Epilepsy

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Epilepsy

Diagnosis, Imaging, and Screening

NEWS:

Epilepsy is misdiagnosed in 90 000 people a year in England and Wales

Seizures Don't Always Signal Epilepsy "Not all seizures are caused by epilepsy, but psychological seizures can be hard for even trained medical professionals to distinguish from epileptic seizures, new research has found."

ARTICLES:

JOURNAL ARTICLES:

Degree of Hippocampal Atrophy Is Related to Side of Seizure Onset in Temporal Lobe Epilepsy (American Journal of Neuroradiology 2006)

Gray matter atrophy associated with duration of temporal lobe epilepsy. (Neuroimage. 2006)

Hippocampal Cell Loss in Posttraumatic Human Epilepsy (Epilepsia 2006) "Conclusions: Neocortical pathology was universally present after trauma. Neuronal loss in the hilar region was the most consistent finding in the hippocampal formation, similar to that found in the fluid-percussion model of traumatic head injury. These findings support the idea that head trauma can induce hippocampal epilepsy in humans in the absence of other known risk factors."

Hippocampal volume in childhood complex partial seizures. (Epilepsy Res. 2006) "CONCLUSIONS: These findings imply impaired development of the hippocampus, particularly the anterior hippocampus, and a differential effect of the underlying illness and on-going seizures on hippocampal development in medically controlled pediatric CPS."

How Confident Are We of the Diagnosis of Epilepsy? (Epilepsia 2006) "The accuracy of the diagnosis of epilepsy varies from a misdiagnosis rate of 5% in a prospective childhood epilepsy study in which the diagnosis was made by a panel of three experienced pediatric neurologists to at least 23% in a British population-based study, and may be even higher in everyday practice. The level of experience of the treating physician plays an important role. The EEG may be helpful but one should be reluctant to make a diagnosis of epilepsy mainly on the EEG findings without a reasonable clinical suspicion based on the history."

MRI volumetry shows increased anterior thalamic volumes in patients with absence seizures. (Epilepsy Behav. 2006) "MRI volumetry shows increased anterior thalamic volumes in patients with absence seizures. Epilepsy Behav. 2006"

New-onset temporal lobe epilepsy in children. Lesion on MRI predicts poor seizure outcome. (Neurology. 2006) "CONCLUSION: Seizures spontaneously remit in approximately one third of children with new-onset TLE. A lesion on MRI predicts intractable seizures in TLE and the potential need for epilepsy surgery."

Should We Routinely Perform Blood Tests In Children With Uncontrolled Seizures? (J Child Neurol. 2006)

Structural brain abnormalities in juvenile myoclonic epilepsy patients: volumetry and voxel-based morphometry. (orean J Radiol. 2006) "CONCLUSION: The JME patients showed complex structural abnormalities in the corpus callosum, frontal lobe and hippocampus, and also a decreased gray matter concentration of the prefrontal region, which all suggests there is an abnormal neural network in the JME brain."

The misdiagnosis of epilepsy in children admitted to a tertiary epilepsy centre with paroxysmal events (Archives of Disease in Childhood 2006) "Conclusion: The present study supports the view that misdiagnosis of epilepsy is common. The treating physician should be cautious in diagnosis, especially of staring episodes. A diagnostic re-evaluation should be undertaken in difficult cases with continuing paroxysmal events in order to avoid unnecessary drug treatment and restrictions on the child's lifestyle."

The role of FDG-PET, ictal SPECT, and MEG in the epilepsy surgery evaluation. (Epilepsy Behav. 2006)

Transient and permanent magnetic resonance imaging abnormalities after complex partial status epilepticus. (Epilepsy Behav. 2006)

Volumetric Evidence of Bilateral Damage in Unilateral Mesial Temporal Lobe Epilepsy (Epilepsia 2006) "Conclusions: MRI volumetric data show that the damage in TLE due to MTS may be more widespread and bilateral, even in patients with unilateral TLE by clinical and neurophysiological criteria. Our results are relevant to the discussion of epileptogenic mechanisms in TLE."

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