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Query: UMLS:C0014547 (focal epilepsy)
 1,627 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Epilepsy surgery offers the chance of seizure remission for the 30%-40% of patients with focal epilepsy whose seizures continue despite anti-epileptic medications. Epilepsy surgery encompasses curative resective procedures, palliative techniques such as corpus callosotomy and implantation of stimulation devices. Pre-surgical evaluation aims to identify the epileptogenic zone and to prevent post-operative neurological and cognitive deficits. This entails optimal imaging, prolonged video-electroencephalogram (EEG) recordings, and neuropsychological and psychiatric assessments; some patients may then require nuclear medicine imaging and intracranial EEG recording. The best outcomes are in those with an electro-clinically concordant structural lesion on MRI (60%-70% seizure freedom). Lower rates of seizure freedom are expected in people with extra-temporal lobe foci, focal-to-bilateral tonic-clonic seizures, normal structural imaging, psychiatric co-morbidity and learning disability. Nevertheless, surgery for epilepsy is under-used and should be considered for all patients with refractory focal epilepsy in whom two or three anti-epileptic medications have been ineffective.
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PMID:Epilepsy surgery. 3142 Apr 15

To date, the neurocognitive profile and comorbid psychiatric risks associated with ESES, a syndrome that commonly coincides with a seizure disorder, in contrast to generalized or partial/focal epilepsy without ESES remains unclear. Accordingly, this preliminary study aimed to characterize the neurocognitive differences across pediatric patients with ESES, generalized or focal epilepsy, and risk for comorbid diagnoses (mood disorder, autism, intellectual disability, learning disability, ADHD). We included data from a total of 79 pediatric patients, including those with recently diagnosed ESES (N = 12), generalized epilepsy (GE, N = 25), left focal epilepsy (LFE; N = 20), or right focal epilepsy (RFE; N = 22). All patients completed a neurocognitive evaluation as part of their medical workup and treatment for epilepsy. Cognitive domains assessed include intellectual functioning, verbal/non-verbal reasoning, working memory, processing speed, receptive language, learning and memory. Results showed that children with GE performed more poorly across intellectual functioning, verbal and non-verbal reasoning, working memory, processing speed, and receptive vocabulary; whereas, these areas were most preserved among those with RFE. Working memory and processing speed among those recently diagnosed with ESES was also modestly stronger compared to the GE group. A greater proportion of patients with GE met diagnostic criteria for a learning disability relative to other epilepsy types, although the rates of ADHD, autism spectrum, intellectual disability, and mood disorder were comparable across groups. Findings provide supporting evidence that GE may be associated with greater cognitive risks when refractory to treatment, highlighting the need for earlier intervention services to circumvent adverse effects on adaptive and behavioral functioning. Neuropsychological differences between ESES versus other epilepsy subtypes may emerge as a late-effect of the neurological condition and/or related medication treatment, implicating a greater need for developmentally focused investigations.
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PMID:Neurocognitive Profiles of Pediatric Patients with ESES, Generalized Epilepsy, or Focal Epilepsy. 3273 61