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Drug resistant epilepsy

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https://www.readbyqxmd.com/read/27913266/cost-utility-of-video-electroencephalography-monitoring-followed-by-surgery-in-adults-with-drug-resistant-focal-epilepsy-in-thailand
#1
Pimprapa Kitwitee, Kanjana Unnwongse, Teeradej Srikijvilaikul, Tinonkorn Yadee, Chulaporn Limwattananon
OBJECTIVES: This study assessed, whether video-electroencephalography (VEEG) monitoring followed by surgery was cost-effective in adult patients with drug-resistant focal epilepsy under Thai healthcare context, as compared to continued medical treatment without VEEG. METHODS: Total cost (in Thai Baht, THB) and effectiveness (in quality-adjusted life years, QALYs) were estimated over a lifetime horizon, using a decision tree and a Markov model. Data on short-term surgical outcomes, direct health care costs, and utilities, were collected from Thai patients in a specialized hospital...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27913085/anti-n-methyl-d-aspartate-receptor-encephalitis-and-rasmussen-like-syndrome-an-association
#2
Kevin Gurcharran, Shefali Karkare
BACKGROUND: N-methyl-D-aspartate (NMDA) receptor encephalitis is an immune-mediated condition that has a broad spectrum of manifestations, including seizures, coma, psychosis, and focal neurological deficits. Although usually a diffuse process, unihemispheric involvement mimicking early stages of Rasmussen encephalitis can occur. Rasmussen's encephalitis is a unique syndrome characterized by progressive hemiplegia, drug-resistant focal epilepsy, cognitive decline, and hemispheric brain atrophy contralateral to the hemiplegia...
October 11, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27907839/influence-of-picolinic-acid-on-seizure-susceptibility-in-mice
#3
Anna Cioczek-Czuczwar, Piotr Czuczwar, Waldemar Andrzej Turski, Jolanta Parada-Turska
BACKGROUND: The mechanism of drug resistance in epilepsy remains unknown. Picolinic acid (PIC) is an endogenous metabolite of the kynurenine pathway and a chelating agent added to dietary supplements. Both inhibitory and excitatory properties of PIC were reported. The aim of this study was to determine the influence of exogenously applied PIC upon the electroconvulsive threshold and the activity of chemical convulsants in eight models of epilepsy in mice. METHODS: All experiments were performed on adult male Swiss albino mice...
October 12, 2016: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/27905093/magnetic-resonance-imaging-guided-laser-interstitial-thermal-therapy-for-treatment-of-drug-resistant-epilepsy
#4
Joon Y Kang, Michael R Sperling
Surgery is the most effective treatment for drug-resistant epilepsy. Long-term studies demonstrate that about 60% to 80% of patients become seizure-free after anterior temporal lobectomy and a majority of patients (about 95%) report significant seizure reduction after surgery. In the last few years, there has been significant advances in minimally invasive surgical techniques to treat drug-resistant epilepsy. These minimally invasive procedures have significant advantages over open surgery in that they produce less immediate discomfort and disability, while allowing for greater preservation of functional tissue...
November 30, 2016: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/27903016/predicting-tissue-breaking-strengths-in-the-epileptic-brain-with-t2-relaxometry-application-of-pulsed-water-jet-dissection-system-for-epilepsy-surgery
#5
Yoko Takahashi, Masaki Iwasaki, Atsuhiro Nakagawa, Shiho Sato, Nobukazu Nakasato, Teiji Tominaga
Background The piezo actuator-driven pulsed water jet (ADPJ) system is a novel surgical instrument that enables dissection of tissue without thermal damage. Using the ADPJ system in epilepsy surgery requires prediction of the tissue breaking strength of the epileptic brain. The aim of this study was to elucidate whether magnetic resonance imaging T2 relaxometry could predict the breaking strength. Methods A total of 12 patients with drug-resistant temporal lobe epilepsy who received surgical treatment were included in the study...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27899261/a-prestimulation-evaluation-protocol-for-patients-with-drug-resistant-epilepsy
#6
Sofie Carrette, Paul Boon, Kristl Vonck
Neurostimulation is making its way into the therapeutic armamentarium of the epileptologists, with several invasive neurostimulation modalities available today and several less invasive modalities under investigation. Clinicians will soon face a choice that should not be made randomly. We introduce the concept of a prestimulation evaluation protocol, consisting of a series of rationally chosen investigations that evaluate the presence of biomarkers for response to various neurostimulation therapies. These biomarkers should reflect the susceptibility of the individual's epileptic network to a given neurostimulation technique...
