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Drug resistant epilepsy

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https://www.readbyqxmd.com/read/29341105/metabolomic-characterization-of-human-hippocampus-from-drug-resistant-epilepsy-with-mesial-temporal-seizure
#1
Julien Detour, Caroline Bund, Charles Behr, Hélène Cebula, Ercument A Cicek, Maria-Paola Valenti-Hirsch, Béatrice Lannes, Benoît Lhermitte, Astrid Nehlig, Pierre Kehrli, François Proust, Edouard Hirsch, Izzie-Jacques Namer
OBJECTIVE: Within a complex systems biology perspective, we wished to assess whether hippocampi with established neuropathological features have distinct metabolome. Apparently normal hippocampi with no signs of sclerosis (noHS), were compared to hippocampal sclerosis (HS) type 1 (HS1) and/or type 2 (HS2). Hippocampus metabolome from patients with epilepsy-associated neuroepithelial tumors (EANTs), namely, gangliogliomas (GGs) and dysembryoplastic neuroepithelial tumors (DNTs), was also compared to noHS epileptiform tissue...
January 17, 2018: Epilepsia
https://www.readbyqxmd.com/read/29338667/docosahexaenoic-acid-prevents-resistance-to-antiepileptic-drugs-in-two-animal-models-of-drug-resistant-epilepsy
#2
Melika Moezifar, Mohammad Sayyah, Morteza Zendehdel, Hakimeh Gavzan
OBJECTIVES: One-third of epileptic patients are resistant to antiepileptic drugs. Few clinical studies with small sample size indicate that polyunsaturated fatty acids could control drug-resistant epilepsy. We examined the efficacy of acute and chronic administration of docosahexaenoic acid (DHA) in two animal models of drug-resistant epilepsies, i.e. 6-Hz psychomotor seizures in mice and lamotrigine (LTG)-resistant kindled rats. METHODS: Mice received a single injection of DHA (300 µM, i...
January 16, 2018: Nutritional Neuroscience
https://www.readbyqxmd.com/read/29338461/mtor-dysregulation-and-tuberous-sclerosis-related-epilepsy
#3
Paolo Curatolo, Romina Moavero, Jackelien van Scheppingen, Eleonora Aronica
The mammalian target of rapamycin (mTOR) pathway has emerged as a key player for proper neural network development, and it is involved in epileptogenesis triggered by both genetic or acquired factors. Areas covered. The robust mTOR signaling deregulation observed in a large spectrum of epileptogenic developmental pathologies, such as focal cortical dysplasias and tuberous sclerosis complex (TSC), has been linked to germline and somatic mutations in mTOR pathway regulatory genes, increasing the spectrum of "mTORopathies"...
January 17, 2018: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/29336937/the-combination-of-stereo-eeg-and-radiofrequency-ablation
#4
Hélène Catenoix, Pierre Bourdillon, Marc Guénot, Jean Isnard
SEEG-guided radiofrequency thermocoagulation (SEEG-guided RFTC), a combination of Stereo-electroencephalography (SEEG) and radiofrequency thermocoagulation (RFTC), has been performed since 2001 in drug resistant epilepsy. The interest of this procedure is to aim at total or partial destruction of the epileptogenic zone, as tailored in each individual patient by the SEEG exploration. These multiple SEEG-guided RFTC lesions of epileptic foci are produced by using a radiofrequency generator connected to the electrode contacts...
January 9, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29336297/add-on-perampanel-and-aggressive-behaviour-in-severe-drug-resistant-focal-epilepsies
#5
S Juhl, G Rubboli
This study aimed to investigate the incidence of aggressiveness in patients with severe drug-refractory focal epilepsy (DRE) who started perampanel (PER) as add-on treatment, and to identify possible predisposing factors. Data on 49 consecutive patients with severe DRE who initiated PER were retrospectively collected. Twelve of the 49 patients experienced aggressiveness as adverse event related to PER treatment, one third of them on low (2-4 mg/day) PER dosages. PER was discontinued in 10/12 patients because of aggressive behaviors...
