Intractable Generalized Epilepsy: Therapeutic Approaches

Hwang, Sean; Stevens, Scott J.; Fu, Aradia; Proteasa, Simona V

doi:10.1007/s11910-019-0933-z

Cited by 22 publications

(15 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Etiologies range from structural to genetic and/or metabolic in 70% of patients (tuberous sclerosis complex, malformations of cortical development, and post-ischemic encephalomalacia). 79 Although LGS predominantly manifests with bilateral and diffuse epileptic foci, a subset may have unilateral diffuse and localized epileptic pathology. Imaging may identify this subgroup of potentially curable patients.…”

Section: Focal Lesions With Generalized or Multiregional Electroencepmentioning

confidence: 99%

Neuroimaging of Childhood Epilepsy: Focal versus Generalized Epilepsy

Assadsangabi

Öztürk

Kantamneni

et al. 2021

Journal of Pediatric Epilepsy

View full text Add to dashboard Cite

Neuroimaging plays an increasingly crucial role in delineating the pathophysiology, and guiding the evaluation, management and monitoring of epilepsy. Imaging contributes to adequately categorizing seizure/epilepsy types in complex clinical situations by demonstrating anatomical and functional changes associated with seizure activity. This article reviews the current status of multimodality neuroimaging in the pediatric population, including focal lesions which may result in focal epileptic findings, focal structural abnormalities that may manifest as generalized epileptiform discharges, and generalized epilepsy without evidence of detectable focal abnormalities.

show abstract

Section: Focal Lesions With Generalized or Multiregional Electroencepmentioning

confidence: 99%

Neuroimaging of Childhood Epilepsy: Focal versus Generalized Epilepsy

Assadsangabi

Öztürk

Kantamneni

et al. 2021

Journal of Pediatric Epilepsy

View full text Add to dashboard Cite

show abstract

“…The prevalence of DRE is around 30%, though this statistic varies widely 2 . Surgeries—including resections, lesionectomy, deep‐brain stimulation, and others—are often utilized in such cases 3,4 . Surgeries are often considered last‐resort therapeutics due to their invasiveness, risk, and cost.…”

Section: Introductionmentioning

confidence: 99%

“…2 Surgeries-including resections, lesionectomy, deep-brain stimulation, and others-are often utilized in such cases. 3,4 Surgeries are often considered last-resort therapeutics due to their invasiveness, risk, and cost. An ideal solution is novel…”

mentioning

confidence: 99%

The opioid antagonist naltrexone decreases seizure‐like activity in genetic and chemically induced epilepsy models

et al. 2021

View full text Add to dashboard Cite

Objective A significant number of epileptic patients fail to respond to available anticonvulsive medications. To find new anticonvulsive medications, we evaluated FDA‐approved drugs not known to be anticonvulsants. Using zebrafish larvae as an initial model system, we found that the opioid antagonist naltrexone exhibited an anticonvulsant effect. We validated this effect in three other epilepsy models and present naltrexone as a promising anticonvulsive candidate. Methods Candidate anticonvulsant drugs, determined by our prior transcriptomics analysis of hippocampal tissue, were evaluated in a larval zebrafish model of human Dravet syndrome (scn1Lab mutants), in wild‐type zebrafish larvae treated with the pro‐convulsant drug pentylenetetrazole (PTZ), in wild‐type C57bl/6J acute brain slices exposed to PTZ, and in wild‐type mice treated with PTZ in vivo. Abnormal locomotion was determined behaviorally in zebrafish and mice and by field potential in neocortex layer IV/V and CA1 stratum pyramidale in the hippocampus. Results The opioid antagonist naltrexone decreased abnormal locomotion in the larval zebrafish model of human Dravet syndrome (scn1Lab mutants) and wild‐type larvae treated with the pro‐convulsant drug PTZ. Naltrexone also decreased seizure‐like events in acute brain slices of wild‐type mice, and the duration and number of seizures in adult mice injected with PTZ. Significance Our data reveal that naltrexone has anticonvulsive properties and is a candidate drug for seizure treatment.

show abstract

“…8,9 The impact of childhood epilepsy pediatric patients and their families is considerable, highlighting the need for ongoing research into management strategies. 8 First-and subsequent-generation antiepileptic drugs (AEDs) are available for the management of different types of seizures in patients with epilepsy, 7,[10][11][12] and guidelines provide recommendations for treatment selection, with criteria for selection of newer second-or third-generation AEDs, which may have superior safety profiles compared to first-generation AEDs. 10,13,14 Despite available AEDs, approximately one-third of patients have inadequate seizure control, and evidence suggests rates of control in newly diagnosed epilepsy have not improved over the past 30 years.…”

Section: Introductionmentioning

confidence: 99%