Literature Monitor

In patients who have had surgical resection of an insular glioma, the wider the extent of the resection, the longer they remain free from seizures, according to a study from the department of neurological surgery at the University of California, San Francisco (UCSF).

• The analysis included 109 patients who had surgery for insular tumors from 1997 to 2015 at UCSF.
• At final follow-up, 42 patients (39%) remained seizure free.
• Increasing the extent of the resection predicted freedom from seizures.
• The analysis also revealed that performing a second resection provided even greater seizure control; 8/22 patients with recurrent seizures no longer had them after the second surgery.
• Patients who experienced a second seizure after resection were more likely to have had tumor progression.

Wang DD, Deng H, Hervey-Jumper SL, Molinaro AA, Chang EF, Berger MS. Seizure outcome after surgical resection of insular glioma. [Published online ahead of print Nov 8, 2017] Neurosurgery.  doi: 10.1093/neuros/nyx486.

In patients who have had surgical resection of an insular glioma, the wider the extent of the resection, the longer they remain free from seizures, according to a study from the department of neurological surgery at the University of California, San Francisco (UCSF).

• The analysis included 109 patients who had surgery for insular tumors from 1997 to 2015 at UCSF.
• At final follow-up, 42 patients (39%) remained seizure free.
• Increasing the extent of the resection predicted freedom from seizures.
• The analysis also revealed that performing a second resection provided even greater seizure control; 8/22 patients with recurrent seizures no longer had them after the second surgery.
• Patients who experienced a second seizure after resection were more likely to have had tumor progression.

Wang DD, Deng H, Hervey-Jumper SL, Molinaro AA, Chang EF, Berger MS. Seizure outcome after surgical resection of insular glioma. [Published online ahead of print Nov 8, 2017] Neurosurgery.  doi: 10.1093/neuros/nyx486.

In patients who have had surgical resection of an insular glioma, the wider the extent of the resection, the longer they remain free from seizures, according to a study from the department of neurological surgery at the University of California, San Francisco (UCSF).

• The analysis included 109 patients who had surgery for insular tumors from 1997 to 2015 at UCSF.
• At final follow-up, 42 patients (39%) remained seizure free.
• Increasing the extent of the resection predicted freedom from seizures.
• The analysis also revealed that performing a second resection provided even greater seizure control; 8/22 patients with recurrent seizures no longer had them after the second surgery.
• Patients who experienced a second seizure after resection were more likely to have had tumor progression.

Wang DD, Deng H, Hervey-Jumper SL, Molinaro AA, Chang EF, Berger MS. Seizure outcome after surgical resection of insular glioma. [Published online ahead of print Nov 8, 2017] Neurosurgery.  doi: 10.1093/neuros/nyx486.

Patients who experience altered responsiveness during a psychogenic nonepileptic seizures (PNES) may have some sort of psychological vulnerability suggests a recent analysis of video-EEG confirmed PNES.

• Among 77 patients with confirmed PNES, 47 (66%) were found to have altered responsiveness.
• This group was more likely to display experiential avoidance, the tendency to avoid thoughts, feelings, memories, and related internal experiences.
• A review of patients’ demographics, clinical history, and questionnaires also found patients with altered responsiveness during PNES had more affect intolerance, suggesting their inability to tolerate emotions.
• The same group presented with a family history of seizures, headaches, and loss of consciousness during traumatic brain injury.
• Researchers suggested that these patients may benefit from a treatment plan that concentrates on emotion management.

Baslet G, Tolchin B, Dworetzky BA. Altered responsiveness in psychogenic nonepileptic seizures and its implication to underlying psychopathology. Seizure. 2017;52:162-168.

Patients who experience altered responsiveness during a psychogenic nonepileptic seizures (PNES) may have some sort of psychological vulnerability suggests a recent analysis of video-EEG confirmed PNES.

