In controlled clinical trials, topiramate (Topamax) has demonstrated efficacy in refractory patients with complex partial seizures and secondarily generalized tonic-clonic seizures. Approximately 45 percent of 534 patients had a > or = 50 percent reduction in seizure frequency. Limited open label trials have shown that topiramate has broad spectrum activity and may be effective in patients with...

PURPOSE Ring chromosome 20 {r(20)}--manifests as a refractory epilepsy syndrome with complex partial seizures (CPS), nocturnal frontal lobe seizures and non-convulsive status epilepticus (NCSE) in the majority of cases. r20 lacks a specific phenotypic expression or dysmorphic features. Psychomotor development may be normal, making the diagnosis difficult unless there is a high index of suspicio...

Startle-induced seizures are reflex seizures precipitated by a sudden, surprising stimulus, usually auditory. Aetiologies, electroencephalographic correlates, and brain structural abnormalities are variable. Because of the frequent tonic component at onset, falling is a major clinical problem. There is no established drug of choice, and therapy is often unsatisfactory. Adjunctive lamotrigine th...

Epilepsy is a common problem of adults with learning disabilities. Despite the high prevalence there have been few studies of the epilepsy suffered by adults with learning disabilities. The findings of a Leicestershire study are that multiple seizure types are a common presentation, and that for many (75%) the seizures remain refractory to treatment. Those who suffer tonic-clonic seizures are m...

BACKGROUND Anti N-methyl-D-aspartate (NMDA) receptor encephalitis is an immune mediated disorder. CASE CHARACTERISTICS A previously healthy 14-year-old girl presenting with generalized tonic clonic seizures and altered behavior. OBSERVATION In view of refractory seizures, hallucinations, psychobehavioral and catalepsy like symptoms, and CSF showing lymphocytic pleocytosis, possibility of au...

New-onset refractory status epilepticus (NORSE) is unexpected onset of in individuals with no preexisting relevant neurologic condition. The etiologies remain largely cryptogenic; treatment challenging after failure to control seizures despite use multiple antiepileptic drugs and anesthetic agents. Frequent fever other infectious prodromes, elevated proinflammatory cytokine/chemokine levels, li...

Many studies showed that Topiramate (TPM) may be a useful drug in a wide spectrum of childhood epilepsies. We report a 3-month-old female with stormy onset of secondarily generalized partial seizures. She showed a high seizure frequency and a progressive worsening electroencephalogram (EEG), despite standard antiepileptic drugs administration. TPM succeeded in controlling seizures, even after t...