Epilepsy is one of the most common chronic neurological conditions in children and adults. The lifetime risk of developing epilepsy is 3.2%. In this review article we suggest how to apply a safety protocol for the surgical treatment of antiepileptic drugs resistant patients. We review who the ideal candidate for a pre-surgical evaluation is and when to do it; how to do it, using clinical, physiological, imaging and neuro-cognitive biomarkers in order to achieve medical benefit from epilepsy surgery; why patients should go and receive a surgical evaluation. Finally we review the current concepts of drug resistant epilepsy and the surgical intervention benefit/risk relationship.
electroencephalogram
Cirugía de Epilepsia en Ecuador 2010.
Alteraciones electroencefalográficas en niños con cardiopatías congénitas severas.
Introduction and objectives: Congenital cardiopathies (CC) are among the most common birth defects. Delays of neurodevelopment are among the most frequently observed diseases in school-age children presenting CC. The main objective of this study was to determine the possible impact of severe CC on central nervous system (CNS) development as determined after EEG recording.
Methods: Thirty children of ages between 15 days and 12 years presenting severe CC with hemodynamic consequences and/or chronic hypoxia were studied (21 acyanogenic and 19 cyanogenic). Conventional EEGs were performed on all cases.
Results: In the whole sample we found abnormal EEGs in 43.3% of cases, these mostly showing immature basal activity (slow for the age), and focal and multifocal paroxysmal activity characterised by sharp waves and spikes/slow waves complexes. Abnormal EEG activity was determined in 42.8% of non-cyanogenic CC and 44.4% of cyanogenic CC.
Conclusions: A high percentage of children carrying severe CC showed epiletiform EEG activity. It is possible that in afflicted children resulting from haemodynamic disturbances present from foetal stages onwards, these would favour the development of ectopic growth of grey matter leading to epileptiform activity.
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Epilepsia Parcial Benigna Atípica de la Infancia: Presentación de un Caso Peculiar y Revisión de la Bibliografía.
Introduction: Atypical benign partial epilepsy of childhood is a rare form of epilepsy characterized by a combination of partial seizures, as observed in Partial Benign Epilepsy of Childhood, as well as with centre-temporal paroxysms and generalized seizures; showing furthermore, a continuos peak wake electroencephalographic pattern characteristic of NREM sleep.
Clinical Case: Patient presenting with partial seizures is admitted to the hospital with EEG findings compatible with continuos peak wave electric status of NREM sleep.
