Personalized medicine: Vinpocetine to reverse effects of GABRB3 mutation.

Objective: To screen a library of potential therapeutic compounds for a woman with Lennox-Gastaut syndrome due to a Y302C GABRB3 (c.905A>G) mutation.

Methods: We compared the electrophysiological properties of cells with wild-type or the pathogenic GABRB3 mutation.

Why we urgently need improved epilepsy therapies for adult patients.

Purpose: Up to a third of patients with epilepsy suffer from recurrent seizures despite therapeutic advances.

Results: Current epilepsy treatments are limited by experiential data from treating different types of epilepsy. For example, we lack evidence-based approaches to efficacious multi-drug therapies or identifying potentially serious or disabling adverse events before medications are initiated.

Cannabinoid therapy in epilepsy.

Purpose Of Review: To review the history, pharmacology, and clinical science of cannabidiol (CBD) in the treatment of epilepsy.

Recent Findings: Phase III randomized controlled trials and prospective open label trials have provided efficacy and safety data for the use of CBD in pediatric onset severe epilepsies. The product that was studied in the vast majority of these published trials, Epidiolex (>99% of CBD and <0.

Standard median nerve ultrasound in carpal tunnel syndrome: A retrospective review of 1,021 cases.

Objective: Carpal tunnel syndrome (CTS) is diagnosed with electrodiagnostic (EDx) studies. Investigations have examined US cross sectional-area (CSA) and wrist to forearm ratio (WFR) cut-offs for screening EDx abnormalities in patients with suspected CTS. The objective of this study is to determine if these US parameters are effective in a real world population.

Addition of a hospital bedside sitter during intracranial stereotactic EEG monitoring improves safety and seizure responses in an adult epilepsy monitoring unit.

Expert consensus statements recommend continuous observation for patients undergoing intracranial electroencephalography (EEG), but this practice is neither universal nor specific regarding the type of observation. We compared outcomes for patients who underwent intracranial stereotactic EEG (SEEG) before and after the adoption of continuous monitoring by a staff bedside sitter. We retrospectively studied 26 consecutive adult patients who underwent SEEG placement at our center over a three-year period.

Laser ablation is effective for temporal lobe epilepsy with and without mesial temporal sclerosis if hippocampal seizure onsets are localized by stereoelectroencephalography.

Objective: Selective laser amygdalohippocampotomy (SLAH) using magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is emerging as a treatment option for drug-resistant mesial temporal lobe epilepsy (MTLE). SLAH is less invasive than open resection, but there are limited series reporting its safety and efficacy, particularly in patients without clear evidence of mesial temporal sclerosis (MTS).

Methods: We report seizure outcomes and complications in our first 30 patients who underwent SLAH for drug-resistant MTLE between January 2013 and December 2016.

Ultrasound Imaging of Median Nerve Conduit in a Patient With Persistent Median Nerve Symptoms.

Peripheral nerve injury can be reconstructed using composite polymer nerve autografts, but the sonographic appearance of nerve wraps and conduits have not been well documented. This case report describes the sonographic findings in a 42-year-old woman with bilateral carpal tunnel syndrome status post nerve repair with a conduit. The cross-sectional area of the left median nerve was 24 mm at the carpal tunnel inlet and 5 mm at the forearm.

The extrapolated reference values procedure: Theory, algorithm, and results in patients and control subjects.

Introduction: Reference values (RVs) are required to separate normal from abnormal values obtained in electrodiagnostic (EDx) testing. However, it is frequently impractical to perform studies on control subjects to obtain RVs. The Extrapolated Reference Values (E-Ref) procedure extracts RVs from data obtained during clinically indicated EDx testing.

Utility of Continuous EEG Monitoring in Noncritically lll Hospitalized Patients.

Introduction: Continuous EEG (cEEG) monitoring is used in the intensive care unit (ICU) setting to detect seizures, especially nonconvulsive seizures and status epilepticus. The utility and impact of such monitoring in non-ICU patients are largely unknown.

Methods: Hospitalized patients who were not in an ICU and underwent cEEG monitoring in the first half of 2011 and 2014 were identified.

Postictal Magnetic Resonance Imaging Changes Masquerading as Brain Tumor Progression: A Case Series.

Seizures are common among patients with brain tumors. Transient, postictal magnetic resonance imaging abnormalities are a long recognized phenomenon. However, these radiographic changes are not as well studied in the brain tumor population.

Ultrasound in EMG-Guided Biopsies: A Prospective, Randomized Pilot Trial.

Introduction: At our institution, core muscle biopsies are performed on muscles selected using electromyography (EMG). Ultrasound (US) guidance is not used routinely. The aim of this study was to determine if US guidance of EMG selected muscles would increase the diagnostic yield of the biopsy as compared to the current practice standards.