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Epilepsy literature

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17 papers 25 to 100 followers
By Andreas Tarnaris Consultant Neurosurgeon
Churl-Su Kwon, Valeria Ripa, Omar Al-Awar, Fedor Panov, Saadi Ghatan, Nathalie Jetté
Neuromodulation is a treatment strategy that is increasingly being utilized in those suffering from drug-resistant epilepsy who are not appropriate for resective surgery. The number of double-blinded RCTs demonstrating the efficacy of neurostimulation in persons with epilepsy is increasing. Although reductions in seizure frequency is common in these trials, obtaining seizure freedom is rare. Invasive neuromodulation procedures (DBS, VNS, and RNS) have been approved as therapeutic measures. However, further investigations are necessary to delineate effective targeting, minimize side effects that are related to chronic implantation and to improve the cost effectiveness of these devices...
April 18, 2018: Brain Sciences
Byung-Chul Son, Jin-Gyu Choi, Sang-Woo Ha
Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is an effective treatment for refractory epilepsy. Due to the unique location of ANT in the thalamus facing the lateral and third ventricles, transventricular DBS lead placement is an essential part of ANT DBS. However, there is no report regarding hardware problems including impedance variability in transventricular ANT DBS due to limited experience. A 45-year-old male patient with previously effective, bilateral ANT DBS presented with increasing seizure frequency and a shortened battery longevity within 2 years...
April 2018: Asian Journal of Neurosurgery
Chad R Gordon, Gabriel F Santiago, Judy Huang, Gregory K Bergey, Shuya Liu, Mehran Armand, Henry Brem, William S Anderson
BACKGROUND: Neuromodulation devices have the potential to transform modern day treatments for patients with medicine-resistant neurological disease. For instance, the NeuroPace System (NeuroPace Inc, Mountain View, California) is a Food and Drug Administration (FDA)-approved device developed for closed-loop direct brain neurostimulation in the setting of drug-resistant focal epilepsy. However, current methods require placement either above or below the skull in nonanatomic locations. This type of positioning has several drawbacks including visible deformities and scalp pressure from underneath leading to eventual wound healing difficulties, micromotion of hardware with infection, and extrusion leading to premature explantation...
October 6, 2017: Operative Neurosurgery (Hagerstown, Md.)
Evren Burakgazi Dalkilic
Epilepsy is a chronic neurological disorder frequently requiring lifelong treatment. In 70% of epilepsy patients, seizures are well controlled by antiepileptic medications. About 30% of epilepsy patients remain refractory to medical treatments and may need surgical interventions for better seizure control. Unfortunately and not infrequently, surgical intervention is not feasible due to various reasons such as multiple seizure foci, not resectable focus because of eloquent cortex location, or inability to tolerate surgery due to ongoing concomitant medical conditions...
February 2017: Current Treatment Options in Neurology
Markus Gschwind, Margitta Seeck
Complete seizure control is achieved in 40-50% of all epileptic patients with drug treatment, as reported in most epidemiological studies. Many effective antiepileptic drugs with a favourable profile are available in Switzerland, allowing treatment tailored to the patient's needs. Unfortunately, up to 40-50% of all patients will eventually relapse (pharmacoresistant epilepsy). These patients run a high risk of additional morbidity and mortality. Possible pharmacoresistant epilepsy should be considered early in the disease, when there is a lack of response to the first antiepileptic drug, since only 14% of those will respond to a second drug, and only 2% to a third drug if the second fails too...
2016: Swiss Medical Weekly
Ryosuke Hanaya, Kazunori Arita
The administration of antiepileptic drugs (AEDs) is the first treatment of epilepsy, one of the most common neurological diseases. Therapeutic guidelines include newer AEDs as front-line drugs; monotherapy with new AEDs is delivered in Japan. While about 70% of patients obtain good seizure control by taking one to three AEDs, about 60% experience adverse effects and 33% have to change drugs. Compared to traditional AEDs, the prolonged administration of new AEDs elicits fewer adverse effects and fewer drug interactions and their teratogenicity may be lower...
