Introduction to Refractory Focal

What is/are Refractory Focal?

Refractory Focal - Our retrospective review suggests that brivaracetam is an effective therapy for refractory focal epilepsy in children older than 4 years of age. ^[1] INTRODUCTION Stereoelectroencephalography (sEEG) is a diagnostic procedure for patients with refractory focal epilepsies that is performed to localize and define the epileptogenic zone. ^[2] Case Report A 33-year-old male patient was suffering from refractory focal epilepsy since adolescence. ^[3] The included SRs enrolled patients with pediatric epilepsy, epilepsy in pregnancy, focal epilepsy, generalized epilepsy and refractory focal epilepsy. ^[4] OBJECTIVE/HYPOTHESIS We studied functional connectivity changes in several brain areas during the induction of ecstatic auras by direct electrical stimulation of the dorsal anterior insular cortex in patients with refractory focal epilepsy implanted with intracerebral electrodes (stereotactic-EEG, SEEG) in the context of their pre-surgical evaluation. ^[5] Methods: A retrospective study was conducted on 199 patients with refractory focal epilepsy who were admitted for presurgical evaluation. ^[6] In selected patients with refractory focal segmental glomuerulosclerosis (FSGS), adrenocorticotropin (ACTH) can be used to induce remission and decrease the progression of the disease. ^[7] OBJECTIVE To report the long-term seizure control and safety of open-loop electrical cortical stimulation in patients with refractory focal epilepsy of diverse etiologies. ^[8] Objective: To evaluate the safety and tolerability of adjunctive eslicarbazepine acetate (ESL) in pediatric patients (aged 4-17 years) with refractory focal seizures. ^[9] Case presentationWe present a case report of a 65-year -old man with refractory focal ‘task-specific’ dystonia. ^[10] Interictal stereotactic-EEG functional connectivity in refractory focal epilepsies Lagarde S, Roehri N, Lambert I, et al. ^[11] Burst detection procedures are demonstrated on data from continuous intracranial ambulatory EEG monitoring in a patient diagnosed with drug-refractory focal epilepsy. ^[12] We have reported alteration of consciousness resulting from electrical stimulation of the claustrum via a depth electrode in a woman with refractory focal epilepsy. ^[13] Nevertheless, surgery for epilepsy is under-used and should be considered for all patients with refractory focal epilepsy in whom two or three anti-epileptic medications have been ineffective. ^[14] BACKGROUND AND OBJECTIVE Accurate seizure onset zone (SOZ) localization is an essential step in pre-surgical assessment of patients with refractory focal epilepsy. ^[15] Four patients undergoing stereo‐electroencephalography (SEEG) for presurgical investigation of refractory focal epilepsy were enrolled. ^[16] MethodsFourteen adult patients with refractory focal epilepsy admitted for presurgical evaluation were prospectively recruited and underwent CTP scanning within 80 min of a habitual seizure. ^[17] To determine the incidence of clinically relevant arrhythmias in refractory focal epilepsy and to assess the potential of postictal arrhythmias as risk markers for sudden unexpected death in epilepsy (SUDEP). ^[18] Vigabatrin is indicated as adjunctive therapy for refractory focal seizures. ^[19] We performed two 30 minute OP-MEG recording sessions in a patient with refractory focal epilepsy and compared these with clinical scalp EEG performed earlier. ^[20] Our post hoc analysis evaluated the efficacy, safety, and tolerability of perampanel in Asian and non‐Asian populations with refractory focal seizures with or without focal to bilateral tonic‐clonic (FBTC) seizures. ^[21] SIGNIFICANCE We need higher quality studies allowing unbiased test evaluation to determine the added value and diagnostic accuracy of source imaging in the presurgical workup of refractory focal epilepsy. ^[22] Focal cortical cooling (FCC) suppresses epileptiform discharges (EDs) in patients with refractory focal cortical epilepsy. ^[23] A 37-year-old man with refractory focal epilepsy and a known focal cortical dysplasia involving motor cortex was implanted with an RNS System device after being in super refractory SE for 20 days. ^[24] Refractory focal epilepsy is a devastating disease for which there is frequently no effective treatment. ^[25] This post hoc analysis assessed the long‐term safety, tolerability, and efficacy of perampanel in Asian patients with refractory focal seizures; an additional analysis assessed the effect of perampanel on focal impaired awareness seizures (FIAS) with focal to bilateral tonic‐clonic (FBTC) seizures. ^[26] Refractory focal epilepsy is a devastating disease for which there is frequently no effective treatment. ^[27] We aimed to evaluate the effect of sleep quality on memory, executive function, and language performance in patients with refractory focal epilepsy and controlled epilepsy and compare these with healthy individuals. ^[28] Tsai et al assess the efficacy, safety, and tolerability of perampanel as adjunctive therapy in Asian patients with focal epilepsy with or without secondary generalization; Nishida et al examine its efficacy and safety in Asian patients with primary or secondarily generalized tonic– clonic seizures; and Inoue et al investigate the long‐term use of perampanel in Asian patients with refractory focal seizures or complex partial seizures with or without secondary generalization. ^[29] Epilepsy surgery is the most effective treatment option for children with refractory focal lesional epilepsy, with seizure-freedom rates exceeding 70% two years after surgery. ^[30] Hence, in this study stereo-electroencephalograph (SEEG) recordings from 10 patients with refractory focal epilepsy were collected, and recurrence plot was used to investigate the dynamical differences between different epilepsy stages as well as regions. ^[31] Use of anaesthetic drugs should be delayed for as long as possible in patients with refractory focal SE. ^[32]

