Jafar Mehvari-Habibabadi; Reza Basiratnia; Houshang Moein; Mohammad Zare; Majid Barakatain; Yahya Aghakhani; Nasim Tabrizi
Volume 16, Issue 4 , October 2017, , Pages 185-191
Abstract
Background: To investigate ictal onset patterns (IOP) in scalp electroencephalography (EEG) of patients with temporal lobe epilepsy (TLE) and their prognostic effect on the postoperative outcome.Methods: We conducted a retrospective cohort study between 2011 and 2015 in our referral Epilepsy Surgery ...
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Background: To investigate ictal onset patterns (IOP) in scalp electroencephalography (EEG) of patients with temporal lobe epilepsy (TLE) and their prognostic effect on the postoperative outcome.Methods: We conducted a retrospective cohort study between 2011 and 2015 in our referral Epilepsy Surgery Center enrolling adult patients with refractory TLE and a visible epileptogenic lesion in magnetic resonance imaging (MRI), who underwent epilepsy surgery. Demographic, clinical and MRI findings were collected and ictal findings during video-EEG monitoring were reviewed in detail. The correlation between preoperative findings and the postsurgical outcome was analyzed.Results: We reviewed 303 seizures in 93 patients. Rhythmic theta and rhythmic spike/sharp and wave were respectively the most common initial ictal pattern and late significant discharges. Engel class I outcome was observed in 88.2% of patients. Female sex, aura, the absence of secondary generalization, rhythmic theta as initial ictal pattern and concordance of ictal-interictal EEG findings were correlated with favorable 1-year postsurgical outcome.Conclusion: Preoperative clinical and EEG findings can provide valuable information regarding postsurgical prognosis in TLE patients.
Mohammad Zare; Ali Asghar Okhovat; Ahmad Esmaillzadeh; Jafar Mehvari; Mohammad Reza Najafi; Mohammad Saadatnia
Volume 16, Issue 2 , April 2017, , Pages 72-77
Abstract
Background: The usefulness of the modified Atkins diet (mAD) in refractory epilepsy in adults has been rarely investigated. We aimed to evaluate the efficacy of mAD in adult with refractory epilepsy.
Methods: In a controlled randomized clinical trial, we enrolled 66 refractory adult epileptic cases ...
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Background: The usefulness of the modified Atkins diet (mAD) in refractory epilepsy in adults has been rarely investigated. We aimed to evaluate the efficacy of mAD in adult with refractory epilepsy.
Methods: In a controlled randomized clinical trial, we enrolled 66 refractory adult epileptic cases from February 2010 to December 2012. The patients were randomly divided into two groups, case groups (22 patients) used antiepileptic drugs and mAD and control group (32 patients) only use antiepileptic drugs. The primary outcome was at least 50% decrement in seizure frequency after 2 months of therapy.
Results: No significant difference was shown in our data between groups regarding baseline characteristic. The differences of mean seizure attack after 2 months (P < 0.001). 6 (17.6%) had > 50% seizure decrease at 1 and after 2 months and 12 (35.3%) had 50% decrease in seizure frequency. Furthermore, in mAD group, the mean urinary ketone positivity was 1.75 ± 0.28 and increasing liver enzyme was shown 5 cases (14.7%) in mAD group and 5 cases (15.6%) in control group (P < 0.050).
Conclusion: The mAD may be effective as a cotherapy treatment for adults with refractory epilepsy and decrease 2.19 times seizure frequency in comparison with control groups. Trials with the more tolerant dietary regime, with larger sample size and longer duration, should be performed in future.
