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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Psychological long‐term outcome in patients with psychogenic nonepileptic seizures

Summary

Objective

To examine the long‐term outcome of psychological status, personality, and health‐related quality of life (HRQoL) in patients with psychogenic nonepileptic seizures (PNES) and to define predictors of favorable outcome of cessation of PNES.

Method

Patients diagnosed with PNES during video–electroencephalography (EEG) monitoring at the Erlangen Epilepsy Center were contacted 1‐16 years after communicating the diagnosis. Follow‐up information from each participant was obtained by interview (PNES outcome) and by self‐reported questionnaires of psychological symptoms (Beck Depression Inventory‐II, Symptom Checklist‐90‐Standard, Dissociative Symptoms questionnaire), personality traits ...

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Effect of carbamazepine on spontaneous recurrent seizures recorded from the dentate gyrus in rats with kainate‐induced epilepsy

Summary

Objective

Animal models of chronic epilepsy with spontaneous recurrent seizures (SRSs) may be useful in the discovery and mechanistic analyses of antiseizure drugs (ASDs). Carbamazepine (CBZ), a widely used ASD with a well‐defined mechanism, was analyzed in this proof‐of‐principle study to determine how a traditional ASD affects the properties of SRSs.

Methods

The effects of CBZ on electrographic SRSs recorded from the dentate gyrus were studied in freely behaving rats using a repeated, low‐dose kainate model of acquired epilepsy with a repeated‐measures, crossover ...

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Transient use of a systemic adenosine kinase inhibitor attenuates epilepsy development in mice

Summary

Objective

Over one‐third of all patients with epilepsy are refractory to treatment and there is an urgent need to develop new drugs that can prevent the development and progression of epilepsy. Epileptogenesis is characterized by distinct histopathologic and biochemical changes, which include astrogliosis and increased expression of the adenosine‐metabolizing enzyme adenosine kinase (ADK; EC 2.7.1.20). Increased expression of ADK contributes to epileptogenesis and is therefore a target for therapeutic intervention. We tested the prediction that the transient use of an ADK ...

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Effects of an epilepsy‐specific Internet intervention (Emyna) on depression: Results of the ENCODE randomized controlled trial

Summary

Objective

Depression and anxiety are highly prevalent among people with epilepsy (PwE) but often remain unrecognized and treated inadequately. Effective psychosocial treatments such as cognitive behavioral therapy (CBT) are rarely available to most PwE, which is one reason electronically delivered CBT (eCBT) is regarded as promising. This study examined an eCBT intervention, termed Emyna, that was tailored to suit the needs of PwE. It includes CBT‐related content on depression, stress and anxiety, seizure triggers and auras, and lifestyle habits. The trial ...

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Efficacy and tolerability of the ketogenic diet versus high‐dose adrenocorticotropic hormone for infantile spasms: A single‐center parallel‐cohort randomized controlled trial

Summary

Objective

To compare the efficacy and safety of the ketogenic diet (KD) with standard adrenocorticotropic hormone (ACTH) treatment in infants with West syndrome.

Methods

In this parallel‐cohort (PC) randomized controlled trial (RCT), infants were randomly allocated to KD or high‐dose ACTH. Those who could not be randomized were followed in a PC. Primary end point was electroclinical remission at day 28. Secondary end points were time to electroclinical remission, relapse after initial response, seizure freedom at last follow‐up, adverse effects, and developmental progress.

Results

One ...

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