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By Alejandro Herrera Trujillo Neurosurgeon epilepsy surgery,
https://www.readbyqxmd.com/read/29117924/red-flags-in-epilepsy-surgery-identifying-the-patients-who-pay-a-high-cognitive-price-for-an-unsuccessful-surgical-outcome
#1
Sallie Baxendale, Pamela Thompson
Preoperative estimates of cognitive and seizure outcome must be as accurate as possible if the candidate is to make an informed decision about epilepsy surgery. Significant declines in memory function are reported in approximately 30% of temporal lobe surgery patients. The percentage varies according to the ways in which a postoperative deterioration is defined but since the majority of outcome studies do not take into account the patient's capacity to deteriorate if they are functioning at or close to the floor of a memory test prior to surgery, the published percentages may be an underrepresentation of the true extent of memory decline following epilepsy surgery...
November 5, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29128469/the-different-patterns-of-seizure-induced-aphasia-in-temporal-lobe-epilepsies
#2
Agnès Trebuchon, Isabelle Lambert, Bernard Guisiano, Aileen McGonigal, Charline Perot, Francesca Bonini, Romain Carron, Catherine Liegeois-Chauvel, Patrick Chauvel, Fabrice Bartolomei
OBJECTIVES: Ictal language disturbances may occur in dominant hemisphere temporal lobe epilepsy (TLE), but little is known about the precise anatomoelectroclinical correlations. This study investigated the different facets of ictal aphasia in intracerebrally recorded TLE. METHODS: Video-stereoelectroencephalography (SEEG) recordings of 37 seizures in 17 right-handed patients with drug-resistant TLE were analyzed; SEEG electroclinical correlations between language disturbance and involvement of temporal lobe structures were assessed...
November 8, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29137921/intraoperative-definition-of-bottom-of-sulcus-dysplasia-using-intraoperative-ultrasound-and-single-depth-electrode-recording-a-technical-note
#3
Dorothea Miller, Patrick Carney, John S Archer, Gregory J Fitt, Graeme D Jackson, Kristian J Bulluss
Bottom of sulcus dysplasias (BOSDs) are localized focal cortical dysplasias (FCDs) centred on the bottom of a sulcus that can be highly epileptogenic, but difficult to delineate intraoperatively. We report on a patient with refractory epilepsy due to a BOSD, successfully resected with the aid of a multimodal surgical approach using neuronavigation based on MRI and PET, intraoperative ultrasound (iUS) and electrocorticography (ECoG) using depth electrodes. The lesion could be visualized on iUS showing an increase in echogenicity at the grey-white matter junction...
November 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29066951/connexin43-and-pannexin-based-channels-in-neuroinflammation-and-cerebral-neuropathies
#4
REVIEW
Denis Sarrouilhe, Catherine Dejean, Marc Mesnil
Connexins (Cx) are largely represented in the central nervous system (CNS) with 11 Cx isoforms forming intercellular channels. Moreover, in the CNS, Cx43 can form hemichannels (HCs) at non-junctional membrane as does the related channel-forming Pannexin1 (Panx1) and Panx2. Opening of Panx1 channels and Cx43 HCs appears to be involved in inflammation and has been documented in various CNS pathologies. Over recent years, evidence has accumulated supporting a link between inflammation and cerebral neuropathies (migraine, Alzheimer's disease (AD), Parkinson's disease (PD), major depressive disorder, autism spectrum disorder (ASD), epilepsy, schizophrenia, bipolar disorder)...
2017: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/28780154/chemokines-as-new-inflammatory-players-in-the-pathogenesis-of-epilepsy
#5
REVIEW
Chiara Cerri, Matteo Caleo, Yuri Bozzi
A large series of clinical and experimental studies supports a link between inflammation and epilepsy, indicating that inflammatory processes within the brain are important contributors to seizure recurrence and precipitation. Systemic inflammation can precipitate seizures in children suffering from epileptic encephalopathies, and hallmarks of a chronic inflammatory state have been found in patients with temporal lobe epilepsy. Research performed on animal models of epilepsy further corroborates the idea that seizures upregulate inflammatory mediators, which in turn may enhance brain excitability and neuronal degeneration...
October 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28912503/systematic-review-and-meta-analysis-of-differentially-expressed-mirnas-in-experimental-and-human-temporal-lobe-epilepsy
#6
A Korotkov, J D Mills, J A Gorter, E A van Vliet, E Aronica
Temporal lobe epilepsy (TLE) is a common chronic neurological disease in humans. A number of studies have demonstrated differential expression of miRNAs in the hippocampus of humans with TLE and in animal models of experimental epilepsy. However, the dissimilarities in experimental design have led to largely discordant results across these studies. Thus, a comprehensive comparison is required in order to better characterize miRNA profiles obtained in various post-status epilepticus (SE) models. We therefore created a database and performed a meta-analysis of differentially expressed miRNAs across 3 post-SE models of epileptogenesis (electrical stimulation, pilocarpine and kainic acid) and human TLE with hippocampal sclerosis (TLE-HS)...
