Seizures in some 30% to 40% of patients with epilepsy fail to respond to antiepileptic drugs or other treatments. While much has been made of the risks of new drug therapies, not enough attention has been given to the risks of uncontrolled and progressive epilepsy. This critical review summarizes known risks associated with refractory epilepsy, provides practical clinical recommendations, and i...

Epilepsy is a common neurological disorder that affects over 70 million people worldwide. Despite the recent introduction of new antiseizure drugs (ASDs), about one-third of patients with epilepsy have seizures refractory to pharmacotherapy. Early identification of patients who will become refractory to ASDs could help direct such patients to appropriate non-pharmacological treatment, but the c...

During the last decade, advances in genetic technology have led to an explosion of identification genes associated with epilepsy. A diagnosis for individual epilepsy can clarify and predict prognosis, treatment options, need screen additional clinical features. Next-generation sequencing has enabled simultaneous a large number DNA segments. Using this technology, group is organized into panel a...

EXTRACELLULAR GLUTAMATE, GLUTAMINE, AND GABA IN THE HIPPOCAMPUS AND CORTEX OF REFRACTORY EPILEPSY PATIENTS. Jonathan C. Romanyshyn and Idil Cavus MD, PhD. Departments of Psychiatry and Neurosurgery, Yale University School of Medicine, New Haven, CT. Antiepileptic drug (AED) resistance affects one third of patients with epilepsy and is associated with significant disability. Brain microdialysis ...

We investigated the coping behaviour and its correlation with demographic and illness-related data, depression, locus of control and psychosocial adaptation in 40 patients with intractable epilepsy with primarily or secondarily generalized tonic-clonic seizures. Three standardized self-reporting questionnaires were applied, which are the Freiburg Questionnaire of Coping with Illness (FKV), the ...

Magnetic Resonance Imaging (MRI) is the method of choice to search for epileptogenic lesions. We correlated MRI findings with the epileptogenic zone (EZ) depicted by clinical and electroencephalographic (EEG) data. We studied 400 clinical records of patients who had been submitted to MRI studies and we analyzed, retrospectively, their ictal semiology, EEG characteristics and response to treatme...

BACKGROUND High-field 3.0 T MR scanners provide an improved signal-to-noise ratio which can be translated in higher image resolution, possibly allowing critical detection of subtle epileptogenic lesions missed on standard-field 1.0-1.5 T MRIs. In this study, the authors explore the potential value of re-imaging at 3.0 T patients with refractory partial epilepsy and negative 1.5 T MRI. METHODS...

While several newer AEDs have study data that support monotherapy usage, most possess FDA indications for adjunctive treatment of partial onset seizures, leading to their initial (and often persistent) clinical use as adjunctive polytherapy for patients with refractory epilepsy. This review considers a practical approach to the appropriate role for polytherapy in epilepsy, presents the evidence...

BACKGROUND Status epilepticus (SE) is a common neurological emergency. In around 10 percent, the etiology of SE is not clear, i.e. cryptogenic SE. AIM To describe six young adult patients with de novo cryptogenic multifocal febrile SE with poor outcome. METHODS Retrospective chart review. RESULTS We describe six patients who presented with de novo SE. All were young adults with an unremar...

objective in the majority of patients with intractable epilepsy, seizures can be well controlled with appropriate medication. however, current estimates indicate that some of patients with epilepsy are refractory to all forms of medical therapy. the surgical treatment of intractable epilepsy in children has  evolved with advances in technical innovations. these medically intractable patients ar...