October 2017: Functional Neurology
https://www.readbyqxmd.com/read/29336029/sudden-unexpected-death-in-epilepsy-in-patients-treated-with-brain-responsive-neurostimulation
#6
Orrin Devinsky, Daniel Friedman, Robert B Duckrow, Nathan B Fountain, Ryder P Gwinn, James W Leiphart, Anthony M Murro, Paul C Van Ness
OBJECTIVE: To study the incidence and clinical features of sudden unexpected death in epilepsy (SUDEP) in patients treated with direct brain-responsive stimulation with the RNS System. METHODS: All deaths in patients treated in clinical trials (N = 256) or following U.S. Food and Drug Administration (FDA) approval (N = 451) through May 5, 2016, were adjudicated for SUDEP. RESULTS: There were 14 deaths among 707 patients (2208 postimplantation years), including 2 possible, 1 probable, and 4 definite SUDEP events...
January 16, 2018: Epilepsia
https://www.readbyqxmd.com/read/29336017/long-term-surveillance-of-sudep-in-drug-resistant-epilepsy-patients-treated-with-vns-therapy
#7
Philippe Ryvlin, Elson L So, Charles M Gordon, Dale C Hesdorffer, Michael R Sperling, Orrin Devinsky, Mark T Bunker, Bryan Olin, Daniel Friedman
OBJECTIVE: Limited data are available regarding the evolution over time of the rate of sudden unexpected death in epilepsy patients (SUDEP) in drug-resistant epilepsy. The objective is to analyze a database of 40 443 patients with epilepsy implanted with vagus nerve stimulation (VNS) therapy in the United States (from 1988 to 2012) and assess whether SUDEP rates decrease during the postimplantation follow-up period. METHODS: Patient vital status was ascertained using the Centers for Disease Control and Prevention's National Death Index (NDI)...
January 16, 2018: Epilepsia
https://www.readbyqxmd.com/read/29332084/thalamic-deep-brain-stimulation
#8
Benjamin B Whiting, Alexander C Whiting, Donald M Whiting
The use of deep brain stimulation (DBS) of the thalamus has been proven to be a safe and efficacious treatment for the management of many diseases. The most common indication for thalamic DBS remains essential tremor (ET), one of the most common movement disorders in the world. ET patients should be considered for surgical intervention when their tremor has demonstrated to be refractory to medication, a characteristic estimated to be present in roughly 50% of ET cases. Advantages of DBS over thalamotomy include its reversibility, the ability to adjust stimulation settings to optimize efficacy and minimize side effects, the ability to perform bilateral procedures safely, and an association with a lower risk of postoperative cognitive problems...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29331082/mechanistic-target-of-rapamycin-complex-1-and-2-in-human-temporal-lobe-epilepsy
#9
Delia M Talos, Leah M Jacobs, Sarah Gourmaud, Carlos A Coto, Hongyu Sun, Kuei-Cheng Lim, Timothy H Lucas, Kathryn A Davis, Maria Martinez-Lage, Frances E Jensen
OBJECTIVE: Temporal lobe epilepsy (TLE) is a chronic epilepsy syndrome defined by seizures and progressive neurological disabilities, including cognitive impairments, anxiety and depression. Here, human TLE specimens were investigated focusing on the mechanistic target of rapamycin (mTOR) Complex 1 (mTORC1) and Complex 2 (mTORC2) activities in the brain, as both pathways may represent unique targets for treatment. METHODS: Surgically resected hippocampal and temporal lobe samples from therapy-resistant TLE patients were analyzed by Western blotting to quantify the expression of established mTORC1 and mTORC2 activity markers and upstream or downstream signaling pathways involving the two complexes...
January 13, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29321231/chronic-traumatic-encephalopathy-in-an-epilepsy-surgery-cohort-clinical-and-pathologic-findings
#10
Amy L Jones, Jeffrey W Britton, Melissa M Blessing, Joseph E Parisi, Gregory D Cascino
OBJECTIVE: To determine the occurrence of chronic traumatic encephalopathy (CTE) in young adult patients undergoing epilepsy surgery. METHODS: Ten patients who underwent epilepsy surgery were randomly selected for this retrospective study. The patients were 18-45 years of age, had preoperative neuropsychological evaluation, and had 1 year postoperative follow-up. Microscopic sections from resections were evaluated for the presence of CTE with standard stains and antibodies to tau (clone AT8)...
