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Pharmacoresistant epilepsy

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https://www.readbyqxmd.com/read/29307009/does-early-postoperative-drug-regimen-impact-seizure-control-in-patients-undergoing-temporal-lobe-resections
#1
Barbara Schmeiser, Bernhard J Steinhoff, Andreas Schulze-Bonhage
OBJECTIVE: To evaluate the impact of postoperative antiepileptic drug (AED) load on seizure control in patients who underwent surgical treatment for pharmacoresistant mesiotemporal lobe epilepsy during the first two postoperative years. PATIENTS AND METHODS: 532 consecutive patients (48.7% males and 51.7% females) who underwent surgical treatment for mesiotemporal lobe epilepsy were retrospectively evaluated regarding effects of AED load on seizures control during the first 2 years following epilepsy surgery...
January 6, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29303961/individualizing-treatment-approaches-for-epileptic-patients-with-glucose-transporter-type1-glut-1-deficiency
#2
REVIEW
Armond Daci, Adnan Bozalija, Fisnik Jashari, Shaip Krasniqi
Monogenic and polygenic mutations are important contributors in patients suffering from epilepsy, including metabolic epilepsies which are inborn errors of metabolism with a good respond to specific dietetic treatments. Heterozygous variation in solute carrier family 2, facilitated glucose transporter member 1 (SLC2A1) and mutations of the GLUT1/SLC2A2 gene results in the failure of glucose transport, which is related with a glucose type-1 transporter (GLUT1) deficiency syndrome (GLUT1DS). GLUT1 deficiency syndrome is a treatable disorder of glucose transport into the brain caused by a variety of mutations in the SLC2A1 gene which are the cause of different neurological disorders also with different types of epilepsy and related clinical phenotypes...
January 5, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29295802/hydrocephalus-in-pyridoxine-dependent-epilepsy-new-case-and-literature-review
#3
Virginia Navarro-Abia, María Soriano-Ramos, Noemí Núñez-Enamorado, Ana Camacho-Salas, Ana Martinez-de Aragón, Elena Martín-Hernández, Rogelio Simón-de Las Heras
INTRODUCTION: Pyridoxine-dependent epilepsy (PDE) is a rare disorder of the lysine metabolism, characterized by a pharmacoresistant epileptic encephalopathy that usually begins in the neonatal period. However, its phenotypic spectrum is wide and not limited to seizures. We report a new case of PDE who developed hydrocephalus, along with an exhaustive review of the literature. CASE REPORT: Our patient presented with seizures at 13 h of life. Antiepileptic drugs, vitamins and cofactors were required to achieve seizure control...
December 30, 2017: Brain & Development
https://www.readbyqxmd.com/read/29288854/lesional-temporal-lobe-epilepsy-beware-the-deceitful-panic-attack
#4
Kay O Kulason, Julia R Schneider, Ralph Rahme, Bidyut Pramanik, Derek Chong, John A Boockvar
BACKGROUND: Ganglioglioma is a rare, benign, intraaxial glioneuronal tumor, but a relatively common cause of pharmacoresistant temporal lobe epilepsy (TLE). Given its often nonspecific neuropsychiatric manifestations and frequently negative electroencephalographic workup, TLE can be easily misdiagnosed as a psychiatric disorder, particularly panic attacks. CASE DESCRIPTION: We present a case of a 17-year old boy who was found to have lesional TLE secondary to a left temporal ganglioglioma, 5 years after having been misdiagnosed with panic disorder and undergone ineffective and unnecessary psychotherapy...
December 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29273691/neuropsychological-outcome-after-subtemporal-versus-transsylvian-approach-for-selective-amygdalohippocampectomy-in-patients-with-mesial-temporal-lobe-epilepsy-a-randomised-prospective-clinical-trial
#5
Viola Lara Vogt, Daniel Delev, Alexander Grote, Johannes Schramm, Marec von Lehe, Christian Erich Elger, Juri-Alexander Witt, Christoph Helmstaedter
OBJECTIVE: To compare the effects of different surgical approaches for selective amygdalohippocampectomy in patients with pharmacoresistant mesial temporal lobe epilepsy with regard to the neuropsychological outcome and to replicate an earlier study employing a matched-pair design. METHOD: 47 patients were randomised to subtemporal versus transsylvian approaches. Memory, language, attentional and executive functions were assessed before and 1 year after surgery...