• Among 77 patients with confirmed PNES, 47 (66%) were found to have altered responsiveness.
• This group was more likely to display experiential avoidance, the tendency to avoid thoughts, feelings, memories, and related internal experiences.
• A review of patients’ demographics, clinical history, and questionnaires also found patients with altered responsiveness during PNES had more affect intolerance, suggesting their inability to tolerate emotions.
• The same group presented with a family history of seizures, headaches, and loss of consciousness during traumatic brain injury.
• Researchers suggested that these patients may benefit from a treatment plan that concentrates on emotion management.

Baslet G, Tolchin B, Dworetzky BA. Altered responsiveness in psychogenic nonepileptic seizures and its implication to underlying psychopathology. Seizure. 2017;52:162-168.

Patients who experience altered responsiveness during a psychogenic nonepileptic seizures (PNES) may have some sort of psychological vulnerability suggests a recent analysis of video-EEG confirmed PNES.

• Among 77 patients with confirmed PNES, 47 (66%) were found to have altered responsiveness.
• This group was more likely to display experiential avoidance, the tendency to avoid thoughts, feelings, memories, and related internal experiences.
• A review of patients’ demographics, clinical history, and questionnaires also found patients with altered responsiveness during PNES had more affect intolerance, suggesting their inability to tolerate emotions.
• The same group presented with a family history of seizures, headaches, and loss of consciousness during traumatic brain injury.
• Researchers suggested that these patients may benefit from a treatment plan that concentrates on emotion management.

Baslet G, Tolchin B, Dworetzky BA. Altered responsiveness in psychogenic nonepileptic seizures and its implication to underlying psychopathology. Seizure. 2017;52:162-168.

Repeat surgery is worth considering in patients with intractable epilepsy if they continue to have debilitating episodes after the first procedure, according to a meta-analysis and systematic review that looked at 782 patients from 36 studies. But the success of repeat resection is dependent on several positive and negative predictive factors.

• Krucoff et al conducted the first quantitative meta-analysis of theresearch literature from the last 30 years to determine the rate of successful repeat surgeries and to find predictors.
• Congruent electrophysiology data was a better predictor of seizure freedom when compared to noncongruent data, with an odds ratio (OR) of 3.6.
• Freedom from seizures after repeat surgery was better predicted for lesional than nonlesional epilepsy (OR, 3.2).
• Another predictor of seizure freedom was surgical limitations, when compared to disease-related factors that had been associated with failure of the first surgery. (OR, 2.6).
• 58% of patients were seizure free after repeat resection if they had at least one of these predictive factors.

Krucoff MO, Chan AY, Harward SC, et al. Rates and predictors of success and failure in repeat epilepsy surgery: a meta-analysis and systematic review. [Published online ahead of print October 10, 2017] Epilepsia. doi: 10.1111/epi.13920.

Repeat surgery is worth considering in patients with intractable epilepsy if they continue to have debilitating episodes after the first procedure, according to a meta-analysis and systematic review that looked at 782 patients from 36 studies. But the success of repeat resection is dependent on several positive and negative predictive factors.

• Krucoff et al conducted the first quantitative meta-analysis of theresearch literature from the last 30 years to determine the rate of successful repeat surgeries and to find predictors.
• Congruent electrophysiology data was a better predictor of seizure freedom when compared to noncongruent data, with an odds ratio (OR) of 3.6.
• Freedom from seizures after repeat surgery was better predicted for lesional than nonlesional epilepsy (OR, 3.2).
• Another predictor of seizure freedom was surgical limitations, when compared to disease-related factors that had been associated with failure of the first surgery. (OR, 2.6).
• 58% of patients were seizure free after repeat resection if they had at least one of these predictive factors.

Krucoff MO, Chan AY, Harward SC, et al. Rates and predictors of success and failure in repeat epilepsy surgery: a meta-analysis and systematic review. [Published online ahead of print October 10, 2017] Epilepsia. doi: 10.1111/epi.13920.

Repeat surgery is worth considering in patients with intractable epilepsy if they continue to have debilitating episodes after the first procedure, according to a meta-analysis and systematic review that looked at 782 patients from 36 studies. But the success of repeat resection is dependent on several positive and negative predictive factors.

