We investigated the effects of add-on lamotrigine treatment on plasma glutamate (Glu) levels, in 29 epileptic patients. Plasma Glu levels were determined by high-performance liquid chromatography at baseline and at 1 and 3 months post-treatment. In patients with a seizure reduction of > or = 66% a decrease of Glu ...

BACKGROUND: It is now agreed that the prognosis of seizure disorder due to solitary cysticercus granuloma (SCG) is generally good. However, the choice antiepileptic drugs (AEDs) remain empirical, with no comparative trials of different AEDs being available. AIMS: To determine the safety and efficacy (measured by the incidence of 'treatment ...

PURPOSE: The objective of this study was to correlate health-related quality of life (HRQOL) after surgery for mesial temporal lobe epilepsy, as revealed by a postoperative screening tool, to different modalities of seizure outcome classification (Engel, International League Against Epilepsy (ILAE)). METHOD: One hundred twenty-eight of one hundred forty consecutive ...

Epilepsy is a common clinical problem in patients with brain tumours, strongly affecting patients' quality of life. Tumour-related seizures are often difficult to control, and the clinical picture is complicated by frequent interactions between antiepileptic drugs (AEDs) and antineoplastic agents. We studied the safety and efficacy of levetiracetam (LEV), a ...

PURPOSE: To assess the long-term evolution of Unverricht-Lundborg disease (ULD), especially concerning myoclonus, seizures, and EEG characteristics. METHODS: We retrospectively evaluated 20 patients (six women, 14 men; mean age, 37.9 years; range, 26-53 years) with ULD who had been closely followed up since the onset of the disease (mean age, ...

OBJECTIVE: The objective was to assess the efficacy of a yoga meditation protocol (YMP) as an adjunctive treatment in patients with drug-resistant chronic epilepsy. DESIGN: The design was a prospective, nonrandomized, open-label, add-on trial with a 12-week baseline period, followed by a 12-week supervised YMP administration phase. The frequency of ...

Treatment guidelines consider antipsychotic monotherapy the standard of care for patients with schizophrenia. However, previous studies have reported widely varying, and sometimes high, rates of antipsychotic polypharmacy. We identified 61,257 VA patients with schizophrenia in fiscal year 2000 who had >or=90 non-institutionalized days and one or more fills of antipsychotic ...

PURPOSE: To evaluate the role of intravenous methyl prednisolone in patients with solitary cysticercus granuloma with new-onset seizures. METHODS: In this open-label, randomized, prospective, follow-up study, 52 patients with new-onset seizures and a single enhancing CT lesion of cysticercus were randomly divided in two groups to receive either intravenous methyl ...

OBJECTIVES: To estimate frequency and risk factors for acute postoperative seizures (APOS) within the first week after extratemporal cortical resection (ETR) and hemispherectomy (HS) in children and to assess the predictive value of APOS on long-term seizure outcome in this group. METHODS: The authors conducted a retrospective analysis of children ...

BACKGROUND: The MRC Multicentre trial for Early Epilepsy and Single Seizures (MESS) showed a reduced risk of further seizures in patients, for whom treatment with antiepileptic drugs was uncertain, who were randomly assigned immediate treatment compared with delayed treatment. However, there was no evidence of an effect on [corrected] long-term ...

OBJECT: The authors reviewed the long-term outcome of focal resection in a large group of patients who had intractable partial nonlesional epilepsy, including mesial temporal lobe sclerosis (MTS), and who were treated consecutively at a single institution. The goal of this study was to evaluate the long-term efficacy of epilepsy ...

OBJECTIVES: To determine the dosage and factors influencing efficacy of adrenocorticotropic hormone (ACTH) for West syndrome. STUDY DESIGN: A retrospective study of 135 patients receiving ACTH therapy with a synthetic analogue for initial effect, seizure outcome 1 year after therapy, and adverse effects. Efficacy and adverse effects were compared among ...

