Epilepsy research and treatment最新文献

{"title":"Temporal lobe epilepsy after refractory status epilepticus: an illustrative case and review of the literature.","authors":"J Gordon Boyd,&nbsp;Derek B Debicki,&nbsp;G Bryan Young","doi":"10.1155/2012/209701","DOIUrl":"https://doi.org/10.1155/2012/209701","url":null,"abstract":"<p><p>New onset refractory status epilepticus (NORSE) is a relatively newly defined disease entity, where otherwise healthy individuals develop unrelenting seizures that do not respond to conventional anticonvulsant therapy and may require months of therapy with anesthetic drugs. We have described a case of NORSE who subsequently developed mesial temporal lobe sclerosis (MTS) and recurrent temporal lobe seizures. We discuss the possible pathophysiological mechanisms by which refractory seizures may contribute to the development of temporal lobe epilepsy (TLE).</p>","PeriodicalId":72948,"journal":{"name":"Epilepsy research and treatment","volume":" ","pages":"209701"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/209701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30885725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychology in temporal lobe epilepsy: influences from cognitive neuroscience and functional neuroimaging.","authors":"Mary Pat McAndrews,&nbsp;Melanie Cohn","doi":"10.1155/2012/925238","DOIUrl":"https://doi.org/10.1155/2012/925238","url":null,"abstract":"<p><p>Neuropsychologists assist in diagnosis (i.e., localization of dysfunction) and in prediction (i.e., how cognition may change following surgery) in individuals being considered for temporal lobe surgery. The current practice includes behavioural testing as well as mapping function via stimulation, inactivation, and (more recently) functional imaging. These methods have been providing valuable information in surgical planning for 60 years. Here, we discuss current assessment strategies and highlight how they are evolving, particularly with respect to integrating recent advances in cognitive neuroscience.</p>","PeriodicalId":72948,"journal":{"name":"Epilepsy research and treatment","volume":" ","pages":"925238"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/925238","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30888602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epileptic encephalopathy.","authors":"Nicola Specchio,&nbsp;Marina Trivisano,&nbsp;Rod C Scott,&nbsp;Colin Ferrie","doi":"10.1155/2012/460256","DOIUrl":"https://doi.org/10.1155/2012/460256","url":null,"abstract":"Epileptic encephalopathies are conditions in which epileptic activity itself is postulated to contribute to severe cognitive and behavioural impairments above and beyond what might be expected from the underlying pathology alone. The term has been used in two ways: (1) as a generic classification term for epilepsies with severe cognitive and be-havioural outcomes and (2) as a pathophysiological process. We argue that the term is not synonymous with \" severe epileptic syndrome \". Epileptic encephalopathy can complicate many different epileptic conditions. In some it is an almost constant feature (e.g., Lennox-Gastaut syndrome), in others expected but not invariable (e.g., West syndrome) whilst in yet others it may or may not occur with almost equal frequency (e.g., Doose syndrome). Epileptic encephalopathy very occasionally complicates otherwise benign epilepsies (e.g., benign rolandic epilepsy). Epileptic encephalopathy is a dynamic condition that may persist over time causing increasingly severe functional effects or else it may improve and remit, either spontaneously or with treatment which suppresses the proposed causative epileptic activity. Fundamental to the concept of epileptic encephalopathy is that the cognitive and other problems which characterise it result from epileptic activity, rather than being a consequence of any underling cerebral pathology (whether genetic, structural, metabolic inflammatory, etc.) which may itself be causing the epilepsy. However, all spontaneous epileptic phenomena in humans are a function of some kind of brain disease (genetic through to structural) and therefore it is likely that all cognitive impairments in children with epilepsy are at least in part a function of aetiology. When a brain disorder gives rise to both epilepsy and cog-nitive and behavioural problems, it should not be classed as an epileptic encephalopathy, but rather as an \" epileptogenic encephalopathy \". The crucial difference being that the cogni-tive and behavioural problems are not a consequence of the epilepsy, but of the cerebral pathology. However, in epilepto-genic encephalopathies seizures may aggravate cognitive and behavioural problems and thus treatment of seizures may improve outcomes. Some disorders, mostly genetically determined and char-acterised by the onset of seizures in the first months of life and with developmental stagnation are best considered as \" early onset epilepsies with encephalopathy \" rather than epileptic encephalopathy. Both the epilepsy and the enceph-alopathy appear to be symptoms of a known or unknown genetic defect and there is no evidence that epileptic activity is primarily responsible for the developmental stagnation. Examples of this include disorders associated with CDKL5, …","PeriodicalId":72948,"journal":{"name":"Epilepsy research and