Article
Neurosciences
Helia Hosseini, Mahan Shafie, Alia Shakiba, Hani Ghayyem, Mahsa Mayeli, Matineh Hassani, Vajiheh Aghamollaii
Summary: This study aims to investigate the characteristics of valproic acid-induced hyperammonemia (HA) and its association with the total dose, duration, and level of valproic acid. The study also explores whether the use of valproic acid in combination with other medications affects serum ammonia levels. The results show that 17% of patients receiving valproic acid treatment developed HA, with symptomatic cases occurring in 15 patients. Co-administered medications were found to be associated with valproic acid levels, and further research is recommended.
PSYCHOPHARMACOLOGY
(2023)
Article
Clinical Neurology
Konstantin L. Makridis, Sebastian Triller, Deniz A. Atalay, Christine Prager, Christian E. Elger, Angela M. Kaindl
Summary: This study describes a patient who experienced severe behavioral problems after hemispherotomy, which subsided when valproate was tapered off. The research suggests possible altered effects of valproic acid parallel to reorganizational processes after hemispherotomy.
FRONTIERS IN NEUROLOGY
(2021)
Review
Pharmacology & Pharmacy
Yiu-Ching Jennifer Wong, Julia Fan, Andrea Wan, Tamara Mihic, Michelle Gnyra
Summary: This systematic review aims to summarize the evidence available regarding valproic acid (VPA)-associated hyperammonemia, including its prevalence, clinical outcomes, and management. The study found that the prevalence of asymptomatic hyperammonemia (5%-73%) was higher than symptomatic hyperammonemia (0.7%-22.2%), and it occurred within the therapeutic range of VPA serum concentration. Various risk factors were identified, and most symptomatic patients returned to baseline mental status with normalized ammonia level after discontinuing VPA. There is currently insufficient data to support routine monitoring of ammonia level for VPA-associated hyperammonemia.
JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY
(2023)
Article
Pharmacology & Pharmacy
Paulo Teixeira-da-Silva, Jonas Samuel Perez-Blanco, Dolores Santos-Buelga, Maria Jose Otero, Maria Jose Garcia
Summary: The study aimed to explore the pharmacokinetic characteristics of valproic acid (VPA) in a large Caucasian population and establish a robust population pharmacokinetic (PopPK) model. A one-compartment model with first-order absorption and elimination successfully described the data, incorporating factors such as total body weight, age, and comedication with other drugs. Internal and external evaluations showed good predictability of the model, indicating its potential application in precision dosing approaches for clinical patient care.
Article
Clinical Neurology
Yi Li, Sarah Tymchuk, John Barry, Srikanth Muppidi, Scheherazade Le
Summary: The study found that some patients with drug-resistant focal epilepsy may have immune-mediated causes, and proposed an APES score to help identify patients for immunological evaluation in the pre-surgical assessment of refractory focal epilepsy with unknown cause.
Review
Clinical Neurology
Sara Lariviere, Andrea Bernasconi, Neda Bernasconi, Boris C. Bernhardt
Summary: Drug-resistant epilepsy significantly impacts patient health and cognition. While brain surgery is effective for many patients, increasing evidence suggests that DRE patients may also have widespread network disruptions leading to cognitive impairment and prognosis issues. Advanced neuroimaging techniques offer new insights into these network biomarkers, but further clinical studies are needed to translate these findings into actionable decisions for patient management.
Article
Clinical Neurology
Konstantin L. Makridis, Christine Prager, Anna Tietze, Deniz A. Atalay, Sebastian Triller, Christian E. Elger, Ulrich-Wilhelm Thomale, Angela M. Kaindl
Summary: In an infant at the corrected age of 1 week, hemispherotomy for drug-resistant epilepsy was successful, with no complications during the surgery and the patient has been seizure-free since discharge. Early epilepsy surgery in very young infants can be safe and effective if performed in a specialized center experienced with age-specific conditions.
FRONTIERS IN NEUROLOGY
(2021)
Article
Medicine, Research & Experimental
Xiaobu Lan, Kai Mo, Li Nong, Yi He, Yuhong Sun
Summary: The study showed that the standard-reaching rate of serum VPA-Na concentration was higher in the juvenile group compared to the adult and elderly groups, and lower in the low-dose and intermediate-dose groups compared to the high-dose group. Additionally, the standard-reaching rate of serum VPA-Na concentration was lower in patients receiving carbapenems in combination compared to those not receiving combination therapy.