BACKGROUND: Adjustable, reversible therapies are needed for patients with pharmacoresistant epilepsy. Electrical stimulation of the hippocampus has been proposed as a possible treatment for mesial temporal lobe epilepsy (MTLE). METHODS: Four patients with refractory MTLE whose risk to memory contraindicated temporal lobe resection underwent implantation of a chronic stimulating depth ...

BACKGROUND: Subacute sclerosing panencephalitis (SSPE) usually has a progressive stereotypic downhill course and results in premature death. Long-term stabilization or remission is exceptional. OBJECTIVE: To analyze the profile of patients with a relatively 'benign' course who survive beyond 3 years. DESIGN: Descriptive analysis of 19 (16 male, 3 females)/307 (6.2%) ...

The long-term effects of zonisamide as monotherapy or adjunctive therapy were investigated in patients with seizure disorders. One hundred twelve adult neurology patients treated with zonisamide were retrospectively identified through a chart review; 90 patients (n=45 monotherapy, n=45 adjunctive therapy) who received zonisamide for 3 months were included in the ...

OBJECTIVE: To determine the presenting features of brain tumours in children. DESIGN: Retrospective case note review. SETTING: Paediatric and neurosurgical services at the Wessex Neurology Centre and Southampton General Hospital, UK. Patients: 200 patients presenting with a CNS tumour between 1988 and 2001. RESULTS: The commonest first presenting symptoms were ...

OBJECTS: We analyzed 30 patients with cortical dysplasia (CD) and epilepsy to evaluate the clinical characteristics and surgical outcome of both epilepsy control and neurocognition. MATERIALS AND METHODS: The mean ages at seizure onset and at the time of the operation were 3.6 years (range, 1 month-12.6 years) and 10.3 ...

The authors describe long-term follow-up (mean, 5 years) in patients with anterior (AN) (n = 6) or centromedian (n = 2) thalamic deep brain stimulation (DBS) for epilepsy. Five patients (all AN) had > or = 50% seizure reduction, although benefit was delayed in two until years 5 to 6, ...

We aimed to assess the relapse rate of epilepsy, prospectively attributable to antiepileptic drug (AED) withdrawal in seizure-free patients and to determine the risk factors for seizure recurrence. Seventy-nine patients with epilepsy who were seizure-free for at least 4 years were enrolled into the study. The AEDs were tapered by ...

Diagnosing refractory epilepsy would facilitate referral for specialist pharmacological review and early consideration of epilepsy surgery. An outcomes study was undertaken in an unselected cohort of newly diagnosed patients to determine the number of antiepileptic drug (AED) regimens needed to be failed before the epilepsy could be designated as pharmacoresistant. ...

OBJECTIVES: The duration of antiepileptic drug (AED) therapy in cases of solitary cerebral cysticercus granuloma (SCCG) presents a major dilemma and the efficacy of short-term (6 months) vs long-term (2 years) AED therapy has been studied. MATERIALS AND METHODS: Prospective randomized study of short-term vs long-term AED treatment with SCCG ...

OBJECTIVE: This current study was performed to evaluate whether superficial cerebral haemosiderosis (SCH) is still a complication of modern day anatomical hemispherectomy. METHODS: We report a 13-year institutional experience with anatomical hemispherectomy for intractable epilepsy. Seizure control at a mean follow-up interval of 7 years was 83%. Though one patient ...

Anatomical hemispherectomy has been used for the treatment of seizures since 1938. However, it was almost abandoned in the 1960s after reports of postoperative fatalities caused by hydrocephalus, hemosiderosis, and trivial head traumas. Despite serious complications, the remarkable improvement of patients encouraged authors to carry out modifications on anatomical hemispherectomy ...

To study the efficacy of adrenocorticotrophic hormone (ACTH) in treating Taiwanese children with West syndrome (WS) and the impact on long-term prognosis, 66 patients with WS (54 symptomatic and 12 cryptogenic) were collected from 1987 to 1998 in a medical center in Taiwan. A total of 53 patients were enrolled ...