treatment","volume":" ","pages":"460256"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/460256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31180587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epileptic encephalopathies in adults and childhood.","authors":"Zekiye Kural,&nbsp;Ali Fahir Ozer","doi":"10.1155/2012/205131","DOIUrl":"https://doi.org/10.1155/2012/205131","url":null,"abstract":"Epileptic encephalopathies are motor-mental retardations or cognitive disorders secondary to epileptic seizures or epileptiform activities. Encephalopaties due to brain damage, medications, or systemic diseases are generally not in the scope of this definition, but they may rarely accompany the condition. Appropriate differential diagnosis of epileptic seizures as well as subclinical electroencephalographic discharges are crucial for management of seizures and epileptiform discharges and relative regression of cognitive deterioration in long-term followup. Proper antiepileptic drug, hormonal treatment, or i.v. immunoglobulin choice play major role in prognosis. In this paper, we evaluated the current treatment approaches by reviewing clinical electrophysiological characteristics of epileptic encephalopathies.","PeriodicalId":72948,"journal":{"name":"Epilepsy research and treatment","volume":" ","pages":"205131"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/205131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30969655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal lobe epilepsy in children.","authors":"Katherine C Nickels, Lily C Wong-Kisiel, Brian D Moseley, Elaine C Wirrell","doi":"10.1155/2012/849540","DOIUrl":"10.1155/2012/849540","url":null,"abstract":"<p><p>The temporal lobe is a common focus for epilepsy. Temporal lobe epilepsy in infants and children differs from the relatively homogeneous syndrome seen in adults in several important clinical and pathological ways. Seizure semiology varies by age, and the ictal EEG pattern may be less clear cut than what is seen in adults. Additionally, the occurrence of intractable seizures in the developing brain may impact neurocognitive function remote from the temporal area. While many children will respond favorably to medical therapy, those with focal imaging abnormalities including cortical dysplasia, hippocampal sclerosis, or low-grade tumors are likely to be intractable. Expedient workup and surgical intervention in these medically intractable cases are needed to maximize long-term developmental outcome.</p>","PeriodicalId":72948,"journal":{"name":"Epilepsy research and treatment","volume":" ","pages":"849540"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3420576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30889206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neocortical temporal lobe epilepsy.","authors":"Eduard Bercovici, Balagobal Santosh Kumar, Seyed M Mirsattari","doi":"10.1155/2012/103160","DOIUrl":"10.1155/2012/103160","url":null,"abstract":"<p><p>Complex partial seizures (CPSs) can present with various semiologies, while mesial temporal lobe epilepsy (mTLE) is a well-recognized cause of CPS, neocortical temporal lobe epilepsy (nTLE) albeit being less common is increasingly recognized as separate disease entity. Differentiating the two remains a challenge for epileptologists as many symptoms overlap due to reciprocal connections between the neocortical and the mesial temporal regions. Various studies have attempted to correctly localize the seizure focus in nTLE as patients with this disorder may benefit from surgery. While earlier work predicted poor outcomes in this population, recent work challenges those ideas yielding good outcomes in part due to better localization using improved anatomical and functional techniques. This paper provides a comprehensive review of the diagnostic workup, particularly the application of recent advances in electroencephalography and functional brain imaging, in neocortical temporal lobe epilepsy.</p>","PeriodicalId":72948,"journal":{"name":"Epilepsy research and treatment","volume":" ","pages":"103160"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3420667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30884560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A seizure care pathway in the emergency department: preliminary quality and safety improvements.","authors":"Parameswaran M Iyer,&nbsp;Patricia H McNamara,&nbsp;Margaret Fitzgerald,&nbsp;Liam Smyth,&nbsp;Christopher Dardis,&nbsp;Tania Jawad,&nbsp;Patrick K Plunkett,&nbsp;Colin P Doherty","doi":"10.1155/2012/273175","DOIUrl":"https://doi.org/10.1155/2012/273175","url":null,"abstract":"<p><p>Aim. To evaluate the utility of a seizure care pathway for seizure presentations to the emergency department (ED) in order to safely avoid unnecessary admission and to provide early diagnostic and therapeutic guidance and minimize length of stay in those admitted. Methods. 