November 19, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27898202/optimization-of-transcutaneous-vagus-nerve-stimulation-using-functional-mri
#7
Natalia Yakunina, Sam Soo Kim, Eui-Cheol Nam
OBJECTIVE/HYPOTHESIS: Vagus nerve stimulation (VNS) is an established therapy for drug-resistant epilepsy, depression, and a number of other disorders. Transcutaneous stimulation of the auricular branch of the vagus nerve (tVNS) has been considered as a non-invasive alternative. Several functional magnetic resonance imaging (fMRI) studies on the effects of tVNS used different stimulation parameters and locations in the ear, which makes it difficult to determine the optimal tVNS methodology...
November 29, 2016: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/27894944/surface-projected-flair-supr-flair-analysis-a-novel-tool-for-advanced-imaging-of-epilepsy
#8
Francesco Cardinale, Stefano Francione, Luciana Gennari, Alberto Citterio, Maurizio Sberna, Laura Tassi, Roberto Mai, Ivana Sartori, Lino Nobili, Massimo Cossu, Laura Castana, Giorgio Lo Russo, Nadia Colombo
OBJECTIVE: The objective of this pilot retrospective study is to describe the SUrface-PRojected FLuid-Attenuation-Inversion-Recovery (SUPR-FLAIR) analysis, a novel method mainly aimed at revealing cortical areas with subtle signal hyper-intensity. METHODS: Images from 101 healthy controls and ten patients suffering from drug-resistant partial epilepsy were retrospectively post-processed. Brain surface was reconstructed from a 3D T1-weighted fast field echo (3D T1W-FFE) MRI scan...
November 25, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27888502/a-novel-c132-134del-mutation-in-unverricht-lundborg-disease-and-the-review-of-literature-of-heterozygous-compound-patients
#9
Giovanni Assenza, Antonella Benvenga, Elena Gennaro, Mario Tombini, Chiara Campana, Federica Assenza, Giovanni Di Pino, Vincenzo Di Lazzaro
Unverricht-Lundborg disease or progressive myoclonic epilepsy type 1 (EPM1) is an autosomal recessive disease caused by mutation of the cystatin B gene (CSTB), located on chromosome 21q22.3. The most common mutation is an expansion of unstable dodecamer repetition (CCCCGCCCCGCG), whereas other types of mutations are rare. Among these, heterozygous compound mutations are described to induce a more severe phenotype than that of homozygous dodecameric repetition. We report two siblings affected by heterozygous compound mutations carrying a novel mutation of the deletion of three nucleotides in exon 2 of the gene in position 132-134 of the coding sequence (c...
November 26, 2016: Epilepsia
https://www.readbyqxmd.com/read/27887842/simple-n-n-dimethyl-phenylsulfonamides-show-potent-anticonvulsant-effect-in-two-standard-epilepsy-models
#10
Tomoyuki Tanaka, Nana Yajima, Tomoko Kiyoshi, Yoshiki Miura, Seiji Iwama
Optimization of the previously reported benzothiazine analogue A led to the identification of compound 1, which showed anti-convulsant activity in two golden standard animal models of seizure, the MES and scPTZ models. Structure-activity relationship investigation of compound 1 revealed compounds 2, 6 and 19 as attractive anti-epileptic drug (AED) candidates with potent anticonvulsant effect in both the MES and scPTZ models. As these compounds are structurally different from existing AEDs, determination of their mechanism of actions could provide clues to understanding current therapy-resistant seizures...
November 15, 2016: Bioorganic & Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/27886333/association-between-the-polymorphisms-in-the-atp-binding-cassette-genes-abcb1-and-abcc2-and-the-risk-of-drug-resistant-epilepsy-in-a-chinese-han-population
#11
T Xue, Z N Lu
Epilepsy is a common disease of the nervous system; approximately 20-30% of all patients with epilepsy are reported resistant to antiepileptic drugs. ABCB1 and ABCC2 are members of ATP-binding cassette transporter (ABC) family that is involved in the excretion of antiepileptic drugs. In this case-control study, we have investigated the role of ABCB1 rs1045642 and rs2032582 and ABCC2 rs2273697 and rs717620 single nucleotide polymorphisms in antiepileptic drug-resistance in patients with epilepsy. A total of 254 patients with epilepsy (104 drug-resistant and 150 drug-responsive) were recruited from the People's Hospital of Wuhan University between March 2013 and April 2014...
