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Wednesday, August 27, 2008
 Latest
Epilepsy Medical and Health News Headlines
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Epilepsy Medical and Health News Headlines
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All Recent Epilepsy Medical Condition News Headlines |
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Epilepsy raises drowning risk
People with epilepsy appear to have a much higher risk of drowning compared to people without epilepsy (Source: Nursing in Practice)...
POSTED 08/27/2008 at 08:59 AM --
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Children are not just small adults: the urgent need for high-quality trial evidence in children
Terry Klassen and colleagues discuss a new study examining whether children and adults with drug-resistant partial epilepsy respond differently to antiepileptic drugs. (Source: PLoS Medicine)...
POSTED 08/27/2008 at 01:40 AM --
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Greater response to placebo in children than in adults: a systematic review and meta-analysis in drug-resistant partial epilepsy
In a systematic review of antiepileptic drugs, Philippe Ryvlin and colleagues find that children with drug-resistant partial epilepsy enrolled in trials seem to have a greater response to placebo than adults enrolled in such trials. (Source: PLoS Medicine)...
POSTED 08/27/2008 at 01:40 AM --
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High cholesterol levels drop naturally in children on high-fat antiseizure diet
Elevated cholesterol levels return to normal or near normal levels over time in four out of 10 children with uncontrollable epilepsy treated with the high-fat ketogenic diet, according to results of a Johns Hopkins Children's Center study reported in the Journal of Child Neurology. (Source: News-Medical News Feed)...
POSTED 08/26/2008 at 07:40 PM --
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Pediatric epilepsy surgery
Title: Pediatric Epilepsy SurgeryCategory: Procedures and TestsCreated: 1/18/2001Last Editorial Review: 8/26/2008 (Source: MedicineNet Kids Health General)...
POSTED 08/26/2008 at 02:00 AM --
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Recent insights into the impairment of memory in epilepsy: transient epileptic amnesia, accelerated long-term forgetting and remote memory impairment
Complaints of memory difficulties are common among patients with epilepsy, particularly with temporal lobe epilepsy where memory-related brain structures are directly involved by seizure activity. However, the reason for these complaints is often unclear and patients frequently perform normally on standard neuropsychological tests of memory. In this article, we review the literature on three recently described and interrelated forms of memory impairment associated with epilepsy: (i) transient epileptic amnesia, in which the sole or main manifestation of seizures is recurrent episodes of amnesia; (ii) accelerated long-term forgetting, in which newly acquired memories fade over days to weeks and (iii) remote memory impairment, in which there is loss of memories for personal or public facts or events from the distant past. Accelerated long-term forgetting and remote memory impairment are common amongst patients with transient epileptic amnesia, but have been reported in other forms of epilepsy. Their presence goes undetected by standard memory tests and yet they can have a profound impact on patients’ lives. They pose challenges to current theoretical models of memory. We discuss the evidence for each of these phenomena, as well as their possible pathophysiological bases, methodological difficulties in their investigation and their theoretical implications. (Source: Brain)...
POSTED 08/25/2008 at 11:00 PM --
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Benign childhood focal epilepsies: assessment of established and newly recognized syndromes
A big advance in epileptology has been the recognition of syndromes with distinct aetiology, clinical and EEG features, treatment and prognosis. A prime and common example of this is rolandic epilepsy that is well known by the general paediatricians for over 50 years, thus allowing a precise diagnosis that predicts an excellent prognosis. However, rolandic is not the only benign childhood epileptic syndrome. Converging evidence from multiple and independent clinical, EEG and magnetoencephalographic studies has documented Panayiotopoulos syndrome (PS) as a model of childhood autonomic epilepsy, which is also common and benign. Despite high prevalence, lengthy and dramatic features, PS as well as autonomic status epilepticus had eluded recognition because emetic and other ictal autonomic manifestations were dismissed as non-epileptic events of other diseases. Furthermore, PS because of frequent EEG occipital spikes has been erroneously considered as occipital epilepsy and thus confused with the idiopathic childhood occipital epilepsy of Gastaut (ICOE-G), which is another age-related but rarer and of unpredictable prognosis syndrome. Encephalitis is a common misdiagnosis for PS and migraine with visual aura for ICOE-G. Pathophysiologically, the symptomatogenic zone appears to correspond to the epileptogenic zone in rolandic epilepsy (sensory-motor symptomatology of the rolandic cortex) and the ICOE-G (occipital lobe symptomatology), while the autonomic clinical manifestations of PS are likely to be generated by variable and widely spread epileptogenic foci acting upon a temporarily hyperexcitable central autonomic network. Rolandic epilepsy, PS, ICOE-G and other possible clinical phenotypes of benign childhood focal seizures are likely to be linked together by a genetically determined, functional derangement of the systemic brain maturation that is age related (benign childhood seizure susceptibility syndrome). This is usually mild but exceptionally it may diverge to serious epileptic disorders such as epileptic encephalopathy with continuous spike and wave during sleep. Links with other benign and age-related seizures in early life such as febrile seizures, benign focal neonatal and infantile seizures is possible. Overlap with idiopathic generalized epilepsies is limited and of uncertain genetic significance. Taking all these into account, benign childhood focal seizures and related epileptic syndromes would need proper multi-disciplinary re-assessment in an evidence-based manner. (Source: Brain)...
