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Article: Levetiracetam in porphyric status epilepticus: a case report.

Zaatreh, Megdad M

2005 Volume 28, Issue 5, Page(s) 243–244

Abstract: Status epilepticus in patients with acute intermittent porphyria (AIP) are difficult to treat. In this report the author describes a patient with AIP and status epilepticus who was successfully treated with a combination of intravenous magnesium and ... ...

Abstract	Status epilepticus in patients with acute intermittent porphyria (AIP) are difficult to treat. In this report the author describes a patient with AIP and status epilepticus who was successfully treated with a combination of intravenous magnesium and levetiracetam. This case and the limited experience reported in the literature show that it is probably safe to administer levetiracetam in patients with AIP; however, its role in the treatment of status epilepticus deserves further evaluation.
MeSH term(s)	Anticonvulsants/therapeutic use ; Humans ; Injections, Intravenous ; Levetiracetam ; Magnesium/administration & dosage ; Magnesium/therapeutic use ; Male ; Middle Aged ; Piracetam/analogs & derivatives ; Piracetam/therapeutic use ; Porphyria, Acute Intermittent/complications ; Status Epilepticus/drug therapy ; Status Epilepticus/etiology
Chemical Substances	Anticonvulsants ; Levetiracetam (44YRR34555) ; Magnesium (I38ZP9992A) ; Piracetam (ZH516LNZ10)
Language	English
Publishing date	2005-09-12
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	199293-4
ISSN	1537-162X ; 0362-5664
ISSN (online)	1537-162X
ISSN	0362-5664
DOI	10.1097/01.wnf.0000185828.80561.ad
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Article: Anticonvulsant-induced dyskinesia.

Zaatreh, Megdad M

Expert opinion on drug safety

2003 Volume 2, Issue 4, Page(s) 385–393

Abstract: Anticonvulsant-induced dyskinesia (AID) is an underdiagnosed side effect of many anticonvulsants that may take place during initial or chronic treatment at normal or toxic drug levels. The occurrence of AID subjects the patient to another medical ... ...

Abstract	Anticonvulsant-induced dyskinesia (AID) is an underdiagnosed side effect of many anticonvulsants that may take place during initial or chronic treatment at normal or toxic drug levels. The occurrence of AID subjects the patient to another medical condition and may prompt an extensive work-up. Similarities with other drug-induced dyskinesias and some animal studies suggest that dopaminergic dysfunction in the basal ganglia is pivotal in the occurrence of dyskinesia. Clinical presentation and outcomes are variable; however, in most cases, dyskinesias respond well to anticonvulsant withdrawal. Enhancing the awareness of AID is important in light of the recent development of many new anticonvulsants and their wider clinical use.
MeSH term(s)	Anticonvulsants/adverse effects ; Dyskinesia, Drug-Induced/diagnosis ; Dyskinesia, Drug-Induced/etiology ; Humans ; Risk Factors
Chemical Substances	Anticonvulsants
Language	English
Publishing date	2003-07-22
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2088728-0
ISSN	1744-764X ; 1474-0338
ISSN (online)	1744-764X
ISSN	1474-0338
DOI	10.1517/14740338.2.4.385
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Article ; Online: Images in clinical medicine. Disseminated central nervous system nocardiosis.

Zaatreh, Megdad / Alabulkarim, Wael

The New England journal of medicine

2006 Volume 354, Issue 26, Page(s) 2802

MeSH term(s)	Central Nervous System Bacterial Infections/pathology ; Humans ; Immunocompromised Host ; Kidney Transplantation ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nocardia Infections/pathology ; Nocardia asteroides/isolation & purification
Language	English
Publishing date	2006-06-29
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMicm990952
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Article: Spontaneous intracranial hypotension.

Zaatreh, Megdad / Finkel, Alan

Southern medical journal

2002 Volume 95, Issue 11, Page(s) 1342–1346

Abstract: Spontaneous intracranial hypotension (SIH) is an increasingly recognized syndrome. Postural headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Delay in diagnosing this condition may subject patients to ... ...

