Extratemporal Refractory Epilepsy

2019 ◽  
pp. 117-125
Author(s):  
Vamsidhar Chavakula ◽  
Eun-Hyoung Park ◽  
Joseph R. Madsen
Keyword(s):  
Surgical Treatment ◽  
Refractory Epilepsy ◽  
Treatment Options ◽  
Clinical History ◽  
Postoperative Management ◽  
Metabolic Imaging ◽  
Appropriate Treatment ◽  
Functional Localization ◽  
History Of ◽  
Medically Refractory Epilepsy

Medically refractory epilepsy is defined as the persistence of seizures after appropriate treatment with 2 different medications. A thorough understanding of the clinical history and semiology of seizures is important when considering surgical treatment options, as multifocal epilepsy may not be amenable to resective surgery. Anatomic, functional, and metabolic imaging sequences may assist in identifying a seizure focus, and EEG will provide a functional localization. The surgeon must make a careful and informed decision about the maximal amount of lesion that may be resected without incurring neurologic deficits. Specific postoperative management should be dictated by the natural history of the noted pathology.

scholarly journals Management Considerations in Ruptured Isolated Radiculopial Artery Aneurysms

2013 ◽  
Vol 19 (1) ◽  
pp. 60-66 ◽  
Author(s):  
A.C.G.M. Van Es ◽  
P.A. Brouwer ◽  
P.W.A. Willems
Keyword(s):  
Surgical Treatment ◽  
Management Strategy ◽  
Clinical Course ◽  
Treatment Strategies ◽  
The Other ◽  
Posterior Spinal Artery ◽  
Appropriate Treatment ◽  
History Of ◽  
Clinical Paradigm ◽  
Slight Growth

Little is known on the natural history of ruptured isolated aneurysms of the posterior spinal artery (PSA). To date, only a few of such cases have been described in the literature. This paper aims to assess the most appropriate management strategy, based on the available literature and two new cases. In one of these, treatment was postponed until day 33, when angiography showed slight growth of the aneurysm. In the other, conservative treatment, requested by the patient, was successful. From these data, we conclude that treatment strategies for ruptured PSA aneurysms may vary. Aside from the recommendation by others to perform prompt surgical treatment, we suggest an alternative clinical paradigm allowing for the evaluation of the early clinical course. This may preclude the unnecessary treatment of spontaneously regressing lesions and still allows for appropriate treatment for persistent lesions.

Successful Surgical Treatment of Medically Refractory Epilepsy After Chemotherapy in a Child With Leukemia

2010 ◽  
Vol 16 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Ebru Arhan ◽  
Zühre Kaya ◽  
Ayse Serdaroğlu ◽  
Aysima Akturk Ozcelik ◽  
Erhan Bilir ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Refractory Epilepsy ◽  
Medically Refractory Epilepsy

GROUP B STREPTOCOCCAL INFECTION AND RPL – A CASE REPORT

2021 ◽  
pp. 34-35
Author(s):  
Neelotparna Saikia ◽  
Himadri Bhuyan ◽  
Punam Jain
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Polycystic Ovary ◽  
Treatment Options ◽  
Previous History ◽  
Clinical History ◽  
Serum Biochemistry ◽  
Maternal Serum ◽  
History Of ◽  
Group B

Recurrent pregnancy loss (RPL) has become an important cause of pregnancy loss, with major emotional implications to the couple experiencing such an event. Increasing age of women, smoking, obesity or polycystic ovary syndrome (PCOS) and a previous history of miscarriage and various infections are also considered risk factors for RPL. A thorough clinical history and examination, maternal serum biochemistry and ultrasound ndings are important to determine the treatment options and provide valuable information for the prognosis. A woman who do not have a explanation for the RPL maybe subjected to ano-genital swab culture to identify infections, as chronic and subclinical infections can cause abortion. As bacterial vaginosis has been already established with causing recurrent pregnancy loss and preterm delivery. Here we are presenting a case of successful pregnancy outcome following treatment for GBS vaginal infection where other possible aetiologies were ruled out.

Vagus nerve stimulation

2009 ◽  
Vol 27 (3) ◽  
pp. E5 ◽  
Author(s):  
Dzenan Lulic ◽  
Amir Ahmadian ◽  
Ali A. Baaj ◽  
Selim R. Benbadis ◽  
Fernando L. Vale
Keyword(s):  
Vagus Nerve ◽  
Mechanism Of Action ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Refractory Epilepsy ◽  
Drug Resistant ◽  
Nonpharmacological Treatment ◽  
History Of ◽  
Drug Resistant Epilepsy ◽  
Medically Refractory Epilepsy

Vagus nerve stimulation (VNS) is a key tool in the treatment of patients with medically refractory epilepsy. Although the mechanism of action of VNS remains poorly understood, this modality is now the most widely used nonpharmacological treatment for drug-resistant epilepsy. The goal of this work is to review the history of VNS and provide information on recent advances and applications of this technology.

scholarly journals Differentiating tardive dyskinesia: a video-based review of antipsychotic-induced movement disorders in clinical practice

