O Devinsky

..Better recognition will help to develop and implement appropriate diagnostic and treatment programs, and improve functional outcomes and quality of life in people with epilepsy...

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..This review critically evaluates the role of glia-induced hyperexcitability and inflammation in epilepsy...

..To improve the outcomes of focal cortical resections for seizure control, we need to better define functional and nociferous cortex and more clearly understand their boundaries and interactions...

..To report 4 cases of hyperfamiliarity for faces (HFF) and review 5 previously reported cases...

..Multiple independent seizure foci made these patients poor candidates for conventional surgery...

..To determine changes in depression and anxiety after resective surgery...

..From tape recordings of the Spring 1974 course, 10 lectures were transcribed. One of these slightly edited lectures, "Personality Changes in Temporal Lobe Epilepsy," is reproduced in this issue of Epilepsy & Behavior...

..Clinical obser-vations are consistent with these findings...

..Despite this, a clearer picture of the effects of callosotomy, as defined by clinical neurology and neuropsychology as well as cognitive neuroscience, is emerging...

..Delusions result from right hemisphere lesions. But it is the left hemisphere that is deluded...

..Yet these problems often go unrecognized and, even when identified, are often undertreated or untreated...

..Findings indicate that PIP is associated with thickening of the right anterior cingulate cortex, which may serve as a marker for patients at risk for developing PIP...

..This study explored the association between long-term epilepsy surgery outcome and changes in depressive symptoms...

..This suggests that late seizure recurrence is a more important problem in cases in which MST has been performed than for pure resections...

..Vagus nerve stimulation and epilepsy surgery for those with medically refractory epilepsy may be options after careful evaluation...

..This suggests that late seizure recurrence is a more important problem in cases in which MST has been performed than for pure resections...

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..The different patterns of naming areas identified in patients with and without HS may also carry clinical implications, potentially improving efficiency during the time-constrained process of stimulation mapping...

..49, P=0.001). Possible mechanisms linking vulnerability toward mood disorders and the development of psychotic symptoms in epilepsy are discussed...

..05). Exploratory factor analysis indicated a different pattern of associations among the 12 importance items for men and women. Whether gender differences in presurgical values are associated with outcomes needs exploration...

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..CONCLUSION: In selected patients with bilateral seizure foci involving separate lobes, aggressive bilateral surgery can be safe and effective...

..The results provide a means to evaluate long-term outcome in epilepsy patients using the ROCF...

..In pediatric patients, however, functional mapping studies frequently fail to localize language. Wada testing has also been reported to be less sensitive in children...

..CONCLUSIONS: Adult-onset IGE is associated with a good prognosis. An association may exist between psychological disorders, psychotropic medication, and level of seizure control in adults with IGE...

..The results of receiver operating curve analyses revealed little discrimination in performance between groups. The BVMT-R does not appear to have the sensitivity required for assessing nonverbal memory in this population...

..001) or recollection (P<0.001). These models reveal that patients were highly aware of their seizures, and in many cases, were able to make accurate predictions, for which seizure rate may be an important factor...

..The direct cortical application of lidocaine appears to affect local epileptogenic activity in human patients with intractable focal epilepsy...

..These changes can impair cognitive and behavioral function. Seizure control may help minimize or prevent these changes...

..CONCLUSIONS: In some cases, NES are not the product of the awake mind, but rather represent a psychiatric condition that can be manifest in sleep...

..These results suggest that when used at low concentration muscimol was the best of the five drugs for transmeningeal pharmacotherapy trials for focal neocortical epilepsy...

..This article describes three patients with TSC who underwent three-stage epilepsy surgery at our center, with the intention of examining local electrophysiological changes after each stage of the procedure...

..Ictal and postictal psychosis can be prevented with seizure control, but postictal and chronic interictal psychoses require multidisciplinary and psychopharmacologic management...

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..Auras were equally common (70%) among patients with idiopathic generalized epilepsy as they were among those with localization-related epilepsy. Presence of an aura is not a reliable indicator of localization-related epilepsy...

