Epilepsy surgery is indicated in select patients with medically refractory focal epilepsy. Seizure freedom or significant reduction of seizure burden without risking new neurological deficits is the expected goal of epilepsy surgery. Typically, when the seizure onset zone overlaps with eloquent cortex, patients are excluded from the surgery. We present a patient with medically refractory fronta...

PURPOSE This study was conducted to evaluate the efficacy and safety of anterior corpus callosotomy with a keyhole approach on refractory seizures and to evaluate this procedure for drop attacks (DAs) and generalized tonic-clonic seizures (GTCSs). METHODS All refractory seizure patients underwent anterior corpus callosotomy (n=31) without other epilepsy surgery. Seizure response and procedure...

OBJECTIVES Intravenous levetiracetam (LEV) has been shown to be effective and safe in treating adults with refractory status epilepticus (SE). We sought to investigate the efficacy and safety of intravenous LEV for pediatric patients with refractory SE. METHODS We performed a retrospective medical-record review of pediatric patients who were treated with intravenous LEV for refractory SE. Cli...

Status epilepticus (SE) is one of the most common emergencies in neurocritical care. In Germany, the incidence of SE is about 17/100 000 per year, increasing with age [1]. Especially generalized convulsive (tonic-clonic) status epilepticus (GCSE) is still associated with a high risk of morbidity and mortality [2]. SE is defined as a single prolonged seizure or a series of two or more consecutiv...

Status epilepticus (SE) is defined as a seizure lasting longer than 5 min, or at least two seizures without full recovery of consciousness between them. Early emergent medical management consists of life support and an etiology survey, and subsequent treatment can be classified into 4 stages: (1) early SE, (2) established SE, (3) refractory SE, and (4) super-refractory SE. For early SE, benzodi...

PURPOSE Vagus nerve stimulation (VNS) is used increasingly as adjunctive therapy for refractory epilepsy. Studies of VNS in children report mainly seizure frequency reduction as a measure of efficacy and clinical details are often scanty. We report our experience with VNS in children with refractory epilepsy and emphasize the positive effects of VNS in terms of seizure severity. METHODS We re...

PURPOSE To investigate response to sequential treatment schedules and risk of development of refractory epilepsy in childhood. METHODS All children younger than 14 years with two or more unprovoked seizures seen at our hospital between 1994 and 2004 were included and prospectively followed. "Seizure control" was defined as a 2-year seizure-free interval without further recurrences except thos...

Background: Refractory status epilepticus usually defined as a seizure lasting at least 60 minutes which is uncontrollable by Diazepam, Phenytoin, or Phenobarbital. The aim of this study was to compare the effect of interavenous Midazolam and rectal Sodium valproate in controlling refractory status epilepticus. Methods: In this case-control study; 76 children with (mean age of 37± 20 months) wi...

objective midazolam is a significant and effective drug for control of a life-threatening condition, generalized and partial refractory convulsive status epilepticus. the goal of this study was evaluation of midazolam efficacy for management of this serious disease and its two side effects, hypotension and respiratory failure. materials & methods our study was done using a quasi experimental me...