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J Janszky

Publications and source records attributed to J Janszky.

59 records · Page 4Linked to original sources
PubMedDate not supplied

Failed surgery for temporal lobe epilepsy: predictors of long-term seizure-free course.

OBJECTIVES: To identify prognostic factors which predict the outcome 2 years after TLE surgery in those patients who were not seizure-free at the 6-month postoperative examination. METHODS: We included 86 postoperative TLE patients who had undergone presurgical evaluation, including video-EEG and high-resolution MRI, and who had seizures between the second and sixth postoperative months. RESULTS: 32% of patients were seizure-free in the second postoperative year. We found that normal MRI findings and secondarily generalized seizures (SGTCS) preoperatively were associated with a non-seizure-free outcome, while rare postoperative seizures and ipsilateral temporal IED with seizure-free outcome. Newly administered levetiracetam showed a significant positive effect on the postoperative outcome independent of other prognostic factors. Five of seven patients who received levetiracetam became seizure-free (p = 0.006). CONCLUSION: One-third of patients who did not become seizure-free immediately after surgery, eventually achieved long-term seizure freedom. We suggest watching for long-term seizure freedom after failed epilepsy surgery especially in patients who had rare postoperative seizures, focal MRI abnormality, ipsilateral temporal spikes, or no SGTCS preoperatively. Levetiracetam may have a positive effect on postsurgical seizures.

Adult↗
PubMedDate not supplied

Clinical features and surgical outcome of medial temporal lobe epilepsy with a history of complex febrile convulsions.

PURPOSE: Temporal lobe epilepsy (TLE) is frequently associated with hippocampal sclerosis (HS) and complex febrile convulsions (CFC). The causal relationship between TLE, HS, and CFC is unclear. There is also contradictory data whether CFC-associated TLE is a distinct epilepsy syndrome and has different surgical outcome than other medial TLEs. METHODS: We investigated 133 patients (aged 16-59 years) with HS-associated TLE. Thirty-six patients with CFC (CFC group) versus 97 patients without febrile convulsions (NFC group) were compared for clinical history, video-EEG recorded seizure semiology, and surgical outcome. RESULTS: In the CFC group the right-sided HS (67% versus 32%) occurred more frequently than in the NFC group (P<0.001). The two groups did not differ according to the clinical features, both groups share the typical symptoms and findings of the medial TLE. In the CFC group, seizure-freedom 2 years after surgery was 91%, while in the NFC group it was only 64% (P=0.023). This difference was significant even after considering the other known predictive factors for medial TLE. CONCLUSIONS: Medial TLE with CFC is not a distinct epilepsy syndrome. The surgical outcome, however, is much more favorable in these patients in comparison with medial TLE patients who had no history of febrile convulsions.

Adolescent↗
PubMedDate not supplied

Disabling erratic myoclonus during lamotrigine therapy with high serum level--report of two cases.

We present two patients with epilepsy who experienced disabling myoclonic jerks during lamotrigine treatment. Both were young males who had intractable cryptogenic generalized epilepsy since childhood. They received a lamotrigine-valproate combination resulting in an excellent improvement; however, after 2-3 years of therapy, both patients were hospitalized because of continuous disabling myoclonic jerks. The dosage of lamotrigine was the same before and at the onset of myoclonus. When the severe myoclonus started, both patients had a higher serum lamotrigine level (16.5 and 17.7 mg/L, respectively) than in previous findings. Disabling myoclonus was also present during lamotrigine monotherapy with 15 mg/L serum level. Lamotrigine may severely worsen myoclonic phenomena in generalized epilepsies, in which adverse events may be dependent on drug serum level.

Adolescent↗