• Krucoff et al conducted the first quantitative meta-analysis of theresearch literature from the last 30 years to determine the rate of successful repeat surgeries and to find predictors.
• Congruent electrophysiology data was a better predictor of seizure freedom when compared to noncongruent data, with an odds ratio (OR) of 3.6.
• Freedom from seizures after repeat surgery was better predicted for lesional than nonlesional epilepsy (OR, 3.2).
• Another predictor of seizure freedom was surgical limitations, when compared to disease-related factors that had been associated with failure of the first surgery. (OR, 2.6).
• 58% of patients were seizure free after repeat resection if they had at least one of these predictive factors.

Krucoff MO, Chan AY, Harward SC, et al. Rates and predictors of success and failure in repeat epilepsy surgery: a meta-analysis and systematic review. [Published online ahead of print October 10, 2017] Epilepsia. doi: 10.1111/epi.13920.

Magnetic resonance-guided laser interstitial therapy (MRgLITT) is as efficacious as open surgery for patients with medically intractable epilepsy, according to a recent review of the research literature. 

• MRgLITT can effectively ablate seizure foci without disrupting neuropsychological functioning.
• The procedure allows clinicians to receive real-time feedback and lets them monitor tissue ablation.
• By contrast, open surgery can control seizures but risks complications, including cognitive problems and neurologic deficits.
• Patients who undergo MRgLITT will likely spend less time in the hospital and experience less postoperative pain, when compared to open surgical procedures.
• Although the research comparing open surgery to laser interstitial therapy suggests the latter offers advantages, the review points out that the research under consideration involved small sample sizes.
• Another limitation of the available studies is that they do not report the long-term outcomes of MRgLITT.

Shukla ND, Ho AL, Pendharkar AV, Sussman ES, Halpern CH. Laser interstitial thermal therapy for the treatment of epilepsy: evidence to date. Neuropsychiatr Dis Treat. 2017;13:2469-2475.

Magnetic resonance-guided laser interstitial therapy (MRgLITT) is as efficacious as open surgery for patients with medically intractable epilepsy, according to a recent review of the research literature. 

• MRgLITT can effectively ablate seizure foci without disrupting neuropsychological functioning.
• The procedure allows clinicians to receive real-time feedback and lets them monitor tissue ablation.
• By contrast, open surgery can control seizures but risks complications, including cognitive problems and neurologic deficits.
• Patients who undergo MRgLITT will likely spend less time in the hospital and experience less postoperative pain, when compared to open surgical procedures.
• Although the research comparing open surgery to laser interstitial therapy suggests the latter offers advantages, the review points out that the research under consideration involved small sample sizes.
• Another limitation of the available studies is that they do not report the long-term outcomes of MRgLITT.

Shukla ND, Ho AL, Pendharkar AV, Sussman ES, Halpern CH. Laser interstitial thermal therapy for the treatment of epilepsy: evidence to date. Neuropsychiatr Dis Treat. 2017;13:2469-2475.

Magnetic resonance-guided laser interstitial therapy (MRgLITT) is as efficacious as open surgery for patients with medically intractable epilepsy, according to a recent review of the research literature. 

• MRgLITT can effectively ablate seizure foci without disrupting neuropsychological functioning.
• The procedure allows clinicians to receive real-time feedback and lets them monitor tissue ablation.
• By contrast, open surgery can control seizures but risks complications, including cognitive problems and neurologic deficits.
• Patients who undergo MRgLITT will likely spend less time in the hospital and experience less postoperative pain, when compared to open surgical procedures.
• Although the research comparing open surgery to laser interstitial therapy suggests the latter offers advantages, the review points out that the research under consideration involved small sample sizes.
• Another limitation of the available studies is that they do not report the long-term outcomes of MRgLITT.

Shukla ND, Ho AL, Pendharkar AV, Sussman ES, Halpern CH. Laser interstitial thermal therapy for the treatment of epilepsy: evidence to date. Neuropsychiatr Dis Treat. 2017;13:2469-2475.

Efficacy data from adult clinical trials of antiepileptic drugs (AEDs) can be used to determine the efficacy of these agents in children according to a recent analysis published in Epilepsia.