MEDICAL SCIENCE MONITOR
(2021)
Article
Clinical Neurology
Xianyun Liu, Xi Peng
Summary: This article presents a case of valproate-related hyperammonemic encephalopathy (VHE) in a patient with epilepsy, showing a generalized suppression pattern on the electroencephalogram (EEG). After discontinuation of valproic acid (VPA) and phenytoin, the patient's EEG gradually returned to normal, and consciousness was fully restored.
NEUROLOGICAL SCIENCES
(2023)
Article
Veterinary Sciences
Daisuke Hasegawa, Rikako Asada, Satoshi Mizuno, Yoshihiko Yu, Yuji Hamamoto, Shinichi Kanazono
Summary: This case report documents the one-year clinical outcome of corpus callosotomy in a clinical feline case with drug-resistant epilepsy. After the surgery, the cat's mental status and ambulation improved significantly, and seizure frequency and duration were remarkably reduced, leading to improved quality of life for both the cat and the owner.
FRONTIERS IN VETERINARY SCIENCE
(2021)
Article
Pharmacology & Pharmacy
Shih-Yin Ho, Li Lin, I-Chun Chen, Che-Wen Tsai, Fang-Chia Chang, Horng-Huei Liou
Summary: The study evaluated the antiepileptic effect of the AMPA receptor antagonist perampanel (PER) on a mouse model of Dravet syndrome, showing significant therapeutic potential in reducing spontaneous recurrent seizures and improving hyperthermia-induced seizures. PER also demonstrated a synergistic effect in combination with stiripentol or valproic acid for attenuating heat-induced seizures, highlighting its potential as a treatment option for Dravet syndrome.
FRONTIERS IN PHARMACOLOGY
(2021)
Article
Clinical Neurology
Nishanth Sadashiva, Raju Kadam, Arivazhagan Arimappamagan, Malla Bhaskara Rao, Ravindranadh Chowdary Mundlamuri, Kenchaiah Raghavendra, Ajay Asranna, Lakshminarayanapuram Gopal Viswanathan, Narayanan Mariyappa, Karthik Kulanthaivelu, Sandhya Mangalore, Chandana Nagaraj, Jitender Saini, Rose Dawn Bharath, Jamuna Rajeswaran, Anita Mahadevan, Parthasarathy Satishchandra, Sanjib Sinha
Summary: This study retrospectively analyzed the clinical outcomes of 17 patients who underwent corpus callosotomy for drug resistant epilepsy with drop attacks. All patients experienced cessation of drop attacks postoperatively, with 3 patients experiencing complications. The results support the efficacy of corpus callosotomy in treating patients with drug resistant epilepsy and reducing seizure frequency.
WORLD NEUROSURGERY
(2023)
Review
Clinical Neurology
Deborah Gueryi, Sylvain Rheims
Summary: Drug resistant epilepsy (DRE) is defined as the persistence of seizures despite at least two syndrome-adapted antiseizure drugs. Patients with DRE may benefit from non-pharmacological therapies in addition to optimizing drug management. Surgery may provide long-term seizure freedom for patients with drug resistant focal epilepsy. Comprehensive care adaptations are crucial for improving quality of life in DRE patients.
NEUROPSYCHIATRIC DISEASE AND TREATMENT
(2021)
Article
Neurosciences
Rikako Asada, Satoshi Mizuno, Yoshihiko Yu, Yuji Hamamoto, Tetsuya Anazawa, Daisuke Ito, Masato Kitagawa, Daisuke Hasegawa
Summary: Corpus callosotomy (CC) is an effective palliative surgery for drug-resistant epilepsy (DRE) in human patients, but there is limited research on its use in canine patients. This case series evaluated three Cavalier King Charles Spaniels with DRE who underwent CC surgery, showing a significant decrease in seizure frequency and improvement in quality of life for both the dogs and owners postoperatively. Additional technical improvements and larger scale studies are needed to further explore the use of CC as a treatment option for DRE in veterinary medicine.
Article
Pharmacology & Pharmacy
Meng Fu, Yiqing Zhu, Junqi Zhang, Wei Wu, Yunxia Sun, Xuemei Zhang, Jie Tao, Zhiping Li
Summary: Research shows that the pathogenesis of VPA-resistant epilepsy is closely related to HIF-1 alpha and miR-221-3p. MiR-221-3p inhibits microglial activation by regulating HIF-1 alpha expression, thus alleviating epileptic seizures in VPA-resistant epilepsy.
