scholarly journals The Clinical Research Landscape of Pediatric Drug-Resistant Epilepsy

2020 ◽  
Vol 35 (11) ◽  
pp. 763-766 ◽  
Author(s):  
K. Julia Kaal ◽  
Magda Aguiar ◽  
Mark Harrison ◽  
Patrick J. McDonald ◽  
Judy Illes
Keyword(s):  
Clinical Practice ◽  
Clinical Research ◽  
Primary Outcome ◽  
Diagnostic Procedures ◽  
Dietary Therapy ◽  
Drug Resistant ◽  
Pediatric Drug ◽  
Drug Resistant Epilepsy ◽  
Age Range ◽  
Deep Brain

Objective: To characterize the clinical research landscape of pediatric drug-resistant epilepsy (DRE) with a focus on neurotechnology. Method: We searched the ClinicalTrials.gov registry using the terms “epilepsy” and “drug resistant” for studies including participants age 0-17 years. Returns were grouped by intervention (eg, neurotechnological, drug). Key trial features such as age range, trial status and outcomes were compared across interventions. Results: We identified 101 registered trials with pediatric DRE patients. Thirty-two (32%) investigate neurotechnological interventions, devices, or diagnostic procedures; 13 (41%) are currently active. Among neurotechnology trials, 15 (46%) investigate vagus nerve stimulation, transcranial direct current stimulation, or deep brain stimulation; few are specific to children. Of the remaining 69 trials, 37 investigate a drug, 17 investigate a dietary therapy, and 15 investigate another intervention. Seizure frequency is the most frequent primary outcome measured in the trials identified. Significance: The landscape of registered trials pertaining to pediatric DRE reflects a lag between clinical research and clinical practice, and highlights the need for timely evidence before novel neurotechnological interventions are widely adopted into clinical practice.

scholarly journals Deep brain stimulation of the anterior nucleus of the thalamus for drug-resistant epilepsy

2018 ◽  
Vol 42 (2) ◽  
pp. 287-296 ◽  
Author(s):  
Tim A. M. Bouwens van der Vlis ◽  
Olaf E. M. G. Schijns ◽  
Frédéric L. W. V. J. Schaper ◽  
Govert Hoogland ◽  
Pieter Kubben ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Drug Resistant ◽  
Anterior Nucleus ◽  
Drug Resistant Epilepsy ◽  
Deep Brain ◽  
Stimulation Of

The role of targeted gene panel in pediatric drug-resistant epilepsy

2020 ◽  
Vol 106 ◽  
pp. 107003
Author(s):  
Chang-Chun Wu ◽  
Meng-Han Tsai ◽  
Yen-Ju Chu ◽  
Wen-Chin Weng ◽  
Pi-Chuan Fan ◽  
...  
Keyword(s):  
Gene Panel ◽  
Drug Resistant ◽  
Pediatric Drug ◽  
Drug Resistant Epilepsy

scholarly journals Novel Neurotechnological Interventions for Pediatric Drug-Resistant Epilepsy: Physician Perspectives

2020 ◽  
pp. 088307382096693
Author(s):  
Patrick J. McDonald ◽  
Viorica Hrincu ◽  
Mary B. Connolly ◽  
Mark J. Harrison ◽  
George M. Ibrahim ◽  
...  
Keyword(s):  
Decision Making ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Qualitative Content Analysis ◽  
Scientific Evidence ◽  
Clinical Decision ◽  
Drug Resistant ◽  
Ethical Considerations ◽  
Pediatric Drug ◽  
Drug Resistant Epilepsy

This qualitative study investigated factors that guide physicians’ choices for minimally invasive and neuromodulatory interventions as alternatives to conventional surgery or medical management for pediatric drug-resistant epilepsy. North American physicians were recruited to one of 4 focus groups at national conferences. Discussions were analyzed using qualitative content analysis. A pragmatic neuroethics framework was applied to interpret results. Discussions revealed 2 major thematic branches: (1) clinical decision making and (2) ethical considerations. Under clinical decision making, physicians emphasized scientific evidence and patient candidacy when assessing neurotechnologies for patients. Ongoing seizures without intervention was important for safety and neurodevelopment. Under ethical considerations, resource allocation, among other financial considerations for technology adoption, were considerable sources of pressure on decision making. Access to neurotechnology was a salient theme differentiating Canadian and American contexts. When assessing novel neurotechnological interventions for pediatric drug-resistant epilepsy, physicians balance clinical and ethical factors to guide decision making and best practice.

