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Drug resistant epilepsy

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https://www.readbyqxmd.com/read/29775848/long-term-outcome-in-children-with-neonatal-seizures-a-tertiary-center-experience-in-cohort-of-168-patients
#1
Biljana Vucetic Tadic, Ruzica Kravljanac, Vlada Sretenovic, Vladislav Vukomanovic
PURPOSE: The purpose of this study was to evaluate long-term outcome and assess predictors of prognosis in children with neonatal seizures (NS). METHOD: This retrospective study includes children with NS treated at our Institute from January the 1st 2005 until December the 31st 2015. The data were collected from medical charts and the electroencephalogram (EEG) database at the Institute. The predictive value was evaluated for following parameters: (1) characteristics of the patients, such as gender, gestational age, birth body weight, Apgar score, artificial ventilation; (2) etiology; (3) characteristics of seizures such as type, time of onset, resistance to treatment; and (4) EEG background activity and paroxysmal discharges...
May 15, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29764460/benign-and-severe-early-life-seizures-a-round-in-the-first-year-of-life
#2
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/29763803/study-of-the-mozart-effect-in-children-with-epileptic-electroencephalograms
#3
Eliza Grylls, Max Kinsky, Amy Baggott, Cecile Wabnitz, Ailsa McLellan
PURPOSE: To establish if listening to Mozart's Sonata for two pianos in D major (K448) has an anti-epileptic effect on the EEGs (electroencephalograms) of children. METHODS: Forty five children (2-18 years; mean 7 years 10 months) who had epileptiform activity on EEG were recruited from those attending for scheduled EEG investigations. Mozart's Sonata for two pianos in D major (K448) and an age-appropriate control music were played during the EEG. There were five consecutive states during the record, each lasting 5 min; before Mozart music (baseline), during Mozart music, after Mozart music/before control music, during control music and after control music...
May 9, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29762840/the-effect-of-mir-146a-gene-silencing-on-drug-resistance-and-expression-of-protein-of-p-gp-and-mrp1-in-epilepsy
#4
H-L Zhang, Y-H Lin, Y Qu, Q Chen
OBJECTIVE: To investigate the effect of miR-146a gene silencing on brain tissue and related drug-resistance proteins in rats and explore its resistance mechanism. MATERIALS AND METHODS: A rat model of chronic refractory epilepsy was established. The rats were divided into four groups: Normal group, Model group, Negative control group and AntagomiR-146a group. Hematoxylin and eosin (HE) stain was used to detect brain histopathological changes. We examined the expression of mRNA of miR-146a, multidrug resistance (MDR1) and multidrug-resistant associated protein (MRP1) by RT-PCR...
April 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29761351/economic-evaluation-of-stiripentol-for-dravet-syndrome-a-cost-utility-analysis
#5
Jesse Elliott, Bláthnaid McCoy, Tammy Clifford, George A Wells, Doug Coyle
BACKGROUND: Dravet syndrome is a catastrophic form of pediatric treatment-resistant epilepsy with few effective treatment options. Stiripentol is approved for use in Canada for treatment of Dravet syndrome, but the associated long-term costs and benefits have not been well-studied and its cost effectiveness is unclear. OBJECTIVE: The aim of this study was to evaluate the cost effectiveness of stiripentol as an adjunctive treatment to clobazam and valproate for treatment of Dravet syndrome from the perspective of the Canadian public healthcare payer...
May 15, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29760294/breath-profiles-of-children-on-ketogenic-therapy
#6
Vera Ruzsanyi, Miklós Péter Kalapos, Christine Schmidl, Daniela Karall, Sabine Scholl-Buergi, Matthias Baumann
Ketogenic diets (KD) were initially introduced to clinical practice as alimentary approaches with the aim to control drug-resistant epilepsies. Therapy control, particularly at initiation, happens through regular blood analysis and control of urine ketone levels. However, there is a lack of fast, reliable and preferably non-invasive methods of analysis. The exhaled breath contains hundreds of volatile organic compounds (VOCs), which can be modified by diet. The instrumental development of VOC detection converges in the direction of low cost sensors, which can facilitate the self-monitoring of the patients in the future if reliable breath markers are available...