FRONTIERS IN PHARMACOLOGY
(2021)
Review
Clinical Neurology
Kanwaljeet Garg, Bipin Chaurasia, Andrew J. Gienapp, Bruno Splavski, Kenan I. Arnautovic
Summary: This research analyzed the trends in 6 major neurosurgical journals over the past 10 years, revealing that publication numbers increased in proportion with increases in country population, literacy rate, per capita GDP, and neurosurgeon density. Meanwhile, geographical trends in neurosurgical publications showed a steady increase in most developed countries, while the publication gap between developed and developing countries remained unchanged.
WORLD NEUROSURGERY
(2022)
Review
Neurosciences
Edoardo Agosti, Simona Serioli, Kanwaljeet Garg, Alberto Pietrantoni, Pietro Luigi Poliani, Marco Maria Fontanella
Summary: This study reported a rare case of multiple vertebral metastases from anal squamous cell carcinoma (SCC) and aimed to define a treatment strategy. Through case presentation and literature review, it was found that there is currently no universally accepted treatment strategy for vertebral metastases from anal SCC. Prompt and aggressive, local and systemic, and multimodal treatment of the vertebral lesions may be crucial for improving patient outcomes.
INTERNATIONAL JOURNAL OF NEUROSCIENCE
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Pooja Jain, Ankita Aggarwal, Kanwaljeet Garg
Summary: This study evaluates and analyzes the 100 most cited articles in the field of COVID-19 imaging, revealing research trends and common characteristics of the cited works. China leads in both publication numbers and total citations, followed by the United States. The research also found that countries most affected by the pandemic early on contributed the majority of the literature.
INDIAN JOURNAL OF RADIOLOGY AND IMAGING
(2022)
Review
Clinical Neurology
Nidhisha Sadhwani, Kanwaljeet Garg, Amandeep Kumar, Deepak Agrawal, Manmohan Singh, P. Sarat Chandra, Shashank Sharad Kale
Summary: Postoperative surgical site infections (SSIs) in neurosurgery are rare but significantly impact patient outcomes. Immediate cranioplasty performed at the same time as debridement is more effective in reducing treatment failure compared to delayed cranioplasty following SSIs. Furthermore, using prosthetic material such as titanium for cranial vault reconstruction may yield better outcomes compared to using the patient's own bone.
WORLD NEUROSURGERY
(2023)
Editorial Material
Clinical Neurology
Sivaraman Kumarasamy, Kanwaljeet Garg
Summary: Reverse cortical sign is a rare entity in lumbar burst fracture where the fractured posterior wall of the vertebral body rotates 180 degrees with the cortical surface facing anteriorly and the cancellous surface facing posteriorly. Identifying this sign is crucial for treatment decisions as it is contraindicated for ligamentotaxis. With the introduction of computed tomography scans and axial and sagittal reconstruction, we can better understand and describe these rare entities. We present a case of lumbar burst fracture with reverse cortical sign, describing its appearance in axial computed tomography scans, sagittal reconstruction, and magnetic resonance imaging.
WORLD NEUROSURGERY
(2023)
Article
Clinical Neurology
Sujit A. Jagtap, Yogeshwari Deshmukh, Aniruddha Joshi, Sandeep Patil, Nilesh Kurwale, Sujit Nilegaonkar
Summary: This study aimed to investigate the association between imaging characteristics and the presence or evolution of epilepsia partialis continua (EPC) in patients with Rasmussen encephalitis (RE). The findings showed that fluid-attenuated inversion recovery (FLAIR) hyperintensity and focal cortical atrophy on MRI were the most common findings in the early course of RE. T2 and FLAIR hyperintensity in the paramedian frontal or insular cortex may precede or occur simultaneously with the onset of EPC.
EPILEPTIC DISORDERS
(2023)
Review
Clinical Neurology
Sandeep Mishra, Sabina Regmi, Kanwaljeet Garg
Summary: This meta-analysis evaluates the impact of lumbar disc herniation and lumbar spinal stenosis on axial back pain and the extent of pain improvement after lumbar decompression and discectomy surgery.
