Epilepsy research
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Comparative Study
Long-term outcome characteristics in mesial temporal lobe epilepsy with and without associated cortical dysplasia.
The intention of our study was to identify predictive characteristics for long-term seizure control and running down phenomenon after surgical treatment of pharmacoresistant mesiotemporal lobe epilepsy (mTLE) with and without associated cortical dysplasia. ⋯ Depending on the presence or absence of focal cortical dysplasia in addition to mesiotemporal structural alterations, predictors of long-term seizure control differed regarding the relevant clinical and electrophysiological features. This is important for specific patient counseling in respective groups.
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Genetic absence epilepsy rats from Strasbourg (GAERS), a well-validated genetic rat model for typical absence epilepsy, are known to manifest a resistance to secondary generalization of abnormal focal electrical activity evoked by kindling. The mechanism of this resistance is still unclear. In order to understand the possible mechanism of kindling resistance, we investigated for the first time, the differences of short-term synaptic plasticity by using a paired-pulse paradigm as an indicator of GABAergic activity in CA1 region of hippocampus in GAERS and non-epileptic Wistar rats in-vivo. ⋯ The increased inhibition in paired-pulse responses at early stages of kindling in GAERS suggests the role of augmented GABAergic activity as one of the underlying mechanisms of kindling resistance observed in genetic rat models of absence epilepsy.
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The Wada test has been the gold standard for determining hemispheric language dominance (HLD) in the presurgical evaluation of patients scheduled for neurosurgical procedures. As it poses inherent risks associated with intra-arterial catheter techniques and as it occasionally fails to indicate language dominance, an alternative reliable test is needed. We quantitatively assessed the results of functional magnetic resonance imaging (fMRI) using the Shiritori task, a Japanese word chain, to identify the threshold for correctly predicting HLD. ⋯ The fMRI using the Shiritori task showed good activation in ROI of BA 44 and 45. At a cut-off of LI+50, LI of BA 44 and 45 predicted HLD identified by the Wada test with high specificity.
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People with epilepsy (PWE) have a higher risk of mortality than the general population, because of disparities in the receipt of appropriate epilepsy care, which may be affected by socioeconomic status, race/ethnicity and insurance coverage. Increased epilepsy prevalence has been associated with black race, low educational attainment, unemployment, and low income levels. Rural/urban residence may affect health through individual or environmental factors. Health disparities seen in rural residents are likely amplified in rural PWE because of limited access to specialized care. This analysis aims to examine the risk of mortality attributable to rural residence in the statewide population of South Carolina (SC) after adjusting for potential confounders. ⋯ While other covariables were more strongly associated with mortality after adjustment (older age, insurance coverage, income level of zip code, and number of comorbidities), the finding of a higher hazard in black PWE than white PWE after adjustment for rural/urban residence and other demographic and clinical covariables is a concern. Further, the increased risk of mortality with higher numbers of comorbid conditions warrants regular management of these conditions.
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Randomized Controlled Trial Multicenter Study
Long-term safety and seizure outcome in Japanese patients with Lennox-Gastaut syndrome receiving adjunctive rufinamide therapy: An open-label study following a randomized clinical trial.
To evaluate the long-term safety and seizure outcome in Japanese patients with Lennox-Gastaut syndrome (LGS) receiving adjunctive rufinamide therapy. ⋯ This study demonstrated a long-term benefit of rufinamide as adjunctive therapy for Japanese patients with LGS. Exacerbation of seizures and decreased appetite/weight loss should be monitored carefully.