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Drug-resistant AND epilepsy

Domenico Serino, Chiara Davico, Nicola Specchio, Carlo Efisio Marras, Franco Fioretto
Berardinelli-Seip syndrome, or congenital generalized lipodystrophy type 2 (CGL2), is characterized by a lack of subcutaneous adipose tissue and precocious metabolic syndrome with insulin resistance, resulting in diabetes, dyslipidaemia, hepatic steatosis, cardiomyopathy, and acanthosis nigricans. Most reported mutations are associated with mild, non-progressive neurological impairment. We describe the clinical and EEG data of a patient with progressive myoclonus epilepsy (PME), CGL2, and progressive neurological impairment, carrying a homozygous BSCL2 nonsense mutation...
February 15, 2019: Epileptic Disorders: International Epilepsy Journal with Videotape
Cristina Filipescu, Stanislas Lagarde, Isabelle Lambert, Francesca Pizzo, Agnès Trébuchon, Aileen McGonigal, Didier Scavarda, Romain Carron, Fabrice Bartolomei
We investigated the effect of electrical stimulation of the medial pulvinar (PuM) in terms of its effect on temporal lobe seizures. Eight patients with drug-resistant temporal lobe epilepsy undergoing stereoelectroencephalographic exploration were included. All had at least one electrode exploring the PuM. High-frequency (50 Hz) stimulations of the PuM were well tolerated in the majority of them. During diagnostic stimulation to confirm the epileptogenic zone, 19 seizures were triggered by stimulating the hippocampus...
February 14, 2019: Epilepsia
Prarthana Kharod, Devendra Mishra, Monica Juneja
BACKGROUND: Drug-resistant epilepsy (DRE), a condition in which seizures persist and seizure freedom is unlikely to be attained with further manipulation of anti-epileptic drugs, occurs in around 20% of children with epilepsy. This study was conducted with the aim to study the profile of Indian children with resistant epilepsy, using the new consensus definition of DRE. METHODS: All children who had been attending the Pediatric Neurology Clinic regularly for at least 6 months were reviewed between April and September 2015...
February 13, 2019: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Rowena M A Packer, Sarah L Hobbs, Emily J Blackwell
Epilepsy is a common, complex and often challenging neurological disorder to treat in the dog, with 20-30% of dogs resistant to conventional medical therapies, and associated with cognitive and behavioral comorbidities and early death. Behavioral interventions are an emerging area of focus in the adjunctive treatment of drug-resistant human epilepsy patients, with studies indicating positive effects of a variety of interventions including relaxation-based techniques and behavioral therapy interventions. Behavioral interventions have the potential not only to improve seizure control, but also improve behavioral comorbidities and general quality of life in this hard to treat patient group...
2019: Frontiers in Veterinary Science
David Jacquier, Christopher John Newman
OBJECTIVE: Children with motor disabilities such as cerebral palsy or neuromuscular diseases present more sleep disorders than their typically developing (TD) peers. However, research on these populations has always been performed using historical normative datasets or controls such as siblings. Therefore, we assessed the sleep quality of children with motor disabilities in comparison with a large, contemporary, general population sample. METHODS: Demographic, medical, and the Sleep Disturbance Scale for Children (SDSC) questionnaires were sent to parents of children aged 4-18 years and followed by our tertiary pediatric neurorehabilitation clinic, and to those of school-aged children in regional primary and secondary schools...
December 14, 2018: Sleep Medicine
Rachel Rolinski, Alison Austermuehle, Edythe Wiggs, Shubhi Agrawal, Leigh N Sepeta, William D Gaillard, Kareem A Zaghloul, Sara K Inati, William H Theodore
OBJECTIVE: To assess the ability of functional MRI (fMRI) to predict postoperative language decline compared to direct cortical stimulation (DCS) in epilepsy surgery patients. METHODS: In this prospective case series, 17 patients with drug-resistant epilepsy had intracranial monitoring and resection from 2012 to 2016 with 1-year follow-up. All patients completed preoperative language fMRI, mapping with DCS of subdural electrodes, pre- and postoperative neuropsychological testing for language function, and resection...
February 11, 2019: Epilepsia
Ravindra Arya, Brian Ervin, J Adam Wilson, Anna W Byars, Leonid Rozhkov, Jason Buroker, Paul S Horn, Craig Scholle, Hisako Fujiwara, Hansel M Greiner, James L Leach, Douglas F Rose, Francesco T Mangano, Tracy A Glauser, Katherine D Holland
OBJECTIVE: We studied age-related dynamics of information sharing among cortical language regions with electrocorticographic high-gamma modulation during picture-naming and story-listening tasks. METHODS: Seventeen epilepsy patients aged 4-19 years, undergoing extraoperative monitoring with left-hemispheric subdural electrodes, were included. Mutual information (MI), a nondirectional measure of shared information, between 16 pairs of cortical regions of interest, was computed from trial-averaged 70-150 Hz power modulations during language tasks...
