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 ...

OBJECTIVE: To explore the frequency and course of neurodegenerative central nervous system (CNS) disease in Langerhans cell histiocytosis (ND-LCH). STUDY DESIGN: We studied 83 patients with LCH in whom magnetic resonance imaging (MRI) of the brain was performed at least twice for various clinical indications. We defined radiologic ND-LCH as ...

AIM: The main objectives of this a naturalistic, prospective follow-up study were to describe the clinical presentation and predictors of treatment response in Turkish children and adolescents with bipolar disorder (BD) and to document their response to available treatment regimes. METHODS: The study sample consisted of 27 consecutive admissions to ...

OBJECTIVE: To determine the effectiveness of vagus nerve stimulation (VNS) therapy among patients with persistent or recurrent seizures after lobar resection, callosotomy, and other cranial operations for intractable epilepsy. METHODS: Data were obtained from the VNS therapy patient outcome registry, which was established after United States Food and Drug Administration ...

BACKGROUND: Lacking long-term placebo-controlled trials of cholinesterase inhibitors (ChEIs) in Alzheimer's disease, how decline is modeled is crucial to interpreting the effects of long-term, open-label use. We aimed to: 1) understand changes in cognition and function in people taking galantamine; (2) identify treatment subgroups. METHODS: This is an open-label long-term ...

OBJECTIVE: (1) to estimate the occurrence of postdischarge adverse outcomes in surgical patients and their treatment; (2) to explore determinants during admission that may influence the occurrence of postdischarge adverse outcomes. DESIGN: Four weeks after discharge, patients were contacted by telephone and interviewed about: (1) the occurrence of adverse health ...

OBJECT: Seizures play an important role in the clinical presentation and postoperative quality of life of patients who undergo surgical resection of low-grade gliomas (LGGs). The aim of this study was to identify factors that influenced perioperative seizure characteristics and postoperative seizure control. METHODS: The authors performed a retrospective chart ...

Levetiracetam (LEV), the S-enantiomer of alpha-ethyl-2-oxo-1-pyrollidine acetamide, is a recently licensed antiepileptic drug (AED) for adjunctive therapy of partial seizures. Its mechanism of action is uncertain but it exhibits a unique profile of anticonvulsant activity in models of chronic epilepsy. Five randomized, double-blind, placebo-controlled trials enrolling adult or pediatric patients ...

BACKGROUND: Antioxidant therapy is a new therapeutical approach for patients with Friedreich ataxia. AIMS: To assess the effectiveness of long-term idebenone treatment in Friedreich ataxia patients. METHODS: An open-labelled prospective study. Ten paediatric patients (age range 8-18 years) and 14 adults (age range 18-46 years) with genetic diagnosis of Friedreich ...

PURPOSE: Little is known about the prognostic significance of persistent auras following temporal lobe surgery in determining the recurrence of complex partial seizures (CPS) or generalized tonic-clonic seizures (GTCS). METHODS: In a retrospective analysis of temporal lobectomy patients who had preoperative auras associated with CPS or GTCS and who were ...

The aim of this naturalistic study was to investigate the possible influence of the duration of untreated illness (DUI) on the long-term course of Major Depressive Disorder (MDD). One hundred and thirteen patients with recurrent MDD, according to DSM-IV-TR criteria, followed up for 5 years, were selected, interviewed and their ...

BACKGROUND: In the UK it is recommended that acetylcholinesterase inhibitors be restricted to patients with moderate Alzheimer's disease, and progress monitored within specialist clinics. Objective: To describe a cohort of patients with Alzheimer's disease from a whole city population treated with donepezil, and to analyse outcomes over 4 years. METHODS: ...

BACKGROUND: The California Encephalitis Project (CEP) is a program designed to determine causes of encephalitis. We sought to determine whether there are any distinguishing characteristics of patients with encephalitis who develop refractory status epilepticus from those who do not. METHODS: Data from all patients in the CEP were retrospectively reviewed ...

