OBJECTIVE: In certain chronic neuropathic pain (CNP) conditions, extradural electrode implantation is preferred to a subdural location for motor cortex stimulation (MCS) therapy, but the rationale for this preference remains debatable. We provide documented long-term results of subdural MCS in CNP. METHODS: Our eight consecutive patients (five men, three women; ...

The efficacy of treatment with cerebrolysin was studied in 40 patients with cerebral vascular insufficiency. Cerebrolysin (20 daily i.v. infusions of 10 ml in 200 ml of physiological saline) was found to be an effective means of treating this group of patients. Courses of cerebrolysin treatment decreased the severity of ...

OBJECT: The authors propose that anterior callosotomy -- thought to have some advantages over total callosotomy -- is not superior to total callosotomy for prevention of seizure propagation or other complications. METHODS: The study comprised 34 patients in whom generalized epilepsy syndrome or frontal lobe seizures with a secondary generalization ...

OBJECT: Occipital lobe epilepsy (OLE) accounts for a small percentage of extratemporal epilepsies and only few and mostly small patient series have been reported. Preoperative findings, surgical strategies, histopathological bases, and postoperative outcomes for OLE remain to be elucidated. METHODS: A group of 54 patients with occipital lobe involvement were ...

Most results reported in studies focusing on long-term outcomes of epilepsy surgery resemble those reported in studies with shorter follow-up, indicating that many of the surgical results are enduring. In general, about 60% of patients with temporal epilepsy and 25% to 40% of those with extratemporal epilepsy achieve long-term seizure ...

Epilepsy surgery treatment should be considered as standard of care for all patients with medically intractable partial-onset epilepsy who are found to be good surgical candidates based on their presurgical evaluation. Delaying surgical treatment continues to be a problem among neurologists. The early recognition of pharmacoresistance and patients' referral for ...

The aim of this study was to analyse the suspected adverse reactions associated with rituximab or trastuzumab reported to the Spanish Pharmacovigilance System. From this national database, we selected the spontaneous reports registered between 1 January 1999 and 1 June 2006 and analysed both age and gender of the patient, ...

Status epilepticus (SE) is a neurological emergency that requires prompt diagnosis and treatment, as delay is associated with a higher likelihood of poor response to treatment and worse outcome. Lorazepam has been well established as a first-line therapy. Subsequent steps are less established, and there are many reasonable options, including ...

OBJECTIVES: To evaluate levetiracetam (LEV) tolerability in patients with epilepsy and liver disease. METHODS: Fourteen patients with epilepsy and concomitant liver disease were treated with LEV in an open prospective investigation mimicking the daily clinical practice. All patients were stabilized (ie, for at least 1 year) on traditional antiepileptic drugs ...

We report on the long-term follow-up of a patient with refractory non-convulsive SE who was successfully treated with VNS. A 7-year old girl with a medical history of thrombosis in the right internal cerebral vein and right thalamic bleeding 8 days after birth, developed epilepsy at the age of 13 ...

BACKGROUND: Earlier studies have reported that hippocampal atrophy can to some extent predict which patients with mild cognitive impairment (MCI) will subsequently convert to dementia, and that converters have an enhanced rate of hippocampal volume loss. OBJECTIVE: To further validate the hypothesis that hippocampal atrophy predicts conversion from MCI to ...

In a retrospective evaluation of 32 inpatients with therapy-resistant epilepsy and intellectual disability, the efficacy of pregabalin (PGB) treatment was assessed after 6 and 12 months. The combined efficacy measure included the percentage reduction in seizure frequency, as well as the Clinical Global Impression (CGI) scale. Tolerability was assessed using ...

OBJECTIVES: To investigate whether zonisamide remains effective and well tolerated in the treatment of refractory partial epilepsy during long-term treatment and with flexible dosing in clinical practice. MATERIALS AND METHODS: Patients with refractory partial epilepsy who completed a fixed-dose, randomized, double-blind clinical trial were recruited in an open-label extension study ...

