scholarly journals Long-term seizure outcome in patients with status epilepticus due to acute encephalitis

Seizure ◽  
2019 ◽  
Vol 69 ◽  
pp. 70-75
Author(s):  
Xiuxiu Leng ◽  
Fang Yuan ◽  
Jingjing Zhao ◽  
Changgeng Song ◽  
Zhihan Zhao ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Seizure Outcome ◽  
Acute Encephalitis

Comparison of immunotherapy and prognosis of seizures caused by viral encephalitis and autoimmune encephalitis

2021 ◽  
Author(s):  
Xianjun Zhang ◽  
Yanbing Han ◽  
Xiaojuan Liu ◽  
Wenqiu Yang ◽  
Ting Wang ◽  
...  
Keyword(s):  
Antiepileptic Drugs ◽  
Lower Risk ◽  
Yunnan Province ◽  
Viral Encephalitis ◽  
Autoimmune Encephalitis ◽  
Seizure Outcome ◽  
Acute Encephalitis ◽  
Free Rate

Abstract Background: The immunotherapy that is more effective for seizures caused by viral encephalitis and autoimmune encephalitis and the long-term use of anti-epileptic drugs is not clear. We aimed to compare the immunotherapy and prognosis of seizures caused by viral encephalitis and autoimmune encephalitis.Methods: Clinical data of 121 patients with seizures caused by viral encephalitis and autoimmune encephalitis diagnosed and treated in the two largest tertiary general hospitals in the Yunnan Province were retrospectively collected to compare the immunotherapy used. Dynamic follow-up was performed to observe seizures and the use of antiepileptic drugs.Results: The seizure-free rates at 6 months and 12 months after the onset of viral encephalitis were 77.8% and 80.8%, respectively. In total, 79.1% of autoimmune encephalitis cases were seizure-free at 6 months after onset, and the seizure-free rate at 12 months was 91.9%. A total of 75.0% of viral encephalitis and 67.7% of autoimmune encephalitis patients discontinued antiepileptic drugs and were seizure-free at 12 months after onset. Patients with viral encephalitis treated with glucocorticoids alone had a lower risk of seizures after the acute phase than those treated with glucocorticoids combined with immunoglobulin (P < 0.05). The risk of seizures in patients with autoimmune encephalitis treated with glucocorticoids combined with immunoglobulin was lower than that in patients treated with glucocorticoids and immunoglobulin alone (P < 0.05).Conclusions: Immunotherapy may improve the seizure prognosis of patients with acute encephalitis. The prognosis of seizures due to viral encephalitis may be determined as early as 6 months after onset, while the seizure outcome of autoimmune encephalitis is further improved 12 months after onset.

scholarly journals Resection of cerebral gangliogliomas causing drug-resistant epilepsy: short- and long-term outcomes using intraoperative MRI and neuronavigation

2015 ◽  
Vol 38 (1) ◽  
pp. E5 ◽  
Author(s):  
Björn Sommer ◽  
Cornelia Wimmer ◽  
Roland Coras ◽  
Ingmar Blumcke ◽  
Bogdan Lorber ◽  
...  
Keyword(s):  
Diffusion Tensor ◽  
Intraoperative Imaging ◽  
Intractable Epilepsy ◽  
Complete Resection ◽  
Blood Oxygenation ◽  
Seizure Outcome ◽  
Incomplete Resection ◽  
Brain Areas ◽  
Total Resection

OBJECT Cerebral gangliogliomas (GGs) are highly associated with intractable epilepsy. Incomplete resection due to proximity to eloquent brain regions or misinterpretation of the resection amount is a strong negative predictor for local tumor recurrence and persisting seizures. A potential method for dealing with this obstacle could be the application of intraoperative high-field MRI (iopMRI) combined with neuronavigation. METHODS Sixty-nine patients (31 female, 38 male; median age 28.5 ± 15.4 years) suffering from cerebral GGs were included in this retrospective study. Five patients received surgery twice in the observation period. In 48 of the 69 patients, 1.5-T iopMRI combined with neuronavigational guidance was used. Lesions close to eloquent brain areas were resected with the implementation of preoperative diffusion tensor imaging tractography and blood oxygenation level–dependent functional MRI (15 patients). RESULTS Overall, complete resection was accomplished in 60 of 69 surgical procedures (87%). Two patients underwent biopsy only, and in 7 patients, subtotal resection was accomplished because of proximity to critical brain areas. Excluding the 2 biopsies, complete resection using neuronavigation/iopMRI was documented in 33 of 46 cases (72%) by intraoperative imaging. Remnant tumor mass was identified intraoperatively in 13 of 46 patients (28%). After intraoperative second-look surgery, the authors improved the total resection rate by 9 patients (up to 91% [42 of 46]). Of 21 patients undergoing conventional surgery, 14 (67%) had complete resection without the use of iopMRI. Regarding epilepsy outcome, 42 of 60 patients with seizures (70%) became completely seizure free (Engel Class IA) after a median follow-up time of 55.5 ± 36.2 months. Neurological deficits were found temporarily in 1 (1.4%) patient and permanently in 4 (5.8%) patients. CONCLUSIONS Using iopMRI combined with neuronavigation in cerebral GG surgery, the authors raised the rate of complete resection in this series by 19%. Given the fact that total resection is a strong predictor of long-term seizure control, this technique may contribute to improved seizure outcome and reduced neurological morbidity.

scholarly journals Pediatric Epilepsy Surgery

2017 ◽  
Vol 32 (5) ◽  
pp. 467-474 ◽  
Author(s):  
Krista J. Qualmann ◽  
Christine G. Spaeth ◽  
Melanie F. Myers ◽  
Paul S. Horn ◽  
Katherine Holland ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
General Population ◽  
Epilepsy Surgery ◽  
Pediatric Epilepsy ◽  
Seizure Outcome ◽  
Cognitive Disability ◽  
Pediatric Epilepsy Surgery ◽  
Surgery Outcomes

Central nervous system comorbidities have been identified in patients with epilepsy. Several of these comorbidities have been correlated with poor surgery outcomes in patient cohorts. The authors sought to determine if prevalence of comorbidities in pediatric epilepsy surgery patients and their families correlate with long-term seizure outcome in a cross-sectional analysis. Three-generation pedigrees were elicited to compare family history of epilepsy, ADHD, anxiety, autism, bipolar disorder, cognitive disability, depression, migraine, and motor disability to surgery outcomes in 52 patients. Proportions of affected patients and relatives were compared to general population comorbidity rates and the patients’ most recent seizure outcome classification. Patients and families had significantly higher rates of comorbidities than the general population. Poorer long-term seizure outcomes following resective surgery were associated with autism or cognitive disability in patients. Together these data support evidence for a common pathophysiological mechanism between epilepsy and central nervous system comorbidities.

Neuroprotective effects of levetiracetam, both alone and combined with propylparaben, in the long-term consequences induced by lithium-pilocarpine status epilepticus

2018 ◽  
Vol 120 ◽  
pp. 224-232 ◽  
Author(s):  
César Emmanuel Santana-Gómez ◽  
María Guadalupe Valle-Dorado ◽  
Ana Esmeralda Domínguez-Valentín ◽  
Arely Hernández-Moreno ◽  
Sandra Orozco-Suárez ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Neuroprotective Effects ◽  
Long Term Consequences
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