January 10, 2018: Neurology
https://www.readbyqxmd.com/read/29318116/expression-of-multidrug-resistance-genes-in-peripheral-blood-of-patients-with-refractory-epilepsy-and-the-reverse-effect-of-oxcarbazepine-on-its-expression
#11
Jinming Ji, Gang Li, Yunxia Ma, Shuangshuang Pan, Rongrong Yuan
Background: We aimed to investigate the expression levels of multidrug resistance gene 1 (MDR1), multidrug resistance-associated protein 1 (MRP1) and multidrug resistance P-glycoprotein (P-gp) in peripheral blood of patients with refractory epilepsy. Methods: Patients with epilepsy (n=24) and those with refractory epilepsy (n=24) were selected, and 30 normal volunteers were enrolled as control. The expression level of MDR1 genes was detected using semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR)...
January 2018: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/29317588/-autoimmune-factors-and-epilepsy
#12
Yating Wu, Aihua Liu
Epilepsy is a common chronic brain disorder with multiple causes, and now autoimmune factors are believed to be an independent cause for epilepsy. Accumulating data support an autoimmune basis in patients with antiepileptic drug-resistant seizures. Moreover, systemic autoimmune diseases and epilepsy co-occur frequently. Neural specific autoantibodies can also mediate the process of seizures through different pathways. The diagnosis of autoimmune epilepsy is based on frequency of antiepileptic drug-resistant seizures, the presence of neural specific autoantibodies, inflammatory changes in serum or spinal fluid or on magneticresonanceimaging, the change in electroencephalogram, a personal or family history of autoimmunity...
December 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29315516/strong-coupling-between-slow-oscillations-and-wide-fast-ripples-in-children-with-epileptic-spasms-investigation-of-modulation-index-and-occurrence-rate
#13
Yasushi Iimura, Kevin Jones, Lynne Takada, Itsuki Shimizu, Misaki Koyama, Kyoko Hattori, Yushi Okazawa, Yutaka Nonoda, Eishi Asano, Tomoyuki Akiyama, Cristina Go, Ayako Ochi, O Carter Snead, Elizabeth J Donner, James T Rutka, James M Drake, Hiroshi Otsubo
OBJECTIVE: Epileptic spasms (ES) often become drug-resistant. To reveal the electrophysiological difference between children with ES (ES+) and without ES (ES-), we compared the occurrence rate (OR) of high-frequency oscillations (HFOs) and the modulation index (MI) of coupling between slow and fast oscillations. In ES+, we hypothesized that (1) pathological HFOs are more widely distributed and (2) slow oscillations show stronger coupling with pathological HFOs than in ES-. METHODS: We retrospectively reviewed 24 children with drug-resistant multilobar onset epilepsy, who underwent intracranial video electroencephalography prior to multilobar resections...
January 6, 2018: Epilepsia
https://www.readbyqxmd.com/read/29306976/deep-brain-stimulation-of-the-anterior-nucleus-of-the-thalamus-for-drug-resistant-epilepsy
#14
REVIEW
Tim A M Bouwens van der Vlis, Olaf E M G Schijns, Frédéric L W V J Schaper, Govert Hoogland, Pieter Kubben, Louis Wagner, Rob Rouhl, Yasin Temel, Linda Ackermans
Despite the use of first-choice anti-epileptic drugs and satisfactory seizure outcome rates after resective epilepsy surgery, a considerable percentage of patients do not become seizure free. ANT-DBS may provide for an alternative treatment option in these patients. This literature review discusses the rationale, mechanism of action, clinical efficacy, safety, and tolerability of ANT-DBS in drug-resistant epilepsy patients. A review using systematic methods of the available literature was performed using relevant databases including Medline, Embase, and the Cochrane Library pertaining to the different aspects ANT-DBS...
January 6, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29306849/verbal-learning-and-memory-outcome-in-selective-amygdalohippocampectomy-versus-temporal-lobe-resection-in-patients-with-hippocampal-sclerosis
#15
Mette Thrane Foged, Kirsten Vinter, Louise Stauning, Troels W Kjær, Brice Ozenne, Sándor Beniczky, Olaf B Paulson, Flemming Find Madsen, Lars H Pinborg
PURPOSE: With the advent of new very selective techniques like thermal laser ablation to treat drug-resistant focal epilepsy, the controversy of resection size in relation to seizure outcome versus cognitive deficits has gained new relevance. The purpose of this study was to test the influence of the selective amygdalohippocampectomy (SAH) versus nonselective temporal lobe resection (TLR) on seizure outcome and cognition in patients with mesial temporal lobe epilepsy (MTLE) and histopathological verified hippocampal sclerosis (HS)...