Steroids are commonly used for the treatment of intractable epilepsy. Deflazacort has shown similar effects to prednisone, but with a less worrying adverse-effect profile. In this study, we first compared the efficacy, safety, and seizure relapse rate of deflazacort versus hydrocortisone in children affected by drug-resistant epilepsies. This was an ...

Coronal incisions are used in traumatic, reconstructive, and cosmetic procedures to access the lateral facial skeleton. Temporal hollowing is a common complication following coronal incision that affects the patient both physically and psychologically. Several dissections have been recommended through this area to avoid injury to the frontal branch of the ...

Adrenocorticotrophic hormone (ACTH) therapy is an established treatment for West syndrome. However, some patients may relapse after this therapy, for whom there is no established treatment. We describe 3 patients with symptomatic West syndrome and multiple, poor prognostic factors who relapsed after initial ACTH therapy. They were treated with a ...

BACKGROUND: In adult patients, autoantibodies targeting the water channel aquaporin-4 (AQP4) are a biomarker for a spectrum of CNS inflammatory demyelinating disorders with predilection for optic nerves and spinal cord (neuromyelitis optica [NMO]). Here we describe the neurologic, serologic, and radiographic findings associated with CNS AQP4 autoimmunity in childhood. METHODS: ...

PURPOSE: To define characteristics of subclinical seizures (SCS) and their prognostic significance after epilepsy surgery. METHODS: Reports from intracranial video-EEG monitoring were reviewed for patients who had epilepsy surgery between 1989 and 2003. Relationships between SCS and clinical seizures were categorized as either: complete colocalization (Group A), when both SCS ...

BACKGROUND: Psychiatric disorders may occur in patients with intractable partial epilepsy after surgical treatment. Previous reports attributed the presence of psychological adverse events to specific pathological entities such as dysembryoplastic neuroepithelial tumors (DNETs) and gangliogliomas. The rationale for the present study is to evaluate the importance of the surgical pathology ...

OBJECTIVES: The aim of the study described here was to characterize the efficacy and safety of vagus nerve stimulation in a population of patients with tuberous sclerosis complex (TSC) and intractable epilepsy. METHODS: This retrospective study comprised 16 patients with TSC who underwent implantation of a vagus nerve stimulator for ...

OBJECTIVE: To identify predictors of outcome after epilepsy surgery in patients with temporal lobe epilepsy (TLE). METHODS: Seventy-six patients with normal magnetic resonance imaging (MRI) or hippocampal sclerosis on MRI who underwent anterior temporal lobe resections were included. Outcome 2 years after surgery was classified as good (Engel I and ...

BACKGROUND: Deep brain stimulation (DBS) has re-emerged as an alternative therapy for intractable epilepsy. In this study, we investigated the feasibility, efficacy and safety of long-term anterior thalamic nucleus (ATN) stimulation for intractable epilepsy. METHODS: In this open-label pilot study of electrical stimulation of the ATN, we investigated four cases ...

OBJECTIVE: The purpose of this prospective work was to evaluate the relationship between seizure outcome and psychosocial status in patients who underwent temporal lobe epilepsy surgery for medically intractable seizure. METHODS: The Liverpool Psychosocial Battery, which includes physical, social, and psychological domains, was completed by 63 patients with temporal lobe ...

OBJECTIVE: This study investigates the feasibility, safety, and usefulness of depth electrodes stereotactically implanted within the insular cortex. METHODS: Thirty patients with suspected insular involvement during epileptic seizure underwent presurgical stereotactic electroencephalographic recordings using 10 to 16 depth electrodes per patient. Among these, one or two electrodes were implanted via ...

To evaluate the need for antiepileptic drugs after successful epilepsy surgery in pediatric patients, we retrospectively reviewed patients who had epilepsy surgery and were seizure free or had rare nondisabling auras during the first 6 postoperative months. Association between drug discontinuation and seizure recurrence was evaluated using Cox proportional hazards ...

