psychological features and some clinical and demographic information, such as number of antiepileptic drugs (AEDs), epilepsy duration and education level of patients and their caregivers...
June 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28427025/psychiatric-symptoms-after-temporal-epilepsy-surgery-a-one-year-follow-up-study
#16
Carmen Iranzo-Tatay, Teresa Rubio-Granero, Antonio Gutierrez, Mercedes Garcés, Rebeca Conde, Asier Gómez-Ibáñez, Sergio Arques-Egea, Lucia Sancho-Miñana, David Hervas-Marín, Vicente Villanueva
Psychiatric symptoms must be considered in patients with refractory temporal lobe epilepsy after epilepsy surgery. The main objectives of our study were to describe clinical and socio-demographical characteristics of a cohort of patients with pharmacoresistant temporal lobe epilepsy who underwent temporal lobe epilepsy surgery, and moreover, to evaluate possible risk factors for developing psychiatric symptoms. In order to achieve those goals, we conducted a prospective evaluation of psychopathology throughout the first year after surgery in a clinical sample of 72 patients, by means of three clinical rated measures; the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS), and the Brief Psychiatric Rating Scale (BPRS)...
May 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28414069/complications-associated-with-antibiotic-administration-neurological-adverse-events-and-interference-with-antiepileptic-drugs
#17
REVIEW
Susanna Esposito, Maria Paola Canevini, Nicola Principi
Antibiotic use is associated with toxic effects involving the peripheral and central nervous systems and it may interfere with antiepileptic drugs, causing significant variations in their serum levels and activity. Prompt identification of neurological complications during antibiotic therapy is important in order to make appropriate modifications to medication. Characteristics of the drug and the patient, including age and underlying diseases, may favour these complications. The main aim of this study was to review the neurological adverse events that may follow antibiotic administration, the mechanisms that cause them, and the possibility of prevention and treatment...
April 13, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28409335/multichannel-interictal-spike-activity-detection-using-time-frequency-entropy-measure
#18
Palani Thanaraj, B Parvathavarthini
Localization of interictal spikes is an important clinical step in the pre-surgical assessment of pharmacoresistant epileptic patients. The manual selection of interictal spike periods is cumbersome and involves a considerable amount of analysis workload for the physician. The primary focus of this paper is to automate the detection of interictal spikes for clinical applications in epilepsy localization. The epilepsy localization procedure involves detection of spikes in a multichannel EEG epoch. Therefore, a multichannel Time-Frequency (T-F) entropy measure is proposed to extract features related to the interictal spike activity...
April 13, 2017: Australasian Physical & Engineering Sciences in Medicine
https://www.readbyqxmd.com/read/28384161/microrna-hsa-mir-134-is-a-circulating-biomarker-for-mesial-temporal-lobe-epilepsy
#19
Simoni H Avansini, Beatriz Pereira de Sousa Lima, Rodrigo Secolin, Marilza L Santos, Ana Carolina Coan, André S Vieira, Fábio R Torres, Benilton S Carvalho, Marina K M Alvim, Márcia E Morita, Clarissa L Yasuda, Luciana R Pimentel-Silva, Danyella B Dogini, Fabio Rogerio, Fernando Cendes, Iscia Lopes-Cendes
Epilepsy is misdiagnosed in up to 25% of patients, leading to serious and long-lasting consequences. Recently, circulating microRNAs have emerged as potential biomarkers in a number of clinical scenarios. The purpose of this study was to identify and to validate circulating microRNAs that could be used as biomarkers in the diagnosis of epilepsy. Quantitative real-time PCR was used to measure plasma levels of three candidate microRNAs in two phases of study: an initial discovery phase with 14 patients with mesial temporal lobe epilepsy (MTLE), 13 with focal cortical dysplasia (FCD) and 16 controls; and a validation cohort constituted of an independent cohort of 65 patients with MTLE and 83 controls...
2017: PloS One
https://www.readbyqxmd.com/read/28320117/use-of-social-media-to-assess-the-effectiveness-of-vagal-nerve-stimulation-in-dravet-syndrome-a-caregiver-s-perspective
#20
Rushna Ali, Mona Elsayed, Manpreet Kaur, Ellen Air, Naznin Mahmood, Jules Constantinou, Jason Schwalb
BACKGROUND: Dravet syndrome (DS) is a rare genetic epilepsy syndrome which is particularly pharmacoresistant. Vagus nerve stimulation (VNS) is commonly used in the treatment of DS as an adjunct to medical therapy. A meaningful assessment of post-surgical outcomes with VNS is difficult given the rarity of the condition. OBJECTIVE: In a novel approach, we used social media to contact patients with DS to gather data on post-surgical seizure reduction and overall satisfaction with VNS...
April 15, 2017: Journal of the Neurological Sciences
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