February 11, 2019: Epilepsia
Jessica J Falco-Walter, Kelly Roehl, Bichun Ouyang, Antoaneta Balabanov
OBJECTIVE: Adults with drug-resistant epilepsy (DRE) are among the most challenging to treat. This study assessed whether specific subpopulations of adult patients with refractory epilepsy responded differently to modified ketogenic diet (MKD) therapy. METHODS: Changes in seizure frequency, severity, and quality of life (QOL) were retrospectively analyzed based on pre-MKD surgical history, type of epilepsy, imaging findings, and vagal nerve stimulation (VNS) history among adults, ≥17 years of age, with DRE, receiving MKD therapy for three months...
February 6, 2019: Epilepsy & Behavior: E&B
Musa M Watila, Fenglai Xiao, Mark R Keezer, Anna Miserocchi, Andrea S Winkler, Andrew W McEvoy, Josemir W Sander
BACKGROUND: Epilepsy surgery is an important treatment option for people with drug-resistant epilepsy. Surgical procedures for epilepsy are underutilized worldwide, but it is far worse in low- and middle-income countries (LMIC), and it is less clear as to what extent people with drug-resistant epilepsy receive such treatment at all. Here, we review the existing evidence for the availability and outcome of epilepsy surgery in LMIC and discuss some challenges and priority. METHODS: We used an accepted six-stage methodological framework for scoping reviews as a guide...
February 6, 2019: Epilepsy & Behavior: E&B
Aleksandar Gavrilovic, Gordana Toncev, Tatjana Boskovic Matic, Katarina Vesic, Jelena Ilic Zivojinovic, Jagoda Gavrilovic
Cognitive impairment frequently occurs in epilepsy patients. Patients with drug-resistant epilepsy (DRE) have poor drug responsivity and higher seizure frequency which consequently lead to brain damage and may have implications on cognitive status. In the present study, we assessed a frequency and degree of cognitive impairment in 52 patients with drug-sensitive epilepsy (DSE) and 103 DRE patients at three time points (baseline, after 12 and 18 months). Degree of cognitive decline was assessed with Montreal Cognitive Assessment (MoCA) scale...
February 8, 2019: Acta Neurologica Belgica
Haiyan Yang, Rui Zhang, Chen Jia, Mengyu Chen, Wen Yin, Liming Wei, Haisheng Jiao
CONTEXT: Epilepsy is a common life-threatening neurological disorder that is often drug-resistant and associated with cognitive impairment. The traditional Chinese patent medicine Songling Xuemaikang capsules (SXC) is clinically used for epilepsy therapy and alleviation of cognitive impairment. OBJECTIVE: This study investigates the neuronal protective effect of SXC combined with carbamazepine (CBZ) on epilepsy and cognitive impairment in kainic acid-kindled SD rats...
December 2019: Pharmaceutical Biology
Satoru Ikemoto, Shin-Ichiro Hamano, Yuko Hirata, Ryuki Matsuura, Reiko Koichihara
We retrospectively investigated whether perampanel (PER) could serve as an alternative for treating drug-resistant seizures in lissencephaly. We investigated the following data: age at onset of epilepsy, age at start of PER, etiology, brain MRI findings, seizure type, seizure frequency, adverse effects, and concomitant anti-epileptic drugs. There were 5 patients with lissencephaly, including 2 with Miller-Dieker syndrome. Four out of five patients exhibited ≥ 50% seizure reduction. Myoclonic seizures disappeared in 1 patient...
2019: Epilepsy & Behavior Case Reports
Yongxin Li, Ya Wang, Zhen Tan, Qian Chen, Wenhua Huang
The main focus of the present study was to explore the longitudinal changes in the brain executive control system and default mode network after hemispherotomy. Resting-state functional magnetic resonance imaging and diffusion tensor imaging were collected in two children with drug-resistnt epilepsy underwent hemispherotomy. Two patients with different curative effects showed different trajectories of brain connectivity after surgery. The failed hemispherotomy might be due to the fact that the synchrony of epileptic neurons in both hemispheres is preserved by residual neural pathways...