September 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28950818/inflammation-and-epilepsy-preclinical-findings-and-potential-clinical-translation
#7
Gaetano Terrone, Alessia Salamone, Annamaria Vezzani
BACKGROUND: The lack of treatments which can prevent epilepsy development or improve disease prognosis represents an unmet and urgent clinical need. The development of such drugs requires a deep understanding of the mechanisms underlying disease pathogenesis. In the last decade, preclinical studies in models of acute seizures and of chronic epilepsy highlighted that neuroinflammation arising in brain areas of seizure onset and generalization is a key contributor to neuronal hyper-excitability underlying seizure generation...
September 25, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28965622/chronic-inflammation-in-refractory-hippocampal-sclerosis-related-temporal-lobe-epilepsy
#8
REVIEW
Jordan M Gales, Richard A Prayson
Emerging evidence suggests chronic inflammation may play a role in hippocampal sclerosis-associated temporal lobe epilepsy. We sought to systematically evaluate for its presence in a group of 315 patients who underwent surgery for medically-refractory epilepsy and who had hippocampal sclerosis. Upon histologic review of hematoxylin and eosin stained tissue sections, 95 (41%) cases demonstrated the presence of lymphocytes within the perivascular region and diffusely within the brain parenchyma. Those cases with chronic inflammation evident on hematoxylin and eosin staining were significantly more likely to experience a post-operative seizure recurrence than those without it (p=0...
October 2017: Annals of Diagnostic Pathology
https://www.readbyqxmd.com/read/28532711/psychiatric-comorbidities-in-new-onset-epilepsy-should-they-be-always-investigated
#9
REVIEW
Andres M Kanner
The new definition of epilepsy establishes that epilepsy is not only a disorder presenting with epileptic seizures but it can be often associated with cognitive and psychiatric comorbidities. In fact, the prevalence of psychiatric comorbidities is relatively high in patients with epilepsy (PWE), as one in three patients will have experienced a psychiatric disorder in the course of their life, with mood and anxiety disorders being the most frequent. Psychiatric comorbidities often precede the onset of the seizure disorder, and affect the life of these patients and the course of the seizure disorder at several levels, including a worse tolerance of pharmacotherapy with antiepileptic drugs (AEDs), in particular the development of iatrogenic psychiatric symptoms from pharmacologic and surgical treatments, an increased mortality risk, a worse quality of life and higher economic burdens of the patient, family and society as a hole...
July 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28672217/do-people-with-epilepsy-have-a-different-lifestyle
#10
Clara Aguirre, Sonia Quintas, Ana María Ruiz-Tornero, Guadalupe Alemán, Ana Betariz Gago-Veiga, María de Toledo, Jose Vivancos
BACKGROUND: Epilepsy is one of the most common neurological diseases. Its high prevalence, economic relevance and impact on daily life make it crucial that we study this condition in further detail. Our study seeks to investigate whether the lifestyle of people diagnosed with epilepsy is different to that of people without epilepsy, in order to better understand our patients. METHODS: We designed and delivered a questionnaire about quality of life and daily habits to patients from our hospital's Epilepsy Unit...
September 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28715945/methodological-issues-associated-with-clinical-trials-in-epilepsy
#11
REVIEW
Edoardo Ferlazzo, Chiara Sueri, Sara Gasparini, Emilio Russo, Vittoria Cianci, Michele Ascoli, Giovambattista De Sarro, Umberto Aguglia
despite methodological advances in epilepsy clinical trials, the proportion of patients reaching seizure-freedom has not substantially changed over the years. We review the main methodological limitations of current trials, the possible strategies to overcome these limits, and the issues that need to be addressed in next future. Area covered: references were identified by PubMed search until March 2017 and unpublished literature was searched on ClinicalTrials.gov. Add-on trials mainly involve refractory epilepsy subjects, reducing overall response to the investigational drug...
October 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28928712/metabolomics-as-a-tool-for-the-characterization-of-drug-resistant-epilepsy
#12
Federica Murgia, Antonella Muroni, Monica Puligheddu, Lorenzo Polizzi, Luigi Barberini, Gianni Orofino, Paolo Solla, Simone Poddighe, Francesco Del Carratore, Julian L Griffin, Luigi Atzori, Francesco Marrosu
PURPOSE: Drug resistance is a critical issue in the treatment of epilepsy, contributing to clinical emergencies and increasing both serious social and economic burdens on the health system. The wide variety of potential drug combinations followed by often failed consecutive attempts to match drugs to an individual patient may mean that this treatment stage may last for years with suboptimal benefit to the patient. Given these challenges, it is valuable to explore the availability of new methodologies able to shorten the period of determining a rationale pharmacologic treatment...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29070664/epidemiology-of-recurrent-traumatic-brain-injury-in-the-general-population-a-systematic-review
#13
REVIEW
Oliver Lasry, Erin Y Liu, Guido Antonio Powell, Jessica Ruel-Laliberté, Judith Marcoux, David L Buckeridge
OBJECTIVE: To comprehensively assess recurrent traumatic brain injury (rTBI) risk and risk factors in the general population. METHODS: We systematically searched MEDLINE, EMBASE, and the references of included studies until January 16, 2017, for general population observational studies reporting rTBI risk or risk factors. Estimates were not meta-analyzed due to significant methodologic heterogeneity between studies, which was evaluated using meta-regression. RESULTS: Twenty-two studies reported recurrence risk and 11 reported on 27 potential risk factors...