May 15, 2018: Journal of Breath Research
https://www.readbyqxmd.com/read/29755403/has-the-time-come-to-stratify-and-score-sudep-risk-to-inform-people-with-epilepsy-of-their-changes-in-safety
#7
Rohit Shankar, Craig Newman, Alistair Gales, Brendan N McLean, Jane Hanna, Samantha Ashby, Matthew C Walker, Josemir W Sander
Recent publication of the American Academy of Neurology SUDEP guidance highlighted the importance to American clinicians of making people with epilepsy aware of SUDEP risk. It is the first guideline to do this in the United States. It follows precedent set out in the UK by National Institute of Clinical Excellence in 2004. While a significant achievement, the lack of clarity of how to deliver this guidance in an enduring and person-centered manner, raises concerns on how its long-term effectiveness in risk mitigation...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29752488/open-resection-of-hypothalamic-hamartomas-for-intractable-epilepsy-revisited-using-intraoperative-mri
#8
Libby van Tonder, Sasha Burn, Anand Iyer, Jo Blair, Mohammed Didi, Michael Carter, Timothy Martland, Conor Mallucci
INTRODUCTION: Hypothalamic hamartomas (HHs) are rare non-neoplastic lesions which cause drug-resistant epilepsy with associated behavioural, psychiatric and endocrine issues. With the development of new minimally invasive techniques for the treatment of HH, there is a need to reappraise the effectiveness and safety of each approach. We review the outcomes of HH patients treated surgically, utilizing intraoperative magnetic resonance imaging (IOMRI), by a team of Alder Hey NHS Foundation Trust tumour and epilepsy neurosurgeons since 2011...
May 11, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29751364/ictal-and-interictal-electric-source-imaging-in-presurgical-evaluation-a-prospective-study
#9
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/29751140/nanoparticle-based-delivery-of-carbamazepine-a-promising-approach-for-the-treatment-of-refractory-epilepsy
#10
Anna Zybina, Anastasiya Anshakova, Julia Malinovskaya, Pavel Melnikov, Vladimir Baklaushev, Vladimir Chekhonin, Olga Maksimenko, Sergey Titov, Vadim Balabanyan, Jörg Kreuter, Svetlana Gelperina, Kenul Abbasova
Resistance to antiepileptic drugs (AEDs) is a major clinical problem. The overexpression of P-glycoprotein (Pgp), one of the main transporters limiting the entry of xenobiotics into the brain, is among the factors contributing to the AED resistance. Presently, there is no consensus on the interaction of carbamazepine (CBZ) with the Pgp. This study investigates the effect of the Pgp inhibitor verapamil on the anticonvulsant effect of CBZ and its nanoparticulate formulation in the rat model of isoniazid-induced epilepsy...