The effects of long-term treatment in a demented patient were evaluated in this study. One individual diagnosed with Alzheimer's dementia (AD) was treated with neuropsychological rehabilitation techniques as well as drugs for a period of 2 years and 10 months. An A-B-A-B design was performed for the cognitive treatment. Neuropsychological ...

The antiepileptic efficacy and tolerability of oxcarbazepine, used both as monotherapy and adjunctive therapy, were observed for 1 year in 202 adult patients, aged 17-83 years, with newly diagnosed or refractory partial epilepsy in clinical practice in Italy. At first observation, the seizure free rate was 72.2% in newly diagnosed ...

Pregabalin is a recently licensed and marketed antiepileptic drug for use as adjunctive treatment of partial epilepsy. It acts at presynaptic calcium channels, modulating neurotransmitter release in the CNS, properties it shares with gabapentin. Its clinical development over the past decade has included its use in the treatment of neuropathic ...

The objective of this observational study was to compare the efficacy of levetiracetam and topiramate during the first 15 days of add-on treatment in adults with refractory partial epilepsy. Two cohorts of patients with > or =3 simple or complex partial seizures with or without secondary generalisation per month over ...

BACKGROUND: Old age is the most common time in life to develop epilepsy. Despite this, there are few published data exploring pharmacological outcomes in this population. METHODS: We analyzed outcomes in 117 older patients (median age, 73; range, 65-92) for whom localization-related epilepsy was newly diagnosed and treatment begun at ...

Topiramate is a new antiepileptic drug with a broad spectrum of efficacy. Reports on the use of topiramate for treatment of infantile spasms are limited. We prospectively followed 15 children with recently diagnosed infantile spasms treated with topiramate for efficacy and tolerability. Twelve patients had symptomatic infantile spasms, and two ...

BACKGROUND: The choice of an antiepileptic drug (AED) for any individual should take into account reliable information about seizure control, adverse effects and cost. Carbamazepine is the usual drug of choice for people with newly-diagnosed partial onset seizures. Lamotrigine is a relatively new AED which is licensed in many countries ...

BACKGROUND: The ideal objective of treating a person with epilepsy is to induce remission by usage of antiepileptic drugs (AEDs) and withdraw the AEDs without causing seizure recurrence. Prolonged usage of AEDs may have long-term side effects. Hence when a person with epilepsy is in remission (free of seizures for ...

BACKGROUND: Zolpidem is an omega 1 specific indirect GABA agonist that is used for insomnia, but may have efficacy in brain damage. The long term efficacy of zolpidem in the permanent vegetative state is described in three patients. METHOD: Two motor vehicle accident patients and one near drowning patient, all ...

PURPOSE: To evaluate the long-term outcome of patients with pattern-sensitive epilepsy. METHODS: We prospectively studied 35 patients (21 females and 14 males) with pattern-sensitive epilepsy (follow up > or = 5 years; mean 13.9; range 6.4 - 27.6). All cases had regular clinical examinations and serial electroencephalographic (EEG) recordings. Photosensitivity ...

BACKGROUND: Auditory hallucinations are a common and disabling problem for many patients with schizophrenia and often fail to respond to optimal antipsychotic therapy. Repetitive transcranial magnetic stimulation (rTMS) has recently been trialled as an alternative treatment option for these patients. These studies have generally been positive, but treatment has only ...

In 2003, there were 28,092 human exposures to diphenhydramine reported to poison centers in the US. A related drug, dimenhydrinate, is a less frequent cause of poisonings. Between January 2000 and June 2004, there were 2,534 reported dimenhydrinate ingestions in children less than 6 years of age. An evidence-based expert ...

OBJECT: The aim of this study was to compare seizure and memory outcome in patients with medically refractory mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE/HS) treated using an anterior temporal lobectomy (ATL) or a selective amygdalohippocampectomy (SA). METHODS: Surgical outcome data were prospectively collected for 2 to 11 ...