• The need for efficacious AEDs for children is urgent given the fact that epileptic seizures are the most common serious neurological problem in this population.
• The pathophysiology of focal epilepsy in children is similar to that found in adults, based on anatomical and neurophysiological evidence.
• The structural and physiological features that underlie seizures in adults and children aged 2 years and older are similar and justify extrapolation of efficacy data from adults to children.
• However, these similarities do not justify extrapolating pharmacokinetic, tolerability, and safety data from adults to children.
• Similarly, published data do not allow one to assume that long-term follow-up in children on AEDs will be the same as follow-up results in adults.

Pellock JM, Arzimanoglou A, D’Cruz O, Holmes GL, Nordli D, Shinnar S; Pediatric Epilepsy Academic Consortium for Extrapolation. Extrapolating evidence of antiepileptic drug efficacy in adults to children ≥2 years of age with focal seizures: The case for disease similarity. Epilepsia. 2017;58(10):1686-1696.

Efficacy data from adult clinical trials of antiepileptic drugs (AEDs) can be used to determine the efficacy of these agents in children according to a recent analysis published in Epilepsia.

• The need for efficacious AEDs for children is urgent given the fact that epileptic seizures are the most common serious neurological problem in this population.
• The pathophysiology of focal epilepsy in children is similar to that found in adults, based on anatomical and neurophysiological evidence.
• The structural and physiological features that underlie seizures in adults and children aged 2 years and older are similar and justify extrapolation of efficacy data from adults to children.
• However, these similarities do not justify extrapolating pharmacokinetic, tolerability, and safety data from adults to children.
• Similarly, published data do not allow one to assume that long-term follow-up in children on AEDs will be the same as follow-up results in adults.

Pellock JM, Arzimanoglou A, D’Cruz O, Holmes GL, Nordli D, Shinnar S; Pediatric Epilepsy Academic Consortium for Extrapolation. Extrapolating evidence of antiepileptic drug efficacy in adults to children ≥2 years of age with focal seizures: The case for disease similarity. Epilepsia. 2017;58(10):1686-1696.

Efficacy data from adult clinical trials of antiepileptic drugs (AEDs) can be used to determine the efficacy of these agents in children according to a recent analysis published in Epilepsia.

• The need for efficacious AEDs for children is urgent given the fact that epileptic seizures are the most common serious neurological problem in this population.
• The pathophysiology of focal epilepsy in children is similar to that found in adults, based on anatomical and neurophysiological evidence.
• The structural and physiological features that underlie seizures in adults and children aged 2 years and older are similar and justify extrapolation of efficacy data from adults to children.
• However, these similarities do not justify extrapolating pharmacokinetic, tolerability, and safety data from adults to children.
• Similarly, published data do not allow one to assume that long-term follow-up in children on AEDs will be the same as follow-up results in adults.

Pellock JM, Arzimanoglou A, D’Cruz O, Holmes GL, Nordli D, Shinnar S; Pediatric Epilepsy Academic Consortium for Extrapolation. Extrapolating evidence of antiepileptic drug efficacy in adults to children ≥2 years of age with focal seizures: The case for disease similarity. Epilepsia. 2017;58(10):1686-1696.

FDA has approved Aptiom (eslicarbazepine) for an expanded indication to treat partial-onset seizures in children.

Indications: Aptiom was previously approved form the treatment of partial onset seizures in adults. The new approval is for children ages 4 years to 17 years with the same disorder. It is a once daily immediate release anti-epilepsy drug that can be taken whole or crushed, with or without food. The approval is based in part on extrapolation of previous data to support its use in the pediatric population.

Dosage and administration.  The recommended dosage of APTIOM is based on

body weight and is administered orally once daily. The package insert says to increase the dose in weekly intervals based on clinical response and tolerability to the recommended maintenance dosage. The initial pediatric dose is 200 mg/day for a patient 11 to 21 kg, with 200 mg/day as a maximum titration increment.  Maximum dose for a child in this weight range in 400 to 600 mg/day.