December 22, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29238960/is-inpatient-ictal-video-electroencephalographic-monitoring-mandatory-in-mesial-temporal-lobe-epilepsy-with-unilateral-hippocampal-sclerosis-a-prospective-study
#6
Marina K M Alvim, Marcia E Morita, Clarissa L Yasuda, Benito P Damasceno, Tátila M Lopes, Ana Carolina Coan, Enrico Ghizoni, Helder Tedeschi, Fernando Cendes
OBJECTIVE: To compare surgical outcome in mesial temporal lobe epilepsy (MTLE) patients with unilateral hippocampal sclerosis (MTLE-HS) who had or did not have preoperative video-electroencephalographic monitoring (VEEG). METHODS: A prospective study was undertaken with 166 consecutive pharmacoresistant unilateral MTLE-HS patients. All patients were investigated with detailed seizure semiology, serial routine outpatient EEG, magnetic resonance imaging, neuropsychological evaluation, and if necessary, other examinations...
December 13, 2017: Epilepsia
https://www.readbyqxmd.com/read/29213041/-perampanel-in-the-treatment-of-patients-with-epilepsy
#7
F K Rider
Development of new antiepileptic drugs (AED) does not stop due to the fact that the number of patients with pharmacoresistant epilepsy remains at about 30%. One of the newest AEDs is perampanel (PER), a selective, non-competitive AMPA receptor antagonist to target post-synaptic glutamate transmission. PER is approved in the Russian Federation as adjunctive treatment for focal seizures with or without secondarily generalized seizures and for primary generalized tonic-clonic (PGTC) seizures in idiopathic generalized epilepsy (IGE) in patients with epilepsy aged ≥12 years...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29213033/-epigenetic-modifications-of-chromatin-in-epilepsy-a-potential-mechanism-of-pharmacoresistance
#8
L S Sokhranyaeva, V A Aniol, N V Gulyaeva
Pharmacoresistance in epilepsy is an important problem from both clinical and fundamental perspectives. The existent hypotheses of pharmacoresistance are based on long term plastic rebuilding of the epileptic brain. One of potential mechanisms mediating such protracted changes are alterations of gene expression induced by epigenetic modifications of chromatin in brain cells of epileptic patients. Recently, changes in DNA methylation and histone post-translational modifications were reported in brain tissues of patients with pharmacoresistant epilepsy...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29211683/understanding-the-controversial-drug-targets-in-epilepsy-and-pharmacoresistant-epilepsy
#9
Sree Lalitha, Ranjana W Minz, Bikash Medhi
Accumulating experimental data suggests a number of successful drug targets against epilepsy which eventually failed in the clinical setup. Mammalian target of rapamycin inhibitors, multi-drug resistance transporter inhibitors, cyclo-oxygenase-2 inhibitors, statins, etc. are the most promising and well studied among them. Drugs aiming at these targets produced beneficial response in most of the in vitro and in vivo seizure models. However, in certain situations, they have produced differential rather controversial results...
December 6, 2017: Reviews in the Neurosciences
https://www.readbyqxmd.com/read/29205292/brain-regions-and-epileptogenicity-influence-epileptic-interictal-spike-production-and-propagation-during-nrem-sleep-in-comparison-with-wakefulness
#10
Isabelle Lambert, Nicolas Roehri, Bernard Giusiano, Romain Carron, Fabrice Wendling, Christian Benar, Fabrice Bartolomei
OBJECTIVE: Non-rapid eye movement (NREM) sleep is known to be a brain state associated with an activation of interictal epileptic activity. The goal of this work was to quantify topographic changes occurring during NREM sleep in comparison with wakefulness. METHOD: We studied intracerebral recordings of 20 patients who underwent stereo-electroencephalography (SEEG) during presurgical evaluation for pharmacoresistant focal epilepsy. We measured the number of interictal spikes (IS) and quantified the co-occurrence of IS between brain regions during 1 hour of NREM sleep and 1 hour of wakefulness...