Abstract	Spontaneous intracranial hypotension (SIH) is an increasingly recognized syndrome. Postural headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Delay in diagnosing this condition may subject patients to unnecessary procedures and prolong morbidity. We describe a patient with SIH and outline the important clinical and radiographic features of this syndrome. Headache due to SIH is similar to headache occurring after lumbar puncture. Patients with postural headaches should have brain MRI before lumbar puncture. Meningeal abnormalities with typical clinical features are helpful in establishing the diagnosis. When correctly diagnosed, SIH management, in most cases, is easy and highly effective.
MeSH term(s)	Adult ; Female ; Headache/etiology ; Humans ; Intracranial Hypotension/complications ; Intracranial Hypotension/diagnosis ; Intracranial Hypotension/therapy ; Magnetic Resonance Imaging ; Posture ; Spinal Puncture
Language	English
Publishing date	2002-11
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
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Ua VI Zs.117: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Temporal lobe tumoral epilepsy: characteristics and predictors of surgical outcome.

Zaatreh, Megdad M / Firlik, Katrina S / Spencer, Dennis D / Spencer, Susan S

Neurology

2003 Volume 61, Issue 5, Page(s) 636–641

Abstract: Objective: To review the clinical and neurophysiologic features and surgical outcome in patients with intractable temporal lobe tumoral epilepsy.: Methods: Patients with intractable temporal lobe epilepsy who underwent resection of temporal lobe ... ...

Abstract	Objective: To review the clinical and neurophysiologic features and surgical outcome in patients with intractable temporal lobe tumoral epilepsy. Methods: Patients with intractable temporal lobe epilepsy who underwent resection of temporal lobe tumors, confirmed by surgical pathology, seen between 1985 and 2000 at Yale University School of Medicine Epilepsy Center, were selected. Medical records were reviewed for age at diagnosis, age at onset of seizures, delay between seizure onset and tumor diagnosis, types and frequencies of seizures, EEG results, use of anticonvulsants, extent of surgery, and pathologic diagnosis. Results: Sixty-eight patients were identified, 94.1% of them with low-grade tumors. Complex partial seizure was the most common seizure type. All patients underwent at least one surgical procedure with average follow-up of 9 years after surgical intervention. Eighty-seven percent of patients had significant postoperative seizure improvement (Engel's classes I and II). Gross total tumor resection predicted postoperative seizure freedom (p = 0.002), whereas patients with early surgical intervention, auras, and simple partial seizures had a tendency toward better seizure outcome. Conclusions: Long-term follow-up of patients with intractable temporal lobe tumoral epilepsy suggests good response of seizures to surgery, which is unrelated to age at diagnosis, EEG, or pathology. Extent of tumor resection was significantly predictive of outcome, whereas early intervention and presence of simple partial seizures showed trends as predictive factors.
MeSH term(s)	Adolescent ; Adult ; Anticonvulsants/therapeutic use ; Brain Neoplasms/complications ; Brain Neoplasms/pathology ; Brain Neoplasms/surgery ; Child ; Electroencephalography ; Epilepsy, Temporal Lobe/diagnosis ; Epilepsy, Temporal Lobe/etiology ; Epilepsy, Temporal Lobe/surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Risk Factors ; Temporal Lobe/surgery ; Treatment Outcome
Chemical Substances	Anticonvulsants
Language	English
Publishing date	2003-04-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	207147-2
ISSN	1526-632X ; 0028-3878
ISSN (online)	1526-632X
ISSN	0028-3878
DOI	10.1212/01.wnl.0000079374.78589.1b
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Article: Heart rate variability during interictal epileptiform discharges.

Zaatreh, Megdad M / Quint, Stephen R / Tennison, Michael B / D'Cruz, O'Neill / Vaughn, Bradley B

Epilepsy research

2003 Volume 54, Issue 2-3, Page(s) 85–90

Abstract: Rationale: Seizures may produce a variety of autonomic alterations. These alterations may occur due to evoked autonomic reflexes or as a direct cortical effect on autonomic control. In animal studies, lock step phenomena of interictal discharges to ... ...

