Of the 3 million patients with seizures in North America approximately 70% have effective seizure control with medications. In the group refractory to medical treatment only a minority fit the criteria for surgical therapy. Vagus nerve stimulation therapy seems to be a suitable nonpharmacologic therapy for reducing seizure frequency in these cases. It is a simple device with 2 electrodes and an...

In this paper, we present low-power circuit techniques for implementing a closed-loop neurostimulator (CLNS) as an alternative treatment for medically refractory epilepsy. The proposed circuit has low-power dissipation with better detection sensitivity compared to the recently proposed circuit techniques for epileptic seizure detector. We demonstrate low-power circuit techniques for implementat...

PURPOSE The goals of this study are to evaluate the efficacy and tolerability of levetiracetam (LEV) as add-on therapy in children with refractory epilepsies and to determine the value of LEV blood level monitoring in this population. METHODS Sixty-nine children (39 males and 30 females) treated with LEV between 2006 and 2007 were selected. Their medical files were reviewed for LEV efficacy a...

INTRODUCTION Surgical planning for refractory medial temporal lobe epilepsy (rMTLE) relies on seizure localization by ictal electroencephalography (EEG). Multiple factors impact the number of seizures recorded. We evaluated whether seizure freedom correlated to the number of seizures recorded, and the related factors. METHODS We collected data for 32 patients with rMTLE who underwent anterior...

The differentiation of vasovagal syncope and epileptic seizure is sometimes problematic, since vasovagal syncope may mimic epileptic seizures in many ways. The present report describes a patient who had been diagnosed and treated as having epilepsy with medically-refractory sei-zures for 16 years. Often, unlike epileptic seizures, tonic-clonic convulsions and postictal confusion are uncommon fe...

Optimal candidates for VNS as a treatment for refractory epilepsy have not been identified. In this retrospective two-center study, we used the Engel classification for evaluating seizure outcome, and tried to identify predictive factors for outcome by means of subgroup analysis. The medical records of patients who have been treated with VNS for at least one year at Dartmouth-Hitchcock Medical ...

We evaluated the long-term outcome of vagus nerve stimulation (VNS) in 28 children with refractory epilepsy. Of these 28 children, 15 (53.6%) showed a >50% reduction in seizure frequency and 9 (32.1%) had a >75% reduction. When we compared seizure reduction rates according to seizure types (generalized vs. partial) and etiologies (symptomatic vs. cryptogenic), we found no significant difference...

INTRODUCTION Malformations of cortical development (MCDs) are increasingly recognized as important cause of epilepsy, especially refractory epilepsy. In developing countries like India, where the facilities for sophisticated imaging are not easily accessible to all, the prevalence and the types of cortical malformations are largely unknown. Hence this preliminary study has been undertaken to ex...

Epilepsy is among the most common serious neurological disorders and affects around 50 million people worldwide, 80% of which live in developing countries. Despite introduction several new Anti-Epileptic Drugs (AEDs) last two decades, one third treated patients have seizures refractory to pharmacotherapy. This highlights need develop treatments with drugs targeting alternative seizure-induction...

OBJECTIVE The prevalence of active epilepsy is about 0.5-1%, and approximately 70% of patients are cured with first anti-epileptic drugs and the remaining patients need multiple drugs. Pregabalin as an add-on therapy has a postive effect on refractory seizures in adults. To the best of our knowledge, there is no research with this drug in childhood epilepsy. We use pregabalin in children with r...