Innovations In Clinical Neuroscience

Current Trends in Epilepsy 2015

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

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Advancing epilepsy genetics in the genomic era. M yers CT, Mefford HC. Genome Med. 2015;7(1):91. Summary: In this review, the authors discuss gene discovery in epilepsy, as facilitated by genomic technologies, and highlight several novel genes and potential therapies. * PMID: 26302787 EPILEPSY IN CHILDREN Longitudinal trajectories of behavior problems and social competence in children with new onset epilepsy. Zhao Q, Rathouz PJ, Jones JE, et al. Dev Med Child Neurol. 2015 Jan;57(1):37–44. Summary: Here, the investigators sought to characterize the prospective trajectory of parent-reported behavior and social competence problems in children with new or recent onset epilepsy from diagnosis to 5 to 6 years after diagnosis compared to healthy control participants. The authors found that behavior and competence problems in children with idiopathic generalized (IGE) or localization- related epilepsies (LRE) are not characterized by progressive worsening over a 5- to 6-year period. Behavioral problems are present near the time of diagnosis and tend to abate over time, with competence problems being more persistent across serial assessments, and present in both LRE and IGE groups. * PMID: 25040537 Social cognition in children with epilepsy in mainstream education. Lew AR, Lewis C, Lunn J, et al. Dev Med Child Neurol. 2015 Jan;57(1):53–9. Summary: In this cross-sectional study, the authors sought to establish whether deficits in social cognition are present in children with generalized or focal epilepsy in mainstream education, and whether any relation exists b etween social cognition, communication, and behaviour measures. Children with an epilepsy-only diagnoses in mainstream education or focal epilepsy were compared to control participants on Strange Stories task and the Mind in the Eyes task, as well as an IQ assessment. Parents completed the Children's Communication Checklist-2 and the Child Behavior Checklist (CBCL). The authors found that both groups of children with epilepsy performed more poorly than control children on the Mental Stories component of the Strange Stories task. Performance on Mental Stories was related to pragmatic communication, but only in the generalized epilepsy group. There were no differences between epilepsy groups or control participants in the Mind in the Eyes task. Authors concluded that children with "epilepsy only" are at risk of deficits in social cognition and may require appropriate support. * PMID: 25330820 SURGERY AND EPILEPSY The prognosis of refractory epilepsy patients rejected from epilepsy surgery. Gonen OM1, Gandelman-Marton R, Kipervasser S, Neufeld MY. Acta Neurol Scand. 2015;131(1):58–62. Summary: In this retrospective study, the authors compared the outcomes and characteristics of non- operated patients who continued on medical therapy alone with those who underwent vagus nerve stimulator (VNS) implantation in addition to medical therapy. Fifty-two patients who continued solely on medical therapy and 35 patients who additionally underwent VNS implantation were included in the study. Forty-seven of the former and 33 of the latter agreed to be interviewed. There was a significant improvement in the seizure frequency between the time of the p resurgical evaluation and the time of the interview in both groups. Eight medically treated patients (17%) and two patients who also underwent VNS implantation (6%) reported being seizure-free during the preceding three months. The authors concluded that a considerable minority of patients with refractory epilepsy who were rejected or chose not to undergo epilepsy surgery may improve over time and even become seizure-free following adjustment of anti-epileptic drugs with or without concomitant VNS. * PMID: 25273688 Effectiveness of cognitive rehabilitation following epilepsy surgery: current state of knowledge Mazur-Mosiewicz A, Carlson HL, Hartwick C, et al. Epilepsia. 2015;56(5):735–44. Summary: Ihe authors appraise existing evidence regarding cognitive rehabilitation (CR) approaches in patients undergoing resective epilepsy surgery (ES) and review effectiveness of specific CR strategies. Only four citations met inclusion criteria. CR may contribute to improvements in aspects of verbal memory, with particular benefit of visual imagery techniques. CR aimed at verbal memory functions may be less effective for patients with hemispheric-dominant resections, and figural memory may not be improved by CR. CR may improve functional and life outcomes, but its timing does not appear to influence its effectiveness. The authors conclude that CR interventions are overwhelmingly under researched or underreported, and there is a need for a systematic evaluation of CR in this patient population. CR should be given greater attention after ES to determine its efficacy and role in the management of these patients. * PMID: 25809562 JOURNAL WATCH 14 Current Trends in Epilepsy Management [December 2015]

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