OBJECTIVE: To describe new data on the incidence and impact of childhood- and adolescent-onset bipolar illness and make recommendations to help accelerate the acquisition of knowledge in this area. DATA SOURCES: Two large, multicenter out-patient studies in adults with DSM-IV bipolar disorder-the Systematic Treatment Enhancement Program for Bipolar Disorder and ...

We report the case of a 30-year-old woman with severe, prolonged refractory status epilepticus requiring more than 6 months of iatrogenic coma. Opinions on prognosis and clinical management were solicited from a number of experienced neurointensivists and epileptologists at multiple time-points during the clinical course. The ensuing discussion, annotated with ...

Serotonin reuptake inhibitors (SRIs) are considered first-line treatments for obsessive-compulsive disorder (OCD). Many patients achieve some response but remain symptomatic despite an adequate SRI trial. Recent neuroimaging data found abnormally high glutamatergic concentrations in children with OCD. Following selective serotonin reuptake inhibitor (SSRI) treatment, a decrease in OCD symptom severity ...

Delays in the diagnosis of Alzheimer's disease, and, therefore, delays in treatment, may have a detrimental effect on a patient's long-term well-being. This study assessed the effects of postponing donepezil treatment for 1 year by comparing patients treated continuously for 3 years with those who received placebo for 1 year ...

BACKGROUND: Vagus nerve stimulation (VNS) is an FDA-approved treatment for medically intractable epilepsy. The effect of this therapy on body weight is unclear. VNS could cause weight loss by engaging vagal afferents from the gastrointestinal tract mediating satiety. METHODS: We performed a retrospective analysis of body weight changes over a ...

OBJECTIVE: To compare the efficacy of medical and surgical treatment for refractory mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE). METHODS: A prospective controlled non-randomized study of 26 patients with MTLE who underwent surgical treatment and 75 patients with MTLE who underwent medical treatment between August 2002 and October ...

BACKGROUND: Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent attacks of inflammation of serosal membranes. Amyloidosis is the most severe complication of the disease The aim of this study was to explore the magnitude of the FMF problem and to describe clinical phenotypic and genotypic profile ...

BACKGROUND: Over the last decade Streptococcus pneumoniae has emerged as the most common bacterial pathogen for meningitis in all age groups, beyond the neonatal period. OBJECTIVE: To determine the epidemiological and clinical characteristics; and risk factors for mortality of pneumoccocal meningitis in children in a developing transitional country. MATERIALS AND ...

OBJECTIVE: To assess the prognosis of epilepsy, the possibility of achieving remission of seizures, in patients who were identified in a population-based study carried out in Junín, a city of about 70,000 inhabitants in Buenos Aires Province, Argentina. On January 1, 1991 (prevalence day), 106 people had epilepsy, including 64 ...

BACKGROUND: The newer atypical antipsychotics have gained prominence as first-line oral agents to treat severe agitation, but their use in the psychiatric emergency service (PES) setting has been limited because of the unavailability of parenteral formulations. The advent of parenteral formulations of atypical antipsychotics, beginning with ziprasidone in 2002, might ...

BACKGROUND: Rivastigmine is used for symptomatic treatment of mild-to-moderately severe Alzheimer's Dementia (AD). We investigated the frequency of and reasons for rivastigmine discontinuation in clinical practice and possible predictive factors for discontinuation within the first six months after starting therapy. METHODS: A retrospective cohort study was performed in rivastigmine users, ...

To determine whether EEG performed within few months after epilepsy surgery is predictive of seizure outcome, 58 consecutive patients undergoing surgery for presumptive temporal lobe epilepsy (TLE) who had clinical follow-up of at least 2 years and EEG data available both pre- and postoperatively were analyzed. Patients were classified by ...

OBJECTIVES: To define the postoperative seizure outcome and its predictors in patients with ganglioglioma-related temporal lobe epilepsy (TLE). PATIENTS AND METHODS: We reviewed the pre- and post-surgical evaluation data of 23 patients with temporal lobe ganglioglioma, who had completed >or=1 year of postoperative follow-up. They comprised 4.9% of the patients ...