..Marijuana use can transiently impair short-term memory, and like alcohol use, may increase noncompliance with AEDs. Marijuana use or withdrawal could potentially trigger seizures in susceptible patients...

..Advances in diagnostic techniques are likely to improve patient selection, facilitate localization of epileptic foci and functional areas, and enable better prediction of outcomes...

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..No patients were seizure free following callosotomy or resection. No differences in postoperative outcomes were seen between patients with intracranial EEG versus those without...

..Neither age nor gender was related to cognitive status. Further investigation incorporating additional neuroimaging factors, antiepileptic treatment effects, and genetic variables, is needed...

..To determine whether epidural pentobarbital (PB) delivery can prevent and/or terminate neocortical seizures induced by locally administered acetylcholine (Ach) in freely moving rats...

..Mnemestic auras were associated with clinical indices of illness, suggesting that the presence of these auras may be regarded as a risk factor for greater chronicity and severity in epilepsy...

..These results suggest that NMDA-like, water soluble, small molecules can diffuse through the subdural/subarachnoid space into the underlying neocortex and spread in a limited fashion, close to the meningeal penetration site...

..The temporary nature of the prosopagnosia may result from postsurgical tissue injury, including focal cerebral edema, with compensation by ipsilateral or contralateral areas...

..Most previously reported patients were never charged with a crime despite uninvited physical contact in some instances. Our patient was convicted and imprisoned...

..Staged resection of pediatric brain tumors near the eloquent cortex appears safe, allows functional mapping in awake patients, and may assist in decisions between maximal tumor resection and optimal functional outcome...

..Divergent findings among prior studies on correlates of risk for postictal psychosis (PIP) suggest the value of a controlled study involving a relatively large number of patients...

..Furthermore, since TLE subjects performed normally while taking therapeutic doses of multiple AEDs, the data suggest that these AEDs do not impair visual perception...

..Further analysis indicates that FP errors during the Wada test appear to be the primary result of a stable and liberal response-bias rather than a result of any other neurological or procedure-related factor...

..To identify patients who might benefit from surgery and to maximize outcome, we used a novel surgical approach in young children that consists of invasive intracranial monitoring, which is typically 3-staged and often bilateral...

..We hypothesized that in these patients, a negative correlation would exist between diffusivity measures of the mesial temporal lobe and performance on neuropsychological tests...

..We propose that diffuse cortical inhibition led to release of subcortical structures involved in emotional expression. Possible neural substrates of laughter are discussed...

..We report a man who selectively lost emotional attachments to family members after right temporal lobectomy. However, emotional responsiveness to strangers was normal or increased...

..There were no reliable differences in OC symptoms in patients with right versus left hemisphere seizure foci, although the right hemisphere patients tended to score higher on both scales of the OCI...

..Psychoeducation may be an effective method of treating PNES and may improve coping strategies and reduce PNES-associated psychopathology in some patients. Additional controlled studies on larger samples are needed...

..025). CONCLUSIONS: Our findings suggest that right temporal resection contributes to the development of somatoform disorders in our patients and that right temporal dysfunctions may contribute to idiopathic somatoform disorders...

..Long-term follow-up will determine whether this approach has durable effects. We await better methods for identifying the epileptogenic zone, both noninvasive and invasive...

..Seizure control is important for developmental outcome and quality of life. Early behavioral assessment and therapeutic intervention, as well as seizure control, are the most effective means of promoting neurodevelopmental outcome...

..These findings may be useful in presurgical counseling of patients with mesiotemporal sclerosis who undergo intracranial SD monitoring...

..Special considerations about epilepsy care must be made in pediatric populations, those with developmental delays, women, and the elderly...

..01). Ictal multifocality, mental retardation, and discordant EEG and MRI data showed a negative trend toward outcome, but were not significant...

..Age estimates of developmental level indicated developmental progress in the majority of subjects in the current sample, and may yield greater clinical information for individuals with developmental delay than do standard scores...