OBJECTIVE: To investigate the incidence, prevalence and the long-term outcome of autoimmune enteropathy in Sweden. MATERIAL AND METHODS: In 2002 a questionnaire was sent to all paediatric departments in Sweden asking them to report all known cases of this condition from the period 1985-2002. RESULTS: The response rate was 92%. ...

Blood brain barrier disruption enhances drug delivery in primary central nervous system lymphoma. In this study, we report adverse events that were encountered intraoperatively and in the postoperative period in these patients. A retrospective analysis of 17 patients documenting demographic data, preprocedure medical history, intraoperative, and postoperative anesthetic complications was ...

BACKGROUND/AIMS: To build and analyze regression models predicting (1) the long-term cognitive outcome in donepezil-treated patients with Alzheimer's disease, and (2) the short-term (6 months) cognitive impact of treatment depending on cognitive severity at baseline. METHODS: The Swedish Alzheimer Treatment Study (SATS) is an open-label, non-randomized, 3-year, multicentre study in ...

BACKGROUND: Use of the atypical antipsychotic sertindole was suspended for four years due to safety concerns. During the suspension, the regulatory authorities required further studies, including this one, to be conducted. The purpose of this study was to determine if a subset of patients with psychotic illness exists which particularly ...

The authors prospectively followed patients with treatment-resistant obsessive-compulsive disorder (OCD). Between 1988 and 1995, 56 patients with a history of inadequate response to oral clomipramine received 14 infusions of intravenous clomipramine. The follow-up period ranged from 4 to 11 years after treatment. Of the 44 subjects interviewed at follow-up, 70.5% ...

BACKGROUND: Though electroconvulsive therapy (ECT) has been used in Nepal for last twenty years, researches regarding its use, its efficacy and other data are non-existent. AIMS: The objective of this study was to know about diagnostic variability and therapeutic efficacy of the use of ECT in hospitalized patients. METHODS: This ...

After sertindole's suspension, health authorities established a specific named-patient use (NPU) programme in order to supply sertindole to patients who did not respond to or did not tolerate alternative treatments. This programme provided the possibility of prospectively following an exhaustive cohort of patients treated with sertindole after its suspension. A ...

This study evaluated pre- and postoperatively cognitive functions in 15 pediatric patients with surgically treated parietal lobe epilepsy (PLE). Seizure outcome was very satisfying with 87% seizure-free patients 1 year after surgery, and 82% in the long-term follow-up. Preoperative intelligence was in the subaverage range. Impairments in specific cognitive functions ...

The purpose of this study was to measure metabolite level changes in patients with newly diagnosed Alzheimer Disease (AD) following four months of donepezil treatment. A small number of cognitively normal elderly subjects were also scanned longitudinally (twice within one year) to assess the reproducibility. Short echo-time (1)H magnetic resonance ...

BACKGROUND: Our purpose was to assess the safety and tolerability of extended-release galantamine (GAL-ER), using a 1-week dose titration in Alzheimer's patients. METHODS: An open-label, 12-week, multicenter study was performed (n = 82). Results were compared with findings from a placebo-controlled trial using a 4-week titration of GAL-ER and immediate-release ...

OBJECTIVE: This randomized, double-blind, placebo-controlled trial was conducted to assess the efficacy and tolerability of adjunctive lamotrigine for the treatment of partial seizures in infants aged 1 to 24 months. METHODS: The study used a responder-enriched design in which all patients received adjunctive lamotrigine during an open-label phase (n = ...

Epilepsy surgery has been questioned for patients with low IQ, since a low cognitive level is taken to indicate a widespread disturbance of cerebral function with unsatisfactory prognosis following resective surgery. The prevalence of epilepsy in patients with cognitive dysfunction is, however, higher than in the general population and the ...

