Neurologist
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The ideal efficacy outcome after surgery for medically refractory epilepsy is seizure freedom without need for antiepileptic drug (AED) therapy but the appropriate timing of AED withdrawal and other prognostic factors remain unclear. ⋯ In adults who have undergone neocortical resection surgery for medically refractory epilepsy, longer time from surgery to beginning AED taper (eg, greater than 9 months) is associated with a greater proportion of patients maintaining seizure freedom. Other risk factors associated with lower rate of seizure freedom after AED taper include longer duration of epilepsy, normal preoperative magnetic resonance imaging, and occurrence of postoperative seizures before initiation of AED withdrawal, but not cortical location of the epilepsy focus.
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Migraine with aura has long been believed to be related to the phenomenon of cortical spreading depression. Clinically, there are no consistent neuroimaging findings corresponding to an attack of migraine with aura. ⋯ There have been reports of various etiologies associated with a temporary focal lesion in the splenium of the corpus callosum manifested as obviously restricted diffusion. These findings may be the consequence of a high vulnerability of the splenium of the corpus callosum to cytotoxic damage. Migraine with aura was considered to be the cause of the reversible focal injury of the splenium in this case. This association has not been reported earlier.