CNS Spectrums ◽  
2020 ◽  
pp. 1-10
Author(s):  
Robert A. Hauser ◽  
Jonathan M. Meyer ◽  
Stewart A. Factor ◽  
Cynthia L. Comella ◽  
Caroline M. Tanner ◽  
...  
Keyword(s):  
Tardive Dyskinesia ◽  
Movement Disorders ◽  
Treatment Options ◽  
Mood Stabilizers ◽  
Drug Induced ◽  
Parkinsonian Tremor ◽  
Stabilizing Agents ◽  
Appropriate Treatment ◽  
History Of ◽  
Abnormal Behaviors

Abstract Accurate diagnosis and appropriate treatment of tardive dyskinesia (TD) are imperative, as its symptoms can be highly disruptive to both patients and their caregivers. Misdiagnosis can lead to incorrect interventions with suboptimal or even deleterious results. To aid in the identification and differentiation of TD in the psychiatric practice setting, we review its clinical features and movement phenomenology, as well as those of other antipsychotic-induced movement disorders, with accompanying links to illustrative videos. Exposure to dopamine receptor blocking agents (DRBAs) such as antipsychotics or antiemetics is associated with a spectrum of movement disorders including TD. The differential diagnosis of TD is based on history of DRBA exposure, recent discontinuation or dose reduction of a DRBA, and movement phenomenology. Common diagnostic challenges are the abnormal behaviors and dyskinesias associated with advanced age or chronic mental illness, and other movement disorders associated with DRBA therapy, such as akathisia, parkinsonian tremor, and tremor related to use of mood stabilizing agents (eg, lithium, divalproex). Duration of exposure may help rule out acute drug-induced syndromes such as acute dystonia or acute/subacute akathisia. Another important consideration is the potential for TD to present together with other drug-induced movement disorders (eg, parkinsonism, parkinsonian tremor, and postural tremor from mood stabilizers) in the same patient, which can complicate both diagnosis and management. After documentation of the phenomenology, severity, and distribution of TD movements, treatment options should be reviewed with the patient and caregivers.

scholarly journals Salpingopharyngeus fistula by means of videosurgery to treat horse bilateral gutural pouch chronic empyema – a case study

2021 ◽  
Vol 15 (2) ◽  
pp. 106-110
Author(s):  
Lucimara Strugava ◽  
Andressa Duarte Lorga ◽  
Anny Raissa Carolini Gomes ◽  
Ana Paula Rossa ◽  
Jéssica do Rocio Janiszewski ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Management ◽  
Invasive Technique ◽  
Nasal Discharge ◽  
Large Animal ◽  
Natural Orifice ◽  
Moderate Amount ◽  
Chronic Empyema ◽  
History Of

The aim of this paper is to report the Salpingopharyngeus fistula technique by means of videosurgery through a natural orifice (NOTES) in order to treat bilateral empyema. A mare was seen at the Large Animal Sector of UFPR, with a history of bilateral purulent nasal discharge associated with dysphagia lasting for ninety days. The animal was submitted to endoscopy, showing a moderate amount of purulent secretion in both guttural pouches. With no improvement on the clinical treatment, we opted for surgical treatment by endoscopy through Salpingopharyngeus fistula made with the aid of a device containing an electrical scalpel developed to perform this technique. It consisted of making an incision in the pharyngeal recess in order to access the guttural pouches and subsequently drain the purulent content. The patient was discharged at the same day and returned to work 30 days after the procedure. Surgical treatment for cases of guttural pouch empyema is indicated when the clinical resolution has not been effective, and the minimally invasive technique is indicated due to the reduction of risks and the easiness of postoperative management. Until this moment, there are no reports of the salpingopharyngeal fistula technique through video surgery for the treatment of guttural pouch empyema, which has proved to be efficient for the treatment of the disease.

Abdominal desmoid-type fibromatosis – a case report and an overview of treatment options

Nowa Medycyna ◽  
2018 ◽  
Vol 25 (2) ◽  
Author(s):  
Justyna Koszarska-Mirek ◽  
Jakub Orleański
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Abdominal Wall ◽  
Treatment Options ◽  
Fibrous Tissue ◽  
Distant Metastases ◽  
Desmoid Tumour ◽  
Recurrence Rates ◽  
Abdominal Organs ◽  
Appropriate Treatment

Fibromatosis (desmoid, desmoid tumour) is a tumour belonging to the group of fibrous tissue proliferative diseases. Although the tumour cannot produce distant metastases, it shows local malignancy by invading adjacent tissues, as well as high recurrence rates after local resection. The incidence of fibromatosis is 2-4 cases per 1 million inhabitants per year. Three types of fibromatosis have been distinguished: extra-abdominal, abdominal wall and intra-abdominal type. Although the most common types are sporadic, coexistence with familial adenomatous polyposis (FAP), known as the Gardner’s syndrome, is observed. Available therapeutic options include surgical treatment, watchful waiting, hormone therapy, non-steroid anti-inflammatory drugs, chemotherapy and radiation therapy. This case report aims to draw attention to the difficulties in selecting an appropriate treatment option, limited surgical treatment, the psychological aspect of the disease, as well as the need to actively search for modern diagnostic and therapeutic solutions. We present a case of a 26-year-old patient who was ultimately diagnosed with a desmoid tumour invading the abdominal wall and internal abdominal organs. The patient presented to a county hospital due to suspected gastrointestinal obstruction. It was found from medical history that the patient had palpated a tumour of the abdominal wall 9 months before admission.

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