epilepsy treatment,
1h
Temporal encephalocele: a novel indication for magnetic resonance-guided laser interstitial thermal therapy for medically intractable epilepsy.
by Ranjan M, Wilfong AW, Borewinkle V, Jarrar R, David Adelson P via pubmed: epilepsy treatment
Related Articles
Temporal encephalocele: a novel indication for magnetic resonance-guided laser interstitial thermal therapy for medically intractable epilepsy.
Epileptic Disord. 2019 Jun 01;21(3):265-270
Authors: Ranjan M, Wilfong AW, Borewinkle V, Jarrar R, David Adelson P
Abstract
Temporal encephalocele (TE) is a rare but surgically treatable/curable cause of temporal lobe epilepsy (TLE). The surgical intervention varies from local disconnection to extensive anterior temporal lobectomy and amygdalohippocampectomy (ATL/AH). Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has evolved as a minimally invasive alternative for intractable epilepsy with good results, however, application of MRgLITT for intractable pediatric epilepsy secondary to TE has not been reported. We present a detailed technical report and clinical experience of MRgLITT in two adolescent children with medically intractable TLE secondary to TE. Pre-surgical evaluation revealed anterior inferior TE with concordant clinico-electrophysiological data. Both the patients underwent MRgLITT after review with the institutional multidisciplinary epilepsy team and discussion with the patient and the family. Both the patients were discharged on post-operative day one and have been seizure-free since the procedure at the last follow-up visit at 18 months and 6 months, respectively. The present series demonstrates first-ever clinical and technical experience of MRgLITT for TE with intractable pediatric epilepsy. The excellent post-operative seizure outcome and favorable postoperative course support MRgLITT as the first line of surgical intervention for TE with intractable TLE and broadens the application of MRgLITT.
PMID: 31262720 [PubMed - in process]
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1h
Indications and expectations for neuropsychological assessment in epilepsy surgery in children and adults.
by Baxendale S, Wilson SJ, Baker GA, Barr W, Helmstaedter C, Hermann BP, Langfitt J, Reuner G, Rzezak P, Samson S, Smith ML via pubmed: epilepsy treatment
Related Articles
Indications and expectations for neuropsychological assessment in epilepsy surgery in children and adults.
Epileptic Disord. 2019 Jun 01;21(3):221-234
Authors: Baxendale S, Wilson SJ, Baker GA, Barr W, Helmstaedter C, Hermann BP, Langfitt J, Reuner G, Rzezak P, Samson S, Smith ML
Abstract
In our first paper in this series (Epilepsia 2015; 56(5): 674-681), we published recommendations for the indications and expectations for neuropsychological assessment in routine epilepsy care. This partner paper provides a comprehensive overview of the more specialist role of neuropsychological assessment in the pre and postoperative evaluation of epilepsy surgery patients. The paper is in two parts. The first part presents the framework for the mandatory role of neuropsychologists in the presurgical evaluation of epilepsy surgery candidates. A preoperative neuropsychological assessment should be comprised of standardised measures of cognitive function in addition to wider measures of behavioural and psychosocial function. The results from the presurgical assessment are used to: (1) establish a baseline against which change can be measured following surgery; (2) provide a collaborative contribution to seizure characterization, lateralization and localization; (3) provide evidence-based predictions of cognitive risk associated with the proposed surgery; and (4) provide the evidence base for comprehensive preoperative counselling, including exploration of patient expectations of surgical treatment. The second part examines the critical role of the neuropsychologist in the evaluation of postoperative outcomes. Neuropsychological changes following surgery are dynamic and a comprehensive, long-term assessment of these changes following surgery should form an integral part of the postoperative follow-up. The special considerations with respect to pre and postoperative assessment when working with paediatric populations and those with an intellectual disability are also discussed. The paper provides a summary checklist for neuropsychological involvement throughout the epilepsy surgery process, based on the recommendations discussed.
