Epilepsy & behavior : E&B
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Epilepsy & behavior : E&B · Nov 2005
Epilepsy surgery in professional musicians: subjective and objective reports of three cases.
We describe a small series of three professional musicians who had right (two patients) and left (one patient) temporal lobe epilepsy surgery with the histological diagnoses of hippocampal sclerosis (two patients) and benign tumor (one patient, xanthoastrocytoma). The musicians were asked to complete a questionnaire about their musical abilities before and after surgery with respect to special musical skills like melody processing, musical memory, rhythm, meter, harmony/dissonance, timbre, concentration and endurance, emotionality, and absolute pitch. In addition, the musicians submitted reports of their experiences. ⋯ The two patients with right temporal lobe epilepsy reported improvements of specific musical abilities. Vocational development was very positive in all three patients. We conclude that epilepsy surgery can be safe and rewarding in professional musicians and propose initiating a database on epilepsy surgery in this special group of patients.
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Epilepsy & behavior : E&B · Nov 2005
Biography Historical ArticleThe idiosyncratic aspects of the epilepsy of Fyodor Dostoevsky.
The goal of this article is to review the idiosyncratic aspects of the epilepsy of Fyodor Dostoevsky, one of the greatest writers of all time. The onset of his seizures is controversial, with some evidence pointing to his childhood and other reports that would place the onset in his teens or his twenties. His life in prison in Siberia and then in the Russian army is reviewed. ⋯ A review of recent data on the risks to offspring of epileptic fathers confirms that the etiology of Dostoevsky's epilepsy was probably inherited and that he probably had an idiopathic generalized epilepsy with minor involvement of the temporal lobe. A relationship is seen between his severe obsession with gambling and his epilepsy. Finally, Fyodor Dostoevsky is an excellent example of the "temporal lobe personality."
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Epilepsy & behavior : E&B · Sep 2005
Case ReportsSuppression of obsessive-compulsive symptoms after epilepsy surgery.
We report two male patients with medically intractable epilepsy and obsessive-compulsive disorder (OCD) symptoms. Both patients experienced remission of obsessive-compulsive symptoms after surgical treatment of epilepsy. ⋯ On the basis of these observations, we discuss the pathophysiology of OCD symptoms, emphasizing the role of corticosubcortical pathways in their genesis. Our data suggest that surgeries that affect neural loops associated with obsessive-compulsive symptoms can lead to an improvement of OCD; however, the structures responsible for this effect cannot be conclusively determined.
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Epilepsy & behavior : E&B · Aug 2005
Multicenter Study Comparative Study Clinical TrialPatient and physician reactions to generic antiepileptic substitution in the treatment of epilepsy.
The clinical and economic consequences of generic antiepileptic drug (AED) substitution are not yet fully understood. This article provides a broad perspective of generic AED substitution in five countries. ⋯ There is an opposition to generic substitution by both patients and physicians, especially with concern over increased breakthrough seizure risk. Further evidence is required to understand how costs and effects of generic AED substitution affect patient welfare.
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Epilepsy & behavior : E&B · Mar 2005
Comparative Study Clinical TrialMemory and intelligence outcome following surgery for intractable temporal lobe epilepsy: relationship to seizure outcome and evaluation using a customized neuropsychological battery.
The main objectives of this prospective study were to (1) assess memory and intelligence outcome following surgery for intractable temporal lobe epilepsy, (2) correlate this with seizure outcome and side of surgery, and (3) perform (1) and (2) using an indigenously developed battery customized to the Indian population. Prior to use in our epilepsy surgery program, the test-retest and interexaminer variance reliability of this battery had been established in both normal and cognitively compromised populations. The memory scores were overall rather than material-specific. ⋯ In contrast, patients who underwent left temporal surgery had no significant change in cognitive scores irrespective of seizure outcome. Cognitive improvement seems to occur in patients with good seizure outcome following nondominant temporal lobe surgery for intractable epilepsy with no evidence of pathology in the opposite temporal lobe. The same finding was not observed in patients undergoing left temporal surgery.