Derivation and initial validation of a surgical grading scale for the preliminary evaluation of adult patients with drug-resistant focal epilepsy

Epilepsia ◽  
2017 ◽  
Vol 58 (5) ◽  
pp. 792-800 ◽  
Author(s):  
Patricia Dugan ◽  
Chad Carlson ◽  
Nathalie Jetté ◽  
Samuel Wiebe ◽  
Marjorie Bunch ◽  
...  
Keyword(s):  
Focal Epilepsy ◽  
Adult Patients ◽  
Preliminary Evaluation ◽  
Drug Resistant ◽  
Initial Validation ◽  
Grading Scale

scholarly journals The Epilepsy Surgery Grading Scale: Validation in an independent population with drug‐resistant focal epilepsy

Epilepsia ◽  
2019 ◽  
Vol 60 (8) ◽  
Author(s):  
Francesca Conte ◽  
Wim Van Paesschen ◽  
Benjamin Legros ◽  
Chantal Depondt
Keyword(s):  
Epilepsy Surgery ◽  
Scale Validation ◽  
Focal Epilepsy ◽  
Drug Resistant ◽  
Independent Population ◽  
Grading Scale

scholarly journals Chronic subthreshold cortical stimulation for adult drug-resistant focal epilepsy: safety, feasibility, and technique

2018 ◽  
Vol 129 (2) ◽  
pp. 533-543 ◽  
Author(s):  
Panagiotis Kerezoudis ◽  
Sanjeet S. Grewal ◽  
Matthew Stead ◽  
Brian Nils Lundstrom ◽  
Jeffrey W. Britton ◽  
...  
Keyword(s):  
Focal Epilepsy ◽  
Cortical Stimulation ◽  
Adult Patients ◽  
Therapeutic Trial ◽  
Drug Resistant ◽  
Surgical Safety ◽  
Institutional Experience ◽  
Eloquent Cortex ◽  
Drug Resistant Epilepsy ◽  
Seizure Foci

OBJECTIVEEpilepsy surgery is effective for lesional epilepsy, but it can be associated with significant morbidity when seizures originate from eloquent cortex that is resected. Here, the objective was to describe chronic subthreshold cortical stimulation and evaluate its early surgical safety profile in adult patients with epilepsy originating from seizure foci in cortex that is not amenable to resection.METHODSAdult patients with focal drug-resistant epilepsy underwent intracranial electroencephalography monitoring for evaluation of resection. Those with seizure foci in eloquent cortex were not candidates for resection and were offered a short therapeutic trial of continuous subthreshold cortical stimulation via intracranial monitoring electrodes. After a successful trial, electrodes were explanted and permanent stimulation hardware was implanted.RESULTSTen patients (6 males) who underwent chronic subthreshold cortical stimulation between 2014 and 2016 were included. Based on radiographic imaging, intracranial pathologies included cortical dysplasia (n = 3), encephalomalacia (n = 3), cortical tubers (n = 1), Rasmussen encephalitis (n = 1), and linear migrational anomaly (n = 1). The duration of intracranial monitoring ranged from 3 to 20 days. All patients experienced an uneventful postoperative course and were discharged home with a median length of stay of 10 days. No postoperative surgical complications developed (median follow-up length 7.7 months). Seizure severity and seizure frequency improved in all patients.CONCLUSIONSThe authors’ institutional experience with this small group shows that chronic subthreshold cortical stimulation can be safely and effectively performed in appropriately selected patients without postoperative complications. Future investigation will provide further insight to recently published results regarding mechanism and efficacy of this novel and promising intervention.

Chronic traumatic encephalopathy in an epilepsy surgery cohort

Neurology ◽  
2018 ◽  
Vol 90 (6) ◽  
pp. e474-e478 ◽  
Author(s):  
Amy L. Jones ◽  
Jeffrey W. Britton ◽  
Melissa M. Blessing ◽  
Joseph E. Parisi ◽  
Gregory D. Cascino
Keyword(s):  
Young Adult ◽  
Epilepsy Surgery ◽  
Focal Epilepsy ◽  
Chronic Traumatic Encephalopathy ◽  
Neuropsychological Testing ◽  
Adult Patients ◽  
Drug Resistant ◽  
Seizure Disorders ◽  
History Of

ObjectiveTo determine the occurrence of chronic traumatic encephalopathy (CTE) in young adult patients undergoing epilepsy surgery.MethodsTen patients who underwent epilepsy surgery were randomly selected for this retrospective study. The patients were 18–45 years of age, had preoperative neuropsychological evaluation, and had 1 year postoperative follow-up. Microscopic sections from resections were evaluated for the presence of CTE with standard stains and antibodies to tau (clone AT8).ResultsThe median age at resection was 32.5 years (range 23–43) and the median duration of seizures was 23.5 years (range 3–28). Eight had a history of head injury. Preoperative neuropsychological testing showed mild to moderate cognitive impairment in 8 patients (80%). Pathologic examination in one patient showed focal sparse tau-immunoreactive lesions along descending rami and cortical gyral depths of the resected frontal lobe. Nine patients had no evidence of CTE. All focal cortical resections showed variable subpial and subcortical gliosis commonly identified in patients with chronic seizure disorders.ConclusionsThe present small retrospective observational study suggests that CTE may occur, but appears uncommon, in young adult patients undergoing surgical treatment for drug-resistant focal epilepsy. The significance of these findings requires further investigation to define the relative importance of tau accumulation in younger adult patients with drug-resistant focal epilepsy and cognitive decline.

Eslicarbazepine acetate add-on therapy for drug-resistant focal epilepsy

2021 ◽  
Vol 2021 (6) ◽  
Author(s):  
Xian-Chao Chang ◽  
Hai Yuan ◽  
Yi Wang ◽  
Hui-Qin Xu ◽  
Wen-Ke Hong ◽  
...  
Keyword(s):  
Focal Epilepsy ◽  
Drug Resistant ◽  
Eslicarbazepine Acetate

Valproate add-on therapy for drug-resistant focal epilepsy

2021 ◽  
Vol 2021 (7) ◽  
Author(s):  
Myrsini Gianatsi ◽  
Rebecca Bresnahan ◽  
Ruaraidh A Hill ◽  
Sarah J Nevitt ◽  
Anthony G Marson ◽  
...  
Keyword(s):  
Focal Epilepsy ◽  
Drug Resistant
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