The medical treatment of epilepsy in the elderly: A systematic review and meta‐analysis

Abstract

Objective

To evaluate the efficacy and tolerability of antiepileptic drugs (AEDs) in elderly individuals with epilepsy.

Methods

We searched four electronic databases as well as bibliographies and conference abstracts. Published and unpublished, randomized, or quasirandomized trials reporting the use of AEDs in people aged at least 60 years with epilepsy were eligible for inclusion. Two authors independently carried out each stage of the review. Meta‐analyses were performed using random‐effects models.

Results

Three thousand four hundred seventeen titles and abstracts were reviewed. Eighteen studies evaluating 12 ...

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Direct and indirect costs associated with stereotactic radiosurgery or open surgery for medial temporal lobe epilepsy: Results from the ROSE trial

Abstract

Objective

To determine whether a less‐invasive approach to surgery for medically refractory temporal lobe epilepsy is associated with lower health care costs and costs of lost productivity over time, compared to open surgery.

Methods

We compared direct medical costs and indirect productivity costs associated with treatment with stereotactic radiosurgery (SRS) or anterior temporal lobectomy (ATL) in the ROSE (Radiosurgery or Open Surgery for Epilepsy) trial. Health care use was abstracted from hospital bills, the study database, and diaries in which participants recorded health ...

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Anticonvulsant and antiepileptogenic effects of system xc− inactivation in chronic epilepsy models

Abstract

Objective

The cystine/glutamate antiporter system xc− could represent a new target for antiepileptogenic treatments due to its crucial roles in glutamate homeostasis and neuroinflammation. To demonstrate this, we compared epilepsy development and seizure susceptibility in xCT knockout mice (xCT−/−) and in littermate controls (xCT+/+) in different chronic models of epilepsy.

Methods

Mice were surgically implanted with electrodes in the basolateral amygdala and chronically stimulated to develop self‐sustained status epilepticus (SSSE); continuous video‐electroencephalography monitoring was performed for 28 days after SE and hippocampal histopathology was ...

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WONOEP appraisal: Network concept from an imaging perspective

Abstract

Neuroimaging techniques applied to a variety of organisms—from zebrafish, to rodents to humans—can offer valuable insights into neuronal network properties and their dysfunction in epilepsy. A wide range of imaging methods used to monitor neuronal circuits and networks during evoked seizures in animal models and advances in functional magnetic resonance imaging (fMRI) applied to patients with epilepsy were discussed during the XIV Workshop on Neurobiology of Epilepsy (XIV WONOEP) organized in 2017 by the Neurobiology Commission of the International League ...

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Rapid discontinuation of sodium channel–blocking antiseizure drugs evokes focal edema in the splenium corporis callosi: A matched case‐control study

Abstract

Objective

Focal edema of the splenium of the corpus callosum (FESCC) is infrequently seen in patients with epilepsy who are undergoing video–electroencephalography (EEG) monitoring. It is diagnosed by qualitative visual inspection of the magnetic resonance imaging (MRI) and is usually assumed to be a dichotomous phenomenon. Rapid reduction of anticonvulsants has been proposed as a cause. In this study we investigate the relationship between dose reduction of anticonvulsants and the occurrence of FESCC, based on absolute drug doses.

Methods

We examined in detail ...

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High health care costs in minority groups of older US Medicare beneficiaries with epilepsy

Abstract

Objective

To examine health care costs in diverse older Medicare beneficiaries with epilepsy.

Methods

Using 2008‐2010 claims data, we conducted a longitudinal cohort study of a random sample of Medicare beneficiaries augmented for minority representation. Epilepsy cases (n = 36 912) had ≥1 International Classification of Diseases, Ninth Edition (ICD‐9) 345.x or ≥2 ICD‐9 780.3x claims, and ≥1 antiepileptic drug (AED) in 2009; new cases (n = 3706) had no seizure/epilepsy claims nor AEDs in the previous 365 days. Costs were measured by reimbursements for all care received. High ...

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Hippocampal diffusion abnormality after febrile status epilepticus is related to subsequent epilepsy

Abstract

Objective

To assess hippocampal signal changes on diffusion‐weighted imaging (DWI) during the acute period after febrile status epilepticus (FSE) and to examine the relationship between DWI and subsequent epilepsy.

Methods

A prospective, multicenter study of children with a first episode of FSE was performed. The patients underwent magnetic resonance imaging (MRI) within 3 days of FSE, and signal intensity was evaluated on DWI. Electroencephalography studies within 3 days of FSE were also assessed. Nine to 13 years after FSE, information on subsequent epilepsy was obtained.

Results

Twenty‐two children ...

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Usefulness of brain perfusion CT in focal‐onset status epilepticus

Abstract

Objective

To evaluate the perfusion computed tomography (PCT) patterns in patients with status epilepticus (SE).

Methods

We included consecutive SE patients, diagnosed by ictal encephalography (EEG) findings and clinical semiology, who prospectively underwent a dedicated PCT study of SE in the ictal phase. The perfusion maps were visually analyzed. For the quantitative assessment, regions of interest in areas where the maps suggested abnormalities were compared with the corresponding area in the unaffected contralateral cortex. Asymmetry indices between affected and unaffected hemispheres were calculated ...

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