November 25, 2016: Genetics and Molecular Research: GMR
https://www.readbyqxmd.com/read/27878616/effectiveness-of-vagal-nerve-stimulation-in-medication-resistant-epilepsy-comparison-between-patients-with-and-without-medication-changes
#12
María A García-Pallero, Eduardo García-Navarrete, Cristina V Torres, Jesús Pastor, Marta Navas, R G Sola
BACKGROUND: Vagal nerve stimulation (VNS) response is not immediate. A progressive decline in seizure frequency is usually found during a period of 12-18 months after implantation. During this time, the patient's medication is usually modified, which can create doubts about whether their clinical improvement is due to medication changes or to VNS itself. Our goal is to compare two groups of patients treated with VNS, with and without changes in their medication. METHODS: We prospectively analyze 85 patients who were treated with VNS in our hospital between 2005 and 2014...
November 23, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27878559/impact-of-drug-manipulation-on-seizure-freedom-in-adults-with-uncontrolled-epilepsy-a-prospective-controlled-study-in-rural-china
#13
Xiaoting Hao, Ziyi Chen, Bo Yan, Patrick Kwan, Dong Zhou
INTRODUCTION: It has been suggested that uncontrolled epilepsy might not necessarily equate to drug resistance when antiepileptic drugs (AEDs) are used at relatively low doses, a practice frequently observed in rural areas of China. OBJECTIVE: To assess the clinical benefits of further drug manipulation in this situation, we prospectively followed up the outcomes of patients with uncontrolled epilepsy while taking relatively low doses of AEDs. METHODS: The study included patients aged 16 years and older with uncontrolled epilepsy and who were receiving at least one AED at a dosage below 50% of the World Health Organization (WHO) defined daily dose (DDD) (50% DDD) (Group 1)...
November 22, 2016: CNS Drugs
https://www.readbyqxmd.com/read/27875747/new-model-of-pharmacoresistant-seizures-induced-by-3-mercaptopropionic-acid-in-mice
#14
Andrea Enrique, Sofía Goicoechea, Rocío Castaño, Facundo Taborda, Luisa Rocha, Sandra Orozco, Elena Girardi, Luis Bruno Blanch
About 30% of the patients with epilepsy do not respond to clinically established anticonvulsants, despite having effective concentrations of the antiepileptic drug in plasma. Therefore, new preclinical models of epilepsy are needed to identify more efficacious treatments. We describe here a new drug-resistant seizure model in mice to be used at the early stages of pre-clinical trials. This model consists in inducing daily generalized seizures for 23 consecutive days by administration of 3-mercaptopropionic acid (MP)...
October 27, 2016: Epilepsy Research
https://www.readbyqxmd.com/read/27873376/extended-long-term-effects-of-cervical-vagal-nerve-stimulation-on-headache-intensity-frequency-and-affective-cognitive-headache-perception-in-drug-resistant-complex-partial-seizure-patients
#15
Bogdan Pintea, Kevin Hampel, Jan Boström, Rainer Surges, Hartmut Vatter, Ilana S Lendvai, Thomas M Kinfe
OBJECTIVES: Invasive vagal nerve stimulation (iVNS) is an established treatment option for drug-resistant focal seizures and has been assumed to diminish frequent co-incidental daily headache/migraine. However, long-term effects on cognitive/affective head pain perception, headache intensity/frequency are lacking. We therefore investigated potential iVNS-induced effects in patients with drug-resistant focal seizure and daily headache/migraine. MATERIALS AND METHODS: A clinical database was used to select 325 patients with drug-resistant epilepsy treated by either iVNS plus best medical treatment (BMT) or BMT alone, compared to a healthy control group (HC)...
November 22, 2016: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/27873293/supraorbital-keyhole-microsurgical-fenestration-of-symptomatic-temporal-arachnoid-cysts-in-children-advantages-and-limitations
#16
Sherif Elkheshin, Ahmed Soliman
AIM: To investigate the impact of endoscope assisted microsurgical fenestration of temporal arachnoid cysts, the advantages and limitations of the technique. MATERIAL AND METHODS: Retrospective study including twenty five children of symptomatic temporal arachnoid cysts operated via Eyebrow Supra-Orbital Keyhole Microsurgical Fenestration targeting medial cyst wall, Preoperative MRI brain was done for all patients. RESULTS: Preoperative, clinical presentation included headache (80%), nausea & vomiting (64%), drug resistant epilepsy (52%), macrocephaly (12%) papilledema (28%) motor weakness in the form of right sided hemiparesis (12%) and cranial nerve palsy...