OBJECTIVES: Minimally invasive procedures for treating temporal lobe epilepsy have been investigated recently, namely stereotactic and gamma knife amygdalohippocampectomy (AHE). However, the results are not fully satisfactory. Our aim was to evaluate efficacy and side-effects of stereotactic AHE mimicking the neurosurgical procedure in terms of extent of the lesion. METHODS: ...

Zonisamide (ZNS) is a useful antiepileptic drug with a broad therapeutic spectrum. However, there is limited information on the long-term use of ZNS as a monotherapy. This study investigated the long-term effects of ZNS as a monotherapy for the treatment of epilepsy. We retrospectively analyzed the records of epilepsy patients ...

PURPOSE: Previous reports have summarized the seizures types occurring in 1p36 deletion syndrome. To better define the spectrum of epilepsy, we studied 91 patients (median age 7.8 years) with confirmed 1p36 deletion. METHODS: Based on clinical charts, we retrospectively analyzed the evolution of both the EEG findings and seizures. RESULTS: ...

OBJECTIVE: To evaluate seizure outcome following epilepsy surgery for patients with temporal lobe epilepsy and evaluate is gender and race/ethnicity influence it. METHODS: Data were obtained from the discharge database of the University of Alabama at Birmingham, Epilepsy Center, between 1985 and 2001. The sample consisted of all patients with ...

Nocturnal hypermotor seizures (NHSs) suggest seizure onset in the frontal lobe. We present a patient with NHSs and insular seizure onset who underwent successful surgical treatment. A 29-year-old right-handed man suffered from intractable NHSs since the age of 12 years. High-resolution MRI, [(18)F]FDG-PET, and neuropsychological examination gave normal results, ictal ...

AIMS: To evaluate whether rivastigmine, an achetylcholinesterase inhibitor (AChEl), may be effective in restoring memory in Wernicke-Korsakoff's syndrome (WKS). METHODS: Five patients treated with rivastigmine for a period of 6 months were compared with five matched control patients, who received 6 months' conventional treatment, but without rivastigmine. Memory tests were ...

OBJECTIVE: To investigate changes in dermoscopic patterns of acquired acral melanocytic nevi (AAMN) over time. DESIGN: Retrospective analysis of digital dermoscopic follow-up of 230 AAMN located on acral volar skin. SETTING: Outpatient clinics at university dermatology departments. Patients A total of 230 AAMN located on the soles (n = 149), ...

OBJECTIVE: Despite recent management guidelines, no recent study has evaluated outcomes in ICU patients with status epilepticus (SE). DESIGN AND SETTING: An 8-year retrospective study. SUBJECTS AND INTERVENTION: Observational study in 140 ICU patients with SE, including 81 (58%) with continuous SE and 59 (42%) with intermittent SE (repeated seizures ...

Neurocysticercosis is a common cause of acquired seizure disorder in developing countries, including India. The role of antiparasitic (albendazole) therapy for seizure control and resolution of lesions is still controversial due to a lack of adequately controlled studies. The objective of the present study was to evaluate the role of ...

PURPOSE: To evaluate the efficacy and safety of zonisamide (ZNS) as long-term adjunctive therapy in children with Lennox-Gastaut syndrome (LGS). METHOD: We evaluated the seizure frequency, cognitive outcomes, and side effects of 62 LGS patients maintained on ZNS for at least 12 months in three tertiary centers. RESULTS: Of the ...

BACKGROUND: Tumours are a well-recognized cause of medically intractable epilepsies. Tumours represent the primary pathology in 10%-30% of patients undergoing surgical treatment for chronic epilepsy. This study examines the surgical and epileptological outcome of adults with temporal lobe tumoural epilepsy treated within a comprehensive epilepsy surgery programme. METHODS: Between 1999 ...

PURPOSE: To evaluate the efficacy and safety of adjunctive prednisolone therapy in children with cryptogenic epileptic encephalopathy, other than infantile spasms, and to determine its prognosis. METHODS: Prednisolone, 2mg/kg per day for 6 weeks, tapered for a further 2 weeks, was given in combination with previously prescribed antiepileptic drugs. A ...