May 8, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29750337/lamotrigine-resistant-corneal-kindled-mice-a-model-of-pharmacoresistant-partial-epilepsy-for-moderate-throughput-drug-discovery
#11
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/29740014/different-patterns-of-epileptiform-like-activity-are-generated-in-the-sclerotic-hippocampus-from-patients-with-drug-resistant-temporal-lobe-epilepsy
#12
Selvin Z Reyes-Garcia, Carla A Scorza, Noemi S Araújo, Nancy N Ortiz-Villatoro, Anaclara Prada Jardim, Ricardo Centeno, Elza Márcia Targas Yacubian, Jean Faber, Esper A Cavalheiro
Human hippocampal slice preparations from patients with temporal lobe epilepsy (TLE) associated with hippocampal sclerosis (HS) are excellent material for the characterization of epileptiform-like activity. However, it is still unknown if hippocampal regions as cornu Ammonis (CA) 1, CA3 and CA4, generate population epileptiform-like activity. Here, we investigated epileptiform activities of the subiculum, CA1, CA2, CA3, CA4 (induced by elevation of extracellular potassium concentration) and the dentate gyrus (induced with hilar stimulation and elevation of potassium concentration) from sclerotic hippocampi of patients with drug-resistant TLE...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29738432/neuroimmunology-research-a-report-from-the-cuban-network-of-neuroimmunology
#13
María de Los Angeles Robinson-Agramonte, Lourdes Lorigados Pedre, Orlando Ramón Serrano-Barrera
Neuroimmunology can be traced back to the XIX century through the descriptions of some of the disease’s models (e.g., multiple sclerosis and Guillain Barret syndrome, amongst others). The diagnostic tools are based in the cerebrospinal fluid (CSF) analysis developed by Quincke or in the development of neuroimmunotherapy with the earlier expression in Pasteur’s vaccine for rabies. Nevertheless, this field, which began to become delineated as an independent research area in the 1940s, has evolved as an innovative and integrative field at the shared edges of neurosciences, immunology, and related clinical and research areas, which are currently becoming a major concern for neuroscience and indeed for all of the scientific community linked to it...
May 8, 2018: Behavioral Sciences
https://www.readbyqxmd.com/read/29724763/%C3%AE-hydroxybutyrate-detection-with-proton-mr-spectroscopy-in-children-with-drug-resistant-epilepsy-on-the-ketogenic-diet
#14
J N Wright, R P Saneto, S D Friedman
BACKGROUND AND PURPOSE: The ketogenic diet, including both classic and modified forms, is an alternative to antiepileptic medications used in the treatment of drug-resistant epilepsy. We sought to evaluate the utility of proton MR spectroscopy for the detection of β-hydroxybutyrate in a cohort of children with epilepsy treated with the ketogenic diet and to correlate brain parenchymal metabolite ratios obtained from spectroscopy with β-hydroxybutyrate serum concentrations. MATERIALS AND METHODS: Twenty-three spectroscopic datasets acquired at a TE of 288 ms in children on the ketogenic diet were analyzed with LCModel using a modified basis set that included a simulated β-hydroxybutyrate resonance...
May 3, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29724486/computer-based-monitoring-and-evaluation-of-epilepsy-related-health-variables-and-their-impact-on-treatment-decision
#15
Melanie Bergmann, Manuela Prieschl, Gerald Walser, Gerhard Luef, Gerhard Rumpold, Iris Unterberger
OBJECTIVE: This study aimed to determine the effectiveness of electronic patient-reported outcomes (ePROs) with focus on epilepsy-specific quality of life, psychiatric and psychosocial burden, drug side effects, and patient satisfaction via the Computer-based Health Evaluation System (CHES) and to evaluate their impact on treatment regimen. METHODS: Forty consecutive patients with drug-resistant focal epilepsy undergoing prolonged video-electroencephalography (EEG) monitoring at the Department of Neurology, Innsbruck Medical University were included and randomized to an intervention group (questionnaire results accessible to the physicians) and a control group (questionnaire results inaccessible to the physicians)...
April 30, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29709878/genetic-polymorphisms-of-the-5ht-receptors-are-not-related-with-depression-in-temporal-lobe-epilepsy-caused-by-hippocampal-sclerosis
#16
Silvia Vincentiis, Juliana Alcantara, Patricia Rzezak, Daniel S Kerr, Wagner F Gattaz, Helio van der Linden, Bernardo Dos Santos, Sebastiao E Melo-Souza, Francisco Arruda, Paulo Ragazzo, Tiffany Chaim-Avancini, Mauricio H Serpa, Fernando Fernandes, Ricardo A Moreno, Geraldo Busatto, Ruda Alessi, Renata Demarque, Kette D Valente
BACKGROUND: Temporal lobe epilepsy caused by hippocampal sclerosis (TLE-HS) is the most frequent form of drug-resistant epilepsy in adults. Mood disorders are the most frequent psychiatric comorbidities observed in these patients. Common pathophysiological mechanisms of epilepsy and psychiatric comorbidities include abnormalities in the serotonin pathway. The primary goal of this study was to determine the possible association between polymorphisms of genes encoding the serotonin receptors 5HT1A (rs6295), 5HT1B (rs6296), and 5HT2C (rs6318) and the presence of mood disorders in patients with TLE-HS...
