Neuroimaging in Adults and Children With Epilepsy.

Objective: This article discusses the fundamental importance of optimal epilepsy imaging using the International League Against Epilepsy-endorsed Harmonized Neuroimaging of Epilepsy Structural Sequences (HARNESS) protocol and the use of multimodality imaging in the evaluation of patients with drug-resistant epilepsy. It outlines a methodical approach to evaluating these images, particularly in the context of clinical information.

Latest Developments: Epilepsy imaging is rapidly evolving, and a high-resolution epilepsy protocol MRI is essential in evaluating newly diagnosed, chronic, and drug-resistant epilepsy.

Predictive value of early EEG after epilepsy surgery.

To determine whether EEG performed within few months after epilepsy surgery is predictive of seizure outcome, 58 consecutive patients undergoing surgery for presumptive temporal lobe epilepsy (TLE) who had clinical follow-up of at least 2 years and EEG data available both pre- and postoperatively were analyzed. Patients were classified by preoperative brain magnetic resonance imaging into lesional, cryptogenic, and hippocampal sclerosis groups. Seizure outcome was classified according to Engel's outcome scale.

Diagnostic and localizing value of ictal SPECT in patients with nonconvulsive status epilepticus.

In this study, we evaluate the diagnostic and localizing value of SPECT in three patients with nonconvulsive status epilepticus (NCSE). Our results indicate that ictal/subtraction ictal SPECT is a useful complementary noninvasive diagnostic test in patients with focal NCSE. This is especially the case when the EEG findings are inconclusive and for patients in whom surgical treatment is being considered.

Sodium methohexital (brevital) as an anesthetic in the Wada test.

Purposes: We report our experience with sodium methohexital (Brevital) as an anesthetic used in the Wada test for language and memory in 86 epilepsy surgery patients (173 procedures).

Methods: The methods are compared with those of the more commonly used anesthetic sodium amobarbital (Amytal).

Results: Despite differences between the methohexital and amobarbital test protocols, the behavioral and neurologic effects of the two anesthetics are similar.

Appropriate use of medications for seizures. Guiding principles on the path of efficacy.

Selection of medication for treatment of seizures requires careful consideration and a multifactorial, individualized evaluation. First and foremost, the choice of a particular AED should be based on its efficacy against the seizure type or types or epilepsy syndrome being treated. Other factors, such as concomitant medical conditions, may also play a role in the type or dosage of medication prescribed.