Clinical results and prospects for the use of phenosanic acid in patients with focal epilepsy

2021 ◽  
Vol 121 (10) ◽  
pp. 52
Author(s):  
S.G. Burd ◽  
A.V. Lebedeva ◽  
N.V. Pantina ◽  
Yu.V. Rubleva ◽  
N.V. Pizova ◽  
...  
2003 ◽  
Vol 98 (3) ◽  
pp. 631-637 ◽  
Author(s):  
William Feindel

✓ Theodore Brown Rasmussen succeeded Wilder Penfield as director of the Montreal Neurological Institute (MNI) and held this post from 1960 to 1972. During his career, Rasmussen probably performed more operations for epilepsy than any other surgeon of his time; he became the foremost authority in this field. His meticulous follow-up analyses of the MNI seizure series provided substantial evidence for the success of surgery in the treatment of focal epilepsy. In addition, he made significant contributions to surgery of the pituitary gland for control of cancer, treatment of cerebral and spinal tumors, application of the intracarotid Amytal test for lateralization of speech and memory function, and characterization and treatment of epilepsy accompanied by chronic encephalitis, now referred to as Rasmussen syndrome. His painstaking attention to surgical details as well as his insistence on close monitoring of patient care and critical scrutiny of clinical results marked him as an outstanding teacher and role model for young neurosurgeons and neuroscientists.


2021 ◽  
Author(s):  
Denggui Fan ◽  
Zecheng Yang ◽  
Chuanzuo Yang ◽  
Qingyun Wang ◽  
Guoming Luan

Abstract Seizure focus localization is the key to control seizures. However, in this paper, we show that the clinically localized seizure focus may be not exactly the positions to abate seizures. Firstly, the reliability of a previously proposed methodology employed to estimate the synchronicity and directionality of information flows over time between EEG signals, is numerically assessed with a coupled mass neural model. Then 10 channels' EEG signals from a patient with focal epilepsy are used to reconstruct the dynamical complex network of pathological seizure. This may facilitate to identify the evolution paths of information flows and localize the potential seizure foci. What's more, based on the controllability and observability principles of complex systems, we can focus on the key nodes which is effective to control the network seizure behaviors and the key ones that can allow us to estimate the state of all other variables. Results show that to fully control the epileptic network may not just be related to the focus zone, it may also involves in other non-focus nodes. In addition, we use the spatiotemporal neural network model connected by our modeled dynamical adjacent matrix to successfully reproduce the original EEG signals which can be effectively abated by applying the normal distribution noise stimulation with cathodic phase pulses (cNDNs) on the identified key nodes or resecting them. Our results enrich the clinical results and provide new insights into the seizure resection and electronic stimulation therapies.


2018 ◽  
Vol 10 (1S) ◽  
pp. 12-17 ◽  
Author(s):  
V. A. Karlov ◽  
P. N. Vlasov ◽  
I. A. Zhidkova

Objective: to comparatively evaluate the clinical efficacy and tolerability of monotherapy with levetiracetam (LEV), a brand-name drug (bLEV; Keppra, UCB Pharma, Belgium) and its generic (gLEV;  Epiterra, TEVA, Israel) in adolescent (over 16 years of age) and adult patients with focal epilepsy (FE) during a one-year follow-up period.Patients and methods. The patients were divided into two groups: 1) bLEV (n = 143) and 2) gLEV (n = 63). Group 2 received monotherapy with gLEV at baseline, or was switched to it from  another drug within the international nonproprietary name, or to LEV from monotherapy with another antiepileptic drug (AED) due to  inefficiency and/or poor tolerability. The median doses of bLEV and  gLEV were 1000 and 1500 mg/day, respectively.Results and discussion. The results of the clinical trial suggest that LEV shows high efficacy and excellent tolerance in FE therapy. The clinical efficacy of bLEV and gLEV at 12-month follow-up was  high and amounted to 82.5% for the two dosage forms. The  frequency of adverse events was 17.5% for both bLEV and gLEV. The median dose of LEV was 1000 mg/day for Group 1 and 1500 mg/day for Group 2. Higher LEV doses in Group 2 patients were probably  due to their longer disease duration. All patients taking LEV had an  excellent or good quality of life and, when switched from other AEDs,  showed even an improvement. The comparability of clinical  results suggests that there may be bLEV to gLEV and gLEV to bLEV  switches, especially during forced drug supply disruptions; however,  this substitution should be done only after mandatorily discussing  this matter with the patient and telling him about all possible  consequences of this substitution. 


2018 ◽  
Vol 129 (5) ◽  
pp. 1173-1181 ◽  
Author(s):  
Michael C. Dewan ◽  
Robert Shults ◽  
Andrew T. Hale ◽  
Vishad Sukul ◽  
Dario J. Englot ◽  
...  

OBJECTIVEStereotactic electroencephalography (SEEG) is being used with increasing frequency to interrogate subcortical, cortical, and multifocal epileptic foci. The authors describe a novel technique for SEEG in patients with suspected epileptic foci refractory to medical management.METHODSIn the authors’ technique, standard epilepsy evaluation and neuroimaging are used to create a hypothesis-driven SEEG plan, which informs the 3D printing of a novel single-path, multiple-trajectory, omnidirectional platform. Following skull-anchor platform fixation, electrodes are sequentially inserted according to the preoperative plan. The authors describe their surgical experience and technique based on a review of all cases, adult and pediatric, in which patients underwent invasive epilepsy monitoring via SEEG during an 18-month period at Vanderbilt University Medical Center. Platform and anatomical variables influencing localization error were evaluated using multivariate linear regression.RESULTSUsing this novel technology, 137 electrodes were inserted in 15 patients with focal epilepsy with favorable recording results and no clinical complications. The mean entry point localization error was 1.42 mm (SD 0.98 mm), and the mean target point localization error was 3.36 mm (SD 2.68 mm). Platform distance, electrode trajectory angle, and intracranial distance, but not skull thickness, were independently associated with localization error.CONCLUSIONSThe multiple-trajectory, single-path, omnidirectional platform offers satisfactory accuracy and favorable clinical results, while avoiding cumbersome frames and prohibitive up-front costs associated with other SEEG technologies.


1950 ◽  
Vol 14 (2) ◽  
pp. 214-227 ◽  
Author(s):  
Vernon A. Weinstein ◽  
Franklin Hollander ◽  
Frances U. Lauber ◽  
Ralph Colp

VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 36-42 ◽  
Author(s):  
. Bucek ◽  
Hudak ◽  
Schnürer ◽  
Ahmadi ◽  
Wolfram ◽  
...  

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.


VASA ◽  
2012 ◽  
Vol 41 (3) ◽  
pp. 163-176 ◽  
Author(s):  
Weidenhagen ◽  
Bombien ◽  
Meimarakis ◽  
Geisler ◽  
A. Koeppel

Open surgical repair of lesions of the descending thoracic aorta, such as aneurysm, dissection and traumatic rupture, has been the “state-of-the-art” treatment for many decades. However, in specialized cardiovascular centers, thoracic endovascular aortic repair and hybrid aortic procedures have been implemented as novel treatment options. The current clinical results show that these procedures can be performed with low morbidity and mortality rates. However, due to a lack of randomized trials, the level of reliability of these new treatment modalities remains a matter of discussion. Clinical decision-making is generally based on the experience of the vascular center as well as on individual factors, such as life expectancy, comorbidity, aneurysm aetiology, aortic diameter and morphology. This article will review and discuss recent publications of open surgical, hybrid thoracic aortic (in case of aortic arch involvement) and endovascular repair in complex pathologies of the descending thoracic aorta.


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