January 4, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29305185/predictors-of-outcome-after-surgery-in-134-children-with-drug-resistant-tle
#16
Ashalatha Radhakrishnan, Ramshekhar Menon, Mathew Abraham, George Vilanilam, Suvasini Sharma, Bejoy Thomas, Chandrashekharan Kesavadas, Ajith Cherian, Raviprasad Varma, Sanjeev V Thomas
PURPOSE: To determine the factors predicting seizure outcome in children who underwent anterior temporal lobectomy (ATL) for drug-resistant temporal lobe epilepsy (TLE). METHODS: Among the 664 patients who underwent ATL for TLE from 1995 to 2008, there were 134 children. "Excellent" outcome in them was defined as seizure freedom during the entire follow-up (Engel class I a); "good outcome", if in remission last 2 years, and the rest as "unfavorable outcome". To identify the potential predictors of seizure recurrence, the attributes of recurred and non-recurred groups was compared by univariate and multivariate analysis...
January 2, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29291456/does-age-affect-response-to-quinidine-in-patients-with-kcnt1-mutations-report-of-three-new-cases-and-review-of-the-literature
#17
Elie Abdelnour, William Gallentine, Marie McDonald, Monisha Sachdev, Yong-Hui Jiang, Mohamad A Mikati
PURPOSE: Gain-of-function mutations in the KCNT1 gene have been reported in a number of drug resistant epilepsy syndromes including Epilepsy of Infancy with Migrating Focal Seizures. Quinidine, a potassium channel blocker, has been proposed as a potential therapeutic agent with only a few patients reported in the literature to have received it. Here we report 3 additional children, with such KCNT1 mutations and refractory seizures, who received quinidine therapy. METHODS: Retrospective chart review of 3 children with KCNT1 mutations, of ages 3 months, 9 years and 13 years old...
December 23, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29291205/topiramate-induced-peripheral-neuropathy-a-case-report-and-review-of-literature
#18
Sherifa Ahmed Hamed
Drug-induced peripheral neuropathy had been rarely reported as an adverse effect of some antiepileptic drugs (AEDs) at high cumulative doses or even within the therapeutic drug doses or levels. We describe clinical and diagnostic features of a patient with peripheral neuropathy as an adverse effect of chronic topiramate (TPM) therapy. A 37-year-old woman was presented for the control of active epilepsy (2010). She was resistant to some AEDs as mono- or combined therapies (carbamazepine, sodium valproate, levetiracetam, oxcarbazepine and lamotrigine)...
December 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/29289803/application-of-a-rubber-band-with-hooks-on-both-ends-for-vagus-nerve-stimulator-implantation
#19
Hiroshi Hosoyama, Ryosuke Hanaya, Toshiaki Otsubo, Masanori Sato, Yumi Kashida, Sei Sugata, Masaya Katagiri, Koji Iida, Kazunori Arita
BACKGROUND: Vagus nerve stimulation (VNS) is a valuable therapeutic option for many types of drug-resistant epilepsy. Muscle hooks and carotid endarterectomy rings have been used for cervical delamination preceding the implantation of stimulation electrodes. The attachment on both sides of a rubber band of Kamiyama-style hanging needles, as are used for scalp and dural retraction during craniotomy, yields a useful tool for VNS implantation. Here we report our experience with this method...
December 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29289531/epileptic-seizures-are-reduced-by-autonomic-biofeedback-therapy-through-enhancement-of-fronto-limbic-connectivity-a-controlled-trial-and-neuroimaging-study
#20
Yoko Nagai, Julia Aram, Matthias Koepp, Louis Lemieux, Marco Mula, Hugo Critchley, Sanjay Sisodiya, Mara Cercignani
BACKGROUND: Thirty-percent of patients with epilepsy are drug-resistant, and might benefit from effective noninvasive therapeutic interventions. Evidence is accumulating on the efficacy of autonomic biofeedback therapy using galvanic skin response (GSR; an index of sympathetic arousal) in treating epileptic seizures. This study aimed to extend previous controlled clinical trials of autonomic biofeedback therapy with a larger homogeneous sample of patients with temporal lobe epilepsy. In addition, we used neuroimaging to characterize neural mechanisms of change in seizure frequency following the therapy...
December 13, 2017: EBioMedicine
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