Abstract	Rationale: Seizures may produce a variety of autonomic alterations. These alterations may occur due to evoked autonomic reflexes or as a direct cortical effect on autonomic control. In animal studies, lock step phenomena of interictal discharges to autonomic output have been repeatedly documented. However, the association of interictal discharges and autonomic output is not as well established in humans. Methods: RR intervals timely locked to interictal epileptiform discharge (RR(n)) were compared to RR intervals immediately following (RR(n+1)) interictal discharges in 40 patients with focal onset epilepsy and low baseline heart beat variability. Results: In 20 patients with 200 left sided interictal epileptiform discharges, RR(n) shortened in 100 and prolonged in 31 when compared to RR(n+1) intervals. While in 20 patients with 200 right sided interictal epileptiform discharges RR(n) intervals shortened in 17 and prolonged in 116 (Chi square P<0.001). No consistent differences in RR(n) intervals variability between frontal versus temporal localization of the interictal discharges from the same side was found. Conclusions: Interictal discharges, may influence autonomic control over the cardiac cycle and agree with animal studies. Further study of the relationship of interictal discharges to autonomic output is needed to delineate the potential lateralized influences over autonomic nervous system.
MeSH term(s)	Adolescent ; Adult ; Chi-Square Distribution ; Child ; Child, Preschool ; Electroencephalography/statistics & numerical data ; Epilepsy/physiopathology ; Female ; Heart Rate/physiology ; Humans ; Male ; Middle Aged
Language	English
Publishing date	2003-04-28
Publishing country	Netherlands
Document type	Comparative Study ; Journal Article
ZDB-ID	632939-1
ISSN	1872-6844 ; 0920-1211
ISSN (online)	1872-6844
ISSN	0920-1211
DOI	10.1016/s0920-1211(03)00059-7
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Zs.A 2193: Show issues

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Article: Hypothalamic hamartomas: seven cases and review of the literature.

Nguyen, Dang / Singh, Sanjay / Zaatreh, Megdad / Novotny, Edward / Levy, Susan / Testa, Francine / Spencer, Susan S

Epilepsy & behavior : E&B

2003 Volume 4, Issue 3, Page(s) 246–258

Abstract: Hypothalamic hamartomas constitute rare developmental lesions associated with gelastic epilepsy and/or precocious puberty (PP). We elected to review cases encountered at our center (7 patients) and the existing literature (277 patients) to obtain a ... ...

Abstract	Hypothalamic hamartomas constitute rare developmental lesions associated with gelastic epilepsy and/or precocious puberty (PP). We elected to review cases encountered at our center (7 patients) and the existing literature (277 patients) to obtain a better understanding of the clinical aspects, pathogenesis, and treatment of this entity. Evidence suggests that gelastic seizures are due to intrinsic epileptogenicity. The cause of the subsequent development of other seizure types, cognitive decline, and diffuse spike-and-wave pattern remains unresolved and is addressed. Anticonvulsants often fail to control seizures and different surgical options are available. Available evidence suggests that a resection through a subtemporal approach is best for lesions that are pedunculated or with a significant prepontine component, while a transcallosal approach is more appropriate for sessile lesions with an intraventricular component. Gamma knife surgery may be especially useful for small sessile lesions, failed partial resections, or patients not appropriate or refusing open surgery.
MeSH term(s)	Adolescent ; Adult ; Anticonvulsants/therapeutic use ; Brain Diseases/complications ; Brain Diseases/diagnosis ; Brain Diseases/surgery ; Cognition Disorders/diagnosis ; Cognition Disorders/etiology ; Electroencephalography ; Epilepsies, Partial/drug therapy ; Epilepsies, Partial/etiology ; Female ; Growth Hormone-Releasing Hormone/therapeutic use ; Hamartoma/complications ; Hamartoma/diagnosis ; Hamartoma/surgery ; Humans ; Hypothalamus/metabolism ; Hypothalamus/pathology ; Hypothalamus/surgery ; Magnetic Resonance Imaging ; Male ; Neurosurgical Procedures ; Puberty, Precocious/drug therapy ; Puberty, Precocious/etiology ; Radiosurgery/instrumentation ; Tomography, Emission-Computed
Chemical Substances	Anticonvulsants ; Growth Hormone-Releasing Hormone (9034-39-3)
Language	English
Publishing date	2003-04-15
Publishing country	United States
Document type	Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/s1525-5050(03)00086-6
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Article: Morphometric and neuropsychologic studies in children with arachnoid cysts.

