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Management Of Drug-resistant Epilepsy
Drug-resistant epilepsy (DRE), also known as refractory epilepsy or pharmacoresistant epilepsy, is diagnosed when there failure of adequate trials of two tolerated and appropriately chosen and used antiepileptic drugs (AEDs) (whether as monotherapies or in combination) to achieve sustained seizure freedom. The probability that the next medication will achieve seizure freedom drops with every failed AED. For example, after two failed AEDs, the probability that the third will achieve seizure freedom is around 4%. Drug-resistant epilepsy is commonly diagnosed after several years of uncontrolled seizures, however, in most cases, it is evident much earlier. Approximately 30% of people with epilepsy have a drug-resistant form. When 2 AED regimens have failed to produce sustained seizure-freedom, it is important to initiate other treatments to control seizures. Next to indirect consequences like injuries from falls, accidents, drowning and impairment in daily life, seizure control is cri ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Antiepileptic Drug
Anticonvulsants (also known as antiepileptic drugs or recently as antiseizure drugs) are a diverse group of pharmacological agents used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used in the treatment of bipolar disorder and borderline personality disorder, since many seem to act as mood stabilizers, and for the treatment of neuropathic pain. Anticonvulsants suppress the excessive rapid firing of neurons during seizures. Anticonvulsants also prevent the spread of the seizure within the brain. Conventional antiepileptic drugs may block sodium channels or enhance γ-aminobutyric acid ( GABA) function. Several antiepileptic drugs have multiple or uncertain mechanisms of action. Next to the voltage-gated sodium channels and components of the GABA system, their targets include GABAA receptors, the GAT-1 GABA transporter, and GABA transaminase. Additional targets include voltage-gated calcium channels, SV2A, and α2δ. By blocking sodium or calc ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Vagus Nerve
The vagus nerve, also known as the tenth cranial nerve, cranial nerve X, or simply CN X, is a cranial nerve that interfaces with the parasympathetic control of the heart, lungs, and digestive tract. It comprises two nerves—the left and right vagus nerves—but they are typically referred to collectively as a single subsystem. The vagus is the longest nerve of the autonomic nervous system in the human body and comprises both sensory and motor fibers. The sensory fibers originate from neurons of the nodose ganglion, whereas the motor fibers come from neurons of the dorsal motor nucleus of the vagus and the nucleus ambiguus. The vagus was also historically called the pneumogastric nerve. Structure Upon leaving the medulla oblongata between the olive and the inferior cerebellar peduncle, the vagus nerve extends through the jugular foramen, then passes into the carotid sheath between the internal carotid artery and the internal jugular vein down to the neck, chest, and abdom ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Transcutaneous Vagus Nerve Stimulation
Vagus nerve stimulation (VNS) is a medical treatment that involves delivering electrical impulses to the vagus nerve. It is used as an add-on treatment for certain types of intractable epilepsy and treatment-resistant depression. Medical use VNS devices are used to treat drug-resistant epilepsy and treatment-resistant major depressive disorder (TR-MDD). In the United States, VNS is approved as adjunctive therapy for those 4 years of age or older with refractory focal onset seizures. In the European Union, VNS is approved as an adjunctive therapy for patients with either generalized or focal onset seizures without any age restrictions. It is recommended that VNS is only pursued following an adequate trial of at least 2 appropriately chosen anti-seizure medications and that the patient is ineligible for epilepsy surgery. This is because epilepsy surgery is associated with a higher probability of resulting in seizure freedom. Patients who have poor adherence or tolerance of anti ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Responsive Neurostimulation Device
Responsive neurostimulation device is a medical device that senses changes in a person's body and uses neurostimulation to respond in the treatment of disease. The FDA has approved devices for use in the United States in the treatment of epileptic seizures and chronic pain conditions. Devices are being studied for use in the treatment of essential tremor, Parkinson's disease, Tourette's syndrome, depression, obesity, and post-traumatic stress disorder. Medical Uses Epilepsy The use of neurostimulation to treat epileptic seizures is only recommended in those who have failed multiple medications for the treatment of their seizures. The NeuroPace RNS system was approved for use by the FDA in 2013 and is the only medical device for epilepsy that uses responsive neurostimulation. The device is surgically implanted into the patient's head with electrical leads placed near the site in the brain that is believed to be the origin of the patient's seizures. These leads record electri ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Anterior Nuclei Of The Thalamus
The anterior nuclei of thalamus (or anterior nuclear group) are a collection of nuclei at the rostral end of the dorsal thalamus. They comprise the anteromedial, anterodorsal, and anteroventral nuclei. Inputs and outputs The anterior nuclei receive afferents from the mammillary bodies via the mammillothalamic tract and from the subiculum via the fornix. In turn, they project to the cingulate gyrus. The anterior nuclei of the thalamus display functions pertaining to memory. Persons displaying lesions in the anterior thalamus, preventing input from the pathway involving the hippocampus, mammillary bodies and the MTT, display forms of amnesia, supporting the anterior thalamus's involvement in episodic memory. However, although the hypothalamus projects to both the mammillary bodies and the anterior nuclei of the thalamus, the anterior nuclei receive input from hippocampal cells deep to the pyramidal cells projecting to the mammillary bodies. These nuclei are considered to be asso ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Deep Brain Stimulation