WORLD NEUROSURGERY
(2023)
Article
Clinical Neurology
Manbachan Singh Bedi, Amol Raheja, Varidh Katiyar, Shashwat Mishra, Kanwaljeet Garg, Priya Narwal, Akshay Ganeshkumar, Ravi Sharma, Vivek Tandon, Davide Milani, Franco Servadei, Ashish Suri, Shashank S. Kale
Summary: This study compared the SimSpine and EasyGO! systems for endoscopic discectomy simulation. The performance metrics were similar between the two platforms, and SimSpine was found to be a cost-effective alternative to EasyGO! for training purposes.
WORLD NEUROSURGERY
(2023)
Review
Neurosciences
Sivaraman Kumarasamy, Kanwaljeet Garg, Hitesh Kumar Gurjar, Kokkula Praneeth, Rajesh Meena, Ramesh Doddamani, Amandeep Kumar, Shashwat Mishra, Vivek Tandon, Pankaj Singh, Deepak Agrawal
Summary: Decompressive craniectomy is a common surgical procedure for treating intracranial hypertension, but it can result in severe disability and compromise quality of life. Complications can occur early or late after surgery, and timely intervention is necessary to mitigate their impact.
INDIAN JOURNAL OF NEUROTRAUMA
(2023)
Article
Clinical Neurology
Harsh Deora, Kristin L. Kraus, William T. Couldwell, Kanwaljeet Garg
Summary: This study retrospectively analyzed the citation and self-citation rates of articles published in seven major neurosurgery journals, revealing an increasing trend in self-citation rates. Academic neurosurgeons should understand the ecosystem surrounding self-citation and consider self-citation rates when evaluating the impact of an author and research productivity.
WORLD NEUROSURGERY
(2023)
Article
Surgery
Bernardo de Andrada Pereira, Kanwaljeet Garg, James Mamaril-Davis, Bipin Chaurasia, Alfredo Guiroy, Jahangir Asghar, Jay D. Turner, R. John Hurlbert
Summary: This study aimed to understand how spine surgeons learn minimally invasive spine surgery (MISS) and the impact of the COVID-19 pandemic on their educational experience of MISS. It also discussed potential solutions for increasing access to educational resources for MISS among spine surgeons. An internet survey was conducted, with participation from neurosurgical and orthopedic spine surgeons across multiple continents.
BRAZILIAN NEUROSURGERY-ARQUIVOS BRASILEIROS DE NEUROCIRURGIA
(2023)
Article
Clinical Neurology
Alfredo Conti, Marcello Magnani, Matteo Zoli, Ralf A. Kockro, Constantin Tuleasca, Simone Peschillo, Giuseppe Emmanuele Umana, Seow Wan Tew, George Jallo, Kanwaljeet Garg, Robert F. Spetzler, Jesus Lafuente, Bipin Chaurasia
Summary: Social media plays a significant role in medicine by providing a platform for sharing educational material, clinical experiences, and collaboration. This study focuses on analyzing the metrics of the largest neurosurgical group to characterize the role of social media in neurosurgery and assess its impact, flaws, and limitations.
Article
Engineering, Biomedical
T. Alif, Shubhendu Bhasin, Kanwaljeet Garg, Deepak Joshi
Summary: Functional electrical stimulation is commonly used for neurologically disabled individuals in rehabilitation due to its ability to activate paralyzed muscles. However, the nonlinearity and time-varying nature of muscles make it difficult to achieve optimal control solutions in real-time, especially for limb movement control. Previous model-based control methods have limitations in handling uncertainties and dynamic variations. This study presents a model-free adaptive control approach that can regulate knee joint movement with electrical stimulation assistance without prior knowledge of subject dynamics, and it has been validated through experiments.
IEEE TRANSACTIONS ON NEURAL SYSTEMS AND REHABILITATION ENGINEERING
(2023)
Review
Clinical Neurology
Anish Tayal, Bhavya Pahwa, Kanwaljeet Garg
Summary: The risk factors for reoperation in patients with OPLL include increased pre-operative cervical or thoracic angle, post-operative CSF leak, and graft and/or hardware failure.
NEUROSURGICAL REVIEW
(2023)
Article
Neurosciences
Shashwat Mishra, Ramesh C. Mishra, Hitesh K. Gurjar, Kanwaljeet Garg
Summary: This study retrospectively analyzed the experience of using transcranial surgery for pituitary adenomas in peripheral centers, and the results showed that it is a safe and effective option, but it had a certain mortality rate and postoperative complications.
