Refractory seizures are common in pediatric neurology; consideration of whether seizures are acutely symptomatic of an underlying disease process is critical. In this case, a previously healthy 7-year-old patient presented with intractable focal seizures in the setting of a viral prodrome and headache. This case highlights a comprehensive work up of new-onset refractory seizures in a patient with features of encephalitis and describes a diagnostic quandary that ultimately led to a rare unifying diagnosis.
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Source Causal Connectivity Noninvasively Predicting Surgical Outcomes of Drug-Refractory Epilepsy.
CNS Neurosci Ther
January 2025
School of Information Science and Engineering, Lanzhou University, Lanzhou, China.
Aims: Drug-refractory epilepsy (DRE) refers to the failure of controlling seizures with adequate trials of two tolerated and appropriately chosen anti-seizure medications (ASMs). For patients with DRE, surgical intervention becomes the most effective and viable treatment, but its success rate is unsatisfactory at only approximately 50%. Predicting surgical outcomes in advance can provide additional guidance to clinicians.
View Article and Find Full Text PDFA 7-year-old with new-onset seizures, behavior disturbance, and encephalitis.
J Neuroimmunol
December 2024
Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, United States of America; Brain and Spine Center, Primary Children's Hospital, Intermountain Healthcare, United States of America.
Refractory seizures are common in pediatric neurology; consideration of whether seizures are acutely symptomatic of an underlying disease process is critical. In this case, a previously healthy 7-year-old patient presented with intractable focal seizures in the setting of a viral prodrome and headache. This case highlights a comprehensive work up of new-onset refractory seizures in a patient with features of encephalitis and describes a diagnostic quandary that ultimately led to a rare unifying diagnosis.
View Article and Find Full Text PDFNuclear Medicine Imaging in Epilepsy.
Radiographics
January 2025
From the Department of Radiology, University of Cincinnati Medical Center, 3188 Bellevue Ave, Cincinnati, OH 45219 (A.S., A.T.T., B.W.M., L.L.W., J.L.S.); and Department of Radiology, Cincinnati Children's Hospital and Medical Center, Cincinnati, OH (A.T.T.).
Approximately one-third of patients with focal epilepsy have medically refractory focal epilepsy (MRFE), which significantly impacts their quality of life. Once a seizure focus is identified and determined to be in the noneloquent cortex, it can be surgically resected with the goal of freedom from seizures and minimal neurocognitive deficit. During noninvasive (phase I) presurgical planning, functional (nuclear) imaging and structural imaging are complementary in the accurate localization of the epileptogenic zone (EZ).
View Article and Find Full Text PDFCost-Utility Analysis of Add-on Cannabidiol vs Usual Care Alone for the Treatment of Seizures in Patients With Treatment-Resistant Lennox-Gastaut Syndrome or Dravet Syndrome in the Netherlands.
J Health Econ Outcomes Res
December 2024
Jazz Pharmaceuticals UK Ltd., London, UK.
Article Synopsis
- Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) are severe epilepsy types often seen in young children, and a CBD medication (Epidyolex®) has been reimbursed in the Netherlands since December 2022 to help treat their seizures.
- A cost-effectiveness analysis using a Markov model showed that using CBD along with usual care for LGS resulted in additional costs of €28,338 but provided increased quality-adjusted life-years (QALYs) of 1.318, making it cost-effective below the €80,000 threshold.
- For DS patients, CBD plus usual care showed a cost saving of €23,642 while increasing QAL
Introduction: Hereditary bleeding disorders stem from the absence or insufficient levels of particular clotting proteins, essential for facilitating coagulation in the clotting cascade. Among the most prevalent are hemophilia A (deficiency of Factor VIII), hemophilia B (deficiency of Factor IX), and von Willebrand disease. Management of pharmacoresistant epilepsy is more difficult in a patient with bleeding disorder due to increased risk of bleeding during surgery.
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