A B S T R A C TPurpose: To investigate the very long-term (i.e., ≥15 years) seizure, cognitive and psycho-social outcomes in resected patients (RP) with TLE compared to control patients not having undergone epilepsy surgery. Methods: We applied a multiple case-study design including three non-resected patients (NRP) who were compared to a group of six RP. The latter were matched to the NRP according to clinical-demographic data. Outcome measures were various seizure, cognitive, and psycho-social variables. Results: Patients were 56-72 years old. Seizure and AED outcome was more favourable among RP. RP reported better self-perceived overall health but higher subjective memory complaints. Upon formal neuropsychological testing, RP presented with lower verbal memory scores. Very long-term memory decline was evident in left-sided RP with good baseline memory scores, while RP with lower baseline performance, right-sided RP and NRP remained stable. Seizure-freedom had remarkable effects on the relationship between objective and subjective outcome: seizure-free patients, in general, subjectively reported the best psychosocial and cognitive outcomeirrespective of neuropsychological test results. Conclusion: Our study suggests positive effects of TLE surgery in the very long-term course of ≥15 years postoperatively. Long-term seizure-freedom appears to have the strongest impact on patients' subjectively perceived psycho-social and cognitive outcome and may even outweigh actual memory disturbances and/or decline. Overall, our data do not support the assumption of a generally accelerated cognitive decline in patients with TLE.
Knowledge on the effects of gabapentin (GBP) in learning disabled patients is limited. The objective of this study was to assess antiepileptic efficacy and tolerability of GBP in routine therapy. A retrospective open observational study design was applied. Twenty-nine consecutive residential patients with simple and/or complex partial seizures with or without secondary generalization and with different degrees of learning disability were included. All patients had severe therapy-resistant epilepsy. GBP was administered as add-on therapy. Dosages were progressively increased up to 1600-2400 mg/day (in a number of cases up to 4800 mg/day), in accordance with clinical requirements. The seizure frequency was recorded and compared between a baseline and a treatment period (after 3 months of titration) of 3 months duration each. Only three patients (10.3%) had a reduction of their seizure frequency by 50% or more. No patient became seizure-free. Unwanted side effects, mostly mild and dose-dependent, occurred in 37.9% of all patients. Somnolence and ataxia were the most frequently observed unwanted effects. In two cases hyperphagia/weight increase, and in two other cases edema occurred.We conclude the efficacy of GBP in learning disabled patients with highly therapy-resistant partial seizures is limited.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.