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..The objective of the study described here was to determine if LEV modulates brain GABA in vivo...

..076 and 0.095, respectively (P<0.01)]. Thus, this preliminary study showed that marked differences in HPC monoamine neurochemistry occurred in NTLE patients as compared with MTLE patients...

..As depression is associated with reduced QOL in epilepsy and antiepileptic medications (AEDs) can cause depression, it is important to determine the relative roles of depression and seizure frequency in QOL in refractory epilepsy...

..02). This study supports prior studies and clinical observations that cerebral dysfunction can contribute to the pathogenesis of conversion disorder, and that nondominant hemisphere dysfunction may play a greater role...

..This study was designed to further define the electroencephalographic abnormalities seen in the Landau-Kleffner syndrome variants and the associated clinical features...

..Health-related quality of life (HRQOL) improves after resective epilepsy surgery, but data are limited to short follow-up in mostly retrospective reports, with minimal consideration of other potential factors that might influence HRQOL...

..Furthermore, we examined the impact of vagus nerve stimulation failure on the ultimate outcome following subsequent intracranial epilepsy surgery...

..Given that the tumor location corresponds with the ictal onset in the V5 area, and the semiology of her seizures, this case supports that epileptic dysfunction in V5 can cause illusions of visual motion...

..This correspondence is compatible with proposed contributions of the KC to sleep preservation and memory consolidation...

..No serious adverse events occurred; all patients receiving remacemide hydrochloride completed the study. Remacemide hydrochloride was well tolerated and showed significant therapeutic activity in this patient population...

..A clinical case photo is presented to show gingival hyperplasia, along with four tables on which common antiepileptic medications are enumerated...

..When treatment is deemed appropriate, an antiepileptic drug should be chosen after discussion with the patient and consideration of the risk-benefit profile of the available agents...

..In this study, we examine our results in children undergoing surgery for resection of tubers and associated seizure foci in rolandic and perirolandic cortex...

..The diagnosis and a discussion of the case are presented on pages 195-197...

..Therefore stratifying ictal/interictal differences may improve the specificity and localizing value of subtraction SPECT...

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..With increased soft tissue coverage, we provide improved cosmesis, increased wound durability to tampering and trauma, and a comparable infection rate with the SQ group...

..Not only did both patients' eating disorders resolve, but their moods and libidos improved...

..Our results, however, support the contention that multistage epilepsy surgery is safe, effective, and useful in a challenging and select pediatric population with extratemporal medically refractory epilepsy...

..Epilepsy surgery has not only benefited many children with TSC, but it also facilitates the understanding of epileptogenesis in TSC...

..Our purpose was to characterize cerebellar lesions in a cohort of young patients with TSC with specific interest in assessing longitudinal changes...

..In epilepsy patients, unilateral electrical activity might derange autonomic balance between both hemispheres and contribute to cardiovascular dysregulation and sudden fatalities...

..Despite a relative lack of biological insight, many key observations were made in an era mostly devoid of treatments for epilepsy...

..Thus, TLE surgery might contribute to reducing the risk of SUDEP...

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..These results imply that when heuristics use is discouraged on tasks utilizing subtle emotion transitions, deficits in the perception of anger and anger/fear blends, as well as fear, are evident with bilateral amygdala damage...

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..Rational AED strategies and promising interventions to treat or prevent drug resistance will reduce the impact on the patient...

..To examine the relationship between the degree of handedness and hemispheric language dominance in patients with epilepsy...

..Functional data were overlaid onto 3D diffusion tensor tractography, providing a unique image of the right hemisphere language recruitment...

..We review the diagnosis and treatment of NES and suggest directions for future research in these areas...

..These data support the hypothesis that some feature related to epilepsy is the cause of many behavioral events rather than the addition of a specific antiepileptic drug...

..The aim of our study was to examine seizure outcome in the largest published series of surgically treated patients with epilepsy due to a supratentorial CCM, and to define predictors for good surgical outcome...