A long-term follow-up of zonisamide monotherapy.

Objectives: Several studies have reported the safety and efficacy of zonisamide monotherapy, but studies on its long-term outcomes are limited. This chart review was conducted to evaluate the long-term outcomes of zonisamide monotherapy.

Methods: The charts were reviewed for 77 patients treated with zonisamide as monotherapy for 6-180 months between May 1985 and December 2003.

Development of an epilepsy comprehensive care center: a Japanese model.

Purpose: To review the requirements of a comprehensive care center for people with epilepsy.

Methods: Twenty-seven years have passed since the foundation of the Japanese Epilepsy Center in Shizuoka. The development of this center is presented as a model of an epilepsy comprehensive care center.

Discontinuation and duration of antiepileptic drug therapy: a retrospective study of factors for specific epileptic syndromes.

Purpose: To study factors associated with discontinuation of antiepileptic drugs (AEDs) in idiopathic generalized epilepsy (IGE) and symptomatic/cryptogenic localization-related epilepsy (S/CLRE) METHODS: For the IGE study, 71 patients who were able to discontinue their AED (discontinued-IGE group) were compared to 71 patients who continued AED therapy (continued-IGE group) and 20 patients with seizure relapse after discontinuing AED (relapsed-IGE group). For S/CLRE, 90 patients who were able to discontinue AED (discontinued-S/CLRE group) were compared to 90 patients who continued AED (continued-S/CLRE group) and 76 patients with benign childhood epilepsy with centrotemporal spikes who were able to discontinue AED (discontinued-BECTS group).

Results: Compared to the continued-IGE group, the discontinued-IGE group showed a weaker seizure propensity, better response to AEDs, more frequent epileptiform discharge suppression, and lower frequency of generalized tonic-clonic seizures (GTCs).

Long-term seizure outcome following resective surgery at National Epilepsy Center in Shizuoka, Japan.

We analyzed the seizure outcome of 357 patients who were followed for at least 2 years after resective surgeries; 282 underwent temporal lobe resection and 75 had extratemporal lobe resection. This study confirmed that resective surgery provides sustained, positive benefits with a high seizure-free rate of nearly 80% for most medically refractory patients. In patients with no MRI-detectable lesion who underwent extratemporal lobe resection, however, Engel's class I-II (seizure-free or rare seizures) was achieved in less than 50% of patients.

Etiologic factors and clinical features of symptomatic epilepsy: focus on pediatric cases.

We discuss the presumptive etiologic factors of symptomatic epilepsy from the clinical standpoint, based on our experience of 383 inpatients with epilepsy, with a focus on children. The main (top three) presumptive etiologic factors in partial epilepsy are intracranial infection, cerebral malformation and perinatal brain damage. In generalized epilepsy, the main presumptive etiologic factors are perinatal brain damage, intracranial infection, and cerebral malformation.

Therapy-resistant epilepsy in children: with the view of the long-term outcome.

Of 362 children with therapy-resistant epilepsy, 119 patients had generalized tonic seizures, which were the most common seizure type in patients with generalized epilepsy. The long-term observation of the patients with tonic seizures revealed that their seizures were completely controlled in 27 patients for more than 5 years. The effective antiepileptic drugs were VPA (10 patients), PHT (5), CLB (4), ZNS (2), VPA + PHT (4), ZNS + CLB (1) and VPA + AZA (1).

Mutations of sodium channel alpha subunit type 1 (SCN1A) in intractable childhood epilepsies with frequent generalized tonic-clonic seizures.

A group of infant onset epilepsies manifest very frequent generalized tonic-clonic seizures (GTC) intractable to medical therapy, which may or may not be accompanied by minor seizures such as myoclonic seizures, absences and partial seizures. They include severe myoclonic epilepsy in infancy (SMEI) and intractable childhood epilepsy with GTC (ICEGTC). They are commonly associated with fever-sensitivity, family history of seizure disorders and developmental decline after seizure onset.

Quantitative analysis of benzodiazepine receptor in temporal lobe epilepsy: [(125)I]iomazenil autoradiographic study of surgically resected specimens.

Purpose: To evaluate the changes of the inhibitory neurotransmitter receptor system related to epileptogenesis by measuring central benzodiazepine receptors (BZDRs) in surgically resected specimens of temporal lobe epilepsy by using [(125)I]iomazenil autoradiography.

Methods: Surgically resected specimens were obtained from 66 temporal lobe epilepsy patients [51 with mesial temporal lobe epilepsy (MTLE) and 15 with non-MTLE] receiving no BZDs and seven MTLE patients receiving BZDs. BZDR densities in brain sections were measured by using [(125)I]iomazenil autoradiography.