temporal lobe epilepsy

Medial temporal lobe epilepsy (mTLE) is the most common refractory focal epilepsy in adults. ^[1] BACKGROUND Temporal Lobe Epilepsy (TLE) comprises the most common form of symptomatic refractory focal epilepsy in adults. ^[2] Mesial temporal lobe epilepsy (MTLE), one of the most common types of refractory focal epilepsy, has shown white matter abnormalities both within and beyond the temporal lobe. ^[3] Temporal lobe epilepsy (TLE) is a medically refractory focal epilepsy associated with structural deficits. ^[4]

year old female

We describe 4 patients with RS/SE that was aborted when dexamethasone was added to conventional AEDs: a 61-year-old female with temporal lobe epilepsy who presented with delirium, nonconvulsive status epilepticus, and oculomyoclonic status; a 56-year-old female with history of traumatic left frontal lobe hemorrhage who developed right face and hand epilepsia partialis continua followed by refractory focal clonic seizures; a 51-year-old male with history of traumatic intracranial hemorrhage who exhibited left-sided epilepsia partialis continua; and a 75-year-old female with history of breast cancer who manifested nonconvulsive status epilepticus and refractory focal clonic seizures. ^[1]

Medically Refractory Focal

Temporal lobe epilepsy (TLE), the most common form of medically refractory focal epilepsy in adults, often requires surgery to alleviate seizures. ^[1] A total of 222 adults with medically refractory focal epilepsy were selected from 256 total participants in a clinical trial of an implanted responsive neurostimulation device. ^[2] To compare the location of suspect lesions detected by computational analysis of multimodal magnetic resonance imaging data with areas of seizure onset, early propagation, and interictal epileptiform discharges (IEDs) identified with stereoelectroencephalography (SEEG) in a cohort of patients with medically refractory focal epilepsy and radiologically normal magnetic resonance imaging (MRI) scans. ^[3] A total of 222 adults with medically refractory focal epilepsy were selected from 256 total participants in a clinical trial of an implanted responsive neurostimulation device. ^[4] OBJECTIVE We evaluated the incremental cost-effectiveness of responsive neurostimulation (RNS) therapy for management of medically refractory focal onset seizures compared to pharmacotherapy alone. ^[5] During childhood, he developed medically refractory focal epilepsy from the left hemisphere, requiring epilepsy surgery at age 10. ^[6] PURPOSE Both vagal nerve stimulation (VNS) and responsive neurostimulation (RNS System) are treatment options for medically refractory focal epilepsy. ^[7] Controlled clinical trials in adults with medically refractory focal seizures treated with the RNS® system have shown that closed-loop nerve stimulation that responds to epileptic foci can reduce the frequency of disabling seizures, is well tolerated, and It is acceptable security. ^[8] Magnetoencephalography (MEG) is increasingly used for presurgical planning in people with medically refractory focal epilepsy. ^[9] BACKGROUND The responsive neurostimulation system (RNS) (NeuroPace Inc, Mountain View, California) was approved as an adjunctive therapy for medically refractory focal epilepsy. ^[10] Focal cortical dysplasias (FCD) are highly epileptogenic and are frequently associated with medically refractory focal epilepsy. ^[11] We evaluated a patient with PNH and medically refractory focal epilepsy who underwent a presurgical evaluation with stereotactically placed electroencephalographic (SEEG) depth electrodes. ^[12] Closed-loop brain-responsive neurostimulation via the RNS System is a treatment option for adults with medically refractory focal epilepsy. ^[13] Background Focal cortical dysplasias (FCDs) are highly epileptogenic and frequently associated with medically refractory focal epilepsy. ^[14] Since lacosamide was approved as an adjuvant agent for the treatment of medically refractory focal epilepsy over ten years ago, it is becoming more widely used for the treatment of idiopathic (genetic) generalized epilepsies. ^[15] Temporal lobe epilepsy (TLE) is a medically refractory focal epilepsy associated with structural deficits. ^[16] Brain‐responsive neurostimulation (RNS System, NeuroPace) is used to treat medically refractory focal epilepsy and also provides long‐term ambulatory neurophysiologic data. ^[17]