3 studies were conducted, 2 baseline audits and a 12-month intervention study and prospective data was collected over a 12-month period (Nov 2008-09). Results. Use of the Pathway resulted in a reduction in the number of epilepsy related admissions from 341 in 2004 to 276 in 2009 (P = 0.0006); a reduction in the median length of stay of those admittedfrom 4-5 days in the baseline audits to 2 days in the intervention study (P ≤ 0.001); an improvement in time to diagnostic investigations such as CT brain, MRI brain and Electroencephalography (P ≤ 0.001, P ≤ 0.048, P ≤ 0.001); a reduction in readmission rates from 45.1% to 8.9% (P ≤ 0.001); and an improvement in follow-up times from a median of 16 weeks to 5 weeks (P < 0.001). From a safety perspective there were no deaths in the early discharged group after 12 months follow-up. Conclusion. The burden of seizure related admissions through the ED can be improved in a safe and effective manner by the provision of a seizure care pathway.</p>","PeriodicalId":72948,"journal":{"name":"Epilepsy research and treatment","volume":" ","pages":"273175"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/273175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30884562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative neuropsychological outcome in patients with mesial temporal lobe epilepsy in Argentina.","authors":"Silvia Oddo,&nbsp;Patricia Solis,&nbsp;Damian Consalvo,&nbsp;Eduardo Seoane,&nbsp;Brenda Giagante,&nbsp;Luciana D'Alessio,&nbsp;Silvia Kochen","doi":"10.1155/2012/370351","DOIUrl":"https://doi.org/10.1155/2012/370351","url":null,"abstract":"<p><p>The aim of the present study is to compare pre- and postsurgical neuropsychological outcome in individuals suffering from mesial temporal lobe epilepsy (mTLE), in order to evaluate prognosis. The selected thirty-five patients had medically mTLE and had undergone an anterior temporal lobectomy (ATL). Neuropsychological evaluation was performed in three different stages: before ATL, 6 months after resection, and a year afterwards. Neuropsychological protocol evaluated attention, verbal memory, visual memory, executive function, language, intelligence, and handedness. There was a significant improvement (P = 0.030) in the group with visual memory deficit after surgery, whereas no changes were observed across patients with verbal memory deficit. No changes were observed in language after surgery. Executive function showed significant improvement 6 months after surgery (P = 0.035). Postoperative outcome of cognitive impairments depends on baseline neuropsychological status of the patients with TLE. In our case series, deficits found in patients with mTLE after ATL did not result in a subjective complaint.</p>","PeriodicalId":72948,"journal":{"name":"Epilepsy research and treatment","volume":" ","pages":"370351"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/370351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30886654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous EEG-Functional MRI in Mesial Temporal Lobe Epilepsy: Implications for the Neural Correlates of Consciousness.","authors":"Zheng Wang,&nbsp;Loretta Norton,&nbsp;R Matthew Hutchison,&nbsp;John R Ives,&nbsp;Seyed M Mirsattari","doi":"10.1155/2012/385626","DOIUrl":"https://doi.org/10.1155/2012/385626","url":null,"abstract":"<p><p>The combination of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) has been shown to have great potential for providing a greater understanding of normal and diseased states in both human and animal studies. Simultaneous EEG-fMRI is particularly well suited for the study of epilepsy in that it may reveal the neurobiology of ictal and interictal epileptiform discharges and noninvasively localize epileptogenic foci. Spontaneous, coherent fluctuations of neuronal activity and the coupled hemodynamic responses have also been shown to provide diagnostic markers of disease, extending our understanding of intrinsically structured ongoing brain activity. Following a short summary of the hardware and software development of simultaneous EEG-fMRI, this paper reviews a unified framework of integrating neuronal and hemodynamic processes during epileptic seizures and discusses the role and impact of spontaneous activity in the mesial temporal lobe epilepsies with particular emphasis on the neural and physiological correlates of consciousness.</p>","PeriodicalId":72948,"journal":{"name":"Epilepsy research and treatment","volume":" ","pages":"385626"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/385626","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30886657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Language mapping in temporal lobe epilepsy in children: special considerations.","authors":"Sandrine de Ribaupierre,&nbsp;An Wang,&nbsp;Susan Hayman-Abello","doi":"10.1155/2012/837036","DOIUrl":"https://doi.org/10.1155/2012/837036","url":null,"abstract":"<p><p>Temporal lobe epilepsy (TLE) in children is a slightly different entity than TLE in adults not only because of its semiology and pathology but also because of the different approach to surgical treatment. Presurgical investigations for eloquent cortex, especially language, must take these differences into account. Most diagnostic tests were created for adults, and many of the assessment tools need to be adapted for children because they are not just small adults. This paper will highlight the specific challenges and solutions in mapping language in a pediatric population with TLE.</p>","PeriodicalId":72948,"journal":{"name":"Epilepsy research and treatment","volume":" ","pages":"837036"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/837036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30889205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}