Adverse effects.  The most common reactions in adults include dizziness, somnolence, nausea, headache, diplopia, vomiting, fatigue, vertigo, ataxia, blurred vision, and tremor. Adverse reactions are similar in pediatric patients.

Sunovion’s Aptiom (eslicarbazepine acetate) Receives FDA Approval for Expanded Indication to Treat Partial-Onset Seizures in Children and Adolescents 4 Years of Age and Older

http://www.sunovion.us/featured-news/press-releases/20170914a.pdf. Accessed October 16, 2017

FDA has approved Aptiom (eslicarbazepine) for an expanded indication to treat partial-onset seizures in children.

Indications: Aptiom was previously approved form the treatment of partial onset seizures in adults. The new approval is for children ages 4 years to 17 years with the same disorder. It is a once daily immediate release anti-epilepsy drug that can be taken whole or crushed, with or without food. The approval is based in part on extrapolation of previous data to support its use in the pediatric population.

Dosage and administration.  The recommended dosage of APTIOM is based on

body weight and is administered orally once daily. The package insert says to increase the dose in weekly intervals based on clinical response and tolerability to the recommended maintenance dosage. The initial pediatric dose is 200 mg/day for a patient 11 to 21 kg, with 200 mg/day as a maximum titration increment.  Maximum dose for a child in this weight range in 400 to 600 mg/day.

Adverse effects.  The most common reactions in adults include dizziness, somnolence, nausea, headache, diplopia, vomiting, fatigue, vertigo, ataxia, blurred vision, and tremor. Adverse reactions are similar in pediatric patients.

Sunovion’s Aptiom (eslicarbazepine acetate) Receives FDA Approval for Expanded Indication to Treat Partial-Onset Seizures in Children and Adolescents 4 Years of Age and Older

http://www.sunovion.us/featured-news/press-releases/20170914a.pdf. Accessed October 16, 2017

FDA has approved Aptiom (eslicarbazepine) for an expanded indication to treat partial-onset seizures in children.

Indications: Aptiom was previously approved form the treatment of partial onset seizures in adults. The new approval is for children ages 4 years to 17 years with the same disorder. It is a once daily immediate release anti-epilepsy drug that can be taken whole or crushed, with or without food. The approval is based in part on extrapolation of previous data to support its use in the pediatric population.

Dosage and administration.  The recommended dosage of APTIOM is based on

body weight and is administered orally once daily. The package insert says to increase the dose in weekly intervals based on clinical response and tolerability to the recommended maintenance dosage. The initial pediatric dose is 200 mg/day for a patient 11 to 21 kg, with 200 mg/day as a maximum titration increment.  Maximum dose for a child in this weight range in 400 to 600 mg/day.

Adverse effects.  The most common reactions in adults include dizziness, somnolence, nausea, headache, diplopia, vomiting, fatigue, vertigo, ataxia, blurred vision, and tremor. Adverse reactions are similar in pediatric patients.

Sunovion’s Aptiom (eslicarbazepine acetate) Receives FDA Approval for Expanded Indication to Treat Partial-Onset Seizures in Children and Adolescents 4 Years of Age and Older

http://www.sunovion.us/featured-news/press-releases/20170914a.pdf. Accessed October 16, 2017

The diagnosis of psychogenic nonepileptic seizure (PNES) is often delayed—and a history of head trauma can contribute to that delay.

• 49 adult patients who were admitted to the epilepsy unit at the Jefferson Comprehensive Epilepsy Center for PNES were studied to determine how long it took for a correct diagnosis to be reached.
• Of the 49 patients, 39 were women, 10 were men; the study period was 2012 to 2016.
• On average, it took 3 years (median) to arrive at the correct diagnosis.
• A comparison of patients who received an early diagnosis to those whose diagnosis was delayed found that a history of head trauma was the only significant difference between the 2 groups.
• 2 of 19 patients had an early diagnosis (7%) and 11 of 28 patients experienced a delayed diagnosis, which was associated with head trauma (P=0.02).