May 15, 2016: Neurologia Medico-chirurgica
Dario J Englot, Harjus Birk, Edward F Chang
In approximately 30 % of patients with epilepsy, seizures are refractory to medical therapy, leading to significant morbidity and increased mortality. Substantial evidence has demonstrated the benefit of surgical resection in patients with drug-resistant focal epilepsy, and in the present journal, we recently reviewed seizure outcomes in resective epilepsy surgery. However, not all patients are candidates for or amenable to open surgical resection for epilepsy. Fortunately, several nonresective surgical options are now available at various epilepsy centers, including novel therapies which have been pioneered in recent years...
April 2017: Neurosurgical Review
Fernando Alonso, Jennifer Sweet, Jonathan Miller
OBJECTIVES: The Wada test is the gold standard for identification of the side of speech dominance but is associated with risk of angiography and requires patient cooperation. We report a method to verify speech laterality using implanted electrodes in patients undergoing stereo-encephalography (SEEG). PATIENTS AND METHODS: Four pediatric patients with frontal lobe drug-resistant epilepsy underwent implantation of multiple SEEG electrodes using framed stereotaxy to identify the epileptogenic zone, including electrodes placed bilaterally into the pars opercularis of each inferior frontal gyrus from a superior parasagittal entry point...
May 2016: Clinical Neurology and Neurosurgery
Igor Kuzmanovski, Emilija Cvetkovska, Marija Babunovska, Gordana Kiteva Trencevska, Biljana Kuzmanovska, Bojan Boshkovski, Rozalinda Isjanovska
OBJECTIVE: Surveys on mesial temporal lobe epilepsy (MTLE) repeatedly demonstrate that seizures are commonly resistant to antiepileptic drugs (AED), but patients usually came from third-level epilepsy centers, making the medically refractory population larger. The aim of our study is to evaluate patterns of seizure control and prognostic factors of general population of MTLE patients observed in clinical practice. METHODS: Sixty five MTLE patients were evaluated for demographic data, family history, febrile convulsions, detailed descriptions of auras and seizures, presence of secondarily generalized seizures, age at seizure onset, duration of epilepsy, epileptiform discharges in EEG, neuroradiological findings and AED schedules with therapeutic response...
May 2016: Clinical Neurology and Neurosurgery
Brian J Dlouhy, Brian K Gehlbach, George B Richerson
Sudden unexpected death in epilepsy (SUDEP) is the most common cause of death in patients with intractable epilepsy. The substantial lifetime risk of SUDEP and the lack of a clear pathophysiological connection between epilepsy itself and sudden death have fuelled increased attention to this phenomenon. Understanding the mechanisms underlying SUDEP is paramount to developing preventative strategies. In this review, we discuss SUDEP population studies, case-control studies, witnessed and monitored cases, as well as human seizure cardiorespiratory findings related to SUDEP, and SUDEP animal models...
April 2016: Journal of Neurology, Neurosurgery, and Psychiatry
Naotaka Usui
This article reviews the current topics in the field of epilepsy surgery. Each type of epilepsy is associated with a different set of questions and goals. In mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (HS), postoperative seizure outcome is satisfactory. A recent meta-analysis revealed superior seizure outcome after anterior temporal lobectomy compared with selective amygdalohippocampectomy; in terms of cognitive outcome; however, amygdalohippocampectomy may be beneficial. In temporal lobe epilepsy with normal magnetic resonance imaging (MRI), postoperative seizure outcome is not as favorable as it is in MTLE with HS; further improvement of seizure outcome in these cases is necessary...
