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Focal Seizure

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https://www.readbyqxmd.com/read/29786852/evolution-of-lobar-abnormalities-of-cerebral-glucose-metabolism-in-41-children-with-drug-resistant-epilepsy
#1
Tuhina Govil-Dalela, Ajay Kumar, Michael E Behen, Harry T Chugani, Csaba Juhász
OBJECTIVE: We analyzed long-term changes of lobar glucose metabolic abnormalities in relation to clinical seizure variables and development in a large group of children with medically refractory epilepsy. METHODS: Forty-one children (25 males) with drug-resistant epilepsy had a baseline positron emission tomography (PET) scan at a median age of 4.7 years; the scans were repeated after a median of 4.3 years. Children with progressive neurological disorders or space-occupying lesion-related epilepsy and those who had undergone epilepsy surgery were excluded...
May 22, 2018: Epilepsia
https://www.readbyqxmd.com/read/29786811/-50-percent-of-patients-who-had-epilepsy-surgery-are-seizure-free
#2
Anna Edelvik, Ingrid B Olsson, Tove Hallbook, Kristina Malmgren
About one third of patients with epilepsy do not become seizure-free despite medication. For some, resective epilepsy surgery is the treatment of choice. There are three randomized controlled trials, with positive results at a follow-up of 1-2 years: two on temporal lobe resections on adults and young people and one on all types of epilepsy surgery on children. Since 1990 all epilepsy surgery procedures in Sweden are reported to the Swedish Epilepsy Surgery Register, now with data on almost 1500 patients. Two years after surgery about 50% of adults and children are seizure-free, and another 10% have been so during the last year...
May 22, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29786805/-classification-of-seizures-and-epilepsies
#3
Johan Zelano, Tommy Stödberg, Torbjörn Tomson
In 2017 the International League Against Epilepsy (ILAE) published position papers outlining new classifications of seizures and epilepsies. The aims of the new documents are to encompass advances in the field, provide a conceptual framework for future developments, and facilitate communication. In practice, the terminology is somewhat revised. For seizures the terms "partial" and "simple/complex" are replaced by "focal" and "aware/impaired awareness". The classification of a patient's epilepsy is based on seizures types (e...
May 21, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29785508/lacosamide-a-review-in-focal-onset-seizures-in-patients-with-epilepsy
#4
Sheridan M Hoy
Lacosamide (Vimpat® ) is a functionalized amino acid (available orally and intravenously) approved in the EU and the USA for use as monotherapy and adjunctive therapy for the treatment of focal-onset seizures in adults, adolescents and children aged ≥ 4 years with epilepsy. In adults and adolescents (aged ≥ 16 years), oral lacosamide as adjunctive therapy to other antiepileptic drugs was generally effective in reducing seizure frequency during short-term (up to 18 weeks) treatment, with efficacy sustained over the longer-term (up to 8 years)...
May 21, 2018: CNS Drugs
https://www.readbyqxmd.com/read/29782369/neuroimaging-in-epilepsy
#5
Meneka Kaur Sidhu, John S Duncan, Josemir W Sander
PURPOSE OF REVIEW: Epilepsy neuroimaging is important for detecting the seizure onset zone, predicting and preventing deficits from surgery and illuminating mechanisms of epileptogenesis. An aspiration is to integrate imaging and genetic biomarkers to enable personalized epilepsy treatments. RECENT FINDINGS: The ability to detect lesions, particularly focal cortical dysplasia and hippocampal sclerosis, is increased using ultra high-field imaging and postprocessing techniques such as automated volumetry, T2 relaxometry, voxel-based morphometry and surface-based techniques...
May 17, 2018: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29778846/efficacy-and-tolerability-of-treatment-with-lacosamide-postmarketing-experience-from-the-middle-east-region
#6
Maher Arabi, Taoufik Alsaadi, Wassim Nasreddine, Jasem Al-Hashel, Maya Dirani, Ahmad Beydoun
PURPOSE: Lacosamide (LCM) was recently introduced in the Middle East. The aim of this study was to evaluate the safety, tolerability, and efficacy of LCM in patients with focal onset seizures and determine if our results are comparable with those derived from Western countries. METHODS: This is a retrospective analysis from two medical centers on consecutive patients diagnosed as having focal onset seizures and treated with add-on LCM. The primary efficacy variables were the 50% responder and seizure-free rates, and the secondary outcome variables included the percentages of patients who achieved seizure remission during the last 6-month follow-up period and the percentages of discontinuation due to lack of efficacy or tolerability...
