Clinical Neuroscience

[Congress calendar]

SEPTEMBER 23, 2011

Clinical Neuroscience - 2011;64(09-10)

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Clinical Neuroscience

[New antiepileptic drugs, and therapeutic considerations]

SZUPERA Zoltán

[Epilepsy is not a singular disease, but a variety of disorders. It is affects up to 0.5% of the population. Over the past decade, the researchers have been made great advances in the field of epilepsy. These have been accompanied by the licensing of a great number of antiepileptic drugs. However, despite these efforts, up to 15-20% of patients have refractory epilepsy. The novel antiepileptic drugs must suit several requirements: higher efficacy, especially in resistant cases, better tolerability, and improved pharmacokinetic properties. Recently, three new drugs have been introduced for the medication. The retigabine is a carbamic derivate, and the anticonvulsive properties are largely due to its ability to prolong the opening of neuronal voltage-gated potassium Kv7.2 and Kv7.3 channels. The lacosamide is a functionalized amino acid, and selectively enhances voltage-gated sodium channel slow inactivation. The eslicarbazepine acetate is a new member of the dibenzazepine family, and blocks the fast inactivated voltage-gated sodium channel. All three of them differ from the foregoing agents in several important ways, including new mechanism of action (retigabine, lacosamide), or pharmacokinetics (eslicarbazepine acetate). These novel anticonvulsants appears to be a safe and effective addition to the armamentarium for the treatment of patients with refractory epilepsy. However, it must take some new approaches into consideration, in the therapeutic algorithm.]

Clinical Neuroscience

[Magnetic resonance measuring and analitic methods in epilepsy]

BARSI Péter

[Neuroradiology and magnetic resonance imaging (MRI) as its leading tool play a basic role in the diagnostics of epilepsy. The result of the MRI examination is of utmost importance in patients with therapy resistent focal epilepsy possibly requiring neurosurgical intervention. Based on the continuously developing MRI techniques, we can use an optimal imaging protocol. Cerebral structures can be evaluated on a microanatomical level on high-resolution images with thin slices. The three-dimensional (3D) sequence has high spatial resolution, properly distinguishes cerebral grey and white matter, provides the possibility of surface rendering and volumetry, as well as an anatomical basis for other methods like tractography, functional MRI and neuronavigation. Diffusion weighted and diffusion tensor imaging (DWI, DTI) and tractography has an important role in differential diagnostics and tractography visualizes the main white matter tracts and their relation with brain pathologies. MR perfusion (MRP) provides help in differential diagnostics and may have a future role in the determination of the epileptogenic focus in multifocal pathologies. MR spectroscopy (MRS) is important in differential diagnostics, lateralization of focal epilepsy and in the confirmation of hippocampal sclerosis. Several of these methods need special hardware, software and expertise, but the basic MRI protocol for epilepsy can be implemented in all modern MR scanners of middle or high field strength.]

Clinical Neuroscience

[Neuropsychological methods and trends in epilepsy management]

BORBÉLY Csaba

[Neuropsychological assessment makes its own valuable contribution to diagnosis in epilepsy, and the integration of those findings with the data from multiple sources provides the most comprehensive picture for a given epilepsy patient. The objective of this paper is to define and summarize the role and methods of neuropsychological assessment, and to present recommendations on themes for future clinical research in the neuropsychology of epilepsy.]

Clinical Neuroscience

[The methodology and objectives of registrating high frequency oscillation in epilepsy]

CLEMENS Zsófia

[Technological advances in digital EEG allowed the recording the full frequency band of the EEG. Activity beyond the traditional 0.3-70 Hz band reflects both physiological and pathological processes. High frequency activity recorded from the epileptic brain has been related to both epileptogenicity and epileptogenesis. The article reviews research avenues, clinical applications, and the methodology of detecting and quantifying high frequency activity.]

Clinical Neuroscience

[New generation antiepileptic drugs: what do they offer in terms of improved tolerability and safety?]

BIHARI Katalin

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