Epilepsy surgery

Frequent severe epileptic seizures despite treatment with adequate antiepileptic medication for about 2 years means that epilepsy surgery needs to be considered. In addition there are certain disorders such as Sturge-Weber syndrome or unilateral infantile spasms where epilepsy surgery may be of benefit during infancy. The treatment of choice in children with Rasmussen syndrome type 2 currently is hemispherectomy, which need to be done as early as the diagnosis is clear. Although mental retardation per se is not a contraindication for epilepsy surgery, difficulties in co-operation and minimal psychosocial gains due to low IQ as well as progressive underlying disease may be. The preoperative consideration includes extensive examinations such as video-EEG monitoring, high-resolution MRI, positron emission tomography, and neuropsychological and psychiatric evaluation according to the generally accepted principles. (32.) The goal is to select those candidates who will benefit from epilepsy surgery. Surgical outcome varies according to the different pathologies of epileptogenic lesions. Thus, the results of surgery are better among patients with mesial temporal sclerosis, chronic encephalitides, infantile hemiplegia, focal cortical dysplasia, tuberous sclerosis, Sturge-Weber syndrome, or post-traumatic cicatrix than among patients with extratemporal focal sclerosis, polymicrogyria with or without heterotopia or hemimegalencephaly, anoxic brain damage, gliosis of obscure aetiology, or no pathology.(33) All these findings must be taken into account when selecting patients with epilepsy and mental retardation for epilepsy surgery.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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