2019: Epilepsy & Behavior Case Reports
Ravindra Arya, Celie Roth, James L Leach, Denise Middeler, J Adam Wilson, Jennifer Vannest, Leonid Rozhkov, Hansel M Greiner, Jason Buroker, Craig Scholle, Hisako Fujiwara, Paul S Horn, Douglas F Rose, Nathan E Crone, Francesco T Mangano, Anna W Byars, Katherine D Holland
BACKGROUND: Language mapping with high-gamma modulation (HGM) has compared well with electrical cortical stimulation mapping (ESM). However, there is limited prospective data about its functional validity. We compared changes in neuropsychological evaluation (NPE) performed before and 1-year after epilepsy surgery, between patients with/without resection of cortical sites showing HGM during a visual naming task. METHODS: Pediatric drug-resistant epilepsy (DRE) patients underwent pre-surgical language localization with ESM and HGM using a visual naming task...
January 29, 2019: Epilepsy Research
Dong Wook Kim, Hyun Kyung Kim, Eun-Kee Bae
PURPOSE: Lacosamide (LCM) is a recently developed sodium channel blocker (SCB), which acts mainly on the slow activation state in sodium channels. Although LCM shares a range of dose-dependent adverse effects with traditional SCBs, it has several advantages in that it does not induce hepatic drug metabolizing enzymes and has less risk of drug interactions and idiosyncratic adverse effects. METHODS: We retrospectively analyzed the efficacy and tolerability of switching from traditional SCBs to LCM...
January 30, 2019: Seizure: the Journal of the British Epilepsy Association
Reza Rahmanzadeh, Soraya Mehrabi, Mahmood Barati, Milad Ahmadi, Fereshteh Golab, Sareh Kazmi, Mohammad Taghi Joghataei, Morteza Seifi, Mazaher Gholipourmalekabadi
Introduction: The resistance of temporal lobe epilepsy to classic drugs is thought to be due to disruption in the excitation/inhibition of this pathway. Two chloride transporters, NKCC1 and KCC2, are expressed differently for the excitatory state of Gamma-Amino Butyric Acid (GABA). The present study explored the effect of bumetanide as a selective NKCC1 inhibitor either alone or in combination with the phenobarbital in the pilocarpine model of epilepsy. Methods: An animal model of Status Epilepticus (SE) was induced with pilocarpine in Wistar male rats followed by phenobarbital and or bumetanide or saline administration for 45 days after the induction of SE by Intraperitoneal (IP) injection...
November 2018: Basic and Clinical Neuroscience
Thapanee Somboon, Madeleine M Grigg-Damberger, Nancy Foldvary-Schaefer
Epilepsy is the fourth most common neurological disorder in the US, affecting over 2.2 million people. Epilepsy is associated with a number of medical and psychiatric comorbidities, higher health care utilization, cost and substantial economic burden. Obstructive sleep apnea (OSA) is 2-fold more common in adults with epilepsy than age-matched controls and the incidence increases with age. Self-reported daytime sleepiness is not helpful in predicting OSA, possibly related to the ceiling effect of general sleepiness among people with epilepsy from diverse causes...
January 31, 2019: Chest
Young-Min Shon, Sung Chul Lim, Seong Hoon Lim
The effects of repetitive transcranial magnetic stimulation (rTMS) on epilepsy remain unclear. This study was performed to investigate the effects of low-frequency rTMS on non-lesional focal epilepsy. This was a prospective open-label longitudinal study with four patients with multi-drug-resistant non-lesional focal epilepsy and no control group. The patients received daily doses of 900 pulses of 0.5-Hz stimulation for 10 days over the epileptic foci in neocortical areas determined by electrical source analysis...
January 30, 2019: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Emily L Johnson
Epilepsy affects 65 million people worldwide, and is a leading neurologic cause of loss of quality-adjusted life years. The diagnosis of seizures and epilepsy often depends on a careful history, and is supported with electroencephalogram and imaging. First-line treatment of epilepsy includes medical management. Antiepileptic drugs must be chosen with the patient's particular comorbidities in mind. Drug-resistant epilepsy cases should be referred to an epilepsy specialist and may be evaluated for additional medications, epilepsy surgery, neurostimulation, or dietary therapy...
March 2019: Medical Clinics of North America
Shoichi Shimamoto, Chengyuan Wu, Michael R Sperling
PURPOSE OF REVIEW: MRI-guided stereotactic laser interstitial thermal therapy (LiTT) has been utilized in the surgical treatment of discrete, small epileptogenic lesions. This review summarizes the current literature and addresses the clinical application of this technique. RECENT FINDINGS: LiTT has the potential to reduce the morbidity and discomfort of epilepsy surgery. Review of data from retrospective, uncontrolled studies suggests that LiTT may offer benefit when treating drug-resistant epilepsy because of mesial temporal sclerosis, hypothalamic hamartoma, cavernous hemangioma, and small cortical dysplasias and malformations...
January 28, 2019: Current Opinion in Neurology
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