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Biomedical subjects

Antonio Gil-Nagel

Publications and source records attributed to Antonio Gil-Nagel.

6 recordsLinked to original sources
PubMed2005

Occipital lobe epilepsy secondary to ulegyria.

OBJECTIVE: To analyse clinical and therapeutic aspects of epilepsy secondary to ulegyria in adults. PATIENTS: Out of 1,020 consecutive patients studied at a tertiary care epilepsy centre, eight cases of ulegyria were identified. All patients had comprehensive clinical evaluation, neuropsychological testing, interictal EEG, and brain magnetic resonance imaging (MRI). In addition, five patients had video-EEG monitoring. Ulegyria was confirmed by histological analysis in two patients who had successful epilepsy surgery. RESULTS: All patients had a history of perinatal asphyxia. In four of them there was psychomotor developmental delay. Mean age at onset of seizures was 5.8 years (range first week to 21 years). Brain MRI demonstrated predominant involvement of occipito-parietal cortical and subcortical areas. This posterior distribution of lesions was also supported by the presence of auras with occipital and parietal semiology in six patients, and signs of visuospatial dysfunction in five. Four patients had medically refractory epilepsy and two of them had significant improvement with surgical treatment. CONCLUSIONS: In this group of adult epileptic patients with ulegyria brain MRI, ictal semiology, and neurological examination are consistent with occipital lobe epilepsy. Most patients have severe epilepsy, but in some of them epilepsy can be controlled with antiepileptic drugs, while in others surgical treatment can be effective. Brain MRI criteria of ulegyria are well established, and in two cases it was possible to confirm their diagnosis with histological analysis.

Adult↗
PubMed2003

Neurodevelopmental liabilities in epilepsy.

The epilepsies are a heterogenous group of cortical disorders characterized by recurrent excessive neuronal activity. In the pathophysiology of these disorders are included mechanisms of abnormal neuronal potential generation secondary to channelopathies, excitotoxic mechanisms secondary to imbalance in neuronal excitation and inhibition, and abnormalities of neuronal organization. In this article the mechanisms of the epilepsies are reviewed, in the setting of three examples: autosomal dominant nocturnal frontal lobe epilepsy, mesial temporal sclerosis and malformations of cortical development.

Cerebral Cortex↗
PubMed2003

Review of new antiepileptic drugs as initial therapy.

The new onset of epilepsy usually leads to initiation of treatment with antiepileptic drugs (AEDs). Selection of the appropriate drug in this clinical situation is usually based on several factors, including efficacy for the suspected epilepsy type, tolerability, acute and long-term idiosyncratic side effects, pharmacokinetic interactions, possibility of rapid titration, formulation, and expense. Over the last several years, the choices for treatment in newly diagnosed epilepsy have increased because a number of new AEDs have been approved for use in monotherapy. This article reviews randomized, controlled studies that have evaluated the use of new AEDs in monotherapy.

Anticonvulsants↗
PubMed2002

The localizing yield of sphenoidal and anterior temporal electrodes in ictal recordings: a comparison study.

PURPOSE: To compare the localizing yield of sphenoidal electrodes placed under fluoroscopic guidance (SEs) and anterior temporal electrodes (ATEs) in ictal recordings from a group of patients with seizure disorders of anterior temporal origin. METHODS: We compared ictal recordings of 156 seizures obtained with SEs and ATEs from 40 consecutive patients with seizures of anterior temporal origin. Four electroencephalographers reviewed ictal recordings independently and blind to the patients' identity, presurgical data, and inclusion of ATEs or SEs. Outcome variables included (a) number of correctly localized seizures with SE and ATE recordings by at least three raters; (b) number of ictal foci in which all seizures were localized only with SEs; and (c) number of seizures in which SEs identified the ictal onset > or =5 s earlier than ATEs. RESULTS: Interrater agreement among the four raters was significantly greater with SE than with ATE recordings (p < 0.0001). The number of seizures correctly localized was significantly greater with SEs (n = 144) than with ATEs (n = 99; p < 0.0001). All the seizures [n = 36 (23%)] originating from 14 ictal foci (29%) in 11 patients (27.5%) were localized only with SEs. Finally, the ictal onset was detected at SEs > or =5 s earlier than at ATEs in 67 (43%) seizures originating from 33 (69%) foci in 30 (75%) patients. CONCLUSIONS: SEs improve interrater agreement in the localization of seizures of anterior temporal origin, and in about one fourth of patients, SEs add ictal data not identified by ATEs.

Adolescent↗