Localise Refractory Focal

Objective Stereoelectroencephalography (SEEG) is a technique for preoperative evaluation of patients with difficult-to-localise refractory focal epilepsy (DLRFE), enabling the study of deep cortical structures. ^[1] OBJECTIVE Stereoelectroencephalography (SEEG) is a technique for preoperative evaluation of patients with difficult-to-localise refractory focal epilepsy (DLRFE), enabling the study of deep cortical structures. ^[2]

refractory focal epilepsy

The proposed method was retrospectively tested on 24 CT volumes of subjects with drug-refractory focal epilepsy, presenting a large number (> 1700) of round platinum electrodes. ^[1] Methods To explore how sleep and epileptic seizures are associated, we analysed continuous intracranial electroencephalography (EEG) recordings collected from 10 patients with refractory focal epilepsy undergoing ordinary life activities between 2010 and 2012 from three clinical centres (Austin Health, The Royal Melbourne Hospital, and St Vincent's Hospital of the Melbourne University Epilepsy Group). ^[2] OBJECTIVE Subclinical seizures (SCS) are often captured during intracranial EEG monitoring of pediatric patients with refractory focal epilepsy. ^[3] Objective Stereoelectroencephalography (SEEG) is a technique for preoperative evaluation of patients with difficult-to-localise refractory focal epilepsy (DLRFE), enabling the study of deep cortical structures. ^[4] Temporal lobe epilepsy (TLE), the most common form of medically refractory focal epilepsy in adults, often requires surgery to alleviate seizures. ^[5] Our approach promises to optimise the surgical strategy for patients with complex refractory focal epilepsy. ^[6] The aim of this retrospective study was to evaluate relative metabolic and perfusion changes outside the seizure onset zone as predictors of postoperative outcome in patients with unifocal refractory focal epilepsy. ^[7] In every patient with refractory focal epilepsy presumed to be lesional, evaluation for surgery should be considered. ^[8] CONCLUSIONS These data show that bilateral frontal lobe involvement on FDG-PET, especially the medial and inferior frontal cortex, may be a common metabolic pattern associated with high SUDEP risk and SUDEP itself, in patients with refractory focal epilepsy. ^[9] In follow-up, one patient with extralimbic encephalitis recovered completely, while two patients with limbic involvement had poor outcomes with refractory focal epilepsy. ^[10] Brain mosaic mutations are a major cause of refractory focal epilepsies with cortical malformations such as focal cortical dysplasia, hemimegalencephaly, malformation of cortical development with oligodendroglial hyperplasia in epilepsy, and ganglioglioma. ^[11] Methods: We report icEEG-fMRI in eight patients with refractory focal epilepsy who had resective surgery and good postsurgical outcome. ^[12] A total of 222 adults with medically refractory focal epilepsy were selected from 256 total participants in a clinical trial of an implanted responsive neurostimulation device. ^[13] To compare the location of suspect lesions detected by computational analysis of multimodal magnetic resonance imaging data with areas of seizure onset, early propagation, and interictal epileptiform discharges (IEDs) identified with stereoelectroencephalography (SEEG) in a cohort of patients with medically refractory focal epilepsy and radiologically normal magnetic resonance imaging (MRI) scans. ^[14] Here, we measured the influence that K448 had on intracranial interictal epileptiform discharges (IEDs) in sixteen subjects undergoing intracranial monitoring for refractory focal epilepsy. ^[15] OBJECTIVE Periventricular nodular heterotopia (PVNH) is a result of disrupted neuronal migration from the ventricular system and can be a rare cause of refractory focal epilepsy. ^[16] Epilepsy surgery has proven to be very effective in treating refractory focal epilepsies in children, producing seizure freedom or partial seizure control well beyond any other medical or dietary therapies. ^[17] Methods: To explore how sleep and epileptic seizures are associated, we analysed continuous intracranial EEG recordings collected from 10 patients with refractory focal epilepsy undergoing ordinary life activities. ^[18] We studied whether interictal [18 F]GE-179 PET would detect foci of abnormal NMDAR-IC activation in patients with refractory focal epilepsy. ^[19] CONCLUSIONS This pilot study supports the safety and efficacy of multifocal, personalized, multichannel, cathodal transcranial direct current stimulation for adult and pediatric patients with medication-refractory focal epilepsy, although identifies a possibility of seizure exacerbation in some. ^[20] A total of 222 adults with medically refractory focal epilepsy were selected from 256 total participants in a clinical trial of an implanted responsive neurostimulation device. ^[21] This work highlights the advantages of resective surgery on overall brain health in patients with refractory focal epilepsy. ^[22] SIGNIFICANCE MEG beamforming may contribute to non-invasive procedures to