April 27, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29709876/chronic-vagus-nerve-stimulation-reverses-heart-rhythm-complexity-in-patients-with-drug-resistant-epilepsy-an-assessment-with-multiscale-entropy-analysis
#17
Hongyun Liu, Zhao Yang, Fangang Meng, Lei Huang, Wei Qu, Hongwei Hao, Jianguo Zhang, Luming Li
OBJECTIVE: Vagus nerve stimulation (VNS) is an adjunctive treatment in drug-resistant epilepsy. The alterations in heart rate dynamics through VNS are not well understood. This study aimed to determine changes in heart rhythm complexity in association with VNS and to relate the findings to the outcome of VNS treatment in patients with drug-resistant epilepsy. METHODS: We prospectively analyzed 32 patients with drug-resistant epilepsy, who underwent VNS implantation, and 32 age- and sex-matched healthy control subjects...
April 26, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29708508/second-hit-mosaic-mutation-in-mtorc1-repressor-depdc5-causes-focal-cortical-dysplasia-associated-epilepsy
#18
Théo Ribierre, Charlotte Deleuze, Alexandre Bacq, Sara Baldassari, Elise Marsan, Mathilde Chipaux, Giuseppe Muraca, Delphine Roussel, Vincent Navarro, Eric Leguern, Richard Miles, Stéphanie Baulac
DEP domain-containing 5 protein (DEPDC5) is a repressor of the recently recognized amino acid-sensing branch of the mTORC1 pathway. So far, its function in the brain remains largely unknown. Germline loss-of-function mutations in DEPDC5 have emerged as a major cause of familial refractory focal epilepsies, with case reports of sudden unexpected death in epilepsy (SUDEP). Remarkably, a fraction of patients also develop focal cortical dysplasia (FCD), a neurodevelopmental cortical malformation. We therefore hypothesized that a somatic second-hit mutation arising during brain development may support the focal nature of the dysplasia...
April 30, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29707476/evaluation-of-perampanel-as-monotherapy-for-focal-seizures-experience-from-open-label-extension-studies
#19
Patrick Kwan, Scott Mintzer, Antonio Laurenza, Anna Patten, Karen Cartwright
Perampanel, a selective, non-competitive α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist, is approved for adjunctive treatment of focal seizures, with or without secondarily generalized seizures, and for primary generalized tonic-clonic seizures in patients with epilepsy aged ≥ 12 years. Perampanel was recently approved for monotherapy use for focal seizures in the U.S.A. Anti-seizure drug monotherapy may be preferable to polytherapy, which is generally associated with increased toxicity, non-compliance, and cost...
2018: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/29705622/impact-of-resective-epilepsy-surgery-on-health-related-quality-of-life-in-children-with-and-without-low-intellectual-ability
#20
Lauryn Conway, Elysa Widjaja, Mary Lou Smith
OBJECTIVE: The current study examined pre- and postoperative health-related quality of life (HRQL) across children with and without low intellectual ability. We also aimed to clarify the literature on postsurgical change by assessing domain-specific HRQL pre- and postoperatively in children with drug-resistant epilepsy. METHOD: All patients (n=111) underwent resective epilepsy surgery between 1996 and 2016 at the Hospital for Sick Children in Toronto, comparing baseline and 1-year follow-up HRQL with the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-76)...
April 26, 2018: Epilepsy & Behavior: E&B
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