October 25, 2017: Neurology
https://www.readbyqxmd.com/read/29141532/seizures-and-antiepileptic-drugs-from-pathophysiology-to-clinical-practice
#14
Nihan CarCaka, Cigdem Ozkara
Recurrent, spontaneous seizure activity caused by abnormal neuronal firing in the brain is a hallmark of epilepsy, a common chronic neurological disorder. Recent research that has expanded the knowledge of the cellular and molecular mechanisms that modulate neuronal excitability and network activity in the brain provides the development and discovery of antiepileptic drugs (AEDs). AED therapy starts with the selection of the most appropriate drug for individual patient on the basis of strategic decision of the risk-benefit ratio...
November 14, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29130506/animal-models-of-acquired-epilepsy-insights-into-mechanisms-of-human-epileptogenesis
#15
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/27763536/fluid-biomarkers-of-traumatic-brain-injury-and-intended-context-of-use
#16
REVIEW
Tanya Bogoslovsky, Jessica Gill, Andreas Jeromin, Cora Davis, Ramon Diaz-Arrastia
Traumatic brain injury (TBI) is one of the leading causes of death and disability around the world. The lack of validated biomarkers for TBI is a major impediment to developing effective therapies and improving clinical practice, as well as stimulating much work in this area. In this review, we focus on different settings of TBI management where blood or cerebrospinal fluid (CSF) biomarkers could be utilized for predicting clinically-relevant consequences and guiding management decisions. Requirements that the biomarker must fulfill differ based on the intended context of use (CoU)...
October 18, 2016: Diagnostics
https://www.readbyqxmd.com/read/27857621/how-and-why-study-posttraumatic-epileptogenesis-in-animal-models
#17
Bret N Smith
Traumatic brain injury (TBI) greatly increases the risk of medically intractable epilepsy. Several models of TBI have been developed to investigate the relationship between TBI and posttraumatic epileptogenesis. Because the incident that precipitates development of epilepsy is known, studying mechanisms of epileptogenesis, identifying biomarkers to predict PTE, and developing treatments to prevent epilepsy after TBI are attainable research goals.
November 2016: Epilepsy Currents
https://www.readbyqxmd.com/read/27909008/trajectory-of-parvalbumin-cell-impairment-and-loss-of-cortical-inhibition-in-traumatic-brain-injury
#18
Tsung-Hsun Hsieh, Henry Hing Cheong Lee, Mustafa Qadir Hameed, Alvaro Pascual-Leone, Takao K Hensch, Alexander Rotenberg
Many neuropsychiatric symptoms that follow traumatic brain injury (TBI), including mood disorders, sleep disturbance, chronic pain, and posttraumatic epilepsy (PTE) are attributable to compromised cortical inhibition. However, the temporal trajectory of cortical inhibition loss and its underlying mechanisms are not known. Using paired-pulse transcranial magnetic stimulation (ppTMS) and immunohistochemistry, we tracked functional and cellular changes of cortical inhibitory network elements after fluid-percussion injury (FPI) in rats...
December 1, 2017: Cerebral Cortex
https://www.readbyqxmd.com/read/29057628/apraxia-review-and-update
#19
REVIEW
Jung E Park
Praxis, the ability to perform skilled or learned movements is essential for daily living. Inability to perform such praxis movements is defined as apraxia. Apraxia can be further classified into subtypes such as ideomotor, ideational and limb-kinetic apraxia. Relevant brain regions have been found to include the motor, premotor, temporal and parietal cortices. Apraxia is found in a variety of highly prevalent neurological disorders including dementia, stroke and Parkinsonism. Furthermore, apraxia has been shown to negatively affect quality of life...
October 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28675559/neuroinflammation-in-epileptogenesis-insights-and-translational-perspectives-from-new-models-of-epilepsy
#20
Melissa L Barker-Haliski, Wolfgang Löscher, H Steve White, Aristea S Galanopoulou
Animal models have provided a wealth of information on mechanisms of epileptogenesis and comorbidogenesis, and have significantly advanced our ability to investigate the potential of new therapies. Processes implicating brain inflammation have been increasingly observed in epilepsy research. Herein we discuss the progress on animal models of epilepsy and comorbidities that inform us on the potential role of inflammation in epileptogenesis and comorbidity pathogenesis in rodent models of West syndrome and the Theiler's murine encephalomyelitis virus (TMEV) mouse model of viral encephalitis-induced epilepsy...
July 2017: Epilepsia
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