Epilepsy & behavior : E&B
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Epilepsy & behavior : E&B · Dec 2013
Mesial temporal lobe epilepsy with no specific histological abnormality: a distinct surgically remediable syndrome.
The purposes of the study were twofold: to clarify the clinical features and surgical outcome of mesial temporal lobe epilepsy (MTLE) with no specific histological abnormality and to determine the optimal surgical strategy. ⋯ Mesial temporal lobe epilepsy with no specific histological abnormality is a clinical entity distinctly different from MTLE with HS. Bitemporal independent and/or nonlateralizing seizure onset on intracranial EEG is very common. Although the presence of lateral temporal and/or extratemporal epileptogenicity should always be kept in mind, postoperative seizure outcome after AHE is favorable even in cases with bitemporal independent and/or nonlateralizing seizure onset.
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Epilepsy & behavior : E&B · Nov 2013
Age-specific periictal electroclinical features of generalized tonic-clonic seizures and potential risk of sudden unexpected death in epilepsy (SUDEP).
Generalized tonic-clonic seizure (GTCS) is the commonest seizure type associated with sudden unexpected death in epilepsy (SUDEP). This study examined the semiological and electroencephalographic differences (EEG) in the GTCSs of adults as compared with those of children. The rationale lies on epidemiological observations that have noted a tenfold higher incidence of SUDEP in adults. ⋯ Root mean square successive difference was negatively correlated with PGES duration (longer PGES durations were associated with decreased vagally mediated heart rate variability; p<0.05) but not with tonic phase duration. This study clearly points out identifiable electroclinical differences between adult and pediatric GTCSs that may be relevant in explaining lower SUDEP risk in children. The findings suggest that some prolonged seizure phases and prolonged PGES duration may be electroclinical markers of SUDEP risk and merit further study.
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Epilepsy & behavior : E&B · Nov 2013
Multicenter StudyControl of seizures in different stages of partial epilepsy: LACO-EXP, a Spanish retrospective study of lacosamide.
Lacosamide is approved as adjunctive therapy for focal epilepsies. The number of antiepileptic drugs (AEDs) tried is associated with prognosis. This multicenter, retrospective, observational study (LACO-EXP) in Spain in 500 adult patients with focal epilepsies examined the efficacy and tolerability of add-on lacosamide. ⋯ Lacosamide was generally well tolerated. A slower dosage-titration schedule was associated with a lower adverse event rate. Further investigation of the timing of initiation of lacosamide add-on therapy and ideal combinations of AEDs is required.
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Epilepsy & behavior : E&B · Nov 2013
Amygdala enlargement occurs in patients with mesial temporal lobe epilepsy and hippocampal sclerosis with early epilepsy onset.
Mesial temporal lobe epilepsy (MTLE) associated with hippocampal sclerosis (HS) is considered an electroclinical syndrome, and there is a debate whether it is a unique disease or an entity with distinct subtypes. Together with other mesial temporal structures, the amygdala is important in the epileptogenic network of patients with MTLE with HS. ⋯ Patients with MTLE with HS and enlarged amygdala had significantly earlier epilepsy onset than those without an increase of amygdala volumes. Mesial temporal lobe epilepsy with HS and enlarged amygdala may be a part of the spectrum of this condition.