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ObjectiveTo know whether change in the intelligence quotient (IQ) of children who undergo epilepsy surgery is associated with the educational level of their parents.
MethodsRetrospective analysis of data obtained from a cohort of children who underwent epilepsy surgery between January 1996 and September 2010. We performed simple and multiple regression analyses to identify predictors associated with...
ObjectiveTo investigate whether the link between epilepsy and deprivation is due to factors associated with deprivation (social causation) or factors associated with a diagnosis of epilepsy (social drift).
MethodsWe reviewed electronic primary health care records from 2004 to 2010, identifying prevalent and incident cases of epilepsy and recording linked deprivation scores. Logistic and Poisson regression...
ObjectiveWithin its range of therapeutic plasma concentrations, the anticonvulsant retigabine (ezogabine) is believed to selectively act on Kv7 channels. Here, the contribution of specific γ‐aminobutyric acid (GABA)A receptor subtypes to the antiseizure effects of retigabine was investigated.
MethodsUsing patch‐clamp recordings, seizure‐like activity, tonic currents, and GABA‐induced currents in...
Refractory status epilepticus (RSE) can lack overt clinical manifestation and is usually treated with continuous infusion of intravenous anesthetic drugs (IVADs), where the use of continuous electroencephalography (cEEG) is imperative. Ketamine has recently been shown to be effective in the treatment of RSE. We retrospectively review a cohort of 11 patients receiving ketamine as part of their treatment...
ObjectiveAberrations in brain development may lead to dysplastic structures such as periventricular nodules. Although these abnormal collections of neurons are often associated with difficult‐to‐control seizure activity, there is little consensus regarding the epileptogenicity of the nodules themselves. Because one common treatment option is surgical resection of suspected epileptic nodules, it is...
ObjectiveTo prospectively evaluate the etiology of new‐onset infantile spasms and evaluate the yield of genetic and metabolic investigations in those without obvious cause after initial clinical evaluation and magnetic resonance imaging (MRI).
MethodsTwenty‐one U.S. pediatric epilepsy centers prospectively enrolled infants with newly diagnosed West syndrome in a central database. Etiology and investigations...
ObjectiveHyperactivation of the mechanistic target of rapamycin (mTOR; also known as mammalian target of rapamycin) pathway has been demonstrated in human cortical dysplasia (CD) as well as in animal models of epilepsy. Although inhibition of mTOR signaling early in epileptogenesis suppressed epileptiform activity in the neuron subset‐specific Pten knockout (NS‐Pten KO) mouse model of CD, the effects...
ObjectiveCarbamazepine causes severe cutaneous adverse drug reactions that may be predicted by the presence of the HLA‐A*31:01 allele in northern European populations. There is uncertainty as to whether routine testing of patients with epilepsy is cost‐effective. We conducted an economic evaluation of HLA‐A*31:01 testing from the perspective of the National Health Service (NHS) in the United Kingdom...
ObjectiveAlthough a clear correlation has been observed between high‐frequency oscillations (HFOs) and the seizure‐onset zone in distinct lesions, the role of the underlying pathologic substrates in the generation of HFOs is not well established. We aimed to investigate HFO correlates of different pathologic substrates in patients with drug‐resistant epilepsy, and to examine the relation of HFOs with...
Great advancements have been made in understanding the basic mechanisms of ictogenesis using single‐cell electrophysiology (e.g., patch clamp, sharp electrode), large‐scale electrophysiology (e.g., electroencephalography [EEG], field potential recording), and large‐scale imaging (magnetic resonance imaging [MRI], positron emission tomography [PET], calcium imaging of acetoxymethyl ester [AM] dye‐loaded...
ObjectiveTo assess the efficacy and safety of eslicarbazepine acetate (ESL) as monotherapy in North American patients with partial‐onset seizures (POS).
MethodsThis multicenter, randomized, double‐blind “withdrawal to monotherapy” study used historical control data as the comparator. Adults with POS medically uncontrolled by one to two antiepileptic drugs gradually converted to ESL monotherapy. Following...
ObjectiveFor patients with medically intractable focal epilepsy, the benefit of epilepsy surgery must be weighed against the risk of cognitive decline. Clinical factors such as age and presurgical cognitive level partially predict cognitive outcome; yet, little is known about the role of cross‐hemispheric white matter pathways in supporting postsurgical recovery of cognitive function. The purpose...
ObjectiveSeizures are common in patients with posterior reversible encephalopathy syndrome (PRES), which is reported in up to 70% of cases, and antiepileptic drugs (AEDs) are commonly prescribed. There is a paucity of data regarding the risk of subsequent seizures following resolution of PRES, and therefore the optimal duration of treatment with AEDs is currently unknown. The objective of this study...
ObjectiveTo explore the structure–function relation of the temporal lobe in newly diagnosed West syndrome of unknown cause (uWS).
MethodsQuantitative magnetic resonance imaging (three‐dimensional [3D] structural MRI and diffusion tensor imaging [DTI]) was analyzed using voxel‐based morphometry (VBM) and tract‐based spatial statistics (TBSS) in 22 patients and healthy age‐matched controls. The electrophysiologic...
In 2011, the American Academy of Neurology (AAN) established eight epilepsy quality measures (EQMs) for chronic epilepsy treatment to address deficits in quality of care. This study assesses the relationship between adherence to these EQMs and epilepsy‐related adverse hospitalizations (ERAHs). A retrospective chart review of 475 new epilepsy clinic patients with an ICD‐9 code 345.1‐9 between 2010...
ObjectiveThe mismatch negativity (MMN) is an objective measure of central auditory discrimination. MMN alterations have been shown in children with language and/or developmental disorders. In benign focal epilepsies, neuropsychological disorders are often reported and linked to interictal epileptic discharges (IEDs) during non–rapid eye movement (NREM) sleep. There are few studies reporting MMN in...
Valproic acid (VPA) is an antiepileptic drug that has been associated with impaired hemostasis and increased risk for postsurgical bleeding. However, the published reports provide controversial results. We measured parameters of primary hemostasis in VPA‐treated patients with epilepsy, focusing on adenosine nucleotide–dependent platelet responses, which play a central role in primary hemostasis. We...
ObjectiveTo examine antioxidative system in hippocampi of patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (mTLE‐HS).
MethodsActivity and levels of antioxidative enzymes—catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), manganese superoxide dismutase (MnSOD), and copper‐zinc superoxide dismutase (CuZnSOD)—were assessed in hippocampi of nine...
ObjectiveEpilepsy is a common neurologic disorder of childhood. To determine the genetic diagnostic yield in epileptic encephalopathy, we performed a retrospective cohort study in a single epilepsy genetics clinic.
MethodsWe included all patients with intractable epilepsy, global developmental delay, and cognitive dysfunction seen between January 2012 and June 2014 in the Epilepsy Genetics Clinic...
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