OBJECTIVE: To report the successful treatment of a patient with lymphomatoid granulomatosis (LYG), a rare Epstein-Barr virus-positive lymphoproliferative disorder, using rituximab (anti-CD20 monoclonal antibody). The prognosis for LYG has been reported to be poor, and no satisfactory treatment has been established. Because central nervous system (CNS) involvement of LYG has ...

Despite the high incidence of epilepsy in very young children, the availability of approved antiepileptic drugs for this population is limited. This study assessed the efficacy and tolerability of levetiracetam in children younger than 2 years of age with various types of epilepsy. A single-center, retrospective chart review of 28 ...

OBJECTIVE: To compare clinical responses of patients with pediatric bipolar disorder being treated with risperidone versus divalproex. METHODS: Medical records of outpatients younger than 18 years of age were reviewed to gather data on those who received risperidone or divalproex monotherapy for the treatment of bipolar disorder. Effectiveness was assessed ...

BACKGROUND: Hypothalamic hamartomas (HHs), rare developmental abnormalities of the inferior hypothalamus, often cause refractory, symptomatic, mixed epilepsy, including gelastic seizures. We present 37 patients with HH who underwent transcortical transventricular endoscopic resection. METHODS: Between October 2003 and April 2005, 42 consecutive patients with refractory epilepsy who underwent endoscopic resection of ...

PURPOSE: The determination of prognostic factors is important for predicting outcome after epilepsy surgery. We investigated the factors related to surgical outcome within a homogeneous group of patients suffering from pathologically proven mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), and compared Engel's outcome classification system with the latest one ...

BACKGROUND: Gamma knife (GK) radiosurgery has been proposed as an alternative to classic microsurgery in mesial temporal lobe epilepsy (MTLE). Short-term follow-up studies have reported encouraging results, but long-term efficacy is not known. OBJECTIVE: To report the efficacy and tolerance of GK radiosurgery in MTLE after a follow-up > 5 ...

BACKGROUND: Lennox-Gastaut syndrome is a catastrophic pediatric epilepsy syndrome characterized by multiple types of treatment-resistant seizures and high rates of seizure-related injury. Current available treatments are inadequate, leaving patients with few treatment options and opportunities. METHODS: We conducted a double-blind, randomized, placebo-controlled trial of the antiepileptic drug rufinamide in patients ...

The present study was designed to reveal changes of cognitive processes in epilepsy (EP) patients with Topiramate (TPM) or Valproate (VPA) treatment using Wechsler Adult Intelligence Scale (WAIS-CR) and event-related potential (ERP). Thirty untreated epilepsy patients were randomly divided into two groups receiving TPM or VPA, respectively. Fifteen healthy volunteers ...

OBJECTIVES: Autosomal dominant cerebellar ataxias are clinically and genetically heterogeneous neurodegenerative disorders. There is no known treatment to prevent neuronal cell death in these disorders. Current treatment is purely symptomatic; ataxia is one of the most disabling symptoms and represents the main therapeutic challenge. A previous case report suggesting benefit ...

BACKGROUND AND OBJECTIVES: The pharmacotherapy of psychosis often differs between countries and with respect to treatment guidelines. Little is known about the treatment of first episode psychosis in countries of the former Soviet Union. The objective of the study was to analyse and describe the pharmacotherapy of first episode psychosis ...

OBJECT: The goal of this study was to evaluate the long-term outcome of patients who underwent extratemporal epilepsy surgery and to assess preoperative prognostic factors associated with seizure outcome. METHODS: This retrospective study included 154 consecutive adult patients who underwent epilepsy surgery at Bethel Epilepsy Centre, Bielefeld, Germany between 1991 ...

AIM: The purpose of this prospective clinical study was to examine the short- and long-term psychosocial outcomes of a consecutive series of patients who underwent extratemporal lobe resection due to medically-refractory epilepsy. MATERIALS AND METHODS: The sample consisted of 23 consecutive patients and all patients completed a questionnaire assessing especially ...