POSTED 08/25/2008 at 11:00 PM --
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Benign occipital epilepsies of childhood: clinical features and genetics
The early and late benign occipital epilepsies of childhood (BOEC) are described as two discrete electro-clinical syndromes, eponymously known as Panayiotopoulos and Gastaut syndromes. Our aim was to explore the clinical features, classification and clinical genetics of these syndromes using twin and multiplex family studies to determine whether they are indeed distinct. Sixteen probands including seven twins were studied. Non-twin probands (n = 9) with a family history of epilepsy were included. Electroclinical seizure semiology was characterized and probands were classified into BOEC syndromes. Detailed phenotyping of relatives was performed and phenotypic patterns within families were analysed. One-third of the children in this selected series of BOEC did not have a pure syndrome, rather a mixed syndrome with features of both Panayiotopoulos and Gastaut syndromes. Monozygotic twin pairs did not show a higher concordance rate than dizygotic twin pairs suggesting that BOEC may not be a purely genetic disorder. In relatives with epilepsy, there was a mixed pattern of focal and generalized epilepsies with focal epilepsies predominating. BOEC is an electro-clinical spectrum with Panayiotopoulos and Gastaut syndromes at either end; many cases show mixed features. Clinical genetic studies highlight the multifactorial aetiology of BOEC as monozygotic twins have low concordance suggesting that non-conventional genetic influences or environmental factors play a major role. Family studies show both focal and generalized epilepsies reinforcing that these are not discrete categories of idiopathic epilepsies and are likely to share genetic determinants. (Source: Brain)...
POSTED 08/25/2008 at 11:00 PM --
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Neuropathological phenotype of a distinct form of lissencephaly associated with mutations in tuba1a
Lissencephalies are congenital malformations responsible for epilepsy and mental retardation in children. A number of distinct lissencephaly syndromes have been characterized, according to the aspect and the topography of the cortical malformation, the involvement of other cerebral structures and the identified genetic defect. A mutation in TUBA1A, coding for alpha 1 tubulin, was recently identified in a mutant mouse associated with a behavioural disorder and a disturbance of the laminar cytoarchitectony of the isocortex and the hippocampus. Mutations of TUBA1A were subsequently found in children with mental retardation and brain malformations showing a wide spectrum of severities. Here we describe four fetuses with TUBA1A mutations and a prenatal diagnosis of major cerebral dysgeneses leading to a termination of pregnancy due to the severity of the prognosis. The study of these fetuses at 23, 25, 26 and 35 gestational weeks shows that mutations of TUBA1A are associated with a neuropathological phenotypic spectrum which consistently encompasses five brain structures, including the neocortex, hippocampus, corpus callosum, cerebellum and brainstem. Less constantly, abnormalities were also identified in basal ganglia, olfactory bulbs and germinal zones. At the microscopical level, migration abnormalities are suggested by abnormal cortical and hippocampal lamination, and heterotopic neurons in the cortex, cerebellum and brainstem. There are also numerous neuronal differentiation defects, such as the presence of immature, randomly oriented neurons and abnormal axon tracts and fascicles. Thus, the TUBA1A phenotype is distinct from LIS1, DCX, RELN and ARX lissencephalies. Compared with the phenotypes of children mutated for TUBA1A, these prenatally diagnosed fetal cases occur at the severe end of the TUBA1A lissencephaly spectrum. This study emphasizes the importance of neuropathological examinations in cases of lissencephaly for improving our knowledge of the distinct pathogenetic and pathophysiological mechanisms. (Source: Brain)...