October 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27869305/analysis-of-falls-in-patients-with-epilepsy-enrolled-in-the-perampanel-phase-iii-randomized-double-blind-studies
#17
Ilo E Leppik, Haichen Yang, Betsy Williams, Sharon Zhou, Randi Fain, Anna Patten, Francesco Bibbiani, Antonio Laurenza
OBJECTIVE: To analyze occurrence of falls among patients with partial seizures, with/without secondarily generalized seizures (SGS), and primary generalized tonic-clonic seizures (PGTCS) in the perampanel phase III clinical studies. METHODS: Studies 304, 305, and 306 randomized subjects (≥12 years) with drug-resistant partial seizures (with/without SGS) to perampanel 2, 4, 8, or 12 mg or placebo for double-blind treatment. The adverse event (AE) of falls was analyzed in the Safety Analysis Set (N = 1480)...
November 21, 2016: Epilepsia
https://www.readbyqxmd.com/read/27866120/evidence-based-guidelines-on-the-therapeutic-use-of-transcranial-direct-current-stimulation-tdcs
#18
REVIEW
Jean-Pascal Lefaucheur, Andrea Antal, Samar S Ayache, David H Benninger, Jérôme Brunelin, Filippo Cogiamanian, Maria Cotelli, Dirk De Ridder, Roberta Ferrucci, Berthold Langguth, Paola Marangolo, Veit Mylius, Michael A Nitsche, Frank Padberg, Ulrich Palm, Emmanuel Poulet, Alberto Priori, Simone Rossi, Martin Schecklmann, Sven Vanneste, Ulf Ziemann, Luis Garcia-Larrea, Walter Paulus
A group of European experts was commissioned by the European Chapter of the International Federation of Clinical Neurophysiology to gather knowledge about the state of the art of the therapeutic use of transcranial direct current stimulation (tDCS) from studies published up until September 2016, regarding pain, Parkinson's disease, other movement disorders, motor stroke, poststroke aphasia, multiple sclerosis, epilepsy, consciousness disorders, Alzheimer's disease, tinnitus, depression, schizophrenia, and craving/addiction...
October 29, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27864903/long-term-monitoring-of-cardiorespiratory-patterns-in-drug-resistant-epilepsy
#19
Daniel M Goldenholz, Amanda Kuhn, Alison Austermuehle, Martin Bachler, Christopher Mayer, Siegfried Wassertheurer, Sara K Inati, William H Theodore
OBJECTIVE: Sudden unexplained death in epilepsy (SUDEP) during inpatient electroencephalography (EEG) monitoring has been a rare but potentially preventable event, with associated cardiopulmonary markers. To date, no systematic evaluation of alarm settings for a continuous pulse oximeter (SpO2 ) has been performed. In addition, evaluation of the interrelationship between the ictal and interictal states for cardiopulmonary measures has not been reported. METHODS: Patients with epilepsy were monitored using video-EEG, SpO2 , and electrocardiography (ECG)...
November 16, 2016: Epilepsia
https://www.readbyqxmd.com/read/27864847/diagnostic-targeted-resequencing-in-349-patients-with-drug-resistant-pediatric-epilepsies-identifies-causative-mutations-in-30-different-genes
#20
Elena Parrini, Carla Marini, Davide Mei, Anna Galuppi, Elena Cellini, Daniela Pucatti, Laura Chiti, Domenico Rutigliano, Claudia Bianchini, Simona Virdò, Dalila De Vita, Stefania Bigoni, Carmen Barba, Francesco Mari, Martino Montomoli, Tiziana Pisano, Anna Rosati, Renzo Guerrini
Targeted resequencing gene panels are used in the diagnostic setting to identify gene defects in epilepsy. We performed targeted resequencing using a 30-genes panel and a 95-genes panel in 349 patients with drug-resistant epilepsies beginning in the first years of life. We identified 71 pathogenic variants, 42 of which novel, in 30 genes, corresponding to 20.3% of the probands. In 66% of mutation positive patients seizures onset occurred before age 6 months. The 95-genes panel allowed a genetic diagnosis in 22 (6...
November 19, 2016: Human Mutation
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