predict surgical outcome for patients with drug-refractory focal epilepsy. ^[23] During childhood, he developed medically refractory focal epilepsy from the left hemisphere, requiring epilepsy surgery at age 10. ^[24] Patients with refractory focal epilepsy with neuronal antibodies (Abs) tend to have a worse surgical prognosis when compared to other etiologies. ^[25] We study the difference in stereoelectroencephalography electrode implantation time between a robotic trajectory guidance device (iSYS1) and manual frameless implantation (PAD) in patients with drug-refractory focal epilepsy through a single-blinded randomised control parallel-group investigation of SEEG electrode implantation, concordant with CONSORT statement. ^[26] BACKGROUND An implanted device for brain-responsive neurostimulation (RNS System) is approved as an effective treatment to reduce seizures in adults with medically-refractory focal epilepsy. ^[27] We study the difference in stereoelectroencephalography electrode implantation time between a robotic trajectory guidance device (iSYS1) and manual frameless implantation (PAD) in patients with drug-refractory focal epilepsy through a single-blinded randomised control parallel-group investigation of SEEG electrode implantation, concordant with CONSORT statement. ^[28] PURPOSE Both vagal nerve stimulation (VNS) and responsive neurostimulation (RNS System) are treatment options for medically refractory focal epilepsy. ^[29] PURPOSE Brain responsive neurostimulation (NeuroPace) treats patients with refractory focal epilepsy and provides chronic electrocorticography (ECoG). ^[30] Temporal lobe epilepsy (TLE) is the most common form of refractory focal epilepsy and is often associated with hippocampal sclerosis (HS) and cognitive disturbances. ^[31] Magnetoencephalography (MEG) is increasingly used for presurgical planning in people with medically refractory focal epilepsy. ^[32] Temporal lobe epilepsy (TLE) is a form of refractory focal epilepsy, which includes a latent period and a chronic period. ^[33] We evaluated our method on 4,000 signal segments from clinical SEEG recordings that contain both ictal and interictal data obtained from 19 patients who suffer from refractory focal epilepsy. ^[34] Refractory focal epilepsy (rFE) is commonly comorbid with impaired social functioning, which significantly reduces quality of life. ^[35] Our retrospective review suggests that brivaracetam is an effective therapy for refractory focal epilepsy in children older than 4 years of age. ^[36] INTRODUCTION Stereoelectroencephalography (sEEG) is a diagnostic procedure for patients with refractory focal epilepsies that is performed to localize and define the epileptogenic zone. ^[37] Case Report A 33-year-old male patient was suffering from refractory focal epilepsy since adolescence. ^[38] The included SRs enrolled patients with pediatric epilepsy, epilepsy in pregnancy, focal epilepsy, generalized epilepsy and refractory focal epilepsy. ^[39] OBJECTIVE/HYPOTHESIS We studied functional connectivity changes in several brain areas during the induction of ecstatic auras by direct electrical stimulation of the dorsal anterior insular cortex in patients with refractory focal epilepsy implanted with intracerebral electrodes (stereotactic-EEG, SEEG) in the context of their pre-surgical evaluation. ^[40] Methods: A retrospective study was conducted on 199 patients with refractory focal epilepsy who were admitted for presurgical evaluation. ^[41] OBJECTIVE To report the long-term seizure control and safety of open-loop electrical cortical stimulation in patients with refractory focal epilepsy of diverse etiologies. ^[42] OBJECTIVE Stereoelectroencephalography (SEEG) is a technique for preoperative evaluation of patients with difficult-to-localise refractory focal epilepsy (DLRFE), enabling the study of deep cortical structures. ^[43] BACKGROUND The responsive neurostimulation system (RNS) (NeuroPace Inc, Mountain View, California) was approved as an adjunctive therapy for medically refractory focal epilepsy. ^[44] METHODS We implemented a fast algorithm for detection of uniform interictal epileptiform discharges (IEDs) in one-hour scalp EEG recordings of 19 refractory focal epilepsy datasets (from 16 patients) who underwent a simultaneous EEG-rsfMRI recording. ^[45] Interictal stereotactic-EEG functional connectivity in refractory focal epilepsies Lagarde S, Roehri N, Lambert I, et al. ^[46] Burst detection procedures are demonstrated on data from continuous intracranial ambulatory EEG monitoring in a patient diagnosed with drug-refractory focal epilepsy. ^[47] We have reported alteration of consciousness resulting from electrical stimulation of the claustrum via a depth electrode in a woman with refractory focal epilepsy. ^[48] Nevertheless, surgery for epilepsy is under-used and should be considered for all patients with refractory focal epilepsy in whom two or three anti-epileptic medications have been ineffective. ^[49] Focal cortical dysplasias (FCD) are highly epileptogenic and are frequently associated with medically refractory focal epilepsy. ^[50]

