Summary: Purpose: To present the results of transcallosal surgical resection hypothalamic hamartoma (HH) in 26 patients with refractory epilepsy a prospective outcome study. Methods: Patients symptomatic to HH were referred for their (mean age, 10.0 years; range, 2.1–24.2 years). A transcallosal, interforniceal approach was used remove and/or disconnect hamartoma. Volumetry obtained on pre‐ and postoperative brain MRI scans determine percentage resection. Outcome assessment included...

<h3>Objective:</h3> To evaluate efficacy and safety of clobazam, a 1,5-benzodiazepine, as adjunctive therapy for Lennox-Gastaut syndrome (LGS). <h3>Methods:</h3> Patients aged 2–60 years were randomized to placebo or clobazam 0.25, 0.5, 1.0 mg/kg/day. Study consisted 4-week baseline, 3-week titration, 12-week maintenance phases, followed by 2- taper continuation in an open-label extension. Primary endpoint was percentage decrease mean weekly drop seizure rates during vs baseline phases...

This randomized, double-blind, dose-ranging study evaluated safety and efficacy of clobazam (CLB) as adjunctive therapy for drop seizures in patients with Lennox-Gastaut syndrome (LGS).Sixty-eight LGS aged 2-26 years were administered CLB (low dose = target 0.25 mg/kg/day; high 1.0 mg/kg/day). The consisted 4-week baseline, 3-week titration, maintenance periods, followed by a taper or continuation an open-label study. Seizure frequency was recorded diary the parent/caregiver throughout...

Hypothalamic hamartomas (HHs) are rare developmental tumors that cause seizures or pituitary axis dysfunction, usually beginning in childhood. We analyzed HH tissue from 57 patients whose were resected through recently developed transcallosal interforniceal and transventricular endoscopic surgical approaches. All cases composed of abnormally distributed but cytologically normal neurons glia, including fibrillary astrocytes oligodendrocytes. Neuronal elements predominated most cases, a...

The authors present outcomes obtained in patients who underwent Gamma Knife surgery (GKS) at 1 institution as part of a multimodal treatment refractory epilepsy caused by hypothalamic hamartomas (HHs).Between 2003 and 2010, 19 with HH GKS. Eight had follow-up for less than year, patient was lost to follow-up. 10 remaining (mean age 15.1 years, range 5.7-29.3 years) mean 43 months (range 18-81 months) are the focus this report. Five undergone total 6 prior surgeries: transcallosal resection...

Levetiracetam, one of the newer-generation antiepilepsy drugs, is not currently approved for use in children. Given its favorable efficacy, pharmacokinetic, and, particularly, safety profile adults, we felt that it may be a useful drug children with refractory epilepsy. We treated 39 patients (mean age 8.6 years) open-label levetiracetam up to 9 months. Seizure frequency, dosages, adverse events, and neurologic examinations were documented at baseline routine follow-up visits. as add-on...

Lacosamide is a new antiepileptic drug that currently approved by the US Food and Drug Administration (FDA) for adults 17 years or older partial-onset seizures. The authors reviewed 21 pediatric patients (<17 years) with various seizure types who were started on oral lacosamide as part of prospective add-on study adjunctive therapy refractory epilepsy. Five excluded due to less than 3 months meaningful follow-up. Maintenance dosages used ranged from 2.4 19.4 mg/kg/d. Eight 16 (50%) had...

Summary Objective To determine long‐term safety and efficacy of adjunctive clobazam for patients with L ennox‐ G astaut syndrome ( LGS ). Methods Eligible from two randomized controlled trials (Phase II OV ‐1002 Phase III ‐1012) were able to enroll in open‐label extension OLE ) study ‐1004 beginning December 2005 received until they discontinued (mandatory at 2 years outside the U nited S tates) or completion March 2012. P atients United States could have 6 before it became commercially...

Respiratory syncytial virus is an extremely common cause of childhood respiratory infections resulting in significant morbidity and mortality. Although apnea a well-known complication young infants with bronchiolitis, the encephalopathy associated this infection not well recognized. Our study reveals incidence 1.8% total 487 patients bronchiolitis studied over period almost 4 years. Seizures were presenting complication. Based on our cohort children we believe that neurologic complications,...

Hypothalamic hamartomas (HHs) are a malformation of the ventral hypothalamus and tuber cinereum, associated with gelastic seizures epilepsy. We sought to determine spectrum electroencephalography (EEG) abnormalities in large cohort HH patients.Data was collected for patients undergoing evaluation between 2003 2007. Data included seizure history, prior treatment, results diagnostic studies. After informed consent, data were entered into database.We reviewed 133 patients. Mean age at time...

Object The authors provide evidence that direct resection of hypothalamic hamartomas (HHs) can improve associated gelastic and nongelastic seizures. Methods Ten children younger than 17 years age underwent HHs (nine sessile one pedunculated) were causing refractory epilepsy. Lesions approached from above transventricularly through a transcallosal anterior interforniceal approach in six cases, endoscopically the foramen Monro one, below with frontotemporal craniotomy including an...

Summary: A 7‐year‐old boy with left hemiparesis secondary to right hemispheric cortical dysplasia was admitted the hospital increasing numbers of seizures. Magnetic resonance imaging showed a small dysplastic hemisphere abnormally thickened gyri and an apparently normal hemisphere. Previous video‐electroencephalogram (EEG) monitoring bilateral independent spikes generalized slow spike‐and‐wave episodes on EEG [ 18 F]fluorodeoxyglucose (FDG) positron emission tomography scan demonstrated...

In 2006, intravenous levetiracetam received US Food and Drug Administration (FDA) approval for adjunctive treatment of partial onset seizures in adults with epilepsy, 16 years or older. We have established the safety, tolerability, dosage children. This prospective study included 30 children (6 months to &lt;15 age). Patients were administered a single dose (50 mg/kg, maximal 2500 mg) over 15 minutes. A blood level was performed 10 minutes after infusion. The treated children’s average age...

In an ongoing open-label extension (OV-1004), patients with Lennox-Gastaut syndrome who had completed 1 of 2 randomized controlled trials (OV-1002 [Phase II] or OV-1012 III]) are receiving clobazam at dosages ≤2.0 mg/kg/day (≤80 mg/day). Of 306 eligible from OV-1002 OV-1012, 267 entered the extension. As interim date, July 1, 2010, 213 (79.8%) remained in trial, and 189 received for ≥12 months, 128 ≥18 94 ≥24 months. Median percentage decreases average weekly rates drop seizures were 71.1%...