BACKGROUND: Single small enhancing CT lesions (SSECTL) of the brain with or without perifocal oedema are common in patients with symptomatic epilepsy in India. Solitary cysticercus granuloma, a benign form of parenchymal neurocysticercosis, is considered to be the most common aetiology for SSECTL. Definite information is lacking regarding the effectiveness ...

BACKGROUND: Medication nonadherence is a significant problem among patients with bipolar disorder. OBJECTIVE: To compare adherence and persistence among patients with bipolar disorder initiated on antipsychotics in a state Medicaid system over a 12 month follow-up period. METHODS: Claims data for patients with bipolar disorder from a de-identified Medicaid database ...

PURPOSE: The purpose of this prospective clinical study was to assess quality of life (QOL) and impact of seizure status on QOL in patients with extratemporal epilepsy after surgery. PATIENTS AND METHODS: Twenty-three consecutive patients who had been operated due to extratemporal epilepsy were included in this study. Quality of ...

BACKGROUND AND PURPOSE: Reports of central pontine myelinolysis (CPM)-like changes in Wilson's disease (WD) and its sequential changes are exceptional. The aim was to study the MRI characteristics of CPM-like changes in WD and the serial changes. METHODS: Among the 121 patients of WD, twenty (M:F:9:11, age at onset: 14.2 ...

BACKGROUND: Progressive volumetric changes in the brains of people with schizophrenia have been attributed to a number of factors. AIMS: To determine whether glutamatergic changes in patients with schizophrenia correlated with grey-matter losses during the first years of illness. METHOD: Left anterior cingulate and thalamic glutamatergic metabolite levels and grey-matter ...

OBJECTIVES: Vagus nerve stimulation (VNS) is an effective treatment for intractable epilepsy. It is unknown whether acute response is correlated with the amplitude of output current. The purpose of this study was to determine if the output current of VNS is correlated with percent reductions in seizure frequency and response. ...

OBJECT: The authors undertook this study to identify predictors of persistent postoperative seizures in their group of 28 Dutch pediatric and adolescent patients with medically intractable epilepsy who underwent functional hemispherectomy. METHODS: The records of 28 pediatric and adolescent patients who underwent a functional hemispherectomy in the University Medical Center ...

The goal of the work described here was to explore the efficacy, safety, and tolerability of adjunctive therapy with levetiracetam and associated changes in health-related quality of life in Australian patients with uncontrolled partial seizures. A phase IV open-label 16-week clinical trial was undertaken. Patients received adjunctive levetiracetam, adjusted according ...

INTRODUCTION: Hypothalamic hamartomas (HHs) are commonly associated with severe epilepsy resistant to anticonvulsant therapy. Historically, surgical resection of HHs resulted in considerable morbidity. DISCUSSION: Two series of patients who successfully underwent resection using a transcallosal approach have now been published; we report the first UK experience of this technique in ...

OBJECTIVE: To review the result of the infantile spasms' treatment with sodium valproate followed by nitrazepam or clonazepam. STUDY DESIGN: Descriptive retrospective study. SETTING: Srinagarind Hospital, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. MATERIAL AND METHOD: Twenty-four infantile spasms admitted between January 1994 and December ...

OBJECTIVE: To evaluate the efficacy and safety of valproate (VPA) sustained-released in monotherapy across all ages in newly-diagnosed epileptic patients with partial seizures (PS) with or without secondary generalization. METHODS: This was a multicenter, prospective, observational, open-label, non-comparative study involving the Gulf Cooperation Council (GCC) countries except the Kingdom of ...

BACKGROUND: Electroconvulsive therapy (ECT) is a highly effective treatment for depression but its use is limited by the risk of cognitive side effects. This study explored the potential of a novel approach, ultrabrief pulsewidth (0.3 ms) right unilateral (RUL-UB) ECT, to minimise cognitive effects while preserving efficacy. METHODS: Mood and ...