POSTED 08/25/2008 at 11:00 PM --
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High cholesterol levels drop naturally in children on high-fat anti-seizure diet, hopkins study show
(Johns Hopkins Medical Institutions) Elevated cholesterol levels return to normal or near normal levels over time in four out of 10 children with uncontrollable epilepsy treated with the high-fat ketogenic diet, according to results of a Johns Hopkins Children's Center study reported in the Journal of Child Neurology. (Source: EurekAlert! - Medicine and Health)...
POSTED 08/25/2008 at 11:00 PM --
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Platform 2: epilepsy, genetics, therapeutics
No abstract. (Source: Annals of Neurology)...
POSTED 08/25/2008 at 11:00 PM --
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Warning of epilepsy drowning risk
People with epilepsy are 19 times more likely to die from drowning than the general population, a UK study suggests. (Source: BBC News | Health | UK Edition)...
POSTED 08/25/2008 at 06:25 PM --
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Efficacy and tolerability of levetiracetam versus phenytoin after supratentorial neurosurgery
Background: Antiepileptic drugs are routinely given after craniotomy. Though phenytoin (PHT) is still the most commonly used agent, levetiracetam (LEV) is increasingly administered for this purpose. This retrospective study compared the use of LEV and PHT as monotherapy prophylaxis following supratentorial neurosurgery.
Methods: Patients receiving LEV monotherapy after supratentorial craniotomy were reviewed and compared to a control group of patients receiving PHT monotherapy.
Results: One of 105 patients taking LEV and 9/210 patients taking PHT had seizures within 7 days of surgery (p = 0.17). Adverse drug reactions requiring change in therapy during hospitalization occurred in 1/105 patients taking LEV and 38/210 patients taking PHT (p < 0.001). Among patients followed for at least 12 months, 11/42 (26%) treated with LEV vs 42/117 (36%) treated with PHT developed epilepsy (p = 0.34); 64% remained on LEV, while 26% remained on PHT (p = 0.03).
Conclusions: Both levetiracetam (LEV) and phenytoin (PHT) were associated with a low risk of early postoperative seizures and a moderate risk of later epilepsy. LEV was associated with significantly fewer early adverse reactions than PHT and with a higher retention rate in patients who were followed for at least 1 year and developed epilepsy. (Source: Neurology)...
POSTED 08/24/2008 at 11:00 PM --
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Carrier erythrocyte entrapped thymidine phosphorylase therapy for mngie
(Source: Neurology)...
POSTED 08/24/2008 at 11:00 PM --
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The human hippocampus at 7 t - in vivo mri
The human hippocampus plays a central role in various neuropsychiatric disorders, such as temporal lobe epilepsy (TLE), Alzheimer's dementia, mild cognitive impairment, and schizophrenia. Its volume, morphology, inner structure, and function are of scientific and clinical interest. Magnetic resonance (MR) imaging is a widely employed tool in neuroradiological workup regarding changes in brain anatomy, (sub-) volumes, and cerebral function including the hippocampus. Gain in intrinsic MR signal provided by higher field strength scanners and concomitant improvements in spatial resolution seem highly valuable. An examination protocol permitting complete, high-resolution imaging of the human hippocampus at 7 T was implemented. Coronal proton density, T2, T2*, and fluid-attenuated inversion recovery contrasts were acquired as well as an isotropic 3D magnetization-prepared rapid acquisition gradient-echo (500 [mu]m isotropic voxel dimension, noninterpolated). Observance of energy deposition restrictions within acceptable scan times remained challenging in the acquisition of thin, spin-echo-based sections. At the higher resolution enabled by 7 T, demarcation of the hippocampus and some internal features including gray/white matter differentiation and depiction of the hippocampal mantle becomes much more viable when compared with 1.5 T; thus, in the future, this imaging technology might help in the diagnosis of subtle hippocampal changes. © 2008 Wiley-Liss, Inc. (Source: Hippocampus)...