Asadi-Pooya AA, Tinker J. Delay in diagnosis of psychogenic nonepileptic seizures in adults: A post hoc study [published online ahead of print Sept 15, 2017]. Epilepsy Behav. doi: 10.1016/j.yebeh.2017.08.005.

The diagnosis of psychogenic nonepileptic seizure (PNES) is often delayed—and a history of head trauma can contribute to that delay.

• 49 adult patients who were admitted to the epilepsy unit at the Jefferson Comprehensive Epilepsy Center for PNES were studied to determine how long it took for a correct diagnosis to be reached.
• Of the 49 patients, 39 were women, 10 were men; the study period was 2012 to 2016.
• On average, it took 3 years (median) to arrive at the correct diagnosis.
• A comparison of patients who received an early diagnosis to those whose diagnosis was delayed found that a history of head trauma was the only significant difference between the 2 groups.
• 2 of 19 patients had an early diagnosis (7%) and 11 of 28 patients experienced a delayed diagnosis, which was associated with head trauma (P=0.02).

Asadi-Pooya AA, Tinker J. Delay in diagnosis of psychogenic nonepileptic seizures in adults: A post hoc study [published online ahead of print Sept 15, 2017]. Epilepsy Behav. doi: 10.1016/j.yebeh.2017.08.005.

The diagnosis of psychogenic nonepileptic seizure (PNES) is often delayed—and a history of head trauma can contribute to that delay.

• 49 adult patients who were admitted to the epilepsy unit at the Jefferson Comprehensive Epilepsy Center for PNES were studied to determine how long it took for a correct diagnosis to be reached.
• Of the 49 patients, 39 were women, 10 were men; the study period was 2012 to 2016.
• On average, it took 3 years (median) to arrive at the correct diagnosis.
• A comparison of patients who received an early diagnosis to those whose diagnosis was delayed found that a history of head trauma was the only significant difference between the 2 groups.
• 2 of 19 patients had an early diagnosis (7%) and 11 of 28 patients experienced a delayed diagnosis, which was associated with head trauma (P=0.02).

Asadi-Pooya AA, Tinker J. Delay in diagnosis of psychogenic nonepileptic seizures in adults: A post hoc study [published online ahead of print Sept 15, 2017]. Epilepsy Behav. doi: 10.1016/j.yebeh.2017.08.005.

Three million adults and 470,000 children have epilepsy according to the latest statistics from the Centers for Disease Control and Prevention (CDC).  These figures, based on the 2015 National Health Interview Survey, translate into 1.2% of the US population, an all-time high. Previous estimates, based on 2010 data, indicated that 2.3 million adults and 450,000 children had the disorder.

• The CDC report provides the first ever estimates of the prevalence of epilepsy state by state, with the agency reporting higher volumes in more densely populated states, as expected.
• The lowest prevalence of the neurological disease was noted in Wyoming, with 5900 active cases.
• California was estimated to have 427,700 cases of the disease.
• CDC believes increases from 2010 to 2015 are likely due to population growth.
• Among the limitations of the analysis is the fact that the estimates are based on self-reports, which are subject to bias.
• Underreporting by the public may reflect their reluctance to admit to a disorder because of its stigma and because they fear it could lead to driver’s license restrictions.

Zack MM, Kobau R. National and state estimates of the numbers of adults and children with active epilepsy — United States, 2015. MMWR; 2017;66(31):821-825.

Three million adults and 470,000 children have epilepsy according to the latest statistics from the Centers for Disease Control and Prevention (CDC).  These figures, based on the 2015 National Health Interview Survey, translate into 1.2% of the US population, an all-time high. Previous estimates, based on 2010 data, indicated that 2.3 million adults and 450,000 children had the disorder.

• The CDC report provides the first ever estimates of the prevalence of epilepsy state by state, with the agency reporting higher volumes in more densely populated states, as expected.
• The lowest prevalence of the neurological disease was noted in Wyoming, with 5900 active cases.
• California was estimated to have 427,700 cases of the disease.
• CDC believes increases from 2010 to 2015 are likely due to population growth.
• Among the limitations of the analysis is the fact that the estimates are based on self-reports, which are subject to bias.
• Underreporting by the public may reflect their reluctance to admit to a disorder because of its stigma and because they fear it could lead to driver’s license restrictions.

