Seizure : the journal of the British Epilepsy Association
-
Randomized Controlled Trial
Comparison of the effects of different anesthetic techniques on electrocorticography in patients undergoing epilepsy surgery - a bispectral index guided study.
It is well known that general anesthetics suppress/alter electrocorticography (ECoG) activity. However there are no randomized studies available, comparing various anesthetic techniques as regards their effects on ECoG. ⋯ In our study optimal ECoG recordings were possible with use of either isoflurane or propofol. Addition of nitrous oxide to either of the anesthetic regimens suppressed the ECoG score.
-
Seizures frequently impact the quality of life of patients with low grade tumors. Management is often based on best clinical judgment. We examined factors that correlate with seizure outcome to optimize seizure management. ⋯ Seizures at presentation are the most important factor associated with continued seizures after tumor surgery. Pathology does not influence seizure outcome. Use of long term prophylactic anticonvulsants is unwarranted. Chemotherapy and radiation therapy have a favorable impact on seizure outcome. Additional epilepsy surgery is effective.
-
To report the effectiveness and safety of intravenous levetiracetam in the treatment of children with acute repeated seizures, and status epilepticus in a children's hospital. ⋯ This observational study has confirmed previous data that intravenous levetiracetam seems to be effective and safe in the treatment of acute repeated seizures and status epilepticus. A randomised clinical trial is justified to determine whether intravenous levetiracetam should replace intravenous phenytoin as the first long-acting anticonvulsant in the management of acute repetitive seizures and status epilepticus.
-
Allergic reactions to antiepileptic drugs in the form of skin rash are not uncommon but angioedema, an acute life threatening reaction is rare. Angioedema has been reported with the use of oxcarbazepine and carbamazepine. ⋯ The patient had previous skin rashes with both phenytoin and lamotrigine. Levetiracetam was stopped and she improved after treatment with norepinephrine, antihistamines and corticosteroids.
-
Clinical Trial
Cognitive improvement after long-term electrical stimulation of bilateral anterior thalamic nucleus in refractory epilepsy patients.
The cognitive and behavioral effect of deep brain stimulation (DBS) administered to the deep cerebral nuclei for epilepsy treatment is unknown. We investigated the cognitive outcomes at least 12 months after DBS to the bilateral anterior thalamic nucleus (ATN) for controlling intractable epilepsy. ⋯ We showed that ATN DBS not only resulted in promising clinical effects but was also associated with improvements in both verbal recall and oral information processing, which may be related to the bilateral activation of the fronto-limbic circuit following DBS surgery. Further controlled, long-term studies with larger populations are warranted for elucidating the clinical effects of ATN DBS.