May 17, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29778029/late-onset-childhood-neuronal-ceroid-lipofuscinosis-early-clinical-and-electroencephalographic-markers
#7
Lucas Beltrán, Gabriela Reyes Valenzuela, Mariana Loos, Rodrigo Vargas, Rafael Lizama, Pablo Spinsanti, Roberto Caraballo
PURPOSE: The objective of the study was to describe the initial clinical and electroencephalographic findings in children with late-infantile neuronal ceroid lipofuscinosis (LINCL). METHOD: The clinical charts of 35 patients seen between 1990 and 2016 were reviewed. The patients were divided into two groups: Group 1 (G1) consisting of 12 patients with NCL type 2 (CLN2) disease confirmed by enzymatic activity in dried blood spots on filter paper and/or genetic studies, and Group 2 (G2) consisting of 23 patients with a diagnosis of LINCL based on pathology studies by muscle biopsy...
May 15, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29775765/disconnection-surgery-for-intractable-epilepsy-with-a-structural-abnormality-in-the-medial-posterior-cortex
#8
Takeshi Matsuo, Kensuke Kawai, Kenji Ibayashi, Ichiro Shirouzu, Miki Sato
BACKGROUND: The lesionectomy is a general surgical procedure for treating focal epilepsy resulting from a structural abnormality, but some patients can not achieve favorable outcome, especially patients whose symptomatogenic zone is located in remote regions. Herein we propose the surgical disconnection of the seizure propagation pathway, which consists of short and long associating fibers linking the epileptogenic zone to the remote symptomatogenic zone, as an effective method of achieving favorable seizure outcomes in patients with posterior cortex epilepsy...
May 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29771456/serum-serotonin-levels-in-patients-with-epileptic-seizures
#9
Arun Murugesan, M R Sandhya Rani, Johnson Hampson, Bilal Zonjy, Nuria Lacuey, Carl L Faingold, Daniel Friedman, Orrin Devinsky, Rup K Sainju, Stephan Schuele, Beate Diehl, Maromi Nei, Ronald M Harper, Lisa M Bateman, George Richerson, Samden D Lhatoo
Profound cardiovascular and/or respiratory dysfunction is part of the terminal cascade in sudden unexpected death in epilepsy (SUDEP). Central control of ventilation is mediated by brainstem rhythm generators, which are influenced by a variety of inputs, many of which use the modulatory neurotransmitter serotonin to mediate important inputs for breathing. The aim of this study was to investigate epileptic seizure-induced changes in serum serotonin levels and whether there are potential implications for SUDEP...
May 17, 2018: Epilepsia
https://www.readbyqxmd.com/read/29764460/benign-and-severe-early-life-seizures-a-round-in-the-first-year-of-life
#10
REVIEW
Piero Pavone, Giovanni Corsello, Martino Ruggieri, Silvia Marino, Simona Marino, Raffaele Falsaperla
At the onset, differentiation between abnormal non-epileptic movements, and epileptic seizures presenting in early life is difficult as is clinical diagnosis and prognostic evaluation of the various seizure disorders presenting at this age. Seizures starting in the first year of life including the neonatal period might have a favorable course, such as in infants presenting with benign familial neonatal epilepsy, febrile seizures simplex or acute symptomatic seizures. However, in some cases, the onset of seizures at birth or in the first months of life have a dramatic evolution with severe cerebral impairment...
May 15, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29757347/role-of-inhibitory-control-in-modulating-focal-seizure-spread
#11
Jyun-You Liou, Hongtao Ma, Michael Wenzel, Mingrui Zhao, Eliza Baird-Daniel, Elliot H Smith, Andy Daniel, Ronald Emerson, Rafael Yuste, Theodore H Schwartz, Catherine A Schevon
Focal seizure propagation is classically thought to be spatially contiguous. However, distribution of seizures through a large-scale epileptic network has been theorized. Here, we used a multielectrode array, wide field calcium imaging, and two-photon calcium imaging to study focal seizure propagation pathways in an acute rodent neocortical 4-aminopyridine model. Although ictal neuronal bursts did not propagate beyond a 2-3-mm region, they were associated with hemisphere-wide field potential fluctuations and parvalbumin-positive interneuron activity outside the seizure focus...
