Does Emergent Implantation of a Vagal Nerve Stimulator stop Refractory Status Epilepticus in children?

Status Epilepticus (SE) can be a life threatening event in an epileptic population. Accurate definition of SE was necessary for clinical and therapeutic purposes. The definition of SE changed over the years: in the revision (1981) by ILAE [1] SE is “a seizure” that “persists for a sufficient length of time or is repeated frequently enough that recovery between attacks does not occur”. The treatment of SE needs adequate and shared timing-measurements to plan therapeutic decisions. Four phases were currently ...

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Marriage in People with Epilepsy: A Compelling Theme for Psycho-Behavioral Research

Epilepsy, one of the commonest neurological disorders, is not only associated with a large disability burden but also with a range of psycho-social problems [1–4]. Dealing with these psycho-social issues is sometimes more complicated than managing seizures. Difficulties experienced by people with epilepsy (PWE) in the psycho-social sphere include barriers to education, employment and marriage [5–7]. Marriage is an important societal but deeply personal issue, and can be a formidable challenge in the lives of PWE [8,9].

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Presurgical Hyperconnectivity of the Ablation Volume is Associated with Seizure-Freedom after Magnetic Resonance-guided Laser Interstitial Thermal Therapy

Magnetic Resonance-guided Laser Interstitial Thermal Therapy (MRgLITT) is an emerging minimally-invasive alternative to resective surgery for medically-intractable epilepsy. The precise lesioning effect produced by MRgLITT supplies opportunities to glean insights into epileptogenic regions and their interactions with functional brain networks. In this exploratory analysis, we sought to characterize associations between MRgLITT ablation zones and large-scale brain networks that portended seizure outcome using resting-state fMRI.

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Novel drugs and early polypharmacotherapy in status epilepticus

Status epilepticus (SE) is a life-threatening medical emergency. Current guidelines recommend rapid stepwise treatment first using benzodiazepines in monotherapy, followed by a sequential addition of second-line drugs if SE continues [1]. Approximately one-third of cases of SE remain refractory (RSE) or super-refractory (SRSE) to treatment with benzodiazepines and second-line drugs [2,3]. RSE refers to an ongoing SE despite two appropriately selected and dosed antiepileptic drugs, including one benzodiazepine [4].

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Pathophysiology of convulsive status epilepticus

Convulsive status epilepticus (SE) is a common neurological emergency that disproportionately affects young children and older adults [1–3]. SE is associated with a mortality of approximately 0-3% in children [1,4–7], 20-30% in older adults [7–9], and survivors often have neurological and cognitive deficits. Although these outcomes have been attributed to convulsive SE itself, etiology is a primary predictor of long-term outcome. The pathophysiological changes underlying SE are only partially understood [10,11], but an evaluation of the underlying pathophysiology may help ...

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Randomized Controlled Trials of Antiepileptic Drugs for the Treatment of Post-stroke Seizures: a Systematic Review with Network Meta-analysis

Stroke is a frequent cause of epilepsy in the adult and elderly population [1], accounting for 11% of all epilepsy and 55% of newly diagnosed seizures among older people [2]. However, the proportion of all incident cases of epilepsy attributable to stroke can be as high as 14-21% [3]. Based on the different risk of seizure recurrence, poststroke seizures are divided into early (within 7 days of stroke) and late (after 7 days of stroke) [4]. The overall incidence of ...

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“I wonder if I did not mess up….”: Shame and resistance among women with epilepsy in Cape Town, South Africa

The importance of paying attention to individual stories, especially of a stigmatised condition such as epilepsy, cannot be over-emphasised. For Kleinman [1] as cited by Fadiman [2] (p. 262), “every illness is not a set of pathologies but a personal story”. This is crucial because stories enable us to gain an in-depth understanding of the individual’s lived experience of the illness and its symptoms and how the illness disrupts the individual’s life [3] (p. 52). In this article we present ...

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Subsequent experience in hybrid PET-MRI for evaluation of refractory focal onset epilepsy

Epilepsy surgery is a well-known method of treatment for patients with medically refractory epilepsy with a clearly defined focal onset. If a focal, radiographically identifiable lesion can be found, usually on MRI (magnetic resonance imaging), the prognosis for resection of the epileptic focus is significantly better, 60–90% free from disabling seizures, versus 20–65% if no lesion is found [1].

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Factors associated with refractoriness and outcome in an adult status epilepticus cohort

Status epilepticus (SE) is a neurological emergency that is estimated to affect 10-16/100000 per year in Europe [1–3] with a reported mortality rate that varies between 11-37% [4–7]. It has recently been redefined by the International League Against Epilepsy (ILAE) as “a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms which lead to abnormally prolonged seizures (after time point t1). SE is a condition that can have long term ...

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