Zaatreh, Megdad M / Bates, Elizabeth R / Hooper, Stephen R / Palmer, Glen / Elmenshawi, Ebrahim E / Courvoisie, Helen E / Greenwood, Robert S

Pediatric neurology

2002 Volume 26, Issue 2, Page(s) 134–138

Abstract: Temporal lobe arachnoid cysts are common findings during brain imaging. Debate exists regarding whether they result from temporal lobe agenesis or are a malformation of the arachnoid matter. We measured temporal lobe volumes in five children with left ... ...

Abstract	Temporal lobe arachnoid cysts are common findings during brain imaging. Debate exists regarding whether they result from temporal lobe agenesis or are a malformation of the arachnoid matter. We measured temporal lobe volumes in five children with left middle cranial fossa arachnoid cysts using morphometric analysis of magnetic resonance imaging scans. Three patients had neuropsychologic testing, and two patients had positron emission tomography scanning. All patients had significantly smaller left temporal lobes compared with the right side. On neuropsychologic testing two patients had cognitive deficits suggestive of left temporal lobe dysfunction. Temporal lobes adjacent to arachnoid cysts are smaller and less metabolically active when compared with the temporal regions on the opposite side. Patients with middle cranial fossa arachnoid cysts should undergo careful assessment of temporal lobe structure and function before any therapeutic intervention.
MeSH term(s)	Adolescent ; Arachnoid Cysts/congenital ; Arachnoid Cysts/diagnosis ; Cephalometry ; Child ; Child, Preschool ; Dominance, Cerebral/physiology ; Female ; Humans ; Intelligence/physiology ; Magnetic Resonance Imaging ; Male ; Neuropsychological Tests ; Temporal Lobe/abnormalities ; Temporal Lobe/pathology ; Tomography, Emission-Computed
Language	English
Publishing date	2002-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	639164-3
ISSN	1873-5150 ; 0887-8994
ISSN (online)	1873-5150
ISSN	0887-8994
DOI	10.1016/s0887-8994(01)00379-4
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Article: Frontal lobe tumoral epilepsy: clinical, neurophysiologic features and predictors of surgical outcome.

Zaatreh, Megdad M / Spencer, Dennis D / Thompson, James L / Blumenfeld, Hal / Novotny, Edward J / Mattson, Richard H / Spencer, Susan S

Epilepsia

2002 Volume 43, Issue 7, Page(s) 727–733

Abstract: Purpose: To review the clinical, neurophysiologic features and surgical outcomes in patients with frontal lobe tumors and chronic intractable seizures.: Methods: Medical records of patients with intractable epilepsy who underwent resection or ... ...

Abstract	Purpose: To review the clinical, neurophysiologic features and surgical outcomes in patients with frontal lobe tumors and chronic intractable seizures. Methods: Medical records of patients with intractable epilepsy who underwent resection or stereotactic biopsy of frontal lobe tumor (confirmed by surgical pathology) seen between 1985 and 1999 at Yale University School of Medicine Epilepsy Center were reviewed for age at diagnosis, age at onset of seizures, delay between seizure onset and tumor diagnosis, types and frequencies of seizures, EEG results, use of anticonvulsants, extent of surgery, pathological diagnosis, and tumor recurrence. Results: Thirty-seven patients were included. Mean age at seizure onset was 31.6 years, and at tumor diagnosis was 36.2 years. Mean duration between onset of seizures and tumor diagnosis was 6.1 years. Seventeen patients had auras. Seizure frequency averaged 7.6 seizures per week, with 58% of patients having more than one seizure type. All patients used anticonvulsants, with 90% eventually using polytherapy. All patients eventually underwent at least one surgical procedure. Only 13 (35.1%) patients were class I. Twelve (32.4%) patients were class II, seven (18.9%) class III, and five (13.5%) class IV. No statistically significant differences were seen between good and poor long-term seizure outcome in relation to specific tumor pathology, seizure types, or type of resection. Conclusions: Long-term surgical outcomes in tumoral frontal lobe epilepsy are more favorable than those in nontumoral intractable frontal lobe epilepsy (65% class I or II) and less favorable than those in other tumoral epilepsy (overall, 70% class I). Frontal location of intracranial neoplasm may predict a less favorable long-term epilepsy prognosis than tumoral epilepsy in general, an observation for which several explanations are proposed.
MeSH term(s)	Adolescent ; Adult ; Aged ; Brain Neoplasms/physiopathology ; Brain Neoplasms/surgery ; Child ; Child, Preschool ; Electroencephalography/statistics & numerical data ; Epilepsy, Frontal Lobe/diagnosis ; Epilepsy, Frontal Lobe/physiopathology ; Epilepsy, Frontal Lobe/surgery ; Female ; Frontal Lobe/physiopathology ; Frontal Lobe/surgery ; Humans ; Magnetic Resonance Imaging/statistics & numerical data ; Male ; Middle Aged ; Monitoring, Physiologic/statistics & numerical data ; Treatment Outcome
Language	English
Publishing date	2002-07
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1046/j.1528-1157.2002.39501.x
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Article: Levetiracetam efficacy in refractory partial-onset seizures, especially after failed epilepsy surgery.

