Clinical studies with targeted toxins in malignant glioma.

Targeted toxins represent a new class of agents with high specificity for tumor cells. Toxins in current clinical use for the treatment of brain tumors are mostly recombinant polypeptides consisting of a tumor-selective ligand coupled to a peptide toxin of bacterial origin. Targeted toxins are highly potent - one single molecule of toxin is enough to cause cell death.

Efficacy of carbamazepine and valproate as monotherapy for early epilepsy and single seizures.

In the Multi-Centre Study of Early Epilepsy and Single Seizures (MESS), patients were randomly allocated to immediate or delayed antiepileptic drug treatment. For time to first seizure recurrence, MESS provides strong evidence of an effect for carbamazepine as monotherapy but mixed evidence of an effect for valproate.

Capillary physiology of human medulloblastoma: impact on chemotherapy.

Background: Advances in the treatment of medulloblastoma have largely been attributed to the introduction of chemotherapy, although Phase III trials have shown advantages for chemotherapy only in subgroups. Because the efficacy of chemotherapy depends on tumor vascularization, the vascular physiology of human medulloblastomas was evaluated.

Methods: Seven patients with histologically proven medulloblastomas underwent measurements of capillary permeability and vascular plasma volume using contrast-enhanced dynamic computer tomography.

Capillary physiology and drug delivery in central nervous system lymphomas.

To evaluate whether the chemosensitivity of primary central nervous system lymphomas to water-soluble drugs could result from improved drug delivery, we quantitatively assessed pharmacokinetic factors in seven patients. The capillary permeability surface product was found to be significantly increased in central nervous system lymphomas compared with glioblastoma multiforme, medulloblastomas, and metastases. Tumoral blood flow was significantly greater than in normal white matter.

The dos and don'ts of neuropsychological assessment in epilepsy.

Neuropsychologists have a significant role in the assessment, treatment, and rehabilitation of people with epilepsy. This includes providing an assessment of an individual's cognitive strengths and weaknesses with respect to being a candidate for the surgery program, detailing intellectual and memory impairments as part of a rehabilitation service, and documenting specific antiepileptic drug effects as part of routine clinical management. Each of these specific roles requires careful consideration with respect to the potential pitfalls they can present to the neuropsychologist.

Validation of the Wechsler Memory Scale-III in a population of people with intractable temporal lobe epilepsy.

The Wechsler Memory Scale-Third Edition (WMS-III) was developed to overcome the limitations of the Wechsler Memory Scale-Revised and is now routinely used for pre-surgical assessment of memory for patients considering elective surgery for the relief of temporal lobe epilepsy (TLE). We investigated the validity of this relatively new measure in a population of people with resistant TLE. The sample consisted of 99 patients with a diagnosis if TLE in which the epileptogenic focus was clearly identified and localised to either the right or left hemisphere.

Motor cortex stimulation for neuropathic facial pain.

Facial neuralgia is the last common pathway for a variety of pathological conditions with different etiology. Neuropathic facial pain is often refractory to routine medical or surgical treatments. We present here a long-term follow-up of two patients with unilateral facial neuropathic pain due to idiopathic trigeminal neuropathy or to surgical trauma to the glossopharyngeal nerve, respectively.

Levetiracetam, oxcarbazepine, remacemide and zonisamide for drug resistant localization-related epilepsy: a systematic review.

Objective: To undertake a systematic review and meta-analysis of placebo controlled add-on trials of levetiracetam, oxcarbazepine, remacemide and zonisamide for patients with drug resistant localization related epilepsy.

Methods: We searched Medline, The Cochrane Library and contacted the relevant pharmaceutical companies. Outcomes were 50% or greater reduction in seizure frequency and treatment withdrawal for any reason.