scholarly journals Responsive neurostimulation for treatment of pediatric drug-resistant epilepsy

2018 ◽  
Vol 10 ◽  
pp. 21-24 ◽  
Author(s):  
Nilika S. Singhal ◽  
Adam L. Numis ◽  
Morgan B. Lee ◽  
Edward F. Chang ◽  
Joseph E. Sullivan ◽  
...  
Keyword(s):  
Drug Resistant ◽  
Pediatric Drug ◽  
Drug Resistant Epilepsy

scholarly journals Deep brain stimulation for drug-resistant epilepsy

Epilepsia ◽  
2017 ◽  
Vol 59 (2) ◽  
pp. 273-290 ◽  
Author(s):  
Michael C. H. Li ◽  
Mark J. Cook
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
Deep Brain

scholarly journals Impact of the Ketogenic Diet on Linear Growth in Children: A Single-Center Retrospective Analysis of 34 Cases

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1442 ◽  
Author(s):  
Ferraris ◽  
Guglielmetti ◽  
Pasca ◽  
De Giorgis ◽  
Ferraro ◽  
...  
Keyword(s):  
Ketogenic Diet ◽  
Growth Retardation ◽  
Glucose Transporter ◽  
Linear Growth ◽  
Deficiency Syndrome ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
Age Range ◽  
The Impact

Data on the impact of the ketogenic diet (KD) on children’s growth remain controversial. Here, we retrospectively investigated the occurrence of linear growth retardation in 34 children (47% males; age range: 2−17 years) diagnosed with drug-resistant epilepsy (DRE; n = 14) or glucose transporter type 1 deficiency syndrome (GLUT1-DS; n = 20) who had been treated with the KD for 12 months. The general characteristics of children with and without growth retardation were also compared. All participants received a full-calorie, traditional KD supplemented with vitamins, minerals, and citrate. Most children (80%; 11/14 in the DRE subgroup and 16/20 in the GLUT1-DS subgroup) treated with the KD did not show growth retardation at 12 months. Although participants with and without delay of growth did not differ in terms of baseline clinical characteristics, dietary prescriptions, or supplementation patterns, marked ketosis at 12 months tended to occur more frequently in the latter group. Altogether, our results indicate that growth retardation may occur in a minority of children treated with the KD. However, further research is required to identify children at risk and to clarify how increased ketones levels may affect endocrine pathways regulating growth during KD administration.

scholarly journals Deep brain stimulation for seizure control in drug-resistant epilepsy

2018 ◽  
Vol 45 (2) ◽  
pp. E4 ◽  
Author(s):  
Neil Klinger ◽  
Sandeep Mittal
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Seizure Control ◽  
Effective Means ◽  
Drug Resistant ◽  
Thalamic Nuclei ◽  
Stimulation Parameters ◽  
Number Of Patients ◽  
Drug Resistant Epilepsy ◽  
Deep Brain

Antiepileptic drugs prevent morbidity and death in a large number of patients suffering from epilepsy. However, it is estimated that approximately 30% of epileptic patients will not have adequate seizure control with medication alone. Resection of epileptogenic cortex may be indicated in medically refractory cases with a discrete seizure focus in noneloquent cortex. For patients in whom resection is not an option, deep brain stimulation (DBS) may be an effective means of seizure control. Deep brain stimulation targets for treating seizures primarily include the thalamic nuclei, hippocampus, subthalamic nucleus, and cerebellum. A variety of stimulation parameters have been studied, and more recent advances in electrical stimulation to treat epilepsy include responsive neurostimulation. Data suggest that DBS is effective for treating drug-resistant epilepsy.

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