Conversions between monotherapies in epilepsy: expert consensus.

To develop expert consensus for conversion between antiepileptic drug (AED) monotherapies, an 11-member panel used the Delphi Technique over three rounds to: (1) identify relevant issues, (2) vote on the issues, and (3) develop consensus. The panel agreed on the basic principle to taper the existing AED only after a presumably efficacious dose of the planned AED was reached. Application is modified by adverse effects possibly attributable to the existing drug, in which case earlier or more rapid tapering of the existing drug should be considered.

The EEG profile of patients with uncontrolled vs. controlled seizures.

The goal of this study was to provide an EEG profile of patients (150) with uncontrolled (U) seizures, in contrast with those (150) with controlled (C) attacks. In the U group 804 EEGs were done and in the C group 674 were performed, all with both waking and sleep recordings; the range of EEG records on a given patient was 2-23. The number of spikes and the amount of abnormal slowing was quantified in each record.

Long-term studies on patients with absence and bilateral spike-wave complexes: 430 patients, up to 52 years follow-up.

This study involved long-term changes, up to 52 yrs, in 430 patients with absence (A) attacks and bilateral spike and wave complexes (BSW). Nearly 2/3 had additional GTC attacks and only about 1/4 had A alone. Atonic attacks (7%), complex partial (CP) (4%) and other types of seizures also occurred in the group.

Tailored anterior temporal lobectomy. Relation between extent of resection of mesial structures and postsurgical seizure outcome.

Objective: The purpose of this study was to assess the relationship between the extent of resection of mesial temporal structures and postsurgical seizure outcome in a group of patients who had undergone a tailored anterior temporal lobectomy.

Methods: Twenty-four patients with unilateral interictal and ictal foci restricted to anterior/mesial temporal regions underwent resection of mesial and temporal lateral structures, the extent of which was tailored by intraoperative electrocorticographic findings and functional mapping of eloquent cortex. The extent of resection was determined with postoperative magnetic resonance imaging scans, using a semiquantitative method, based on a 20-compartment model of the temporal lobe.