Epilepsia
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Comparative Study
Hemispheric surgery in children with refractory epilepsy: seizure outcome, complications, and adaptive function.
To describe seizure control, complications, adaptive function and language skills following hemispheric surgery for epilepsy. ⋯ Hemispheric surgery is an effective therapy for refractory epilepsy in children. The most common complication was bleeding. Duration of epilepsy prior to surgery is an important factor in determining adaptive outcome.
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Comparative Study
Use of a modified Atkins diet in intractable childhood epilepsy.
To evaluate the efficacy, safety and tolerability of a modified Atkins diet in intractable childhood epilepsy. ⋯ The modified Atkins diet was well tolerated and sometimes a modified Atkins diet can be substituted for the conventional ketogenic diet. Serious complications were rare, but long-term complications remain to be determined.
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Comparative Study
MEG predicts outcome following surgery for intractable epilepsy in children with normal or nonfocal MRI findings.
To identify the predictors of postsurgical seizure freedom in children with refractory epilepsy and normal or nonfocal MRI findings. ⋯ Surgery for intractable epilepsy in children with normal MRI findings provided good postsurgical outcomes in the majority of our patients. As well, restricted ictal onset zone predicted postoperative seizure freedom. Postoperative seizure freedom was less likely to occur in children with bilateral MEG dipole clusters or only scattered dipoles, multiple seizure types and incomplete resection of the proposed epileptogenic zone. Seizure freedom was most likely to occur when there was concordance between EEG and MEG localization and least likely to occur when these results were divergent.
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The involvement of the thalamus in limbic epileptogenesis has recently drawn attention to the connectivity between the nuclei of the thalamus and limbic structures. Thalamo-limbic circuits are thought to regulate limbic seizure activity whereas thalamocortical circuits are involved in the expression and generation of spike-and-wave discharges (SWDs) in the absence epilepsy models. Genetic Absence Epilepsy Rats From Strasbourg (GAERS) and WAG/Rij (Wistar Albino Glaxo from Rijswijk) are well-defined genetic animal models of absence epilepsy. ⋯ The kindling-resistant animals demonstrated a significantly longer duration of SWDs on the first day of the experiment before kindling stimulation and shorter duration of afterdischarge than did the kindled WAG/Rij animals. Behavioral durations at stage 2 were longer in kindled Wistar and WAG/Rij animals compared to kindling-resistant WAG/Rij and GAERS. These results suggest that mechanisms involved in the generation of SWDs act as a counterbalance to the excitability induced by kindling.
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In December 1946, a joint meeting devoted to epilepsy research and care was held by the Association for the Research in Nervous and Mental Disease and the American Chapter of the International League Against Epilepsy. The American Epilepsy Society (AES) has chosen this date and this meeting to mark its founding and recognizes Dr. Charles D. ⋯ Based on this historical review, it is recommended that the AES recognize 1936 as the year of its founding and Dr. William G. Lennox as its founder and first president.