May 10, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29752196/acute-focal-bacterial-nephritis-characterized-by-acute-encephalopathy-with-biphasic-seizures-and-late-reduced-diffusion
#12
Hiroshi Yamaguchi, Hiroaki Nagase, Yusuke Ito, Natsuki Matsunoshita, Makoto Mizutani, Takeshi Matsushige, Yusuke Ishida, Daisaku Toyoshima, Masashi Kasai, Hiroshi Kurosawa, Azusa Maruyama, Kazumoto Iijima
Acute focal bacterial nephritis (AFBN) is a localized bacterial infection of the kidney presenting as an inflammatory mass, and some patients show deterioration of clinical condition with neurological symptoms. Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a syndrome that is characterized by biphasic seizures and impaired consciousness with reduced diffusion in the subcortical white matter on magnetic resonance imaging, typically observed between days 3 and 9 after clinical onset...
May 8, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29751364/ictal-and-interictal-electric-source-imaging-in-presurgical-evaluation-a-prospective-study
#13
Praveen Sharma, Michael Scherg, Lars H Pinborg, Martin Fabricius, Guido Rubboli, Birthe Pedersen, Anne-Mette Leffers, Peter Uldall, Bo Jespersen, Jannick Brennum, Otto Mølby Henriksen, Sándor Beniczky
BACKGROUND: Accurate localization of the epileptic focus is essential for surgical treatment of patients with drug- resistant epilepsy. EEG source imaging (ESI) is increasingly used in presurgical evaluation. However, most previous studies analysed interictal discharges. Prospective studies comparing feasibility and accuracy of interictal (II) and ictal (IC) ESI are lacking. METHODS: We prospectively analysed long-term video EEG recordings (LTM) of patients admitted for presurgical evaluation...
May 11, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29750358/a-population-based-cost-effectiveness-study-of-early-genetic-testing-in-severe-epilepsies-of-infancy
#14
Katherine B Howell, Stefanie Eggers, Kim Dalziel, Jessica Riseley, Simone Mandelstam, Candace T Myers, Jacinta M McMahon, Amy Schneider, Gemma L Carvill, Heather C Mefford, Ingrid E Scheffer, A Simon Harvey
OBJECTIVE: The severe epilepsies of infancy (SEI) are a devastating group of disorders that pose a major care and economic burden on society; early diagnosis is critical for optimal management. This study sought to determine the incidence and etiologies of SEI, and model the yield and cost-effectiveness of early genetic testing. METHODS: A population-based study was undertaken of the incidence, etiologies, and cost-effectiveness of a whole exome sequencing-based gene panel (targeted WES) in infants with SEI born during 2011-2013, identified through electroencephalography (EEG) and neonatal databases...
May 11, 2018: Epilepsia
https://www.readbyqxmd.com/read/29750339/pre-and-postsurgical-cognitive-trajectories-and-quantitative-mri-changes-in-rasmussen-syndrome
#15
Sarah R Rudebeck, Sara Shavel-Jessop, Sophia Varadkar, Tamsin Owen, J Helen Cross, Faraneh Vargha-Khadem, Torsten Baldeweg
OBJECTIVE: To quantify the longitudinal cognitive trajectory, before and after surgery, of Rasmussen syndrome (RS), a rare disease characterized by focal epilepsy and progressive atrophy of one cerebral hemisphere. METHOD: Thirty-two patients (mean age = 6.7 years; 17 male, 16 left hemispheres affected) were identified from hospital records. The changes in intelligence scores during 2 important phases in the patients' journey to treatment were investigated: (1) during the preoperative period (n = 28, mean follow-up 3...
May 11, 2018: Epilepsia
https://www.readbyqxmd.com/read/29750337/lamotrigine-resistant-corneal-kindled-mice-a-model-of-pharmacoresistant-partial-epilepsy-for-moderate-throughput-drug-discovery
#16
Zachery Koneval, Kevin M Knox, H Steve White, Melissa Barker-Haliski
OBJECTIVE: Despite numerous treatments for epilepsy, over 30% of patients remain resistant to available antiseizure drugs (ASDs). Thus, there is a strong need for more effective ASDs for these individuals. Early ASD discovery has historically relied on acute in vivo seizure models (maximal electroshock, subcutaneous pentylenetetrazol, 6 Hz), which lack the pathophysiology that defines chronic epilepsy. Etiologically relevant rodent models of pharmacoresistant epilepsy exist (eg, phenytoin (PHT)- and lamotrigine (LTG)-resistant amygdala-kindled rat and focal kainic acid mouse), but these models are resource- and labor-intensive and thus unsuitable for frontline ASD discovery...
