Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/10971
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dc.contributor.authorBadawy, Radwa A Ben
dc.contributor.authorMacdonell, Richard A Len
dc.contributor.authorBerkovic, Samuel Fen
dc.contributor.authorNewton, Mark Ren
dc.contributor.authorJackson, Graeme Den
dc.date.accessioned2015-05-16T00:32:57Z
dc.date.available2015-05-16T00:32:57Z
dc.date.issued2010-01-01en
dc.identifier.citationAnnals of Neurology; 67(1): 64-73en
dc.identifier.govdoc20186859en
dc.identifier.otherPUBMEDen
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/10971en
dc.description.abstractApproximately 30% of patients with newly diagnosed epilepsy do not respond to antiepileptic drugs (AEDs), but this is not predictable. We used transcranial magnetic stimulation to determine the effect of AEDs on cortical excitability in patients with epilepsy and correlated this with a successful response to treatment.Ninety-nine drug-naïve patients with newly diagnosed epilepsy (55 idiopathic generalized epilepsy, 44 focal epilepsy) were evaluated. Motor threshold and cortical excitability on recovery curve analysis were measured before and 4 to 16 weeks after starting medication. After 1 year of treatment, 43 of 55 idiopathic generalized epilepsy and 26 of 44 focal epilepsy patients were seizure free.A decrease in cortical excitability occurred in the seizure-free group as indicated by an increase in motor threshold (p < 0.05) and intracortical inhibition on recovery curve analysis, maximum at the 250-millisecond interstimulus interval (p < 0.01) compared with pretreatment values. These changes were not present in the group with ongoing seizures.Seizure freedom is marked by a reduction in transcranial magnetic stimulation measures of cortical excitability, evident shortly after beginning therapy. This virtual normalization of cortical excitability occurred regardless of the seizure characteristics or AED used. Failure to show this response to AED treatment may be valuable as an early predictor of pharmacoresistance in individual patients.en
dc.language.isoenen
dc.subject.otherAdolescenten
dc.subject.otherAdulten
dc.subject.otherAgeden
dc.subject.otherAnticonvulsants.therapeutic useen
dc.subject.otherBrain.drug effects.physiopathologyen
dc.subject.otherCohort Studiesen
dc.subject.otherEpilepsies, Partial.diagnosis.drug therapy.physiopathologyen
dc.subject.otherEpilepsy, Generalized.diagnosis.drug therapy.physiopathologyen
dc.subject.otherEvoked Potentials, Motor.drug effectsen
dc.subject.otherFemaleen
dc.subject.otherFollow-Up Studiesen
dc.subject.otherFunctional Lateralityen
dc.subject.otherHumansen
dc.subject.otherMaleen
dc.subject.otherMiddle Ageden
dc.subject.otherSeizures.diagnosis.drug therapy.physiopathologyen
dc.subject.otherTime Factorsen
dc.subject.otherTranscranial Magnetic Stimulation.methodsen
dc.subject.otherTreatment Outcomeen
dc.subject.otherYoung Adulten
dc.titlePredicting seizure control: cortical excitability and antiepileptic medication.en
dc.typeJournal Articleen
dc.identifier.journaltitleAnnals of Neurologyen
dc.identifier.affiliationDepartment of Neurology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.doi10.1002/ana.21806en
dc.description.pages64-73en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/20186859en
dc.type.austinJournal Articleen
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.grantfulltextnone-
item.openairetypeJournal Article-
item.languageiso639-1en-
item.fulltextNo Fulltext-
crisitem.author.deptNeurology-
crisitem.author.deptEpilepsy Research Centre-
crisitem.author.deptNeurology-
crisitem.author.deptNeurology-
crisitem.author.deptThe Florey Institute of Neuroscience and Mental Health-
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