PMID: 31262718 [PubMed - in process]
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1h
Encephalopathy with continuous spike-waves during slow-wave sleep: evolution and prognosis.
by Caraballo R, Pavlidis E, Nikanorova M, Loddenkemper T via pubmed: epilepsy treatment
Related Articles
Encephalopathy with continuous spike-waves during slow-wave sleep: evolution and prognosis.
Epileptic Disord. 2019 May 28;:
Authors: Caraballo R, Pavlidis E, Nikanorova M, Loddenkemper T
Abstract
Encephalopathy with continuous spike-waves during slow-wave sleep (CSWS) evolves over time, and three stages can be recognized: before the onset of CSWS, during CSWS, and after the CSWS period. Clinical seizures tend to remit spontaneously around puberty. This pattern is independent of the etiological lesion. The CSWS also disappears in all cases. Focal abnormalities instead, may persist for some time after the disappearance of CSWS. The disappearance of the clinical seizures and CSWS may be simultaneous or seizures may disappear before or after disappearance of the CSWS pattern on the EEG. Electroclinical parameters in the pre-CSWS period that have been proposed to predict a poor outcome are early-onset seizures, appearance of new seizures, and a significant increase in seizure frequency. From the electrical point of view, an increase in the frequency of the interictal EEG paroxysms while awake and during sleep and bilateral spike-and-wave paroxysms may also be predictive of a poor evolution in CSWS. When CSWS disappears, neurocognitive and behavioral status improve, but in most patients, residual moderate to severe neurocognitive impairments remain. In non-lesional epilepsy, cognitive recovery after cessation of the CSWS depends on the severity and duration of the initial regression. The duration of the CSWS seems to be the most important predictor of cognitive outcome. Early recognition and effective therapy to reduce the seizures and resolve the CSWS may be crucial to improve long-term prognosis. Cognitive recovery is observed in patients who respond well to AED treatment and outcome depends on the etiology.
PMID: 31262717 [PubMed - as supplied by publisher]
Add tags (Currently: PubMed)
Unread Email Website
1h
Temporal encephalocele: a novel indication for magnetic resonance-guided laser interstitial thermal therapy for medically intractable epilepsy.
by Ranjan M, Wilfong AW, Borewinkle V, Jarrar R, David Adelson P via pubmed: epilepsy treatment
Related Articles
Temporal encephalocele: a novel indication for magnetic resonance-guided laser interstitial thermal therapy for medically intractable epilepsy.
Epileptic Disord. 2019 Jun 01;21(3):265-270
Authors: Ranjan M, Wilfong AW, Borewinkle V, Jarrar R, David Adelson P
Abstract
Temporal encephalocele (TE) is a rare but surgically treatable/curable cause of temporal lobe epilepsy (TLE). The surgical intervention varies from local disconnection to extensive anterior temporal lobectomy and amygdalohippocampectomy (ATL/AH). Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has evolved as a minimally invasive alternative for intractable epilepsy with good results, however, application of MRgLITT for intractable pediatric epilepsy secondary to TE has not been reported. We present a detailed technical report and clinical experience of MRgLITT in two adolescent children with medically intractable TLE secondary to TE. Pre-surgical evaluation revealed anterior inferior TE with concordant clinico-electrophysiological data. Both the patients underwent MRgLITT after review with the institutional multidisciplinary epilepsy team and discussion with the patient and the family. Both the patients were discharged on post-operative day one and have been seizure-free since the procedure at the last follow-up visit at 18 months and 6 months, respectively. The present series demonstrates first-ever clinical and technical experience of MRgLITT for TE with intractable pediatric epilepsy. The excellent post-operative seizure outcome and favorable postoperative course support MRgLITT as the first line of surgical intervention for TE with intractable TLE and broadens the application of MRgLITT.
PMID: 31262720 [PubMed - in process]
Add tags (Currently: PubMed)
Unread Email Website
1h
Indications and expectations for neuropsychological assessment in epilepsy surgery in children and adults.
by Baxendale S, Wilson SJ, Baker GA, Barr W, Helmstaedter C, Hermann BP, Langfitt J, Reuner G, Rzezak P, Samson S, Smith ML via pubmed: epilepsy treatment
Related Articles
Indications and expectations for neuropsychological assessment in epilepsy surgery in children and adults.
