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Related Concept Videos

Epilepsy and Seizures: Overview01:24

Epilepsy and Seizures: Overview

369
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
369
Seizures: Classification01:13

Seizures: Classification

687
Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
687
Antiepileptic Drugs: Glutamate Antagonists01:14

Antiepileptic Drugs: Glutamate Antagonists

595
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
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Antiepileptic Drugs: Sodium Channel Blockers01:08

Antiepileptic Drugs: Sodium Channel Blockers

1.1K
Antiepileptic drugs are specialized medications that prevent seizures in individuals diagnosed with epilepsy. These drugs primarily function by blocking the movement of sodium ions through channels in the neuronal membrane, inhibiting the repetitive firing of action potentials often associated with seizures.
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
1.1K
Antiepileptic Drugs: GABAergic Pathway Potentiators01:18

Antiepileptic Drugs: GABAergic Pathway Potentiators

808
γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
808
Electroconvulsive Therapy01:30

Electroconvulsive Therapy

270
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Related Experiment Video

Updated: Oct 19, 2025

Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
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Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization

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Reasons for not having epilepsy surgery.

Anthony Khoo1,2, Jane de Tisi2, Shahidul Mannan2

  • 1Department of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.

Epilepsia
|September 24, 2021
PubMed
Summary

About half of adults with drug-resistant focal epilepsy evaluated for surgery do not proceed. Key reasons include difficulty localizing the seizure source and multifocal epilepsy, impacting surgical candidacy for epilepsy treatment.

Keywords:
multidisciplinary teamoutcomepresurgical evaluationsocioeconomic deprivation

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Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients
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Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients
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Area of Science:

  • Neurology
  • Neurosurgery
  • Epileptology

Background:

  • Drug-resistant focal epilepsy affects a significant patient population.
  • Presurgical evaluation is crucial for determining surgical candidacy.
  • Many patients evaluated for epilepsy surgery do not ultimately undergo the procedure.

Purpose of the Study:

  • To determine the reasons why adults with drug-resistant focal epilepsy do not proceed with surgery after presurgical evaluation.
  • To identify predictors associated with the decision not to proceed with epilepsy surgery.

Main Methods:

  • Retrospective analysis of 617 individuals evaluated for epilepsy surgery between 2015 and 2019.
  • Comparison of characteristics between patients who did not proceed with surgery and those who underwent surgery.
  • Multivariate logistic regression to identify predictors of not proceeding with surgery.

Main Results:

  • 51% (315/617) of individuals did not proceed with surgery.
  • Common reasons included inability to localize the epileptogenic zone (n=104) and multifocal epilepsy (n=74).
  • Predictors for not proceeding with surgery included learning disability, normal MRI, extratemporal epilepsy, bilateral seizure onset, and socioeconomic deprivation.

Conclusions:

  • Approximately half of patients evaluated for epilepsy surgery do not undergo the procedure.
  • Early assessment of surgical suitability and the potential need for intracranial EEG (icEEG) can optimize presurgical evaluation referrals.
  • Understanding reasons for non-surgical candidacy is vital for patient management in drug-resistant epilepsy.