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Letter re: Practice guideline summary: Sudden unexpected death in epilepsy incidence rates and risk factors: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society

The new guideline by the American Academy of Neurology (AAN) and the American Epilepsy Society (AES) on sudden unexpected death in epilepsy (SUDEP) is a landmark.1 The communication between medical professionals and patients about SUDEP risk remains unacceptably low. Tragically, family members often first learn about SUDEP after their loved one's death. Every patient and parent deserves to know the risks of epilepsy. For the first time, the AAN and AES recommend that neurologists inform them about SUDEP, the most common cause of epilepsy-related death.1
Source: Neurology - Category: Neurology Authors: Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research

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Effects of triptolide on the expression of MHC II in microglia in kainic acid‑induced epilepsy. Mol Med Rep. 2018 Apr 18;: Authors: Sun Z, Du M, Lu Y, Zeng CQ Abstract The purpose of the present study was to determine whether triptolide (T10) had any effect on major histocompatibility complex class II (MHC II) expression in kainic acid (KA)‑activated microglia, and to investigate the underlying molecular mechanism. BV‑2 microglia were pretreated with T10 prior to activation with KA. The expression level of MHC II and class II transactivator (CIITA) mRNA was determined via reverse transc...
Source: Molecular Medicine Reports - Category: Molecular Biology Tags: Mol Med Rep Source Type: research
Expression and functions of glutamate and γ‑aminobutyric acid transporters in ischemic models. Mol Med Rep. 2018 Apr 16;: Authors: Qian Z, Lin Y, Xing J, Qiu Y, Ren L Abstract Glutamate and γ‑aminobutyric acid (GABA) transporters serve central roles in normal neuronal activity and are associated with numerous pathological brain conditions, including ischemia and epilepsy. However, the interplay between these transporters in ischemia remains unclear. In the present study, the expression levels of the excitatory amino acid carrier 1 (EAAC1) and GABA transporter 1 (GAT1) were analyzed in&n...
Source: Molecular Medicine Reports - Category: Molecular Biology Tags: Mol Med Rep Source Type: research
Epileptic seizures are the result of excessive and abnormal neuronal activities in the cortex of the cerebrum. Hans Berger (German) initially recorded EEG activities of alpha and beta waves with in 1924. Gibbs, Davis and Lennox described interictal spikes and 3  Hz spike-and-wave pattern on absence seizures in 1935. Jasper and Penfield clarified the epileptic focus in a patient with partial epilepsy using EEG. From 1950s, scalp EEG has been widely used in clinical field of epilepsy. Intracranial EEG was also used for presurgical evaluations.
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Source Type: research
Temporal lobe epilepsy (TLE) is the most common type of drug-resistant epilepsy, partly characterized by hippocampus sclerosis. Recent accumulating evidence show that changes in glial cells are obvious in TEL, but an involvement of glial changes in TLE is still a matter of debate. Here, we show that status epilepticus (SE) induced activation of microglia, followed by induction of “epileptogenic astrocytes” in the hippocampus. Pilocarpine (Pilo) was used to induce SE in male adult B6 mice. Morphological and functional changes in glia were assessed by immunohistochemical analysis and Ca2+ imaging in the hippocamp...
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Source Type: research
We reported two types of histopathological abnormalities in glial cells in children who underwent epilepsy surgery for drug-resistant epilepsy.Oligodendroglia-like cells (OLC) can recruit multiple-lobe epileptogenic zones in pediatric drug-resistant focal epilepsy. Increased OLC presented with non-focal epileptiform discharges on scalp EEG and epileptic spasms (ES), and required multiple-lobe resections.
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Source Type: research
Long-term video-electroencephalography monitoring (LTM) in epilepsy monitoring units (EMUs) is an essential and most meaningful investigation for diagnosis of epilepsy, classification of epileptic seizures and pre-surgical evaluation of patients with intractable localization-related epilepsy. The tapering of antiepileptic drugs is commonly used to record seizures efficiently. However, this practice may expose patients to serious adverse events, such as falls, status epilepticus, psychiatric complication, cardiac events and pulmonary complications.
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Source Type: research
Intracranial electroencephalography (iEEG) is highly invasive but is useful in epilepsy surgery to delineate the margins of an epileptogenic zone and to identify eloquent areas. The involvement of EEG technologists in iEEG varies depending on the institution in Japan. In our hospital, EEG technologists are involved in preparing, recording, and reviewing EEGs, and supporting patients and their family during iEEG.EEG technologists prepare the electroencephalograph setting and connect the intracranial electrodes to the electroencephalograph with the neurosurgeon on the day after implantation.
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Source Type: research
If we can visualize the epileptogenic lesion, the intractable epilepsy might be cured by the resective surgery. PET is a common clinical imaging tool, and it can evaluate and visualize brain function quantitatively and multidimensionally with various radio ligands. (18) FDG-PET and (11) C-flumazenil-PET are mainly used in the clinical settings, and they showed the decrease of glucose metabolism and binding in the epilepsy focus. In this decade, many PET radio-ligands are developed for positive imaging of epileptogenic lesion.
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Source Type: research
Diagnosis and treatment of status epilepticus is needed when we see patients with epilepsy. International League Against Epilepsy (ILAE) proposed a new definition of status epilepticus in 2015. Status epilepticus is categorized as convulsive or nonconvulsive. Non-convulsive status epilepticus (NCSE) includes various type of clinical manifestations with different level of disturbance of consciousness. When we carefully observe patients with NCSE, we need to consider “consciousness”. A new definition of epileptic seizures which was proposed by ILAE in 2017 uses a term “awareness” instead of “con...
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Source Type: research
Epilepsy and autonomic dysregulation are closely related because the centers of the autonomic nervous system are located within the cerebral cortices. Patients with epilepsy can manifest autonomic dysregulation during the ictal and/or interictal periods.Patients with epilepsy may suffer various autonomic symptoms including bradycardia/tachycardia, apnea/tachypnea, abdominal discomfort/nausea/vomiting, and hypersalivation during seizures, caused by propagation of ictal discharges to the central autonomic network.
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Source Type: research
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