December 3, 2017: Epilepsia
https://www.readbyqxmd.com/read/29196579/clinical-and-molecular-characterization-of-kcnt1-related-severe-early-onset-epilepsy
#11
Amy McTague, Umesh Nair, Sony Malhotra, Esther Meyer, Natalie Trump, Elena V Gazina, Apostolos Papandreou, Adeline Ngoh, Sally Ackermann, Gautam Ambegaonkar, Richard Appleton, Archana Desurkar, Christin Eltze, Rachel Kneen, Ajith V Kumar, Karine Lascelles, Tara Montgomery, Venkateswaran Ramesh, Rajib Samanta, Richard H Scott, Jeen Tan, William Whitehouse, Annapurna Poduri, Ingrid E Scheffer, W K Kling Chong, J Helen Cross, Maya Topf, Steven Petrou, Manju A Kurian
OBJECTIVE: To characterize the phenotypic spectrum, molecular genetic findings, and functional consequences of pathogenic variants in early-onset KCNT1 epilepsy. METHODS: We identified a cohort of 31 patients with epilepsy of infancy with migrating focal seizures (EIMFS) and screened for variants in KCNT1 using direct Sanger sequencing, a multiple-gene next-generation sequencing panel, and whole-exome sequencing. Additional patients with non-EIMFS early-onset epilepsy in whom we identified KCNT1 variants on local diagnostic multiple gene panel testing were also included...
January 2, 2018: Neurology
https://www.readbyqxmd.com/read/29179608/surgical-management-of-meningoencephalocele-in-temporal-bone-associated-with-pharmacoresistant-epilepsy-report-of-two-cases
#12
Aleksa T Pejović, Aleksandar J Ristić, Vladimir Baščarević, Leposava Brajković, Ivana Berisavac, Nikola Vojvodić, Aleksandra Parojčić, Dragoslav Sokić
We report good outcome after surgical treatment of two patients with meningoencephalocele associated with pharmacoresistant temporal lobe epilepsy. Surgical management of meningoencephaloceles may result in seizure freedom, although optimal surgical strategy is still controversial.
November 28, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29178354/hyperexcitability-of-the-network-contributes-to-synchronization-processes-in-the-human-epileptic-neocortex
#13
Kinga Tóth, Katharina T Hofer, Ágnes Kandrács, László Entz, Attila Bagó, Loránd Erőss, Zsófia Jordán, Gábor Nagy, András Sólyom, Dániel Fabó, István Ulbert, Lucia Wittner
Interictal activity is a hallmark in epilepsy diagnostics and is linked to neuronal hypersynchrony. Little is known about perturbations in human epileptic neocortical microcircuits, and their role in generating pathological synchronies. To explore hyperexcitability of the human epileptic network, and its contribution to convulsive activity, we investigated an in vitro model of synchronous burst activity spontaneously occurring in postoperative tissue slices derived from patients with or without preoperative clinical and electrographic manifestations of epileptic activity...
November 27, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29152735/6%C3%A2-hz-corneal-kindling-in-mice-triggers-neurobehavioral-comorbidities-accompanied-by-relevant-changes-in-c-fos-immunoreactivity-throughout-the-brain
#14
Giulia Albertini, Laura Walrave, Thomas Demuyser, Ann Massie, Dimitri De Bundel, Ilse Smolders
OBJECTIVE: Besides seizures, patients with epilepsy are affected by a variety of cognitive and psychiatric comorbidities that further impair their quality of life. The present study provides an in-depth characterization of the behavioral alterations induced by 6 Hz corneal kindling. Furthermore, we correlate these behavioral changes to alterations in c-Fos protein expression throughout the brain following kindling. METHODS: Adolescent male Naval Medical Research Institute (NMRI) mice were kindled via repetitive subconvulsive 6 Hz corneal stimulations until they reached the fully kindled state (defined as 10 consecutive generalized seizures)...