May 15, 2016: Neurologia Medico-chirurgica
Vibhor Krishna, Nicolas Kon Kam King, Francesco Sammartino, Ido Strauss, Danielle M Andrade, Richard A Wennberg, Andres M Lozano
BACKGROUND: Anterior nucleus (AN) deep brain stimulation (DBS) is a palliative treatment for medically refractory epilepsy. The long-term efficacy and the optimal target localization for AN DBS are not well understood. OBJECTIVE: To analyze the long-term efficacy of AN DBS and its predictors. METHODS: We performed a retrospective review of 16 patients who underwent AN DBS. We selected only patients with reliable seizure frequency data and at least a 1-year follow-up...
June 2016: Neurosurgery
Dario J Englot, John D Rolston, Clinton W Wright, Kevin H Hassnain, Edward F Chang
BACKGROUND: Neuromodulation-based treatments have become increasingly important in epilepsy treatment. Most patients with epilepsy treated with neuromodulation do not achieve complete seizure freedom, and, therefore, previous studies of vagus nerve stimulation (VNS) therapy have focused instead on reduction of seizure frequency as a measure of treatment response. OBJECTIVE: To elucidate rates and predictors of seizure freedom with VNS. METHODS: We examined 5554 patients from the VNS therapy Patient Outcome Registry, and also performed a systematic review of the literature including 2869 patients across 78 studies...
September 2016: Neurosurgery
Khara M Sauro, Samuel Wiebe, Colin Dunkley, Jozsef Janszky, Eva Kumlien, Solomon Moshé, Nobukazu Nakasato, Timothy A Pedley, Emilio Perucca, Horacio Senties, Sanjeev V Thomas, Yuping Wang, Jo Wilmshurst, Nathalie Jetté
OBJECTIVE: The International League Against Epilepsy (ILAE) Epilepsy Guidelines Task Force, composed of 14 international members, was established in 2011 to identify, using systematic review methodology, international epilepsy clinical care guidelines, assess their quality, and determine gaps in areas of need of development. METHODS: A systematic review of the literature (1985-2014) was performed in six electronic databases (e.g. Medline, Embase) using a broad search strategy without initial limits to language or study design...
January 2016: Epilepsia
Niels Verburg, Johannes C Baayen, Sander Idema, Michiel A J Klitsie, Steven Claus, Catharina S de Jonge, W Peter Vandertop, Philip C de Witt Hamer
BACKGROUND: Accurate frameless neuronavigation is highly important in cranial neurosurgery. The accuracy demonstrated in phantom models might not be representative for results in patients. Few studies describe the in vivo quantitative accuracy of neuronavigation in patients. The use of a frameless stereotactic drilling technique for stereoelectroencephalography depth electrode implantation in epilepsy patients, as well as diagnostic biopsies, provides a unique opportunity to assess the accuracy with postoperative imaging of preoperatively planned trajectories...
March 2016: World Neurosurgery
K Lehtimäki, T Möttönen, K Järventausta, J Katisko, T Tähtinen, J Haapasalo, T Niskakangas, T Kiekara, J Öhman, J Peltola
BACKGROUND: Deep brain stimulation of the anterior nucleus of the thalamus (ANT) is an emerging therapy for refractory focal epilepsy. However, the most optimal target for stimulation has not been unambiguously described. OBJECTIVE: In the present study, we investigated the correlation between the stimulation site and outcome in order to define the optimal target for deep brain stimulation in refractory epilepsy. METHODS: The locations of 62 contacts used in 30 treatment attempts in 15 prospectively followed patients during a 5 year period were assessed...
March 2016: Brain Stimulation
Jianhang Jiao, Kristian R Harreby, Cristian Sevcencu, Winnie Jensen
Vagus nerve stimulation (VNS) is used as an adjunctive therapy for drug-resistant epilepsy and results in a 50% seizure reduction in up to 50% of treated patients. The VNS frequency used in the clinic today is in the range of 10-30 Hz. The evidence for choosing the stimulation frequency is limited, and little knowledge is available on the effect of other VNS frequencies. Deep brain, trigeminal nerve, or spinal cord stimulation studies have suggested the use of stimulation frequencies above 80 Hz for seizure control...
June 2016: Artificial Organs
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