refractory focal seizure

The aim of this retrospective cross-sectional study is to evaluate the efficacy and safety of lacosamide in childhood refractory focal seizures in our clinic. ^[1] A 4-month-old infant with TSC presented with refractory focal seizures despite receiving escalating doses of 5 antiepileptic medications. ^[2] Controlled clinical trials in adults with medically refractory focal seizures treated with the RNS® system have shown that closed-loop nerve stimulation that responds to epileptic foci can reduce the frequency of disabling seizures, is well tolerated, and It is acceptable security. ^[3] Our study evaluated a patient who developed anti-AMPA2 receptor encephalitis with memory deficits and refractory focal seizures as paroxysmal jerking on right face as well as dystonic seizure on right hand. ^[4] Objective: To evaluate the safety and tolerability of adjunctive eslicarbazepine acetate (ESL) in pediatric patients (aged 4-17 years) with refractory focal seizures. ^[5] Vigabatrin is indicated as adjunctive therapy for refractory focal seizures. ^[6] Our post hoc analysis evaluated the efficacy, safety, and tolerability of perampanel in Asian and non‐Asian populations with refractory focal seizures with or without focal to bilateral tonic‐clonic (FBTC) seizures. ^[7] This post hoc analysis assessed the long‐term safety, tolerability, and efficacy of perampanel in Asian patients with refractory focal seizures; an additional analysis assessed the effect of perampanel on focal impaired awareness seizures (FIAS) with focal to bilateral tonic‐clonic (FBTC) seizures. ^[8] Tsai et al assess the efficacy, safety, and tolerability of perampanel as adjunctive therapy in Asian patients with focal epilepsy with or without secondary generalization; Nishida et al examine its efficacy and safety in Asian patients with primary or secondarily generalized tonic– clonic seizures; and Inoue et al investigate the long‐term use of perampanel in Asian patients with refractory focal seizures or complex partial seizures with or without secondary generalization. ^[9]

refractory focal motor

Objective: Pharmacorefractory focal motor epileptic seizures pose a significant challenge. ^[1] In view of refractory focal motor status epilepticus and no improvement with acyclovir along with these neuroimaging findings. ^[2]

refractory focal onset

The principal objective of this review is to assess the efficacy of BRV as an early add-on agent in refractory Focal Onset Seizures (FOS) and its pharmacology and usage in various clinical situations associated with seizures. ^[1] OBJECTIVE We evaluated the incremental cost-effectiveness of responsive neurostimulation (RNS) therapy for management of medically refractory focal onset seizures compared to pharmacotherapy alone. ^[2]