Seizure

Epilepsy is one of the most common neurological conditions seen in pediatric patients. While a majority of cases are effectively treated with anti-epileptic medications (AEDs), roughly one-third of patients will remain refractory to medical treatment[1–3]. Failure to appropriately address seizures in children can result in further negative outcomes, including bodily injury and negative psychosocial sequalae[2]. Neurosurgical treatment offers an alternate approach that can increase the likelihood of seizure freedom or provide better seizure control in refractory cases.

Epilepsy surgery was first described by Horsley [1]. In Montreal in 1937, Penfield and Jasper began performing acute intraoperative electrocorticography in awake patients combined with electrical stimulations in the same step as the surgical treatment [2]. The tailored resection relied on interictal epileptiform abnormalities and on the rare recorded seizures. Electrical stimulations were not only used to localize eloquent cortex, but also to elicit seizures or afterdischarges that were recognized as useful in identifying epileptogenic tissue [3].

Pupillary hippus (PH) refers to spontaneous bilateral synchronous rhythmic constriction and dilatation of the pupils [1]. This rare phenomenon is spasmodic, cyclic and bilaterally in phase, and is usually considered benign [2]. However, this clinical sign can rarely be the main manifestation of refractory epilepsy and nonconvulsive status epilepticus (NCSE) in critically ill patients [1,3–4]. Nevertheless, a detailed description of video-electroencephalography (v-EEG) correlate remains elusive.

Comorbid epilepsy is found in 22.5% of people with ID, a prevalence positively correlated with severity of ID [1,2]. The link between behavioural disturbance in people with ID and epilepsy is complex and poorly understood [3,4]. There is a paucity of research [5,6]. Seizures themselves are often more complex and subtle than in the general population [7], leading to higher rates of misdiagnosis [8,3]. Reliance on informants is another possible source of uncertainty [9]. The confidential inquiry into premature deaths ...

South Sudan is amongst the highly endemic countries for onchocerciasis in Africa, with the disease endemic in around half (49%) the country (1). The most highly endemic foci of onchocerciasis in South Sudan are in Western Equatoria, and Northern and Western Bahr el Ghazal regions. However, in 2006 only 26% of the eligible population received ivermectin in five community directed treatment with ivermectin (CDTi) targeted areas (2) (Fig. 1).

The reported risk of developing post-encephalitic/encephalopathic epilepsy (PEE) in patients who had acute encephalitis/encephalopathy was 6.8% and 16.4% [1,2]. Previous studies have shown that PEE accounts for 5.5% and 10.4% of patients with intractable epilepsy [3,4]. PEE is recognized as drug-resistant epilepsy, and patients with PEE are often affected by adverse effects related to poly-pharmaceutical therapy. We previously reported that sleepiness as an adverse effect of antiepileptic drugs might be causally related to prolonged blood-brain barrier (BBB) dysfunction in patients ...

The “National Epilepsy 12 Audit” aimed to measure and improve the quality of care provided by the National Health Service (NHS) to children and young people with seizures and epilepsies in the United Kingdom (UK) [1]. The audit was co-ordinated by the Royal College of Paediatrics and Child Health in partnership with Epilepsy Action and the British Paediatric Neurology Association, and includes paediatric departments which see children aged 1 month to 16 years with suspected or diagnosed epilepsies [1].

Post-hypoxic myoclonus (PHM), a common consequence of cardiac arrest and anoxic brain injury, is broadly divided into the entities of myoclonic status epilepticus (MSE) and Lance-Adams syndrome (LAS) [1]. MSE and LAS are differentiated on the grounds of clinical and electroencephalographic (EEG) findings, with distinction between the two entities carrying important prognostic information. Here we report a unique case of PHM where our patient defied classification into either MSE or LAS, but whose PHM was instead a continuous myoclonic seizure ...

Visual field defects (VFD), typically homonymous superior quadrantanopsias, commonly occur after temporal lobe resections for patients with medically intractable mesial temporal lobe epilepsy (MTLE). The frequency of VFD after open resection ranges from 9 – 100% [1–3]. Techniques that may limit surgical volumes may prevent VFD. Nilsson et al. found that more restricted resections that spared the superior-most aspect of the superior temporal gyrus yielded less VFD [4]. Mengesha et al. found that the horizontal meridian of visual fields tended ...

Epilepsy, characterized by spontaneous and recurrent seizures, currently affects 1% of the world population [1]. Despite many available therapeutic options, 1/3 of patients do not achieve seizure control [2]. Thus, searching for new and effective anti-epileptic drugs remains a central theme of epilepsy research. Among the many different candidates for drug development, the progesterone family emerges as a potential therapeutic option.