Arch Neurol Chicago
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Arch Neurol Chicago · Oct 2004
Case ReportsLevetiracetam induces a rapid and sustained reduction of generalized spike-wave and clinical absence.
Levetiracetam (LEV) is a new antiepileptic drug with efficacy in partial-onset seizures. We report a case in which generalized-onset absence seizures responded clinically and electrographically to LEV. ⋯ This case showed a dramatic, rapid effect of LEV discontinuation and reinstitution on generalized spike-wave burst frequency and clinical absence. The effects were independent of reduction of lamotrigine and without change in topiramate doses and occurred in a time course consistent with LEV pharmacokinetics. Levetiracetam may be effective in generalized-onset epilepsy, and randomized, controlled trials are indicated.
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Arch Neurol Chicago · Oct 2004
Editorial Comment Historical ArticleViral pathogens in multiple sclerosis: an intriguing (hi)story.
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Arch Neurol Chicago · Aug 2004
Comparative StudyMigraine with aura and brain magnetic resonance imaging abnormalities in patients with CADASIL.
Migraine with aura (MA) is one of the clinical hallmarks of CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy), a small vessel disease of the brain caused by mutations in the NOTCH3 gene, but its exact mechanisms are unknown. ⋯ In CADASIL, MA is characterized by an unusually high frequency of attacks of migraine with atypical aura. The distribution and extent of magnetic resonance signal abnormalities did not differ according to migraine phenotype.
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Arch Neurol Chicago · Aug 2004
Treatment of refractory status epilepticus with inhalational anesthetic agents isoflurane and desflurane.
Refractory status epilepticus (RSE) is defined as continued seizures after 2 or 3 antiepileptic drugs have failed. Several intravenous agents have been used for RSE; however, problems occur with their toxicity and/or effectiveness. ⋯ Isoflurane and desflurane adequately suppressed RSE in all cases. Complications were common, but mortality and long-term morbidity were related to the underlying disease and duration of RSE. Prolonged use of isoflurane and desflurane is well tolerated.