Epileptic Disord. 2019 Jun 01;21(3):221-234
Authors: Baxendale S, Wilson SJ, Baker GA, Barr W, Helmstaedter C, Hermann BP, Langfitt J, Reuner G, Rzezak P, Samson S, Smith ML
Abstract
In our first paper in this series (Epilepsia 2015; 56(5): 674-681), we published recommendations for the indications and expectations for neuropsychological assessment in routine epilepsy care. This partner paper provides a comprehensive overview of the more specialist role of neuropsychological assessment in the pre and postoperative evaluation of epilepsy surgery patients. The paper is in two parts. The first part presents the framework for the mandatory role of neuropsychologists in the presurgical evaluation of epilepsy surgery candidates. A preoperative neuropsychological assessment should be comprised of standardised measures of cognitive function in addition to wider measures of behavioural and psychosocial function. The results from the presurgical assessment are used to: (1) establish a baseline against which change can be measured following surgery; (2) provide a collaborative contribution to seizure characterization, lateralization and localization; (3) provide evidence-based predictions of cognitive risk associated with the proposed surgery; and (4) provide the evidence base for comprehensive preoperative counselling, including exploration of patient expectations of surgical treatment. The second part examines the critical role of the neuropsychologist in the evaluation of postoperative outcomes. Neuropsychological changes following surgery are dynamic and a comprehensive, long-term assessment of these changes following surgery should form an integral part of the postoperative follow-up. The special considerations with respect to pre and postoperative assessment when working with paediatric populations and those with an intellectual disability are also discussed. The paper provides a summary checklist for neuropsychological involvement throughout the epilepsy surgery process, based on the recommendations discussed.
PMID: 31262718 [PubMed - in process]
Add tags (Currently: PubMed)
Unread Email Website
1h
Encephalopathy with continuous spike-waves during slow-wave sleep: evolution and prognosis.
by Caraballo R, Pavlidis E, Nikanorova M, Loddenkemper T via pubmed: epilepsy treatment
Related Articles
Encephalopathy with continuous spike-waves during slow-wave sleep: evolution and prognosis.
Epileptic Disord. 2019 May 28;:
Authors: Caraballo R, Pavlidis E, Nikanorova M, Loddenkemper T
Abstract
Encephalopathy with continuous spike-waves during slow-wave sleep (CSWS) evolves over time, and three stages can be recognized: before the onset of CSWS, during CSWS, and after the CSWS period. Clinical seizures tend to remit spontaneously around puberty. This pattern is independent of the etiological lesion. The CSWS also disappears in all cases. Focal abnormalities instead, may persist for some time after the disappearance of CSWS. The disappearance of the clinical seizures and CSWS may be simultaneous or seizures may disappear before or after disappearance of the CSWS pattern on the EEG. Electroclinical parameters in the pre-CSWS period that have been proposed to predict a poor outcome are early-onset seizures, appearance of new seizures, and a significant increase in seizure frequency. From the electrical point of view, an increase in the frequency of the interictal EEG paroxysms while awake and during sleep and bilateral spike-and-wave paroxysms may also be predictive of a poor evolution in CSWS. When CSWS disappears, neurocognitive and behavioral status improve, but in most patients, residual moderate to severe neurocognitive impairments remain. In non-lesional epilepsy, cognitive recovery after cessation of the CSWS depends on the severity and duration of the initial regression. The duration of the CSWS seems to be the most important predictor of cognitive outcome. Early recognition and effective therapy to reduce the seizures and resolve the CSWS may be crucial to improve long-term prognosis. Cognitive recovery is observed in patients who respond well to AED treatment and outcome depends on the etiology.
PMID: 31262717 [PubMed - as supplied by publisher]
Add tags (Currently: PubMed)
Unread Email Website
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