Zack MM, Kobau R. National and state estimates of the numbers of adults and children with active epilepsy — United States, 2015. MMWR; 2017;66(31):821-825.

Three million adults and 470,000 children have epilepsy according to the latest statistics from the Centers for Disease Control and Prevention (CDC).  These figures, based on the 2015 National Health Interview Survey, translate into 1.2% of the US population, an all-time high. Previous estimates, based on 2010 data, indicated that 2.3 million adults and 450,000 children had the disorder.

• The CDC report provides the first ever estimates of the prevalence of epilepsy state by state, with the agency reporting higher volumes in more densely populated states, as expected.
• The lowest prevalence of the neurological disease was noted in Wyoming, with 5900 active cases.
• California was estimated to have 427,700 cases of the disease.
• CDC believes increases from 2010 to 2015 are likely due to population growth.
• Among the limitations of the analysis is the fact that the estimates are based on self-reports, which are subject to bias.
• Underreporting by the public may reflect their reluctance to admit to a disorder because of its stigma and because they fear it could lead to driver’s license restrictions.

Zack MM, Kobau R. National and state estimates of the numbers of adults and children with active epilepsy — United States, 2015. MMWR; 2017;66(31):821-825.

Laser interstitial thermal ablation (LiTT) appears to benefit patients with temporal lobe epilepsy (TLE) according to a recent article published in Epilepsy Research.

• According to the author, LiTT has been found to eliminate seizures in about half of patients with mesial temporal lobe epilepsy who undergo the procedure.
• Neuropsychological side effects of the procedure seem to be less severe, when compared to surgeries that require large resections.
• LiTT involves inserting a probe into the area of the brain responsible for the seizures, including the mesial temporal lobe and hypothalamic hamartoma, and heating the tip of the probe by means of laser energy.
• Advantages include the fact that LiTT is less invasive than open surgery and allows patients to leave the hospital sooner and experience less pain.
• The minimally invasive surgery typically requires a single day of hospitalization and allows patients to return to work in 3 days.
• It remains uncertain whether LiTT is as efficacious as more invasive procedures but appears to be about as efficacious as anterior temporal lobectomy.

Kang JY, Sperling MR. Epileptologist’s view: Laser interstitial thermal ablation for treatment of temporal lobe epilepsy.  [Published online ahead of print July 25, 2017] Epilepsy Res. https://doi.org/10.1016/j.eplepsyres.2017.07.007

Laser interstitial thermal ablation (LiTT) appears to benefit patients with temporal lobe epilepsy (TLE) according to a recent article published in Epilepsy Research.

• According to the author, LiTT has been found to eliminate seizures in about half of patients with mesial temporal lobe epilepsy who undergo the procedure.
• Neuropsychological side effects of the procedure seem to be less severe, when compared to surgeries that require large resections.
• LiTT involves inserting a probe into the area of the brain responsible for the seizures, including the mesial temporal lobe and hypothalamic hamartoma, and heating the tip of the probe by means of laser energy.
• Advantages include the fact that LiTT is less invasive than open surgery and allows patients to leave the hospital sooner and experience less pain.
• The minimally invasive surgery typically requires a single day of hospitalization and allows patients to return to work in 3 days.
• It remains uncertain whether LiTT is as efficacious as more invasive procedures but appears to be about as efficacious as anterior temporal lobectomy.

Kang JY, Sperling MR. Epileptologist’s view: Laser interstitial thermal ablation for treatment of temporal lobe epilepsy.  [Published online ahead of print July 25, 2017] Epilepsy Res. https://doi.org/10.1016/j.eplepsyres.2017.07.007

Laser interstitial thermal ablation (LiTT) appears to benefit patients with temporal lobe epilepsy (TLE) according to a recent article published in Epilepsy Research.

