Rates and predictors of success and failure in repeat epilepsy surgery: A meta-analysis and systematic review

Summary

Objective

Medically refractory epilepsy is a debilitating disorder that is particularly challenging to treat in patients who have already failed a surgical resection. Evidence regarding outcomes of further epilepsy surgery is limited to small case series and reviews. Therefore, our group performed the first quantitative meta-analysis of the literature from the past 30 years to assess for rates and predictors of successful reoperations.

Methods

A PubMed search was conducted for studies reporting outcomes of repeat epilepsy surgery. Studies were excluded ...

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Rates and predictors of success and failure in repeat epilepsy surgery: A meta-analysis and systematic review

Summary

Objective

Medically refractory epilepsy is a debilitating disorder that is particularly challenging to treat in patients who have already failed a surgical resection. Evidence regarding outcomes of further epilepsy surgery is limited to small case series and reviews. Therefore, our group performed the first quantitative meta-analysis of the literature from the past 30 years to assess for rates and predictors of successful reoperations.

Methods

A PubMed search was conducted for studies reporting outcomes of repeat epilepsy surgery. Studies were excluded ...

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Methylphenidate, cognition, and epilepsy: A 1-month open-label trial

Summary

Objective

Cognitive difficulties are common in epilepsy. Beyond reducing seizures and adjusting antiepileptic medications, no well-validated treatment exists in adults. Methylphenidate is used effectively in children with epilepsy and attention-deficit/hyperactivity disorder, but its effects in adults have not been systematically evaluated. We hypothesized that methylphenidate can safely improve cognition in adults with epilepsy. We detail here the open-label follow-up to a double-blind, placebo-controlled, single-dose study.

Methods

Thirty epilepsy patients entered a 1-month open-label methylphenidate trial after a double-blind phase. ...

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Automated analysis of seizure semiology and brain electrical activity in presurgery evaluation of epilepsy: A focused survey

Summary

Epilepsy being one of the most prevalent neurological disorders, affecting approximately 50 million people worldwide, and with almost 30–40% of patients experiencing partial epilepsy being nonresponsive to medication, epilepsy surgery is widely accepted as an effective therapeutic option. Presurgical evaluation has advanced significantly using noninvasive techniques based on video monitoring, neuroimaging, and electrophysiological and neuropsychological tests; however, certain clinical settings call for invasive intracranial recordings such as stereoelectroencephalography (SEEG), aiming to accurately map the eloquent brain networks ...

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Influence of the location and type of epileptogenic lesion on scalp interictal epileptiform discharges and high-frequency oscillations

Summary

Objective

To increase the diagnostic power of scalp electroencephalography (EEG) by investigating whether lesion type and location influence the morphology of interictal epileptic discharges (IEDs) and the likelihood that IEDs and high-frequency oscillations (HFOs) are present.

Methods

We studied EEG activity in epilepsy patients with lesional epilepsy. Lesions were classified by type and by location (region and depth). We marked a maximum of 50 IEDs during deep non–rapid eye movement sleep. IEDs were identified as spikes or sharp waves ...

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Influence of the location and type of epileptogenic lesion on scalp interictal epileptiform discharges and high-frequency oscillations

Summary

Objective

To increase the diagnostic power of scalp electroencephalography (EEG) by investigating whether lesion type and location influence the morphology of interictal epileptic discharges (IEDs) and the likelihood that IEDs and high-frequency oscillations (HFOs) are present.

Methods

We studied EEG activity in epilepsy patients with lesional epilepsy. Lesions were classified by type and by location (region and depth). We marked a maximum of 50 IEDs during deep non–rapid eye movement sleep. IEDs were identified as spikes or sharp waves ...

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Epileptogenic networks in nodular heterotopia: A stereoelectroencephalography study

Summary

Objective

Defining the roles of heterotopic and normotopic cortex in the epileptogenic networks in patients with nodular heterotopia is challenging. To elucidate this issue, we compared heterotopic and normotopic cortex using quantitative signal analysis on stereoelectroencephalography (SEEG) recordings.

Methods

Clinically relevant biomarkers of epileptogenicity during ictal (epileptogenicity index; EI) and interictal recordings (high-frequency oscillation and spike) were evaluated in 19 patients undergoing SEEG. These biomarkers were then compared between heterotopic cortex and neocortical regions. Seizures were classified as normotopic, ...

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Intractable seizures after a lengthy remission in childhood-onset epilepsy

Summary

Objectives

To establish the risk of subsequent intractable epilepsy after ≥2, ≥5, and ≥10 years of remission in childhood-onset epilepsy.

Methods

From the Nova Scotia childhood-onset epilepsy population-based cohort patients with all types of epilepsy were selected with ≥20 years follow-up from seizure onset (incidence cases). Children with childhood absence epilepsy were excluded. The rate of subsequent intractable epilepsy was then studied for patients with ≥5 years remission on or off AED treatment and compared with the rate for ...

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Intractable seizures after a lengthy remission in childhood-onset epilepsy

Summary

Objectives

To establish the risk of subsequent intractable epilepsy after ≥2, ≥5, and ≥10 years of remission in childhood-onset epilepsy.

Methods

From the Nova Scotia childhood-onset epilepsy population-based cohort patients with all types of epilepsy were selected with ≥20 years follow-up from seizure onset (incidence cases). Children with childhood absence epilepsy were excluded. The rate of subsequent intractable epilepsy was then studied for patients with ≥5 years remission on or off AED treatment and compared with the rate for ...

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Detection of generalized tonic–clonic seizures using surface electromyographic monitoring

Summary

Objective

A prospective multicenter phase III trial was undertaken to evaluate the performance and tolerability in the epilepsy monitoring unit (EMU) of an investigational wearable surface electromyographic (sEMG) monitoring system for the detection of generalized tonic–clonic seizures (GTCSs).

Methods

One hundred ninety-nine patients with a history of GTCSs who were admitted to the EMU in 11 level IV epilepsy centers for clinically indicated video-electroencephalographic monitoring also received sEMG monitoring with a wearable device that was worn on the arm ...

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