May 11, 2018: Epilepsia
https://www.readbyqxmd.com/read/29747241/stiripentol-add-on-therapy-for-focal-refractory-epilepsy
#17
REVIEW
Francesco Brigo, Stanley C Igwe, Nicola Luigi Bragazzi
BACKGROUND: This is an updated version of the Cochrane review last published in 2015 (Issue 10). For nearly 30% of people with epilepsy, seizures are not controlled by current treatments. Stiripentol is a new antiepileptic drug (AED) that was developed in France and was approved by the European Medicines Agency (EMA) in 2007 for the treatment of Dravet syndrome as an adjunctive therapy with valproate and clobazam, with promising effects. OBJECTIVES: To evaluate the efficacy and tolerability of stiripentol as add-on treatment for people with focal refractory epilepsy who are taking AEDs...
May 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29741521/an-outbreak-of-japanese-encephalitis-in-a-non-endemic-region-of-north-east-india
#18
H McNaughton, A Singh, S A Khan
Background There are few comprehensive reports of epidemic Japanese encephalitis in a previously unaffected region. We report our experience of a first-ever outbreak of it in Sonitpur District, Assam, India, with 45 laboratorycon confirmed cases at a single hospital. Method Between 2 July and 11 August 2008, patients meeting the WHO definition of acute encephalitis syndrome were assessed in a single hospital and had tests including blood and cerebrospinal fluid for Japanese encephalitis antibody titres. Results Ninety-six cases meeting the definition of acute encephalitis syndrome were identified with 45 cases of Japanese encephalitis confirmed by cerebrospinal fluid or blood results...
March 2018: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/29740868/de-novo-gain-of-function-variants-in-kcnt2-as-a-novel-cause-of-developmental-and-epileptic-encephalopathy
#19
Paolo Ambrosino, Maria Virginia Soldovieri, Thomas Bast, Peter D Turnpenny, Sabine Uhrig, Saskia Biskup, Miriam Döcker, Thilo Fleck, Ilaria Mosca, Laura Manocchio, Nunzio Iraci, Maurizio Taglialatela, Johannes R Lemke
Variants in several potassium channel genes have been found in developmental and epileptic encephalopathies (DEE). We report two females with de novo variants in KCNT2 with West syndrome followed by Lennox-Gastaut syndrome or with DEE with migrating focal seizures. After in vitro analysis suggested quinidine-responsive gain-of-function effects, we treated one of the girls with quinidine add-on therapy and achieved marked clinical improvements. This suggests that the new spectrum of KCNT2-related disorders do not only share similar phenotypic and in vitro functional and pharmacological features with previously known KCNT1-related disorders but also represents a further example for possible precision medicine approaches...
May 8, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29732549/exposure-safety-and-efficacy-response-relationships-and-population-pharmacokinetics-of-eslicarbazepine-acetate
#20
B E Gidal, M P Jacobson, E Ben-Menachem, M Carreño, D Blum, P Soares-da-Silva, A Falcão, F Rocha, J Moreira, T Grinnell, E Ludwig, J Fiedler-Kelly, J Passarell, S Sunkaraneni
OBJECTIVES: Eslicarbazepine acetate (ESL) is a once-daily (QD) oral antiepileptic drug (AED) for focal-onset seizures (FOS). Pharmacokinetic (PK) and pharmacodynamic (PD) models were developed to assess dose selection, identify significant AED drug interactions, and quantitate relationships between exposure and safety and efficacy outcomes from Phase 3 trials of adjunctive ESL. METHODS: Eslicarbazepine (the primary active metabolite of ESL) population PK was evaluated using data from 1351 subjects enrolled in 14 studies (11 Phase 1 and three Phase 3 studies) after multiple oral doses ranging from 400 to 1200 mg...
May 6, 2018: Acta Neurologica Scandinavica
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