Epilepsy research
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In contrast to the well studied long-term memory dysfunction of temporal lobe epilepsy (TLE) syndromes, data on memory performance of frontal lobe epilepsy (FLE) patients are limited and controversial. Behavioural and functional neuroimaging findings suggest that different regions within the frontal lobes contribute to long-term memory functioning, offering an explanation for the variability on memory function observed on patients with frontal lobe damage. ⋯ Variability on memory performance reported in FLE studies suggest this deficit may be dependant on the areas involved in seizure generation and spread. Recent research findings and the application of cognitive fMRI paradigms to FLE patients holds the promise of increasing understanding further.
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Comparative Study
Efficacy and tolerability of high oral doses of levetiracetam in children with epilepsy.
Despite the advent of new antiepileptic drugs, many children continue to have refractory seizures. We sought to determine whether oral LEV is helpful in seizure control and tolerable at doses higher than 60mg/kg/day in the pediatric outpatient population. ⋯ Not only do some children tolerate high doses and serum levels of levetiracetam, but they may also benefit from them, suggesting that doses higher than 60mg/kg/day may be considered in children who partially respond to the lower doses.
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Randomized Controlled Trial Multicenter Study Comparative Study
A comparison of pregabalin, lamotrigine, and placebo as adjunctive therapy in patients with refractory partial-onset seizures.
This study assessed the comparative efficacy of pregabalin for refractory partial seizures. ⋯ Pregabalin was demonstrated to be noninferior to lamotrigine in the treatment of refractory partial seizures. Overall conclusions were complicated by an unusually large and heterogeneous placebo response.
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Epilepsy is a common disease of childhood, in which almost 25% of cases are resistant to common antiepileptic drugs. Uncontrolled epilepsy increases morbidity and mortality rates, adversely affects growth and development in these children and imposes heavy psychological stress and financial burdens on parents, health care and society, making it mandatory to find effective therapies for the condition. Our aim was to study the efficacy of levetiracetam, as an add-on therapy, in children suffering from refractory epilepsy. ⋯ Levetiracetam can be used as an effective add-on treatment in children with refractory epilepsy.
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Brain stimulation with low-frequency stimulation (LFS) is emerging as an alternative treatment for refractory epilepsy. The present study aimed to investigate the effects of LFS targeting the hippocampal CA3 subfield in different modes on amygdala-kindled seizures in Sprague-Dawley rats. When fully kindled seizures were achieved by daily electrical stimulation of the amygdala, LFS (15 min train of 0.1 ms pulses at 1 Hz and 100 microA) of the CA3 was applied in several modes. ⋯ Interestingly, prior consecutive daily application of LFS in the absence of kindling stimulation did not reduce subsequent evoked seizures, but abolished the anti-epileptic effect of post-treatment. These results indicated that LFS of the CA3 is able to reduce kindled seizures in a mode-dependent manner without cumulative feature. The hippocampal CA3 subfield could be considered as a potential target for epilepsy treatment using LFS, and should be delivered in an appropriate stimulation mode.