Status epilepticus (SE) in adults is a state of continuous seizures lasting more than 5 minutes, or rapidly recurrent seizures without regaining consciousness. The overall US and European estimated crude incidence rate of SE ranges from 6.8 to 41/100,000/yr. The etiologies of SE include primary central nervous system pathologies and ...

BACKGROUND: Seizures are important neurologic complications of traumatic brain injury (TBI). There is a need for better delineation of potential prognostic factors and outcomes in patients with posttraumatic seizures (PTS) who could receive treatment when brought to the hospital. METHODS: In this 10-year retrospective study, 170 adult patients with PTS ...

OBJECTIVE: The aim of the study described here was to investigate the efficacy, tolerability, and side effects of oxcarbazepine (OXC) monotherapy in newly diagnosed, previously untreated adult and elderly patients with partial epilepsy. METHODS: We prospectively analyzed and recorded the efficacy, tolerability, and side effects of OXC monotherapy. The results ...

BACKGROUND: The clinical significance of giant cells seen on temporal artery biopsy in temporal arteritis is unknown. AIM: To help define the prognostic value of the presence of giant cells in temporal arteritis. METHODS: The clinical course of all patients with biopsy proven temporal arteritis from 1994 to 2004 was ...

BACKGROUND AND PURPOSE: Seizures are important neurologic complications of spontaneous aneurysmal subarachnoid hemorrhage (SAH). A better understanding of the risk factors of seizures following aneurysmal SAH is needed to predict those who will require treatment. METHODS: A total of 137 adult patients were enrolled in this two-year retrospective study. Baseline ...

Famous historical cases and current clinical experience clearly indicate that the success of epilepsy surgery cannot be judged with the basic algorithm "fewer seizures = better outcome." Many factors combine and entwine with the experience of medically intractable seizures to create associated patterns of behavior and cognition. Obtaining freedom from ...

PURPOSE: To examine the safety and efficacy of zonisamide in treating myoclonic seizures associated with progressive myoclonic epilepsy (PME), in an open-label setting. METHODS: Thirty patients with refractory PME (aged > or = 5 years), who were taking up to three antiepileptic drugs, received adjunctive zonisamide (< or = 6 ...

OBJECTIVE: A multicenter open-label clinical trial was conducted to evaluate the clinical usefulness of topiramate (TPM) as primary or adjunctive therapy for infantile spasms in the postmarketing period in China. METHODS: Thirty-four centers participated in the trial. Patients included in the study had 1 or more seizures per day before ...

OBJECT: Resection strategies for the treatment of temporal lobe epilepsy (TLE) are a matter of discussion, and little information is available. The aim of this study was to compare seizure outcomes at the 5-year follow-up in patients with medically refractory unilateral mesial TLE (MTLE) due to hippocampal sclerosis (HS) who ...

To provide evidence of whether seizure clustering is associated with drug resistance and increased mortality in childhood-onset epilepsy, a prospective, long-term population-based study was performed. One hundred and twenty patients who had been followed since disease onset (average age 37.0 years, SD 7.1, median 40.0, range 11-42; incident cases) were ...

It has been suggested that aim of the temporal lobe epilepsy surgery is twofold: first is to decrease seizure frequency and second is to improve quality of life without causing intolerable complications. The aim of this prospective, longitudinal clinical study is to report outcomes with respect to seizure, medication, employment ...

BACKGROUND: Currently, there are no published randomized controlled trials evaluating the efficacy and safety of adjunctive antiepileptic therapy in idiopathic generalized epilepsy with myoclonic seizures. METHODS: This randomized, double-blind, placebo-controlled multicenter trial assessed the efficacy and tolerability of adjunctive treatment with levetiracetam 3,000 mg/day in adolescents (>or=12 years) and adults ...

We evaluated the usefulness of intravenous lidocaine therapy for managing of status epilepticus (SE) during childhood in a retrospective multi-institutional study. Questionnaires were sent to 28 hospitals concerning patients admitted for SE who were managed with lidocaine, assessing patient characteristics, treatment protocols and efficacy. In 279 treated patients, 261 SE ...