POSTED 08/24/2008 at 11:00 PM --
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Teaching doctors how to diagnose paroxysmal events: a comparison of two educational methods.
Teaching doctors how to diagnose paroxysmal events: a comparison of two educational methods.
Med Educ. 2008 Sep;42(9):909-14
Authors: Farrar M, Connolly AM, Lawson J, Burgess A, Lonergan A, Bye AM
OBJECTIVES: Two educational methods, facilitated case discussion and a computerised tutorial, were compared for teaching about childhood epilepsy. We used a comprehensive and clinically relevant assessment method to evaluate the hypothesis that a computerised tutorial more effectively increases knowledge acquisition than a facilitated case discussion. METHODS: Paediatric trainees (n = 66) were arbitrarily allocated to facilitated case discussion or computerised tutorial. The analysis of paroxysmal events was taught by the same teacher, using a standardised protocol and principles of active learning. Outcome measures included knowledge acquisition, clinical confidence and usefulness pre- and post-teaching, and at 3 months follow-up. RESULTS: Computerised tutorial participants scored significantly higher on knowledge acquisition post-teaching. There was gain in clinical confidence in both modalities post-teaching which did not differ between the groups. Confidence and knowledge were not related post-teaching. Both groups found the teaching relevant to clinical practice. However, facilitated case discussion participants rated the session as more enjoyable, and more useful in reinforcing and acquiring knowledge, and felt more motivated for further learning. At 3 months follow-up, participants in both modalities showed significant increases in knowledge acquisition, with no difference between modalities. CONCLUSIONS: The computerised tutorial more effectively imparted knowledge immediately post-teaching. However, facilitated case discussion is the preferred modality in terms of participant enjoyment and perceived usefulness.
PMID: 18715488 [PubMed - in process] (Source: Medical Education)...
POSTED 08/23/2008 at 03:01 AM --
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Obese rats successfully treated with addiction drug
US scientists testing the epilepsy drug vigabatrin (GVG) as a potential treatment for drug addiction, discovered that it also led to rapid weight loss and reduced food intake in genetically bred obese rats. The discovery by scientists at the US Department of Energy's (DOE) Brookhaven National Laboratory, is published in the 20 August advance online issue of the journal Synapse. (Source: Health News from Medical News Today)...
POSTED 08/22/2008 at 11:00 AM --
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Neurologic symptoms as a feature of the antiphospholipid syndrome
Semin Thromb Hemost 2008; 34: 286-289DOI: 10.1055/s-0028-1082273ABSTRACTAntiphospholipid antibodies may cause various neurologic diseases by vascular and immune mechanisms. Ischemic stroke and transient ischemic attacks are the most common neurologic complications in patients with antiphospholipid antibodies but migraine, epilepsy, chorea, or multiple sclerosis also may occur. Although the neurologic presentation of patients with the antiphospholipid syndrome may vary, many patients have striking similarities, such as initial memory loss, aphasia, cognitive dysfunction with progressive cerebral deterioration, and even dementia. In conclusion, antiphospholipid syndrome may constitute a treatable cause of neurologic diseases, and the measurement of antiphospholipid antibodies should be routinely performed in patients with neurologic disorders.[...]© Thieme Medical PublishersGet connected:Table of contents | Abstract | Full text (Source: Seminars in Thrombosis and Hemostasis)...
POSTED 08/22/2008 at 08:27 AM --
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Vigabatrin may be effective treatment for obesity
The drug vigabatrin, shown to successfully treat drug addiction and epilepsy, reduces the weight of normal weight and obese rats, report investigators in the journal Synapse. (Source: MedWire News - Lipidology)...
POSTED 08/22/2008 at 07:48 AM --
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Vaccinations aggravated existing flu illness to disabling encephalopathy
WASHINGTON, D.C. - The Office of Special Masters has ruled that the administration of four vaccinations containing six antigens aggravated a 6-month-old child's existing influenza infection to cause an encephalopathy, leaving him spastic, developmentally delayed, deaf and epileptic (Lesli Ridgway, et al v. Secretary, No. 06-834V, Fed. Clms., Off. Spec. Masters).
Full story on lexis.com (Source: LexisNexis® Mealey's™ Thimerosal & Vaccines Legal News)...
POSTED 08/22/2008 at 02:16 AM --
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