• According to the author, LiTT has been found to eliminate seizures in about half of patients with mesial temporal lobe epilepsy who undergo the procedure.
• Neuropsychological side effects of the procedure seem to be less severe, when compared to surgeries that require large resections.
• LiTT involves inserting a probe into the area of the brain responsible for the seizures, including the mesial temporal lobe and hypothalamic hamartoma, and heating the tip of the probe by means of laser energy.
• Advantages include the fact that LiTT is less invasive than open surgery and allows patients to leave the hospital sooner and experience less pain.
• The minimally invasive surgery typically requires a single day of hospitalization and allows patients to return to work in 3 days.
• It remains uncertain whether LiTT is as efficacious as more invasive procedures but appears to be about as efficacious as anterior temporal lobectomy.

Kang JY, Sperling MR. Epileptologist’s view: Laser interstitial thermal ablation for treatment of temporal lobe epilepsy.  [Published online ahead of print July 25, 2017] Epilepsy Res. https://doi.org/10.1016/j.eplepsyres.2017.07.007

The threat of seizures and epilepsy is a significant concern for patients who have had a stroke, according to a review of 41 studies published in Neurology.  

• Investigators found 35 studies that reported stroke-related seizures and 6 studies that found details on the effects of antiepileptic drugs.
• Seizures occurred early on in 3.3% of patients who had experienced a stroke.
• Late-onset seizures or epilepsy was reported in 18/1000 person-years.
• Researchers were unable to find any evidence to suggest that a specific drug was more effective among patients who had seizures after a stroke.
• Newer drugs caused fewer side effects than older medications.
• The systematic review and meta-analysis included measurement of I²statistic to evaluate heterogeneity and sensitivity analyses were also performed.
• Early onset and late onset seizures generated I² statistics of 92.8% and 94.1%, respectively.
• Sensitivity analyses was unable to explain the high degree of heterogeneity.

Wang JZ, Vyas MV, Saposnik G, Burneo JG. Incidence and management of seizures after ischemic stroke. Neurology. 2017;89:1220-1228.  

The threat of seizures and epilepsy is a significant concern for patients who have had a stroke, according to a review of 41 studies published in Neurology.  

• Investigators found 35 studies that reported stroke-related seizures and 6 studies that found details on the effects of antiepileptic drugs.
• Seizures occurred early on in 3.3% of patients who had experienced a stroke.
• Late-onset seizures or epilepsy was reported in 18/1000 person-years.
• Researchers were unable to find any evidence to suggest that a specific drug was more effective among patients who had seizures after a stroke.
• Newer drugs caused fewer side effects than older medications.
• The systematic review and meta-analysis included measurement of I²statistic to evaluate heterogeneity and sensitivity analyses were also performed.
• Early onset and late onset seizures generated I² statistics of 92.8% and 94.1%, respectively.
• Sensitivity analyses was unable to explain the high degree of heterogeneity.

Wang JZ, Vyas MV, Saposnik G, Burneo JG. Incidence and management of seizures after ischemic stroke. Neurology. 2017;89:1220-1228.  

The threat of seizures and epilepsy is a significant concern for patients who have had a stroke, according to a review of 41 studies published in Neurology.  

• Investigators found 35 studies that reported stroke-related seizures and 6 studies that found details on the effects of antiepileptic drugs.
• Seizures occurred early on in 3.3% of patients who had experienced a stroke.
• Late-onset seizures or epilepsy was reported in 18/1000 person-years.
• Researchers were unable to find any evidence to suggest that a specific drug was more effective among patients who had seizures after a stroke.
• Newer drugs caused fewer side effects than older medications.
• The systematic review and meta-analysis included measurement of I²statistic to evaluate heterogeneity and sensitivity analyses were also performed.
• Early onset and late onset seizures generated I² statistics of 92.8% and 94.1%, respectively.
• Sensitivity analyses was unable to explain the high degree of heterogeneity.

Wang JZ, Vyas MV, Saposnik G, Burneo JG. Incidence and management of seizures after ischemic stroke. Neurology. 2017;89:1220-1228.