Motamedi, Mahmood / Nguyen, Dang K / Zaatreh, Megdad / Singh, Sanjay P / Westerveld, Michael / Thompson, James L / Mattson, Richard / Blumenfeld, Hal / Novotny, Edward / Spencer, Susan S

Epilepsia

2002 Volume 44, Issue 2, Page(s) 211–214

Abstract: Purpose: We conducted a retrospective study to evaluate the efficacy of levetiracetam as adjunctive therapy in patients with localization-related epilepsy, and specifically in the subset of patients for whom epilepsy surgery failed.: Methods: Eighty- ... ...

Abstract	Purpose: We conducted a retrospective study to evaluate the efficacy of levetiracetam as adjunctive therapy in patients with localization-related epilepsy, and specifically in the subset of patients for whom epilepsy surgery failed. Methods: Eighty-two patients with uncontrolled partial-onset seizures treated with levetiracetam were identified; epilepsy surgery had failed for 21 (25.6%; group I), and 61 (74.4%) had no prior surgery (group II). Group I and group II patients were comparable in age (mean, 40.7 vs. 41.5 years) and age at seizure onset (mean, 14.4 vs. 18.2 years). Patients who had >/=50% reduction in seizure frequency were considered responders; the remaining patients were considered nonresponders. Results: In patients (group I) for whom surgery had failed, responder rate was 76.1% (16 of 21), including 10 (47.6%) patients who became seizure free. In nonsurgical patients (group II), responder rate was 34.3% (21 of 61), including nine (14.7%) patients who became seizure free. In group I, 11 (91.6%) of 12 temporal resection patients were responders, of whom eight were seizure free; of the remaining nine operated (extratemporal) patients, five (55.5%) were responders, and two were seizure free. In three responders, all in group I, a severe, delayed psychotic syndrome developed 4 to 9 months after levetiracetam introduction, leading to its discontinuation. Conclusions: These findings suggest that adjunctive levetiracetam therapy should be considered early after failed epilepsy surgery, especially after temporal resection, and may have implications for its use before surgical intervention. Patients should be under close psychiatric observation in this clinical setting.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anticonvulsants/administration & dosage ; Anticonvulsants/adverse effects ; Combined Modality Therapy ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drug Therapy, Combination ; Electroencephalography/drug effects ; Epilepsies, Partial/drug therapy ; Epilepsies, Partial/surgery ; Female ; Humans ; Levetiracetam ; Male ; Middle Aged ; Piracetam/administration & dosage ; Piracetam/adverse effects ; Piracetam/analogs & derivatives ; Postoperative Complications/drug therapy ; Postoperative Complications/surgery ; Retrospective Studies ; Treatment Failure ; Treatment Outcome
Chemical Substances	Anticonvulsants ; Levetiracetam (44YRR34555) ; Piracetam (ZH516LNZ10)
Language	English
Publishing date	2002-09-04
Publishing country	United States
Document type	Evaluation Studies ; Journal Article
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1046/j.1528-1157.2003.26302.x
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