November 20, 2017: Epilepsia
https://www.readbyqxmd.com/read/29140112/a-2017-review-of-pharmacotherapy-for-treating-focal-epilepsy-where-are-we-now-and-how-will-treatment-develop
#15
Andreas Schulze-Bonhage
Focal epilepsy is the most common type of epilepsy with approximately 30 million patients affected worldwide. There is a major challenge to develop new antiepileptic treatments as currently approximately one third of patients remain uncontrolled under our best standards of care. Areas covered: An overview is given on first- and second generation antiepileptic drugs and their mechanisms of action, and on recent new strategies for antiepileptic targets, including drugs aiming at disease modification. Expert opinion: Newer antiepileptic drugs have enabled a better tolerated and individualized treatment for many patients...
November 15, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29130506/animal-models-of-acquired-epilepsy-insights-into-mechanisms-of-human-epileptogenesis
#16
Albert J Becker
In many patients who suffer from epilepsies, recurrent epileptic seizures do not start at birth but develop later in life. This holds particularly true for epilepsies with a focal seizure origin including focal cortical dysplasias (FCDs) and temporal lobe epilepsy (TLE). TLE most frequently has its seizure onset in the hippocampal formation. Hippocampal biopsies of pharmacoresistant TLE patients undergoing epilepsy surgery for seizure control most frequently reveal the damage pattern of hippocampal sclerosis, i...
November 12, 2017: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/29122665/in-vitro-screening-of-dual-flavonoid-combinations-for-reversing-p-glycoprotein-mediated-multidrug-resistance-focus-on-antiepileptic-drugs
#17
Ana Ferreira, Adriana O Santos, Amílcar Falcão, Gilberto Alves
The combined use of different P-glycoprotein (P-gp) inhibitors may be a relevant approach to the synergistic and safer inhibition of the P-gp-mediated drug efflux. Herein, we aimed to explore dual combinations of the flavonoids baicalein, (-)-epigallocatechin gallate, kaempferol, quercetin and silymarin to reverse the interference of P-gp on the intracellular accumulation of antiepileptic drugs (AEDs). The intracellular accumulation of rhodamine 123 (a classic P-gp substrate) and of several commonly used AEDs (carbamazepine, phenytoin, oxcarbazepine) or their metabolites (carbamazepine-10,11-epoxide and licarbazepine) was evaluated in MDCK-MDR1 cells in the presence and absence of individual flavonoids and their combinations...
November 6, 2017: Food and Chemical Toxicology
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)...
December 2017: Epilepsia
https://www.readbyqxmd.com/read/29097316/quantitative-surface-analysis-of-combined-mri-and-pet-enhances-detection-of-focal-cortical-dysplasias
#19
Yee-Leng Tan, Hosung Kim, Seunghyun Lee, Tarik Tihan, Lawrence Ver Hoef, Susanne G Mueller, Anthony James Barkovich, Duan Xu, Robert Knowlton
OBJECTIVE: Focal cortical dysplasias (FCDs) often cause pharmacoresistant epilepsy, and surgical resection can lead to seizure-freedom. Magnetic resonance imaging (MRI) and positron emission tomography (PET) play complementary roles in FCD identification/localization; nevertheless, many FCDs are small or subtle, and difficult to find on routine radiological inspection. We aimed to automatically detect subtle or visually-unidentifiable FCDs by building a classifier based on an optimized cortical surface sampling of combined MRI and PET features...
October 31, 2017: NeuroImage
https://www.readbyqxmd.com/read/29064093/focal-cortical-malformations-in-children-with-early-infantile-epilepsy-and-pcdh19-mutations-case-report
#20
Mary Kurian, Christian M Korff, Emmanuelle Ranza, Andrea Bernasconi, Anja Lübbig, Srishti Nangia, Gian Paolo Ramelli, Gabriele Wohlrab, Douglas R Nordli, Thomas Bast
In this case report we assess the occurrence of cortical malformations in children with early infantile epilepsy associated with variants of the gene protocadherin 19 (PCDH19). We describe the clinical course, and electrographic, imaging, genetic, and neuropathological features in a cohort of female children with pharmacoresistant epilepsy. All five children (mean age 10y) had an early onset of epilepsy during infancy and a predominance of fever sensitive seizures occurring in clusters. Cognitive impairment was noted in four out of five patients...
October 24, 2017: Developmental Medicine and Child Neurology
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