Deep brain stimulation (DBS) is a neurosurgical procedure involving the placement of a medical device called a neurostimulator, which sends electrical impulses, through implanted electrodes, to specific targets in the brain (the brain nucleus) for the treatment of movement disorders, including Parkinson's disease, essential tremor, dystonia, and other conditions such as obsessive-compulsive disorder (OCD) and epilepsy. While its underlying principles and mechanisms are not fully understood, DBS directly changes brain activity in a controlled manner. DBS has been approved by the Food and Drug Administration as a treatment for essential tremor and Parkinson's disease (PD) since 1997. DBS was approved for dystonia in 2003, obsessive–compulsive disorder (OCD) in 2009, and epilepsy in 2018. DBS has been studied in clinical trials as a potential treatment for chronic pain for various affective disorders, including major depression. It is one of few neurosurgical procedures that ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Atkins Diet
The Atkins diet is a low-carbohydrate fad diet devised by Robert Atkins in the 1970s, marketed with claims that carbohydrate restriction is crucial to weight loss and that the diet offered "a high calorie way to stay thin forever". The diet became popular in the early 2000s, with Atkins' book becoming one of the top 50 best-selling books in history, and as many as 1 in 11 North American adults claiming to be following it. Atkins died in 2003 and in 2005 Atkins Nutritionals, Inc. filed for bankruptcy following substantial financial losses. There is no good evidence of the diet's effectiveness in achieving durable weight loss; it is unbalanced as it promotes unlimited consumption of protein and saturated fat, and it may increase the risk of heart disease.Longe, Jacqueline L. (2008). ''The Gale Encyclopedia of Diets: A Guide to Health and Nutrition''. The Gale Group. pp. 84-87. [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medium-chain Triglyceride
Medium-chain triglycerides (MCTs) are triglycerides with two or three fatty acids having an aliphatic tail of 6–12 carbon atoms, i.e. medium-chain fatty acids (MCFAs). Rich food sources for commercial extraction of MCTs include palm kernel oil and coconut oil. Sources of MCTs MCTs are found in palm kernel oil and coconut oil and can be separated by fractionation. They can also be produced by interesterification. Retail MCT powder is MCT oil embedded in starch and thus contains carbohydrates in addition to fats. It is manufactured by spray drying. List of MCFAs With regard to MCFAs, apart from the above listed straight chain (unbranched chain) fatty acids, side chain (branched chain) fatty acids also exist. Applications Calorie restriction A 2020 systematic review and meta-analysis by ''Critical Reviews in Food Science and Nutrition'' supported evidence that MCT decreases subsequent energy intake, but does not appear to affect appetite. Dietary relevance Molecular w ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Carbohydrate
In organic chemistry, a carbohydrate () is a biomolecule consisting of carbon (C), hydrogen (H) and oxygen (O) atoms, usually with a hydrogen–oxygen atom ratio of 2:1 (as in water) and thus with the empirical formula (where ''m'' may or may not be different from ''n''), which does not mean the H has covalent bonds with O (for example with , H has a covalent bond with C but not with O). However, not all carbohydrates conform to this precise stoichiometric definition (e.g., uronic acids, deoxy-sugars such as fucose), nor are all chemicals that do conform to this definition automatically classified as carbohydrates (e.g. formaldehyde and acetic acid). The term is most common in biochemistry, where it is a synonym of saccharide (), a group that includes sugars, starch, and cellulose. The saccharides are divided into four chemical groups: monosaccharides, disaccharides, oligosaccharides, and polysaccharides. Monosaccharides and disaccharides, the smallest (lower molecular wei ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Ketogenic Diet
The ketogenic diet is a high- fat, adequate-protein, low-carbohydrate dietary therapy that in conventional medicine is used mainly to treat hard-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally carbohydrates in food are converted into glucose, which is then transported around the body and is important in fueling brain function. However, if only a little carbohydrate remains in the diet, the liver converts fat into fatty acids and ketone bodies, the latter passing into the brain and replacing glucose as an energy source. An elevated level of ketone bodies in the blood (a state called ketosis) eventually lowers the frequency of epileptic seizures. Around half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists after discontinuing the diet. Some evidence shows that adults with epilepsy may benefit from the d ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Low-carbohydrate Diet
Low-carbohydrate diets restrict carbohydrate consumption relative to the average diet. Foods high in carbohydrates (e.g., sugar, bread, pasta) are limited, and replaced with foods containing a higher percentage of fat and protein (e.g., meat, poultry, fish, shellfish, eggs, cheese, nuts, and seeds), as well as low carbohydrate foods (e.g. spinach, kale, chard, collards, and other fibrous vegetables). There is a lack of standardization of how much carbohydrate low-carbohydrate diets must have, and this has complicated research. One definition, from the American Academy of Family Physicians, specifies low-carbohydrate diets as having less than 20% of calories from carbohydrates. There is no good evidence that low-carbohydrate dieting confers any particular health benefits apart from weight loss, where low-carbohydrate diets achieve outcomes similar to other diets, as weight loss is mainly determined by calorie restriction and adherence. An extreme form of low-carbohydrate d ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Tachycardia
Tachycardia, also called tachyarrhythmia, is a heart rate that exceeds the normal resting rate. In general, a resting heart rate over 100 beats per minute is accepted as tachycardia in adults. Heart rates above the resting rate may be normal (such as with exercise) or abnormal (such as with electrical problems within the heart). Complications Tachycardia can lead to fainting. When the rate of blood flow becomes too rapid, or fast blood flow passes on damaged endothelium, it increases the friction within vessels resulting in turbulence and other disturbances. According to the Virchow's triad, this is one of the three conditions that can lead to thrombosis (i.e., blood clots within vessels). Causes Some causes of tachycardia include: * Adrenergic storm * Anaemia * Anxiety * Atrial fibrillation * Atrial flutter * Atrial tachycardia * Atrioventricular reentrant tachycardia * AV nodal reentrant tachycardia * Brugada syndrome * Circulatory shock and its various causes ( obstr ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
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