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The role of intraoperative electrocorticography (iECoG) and of its patterns in epilepsy surgery have shown contradictory results. Our aim was to describe iECoG patterns and their association with outcome in epilepsy surgery.We retrospectively analyzed 104 patients who underwent epilepsy surgery (2009-2015) with pre- and postresection iECoG. We described clinical findings, type of surgery, preresection iECoG patterns according to Palmini et al., 1995 (sporadic, continuous, burst, and recruiting interictal epileptiform discharges-IEDs) and postresection iECoG outcome (de novo, residual, and without IEDs). The Engel scale was used to evaluate the outcome. Descriptive statistics, Kaplan-Meier, the logistic regression model, and analysis of variance tests were used.We included 60.6% (63/104) females, with a mean age of 35 (±10.2) years at the time of epilepsy surgery. The etiologies were hippocampal sclerosis (63.5%), cavernomas (14.4%), cortical dysplasia (11.5%), and low-grade tumors (10.6%). The most common preresection iECoG pattern was sporadic IEDs (47%). Postresection iECoG patterns were de novo (55.7%), residual (27.8%), and without IEDs (16.3%). Mean follow-up was 19.2 months. Engel scale was as follows: Engel I (91 patients, 87.5%), Engel II (10 patients, 9.6%), and Engel III (three patients, 2.9%). Analysis by mixed-design analysis of variance showed a significant difference between etiology groups with a strong size effect (P = 0.021, η = 0.513) and also between preresection iECoG patterns (P = 0.008, η = 0.661).Preresection iECoG patterns and etiology influence Engel scale outcome in lesional epilepsy surgery.

De las diversas complicaciones de la meningoencefalitis infecciosa, el síndrome de Guillain-Barré es raro. Presentamos el caso de una mujer de 37 años de edad, quien inicio con meningoencefalitis infecciosa, a los 9 días se observó empeoramiento de la fuerza y sensibilidad de las cuatro extremidades. Con sospecha clínica y electromiografía se diagnosticó polineuropatía desmielinizante secundariamente axonal sensitiva motora de las cuatro extremidades. No se aisló un patógeno específico. El manejo integral e inmunomodulador (IgG IV 0.4g/kg/dx5d) estuvo basado en los principios establecidos para las dos situaciones neurológicas observadas en la paciente. La paciente se recuperó totalmente a los 6 meses.

Objective The study aimed to establish the prevalence of seizure history (SH) and epilepsy in a rural community in Hidalgo, Mexico and determine the patients' beliefs and attitudes towards the disease and its initial medical treatment. Methodology A transverse, descriptive, door-to-door epidemiological study (April 2011–November 2012) was conducted with 863 inhabitants from Xocotitla, Huejutla, Hidalgo, Mexico (162 housing units). Patients with SH were identified with an adaptation of the WHO protocol for epidemiological studies of neurological diseases. Afterwards, the subjects identified with seizure history (SH) or epilepsy were interviewed with a 20-question Likert type questionnaire regarding the management and belief set of their SH. The interviews were conducted in Spanish and Nahuatl. Results The prevalence of epilepsy and isolated nonrecurring seizures was 38.2/1000 and 25.4/1000, respectively. Out of the total population of 863 inhabitants, 33/863 were identified with SH: only 39.3% were able to identify an epileptic seizure as such, 48.5% sought medical attention upon the first seizure, 33.3% used a traditional healer, 15.2% took no action, 3% sought a religious representative, 85% lacked any lab analysis, and 60% received no antiepileptic drugs. Only 39% received free local medical attention, 69.7% considered seizures and epilepsy to be a consequence of divine intervention, and 94% reported some type of discrimination. Conclusions A high prevalence of epilepsy and SH was found in this rural community in Mexico. Divine/religious beliefs, discrimination, scarce access to basic health services and inadequate medical management of epilepsy and SH persist.

Background: Transcranial direct current stimulation (tDCS) has been evaluated in medication refractory epilepsy patients. The results have been inconclusive and protocols have varied between studies. Objective: To evaluate the safety and efficacy of two protocols of tDCS in adult patients with mesial temporal lobe epilepsy and hippocampal sclerosis (MTLE-HS). Methods: This is a randomized placebo-controlled, double-blinded clinical trial, with 3 arms, 3 sessions, 5 sessions and placebo stimulation. Frequency of seizures (SZs), interictal epileptiform discharges (IEDs) and adverse effects (AEs) were registered before and after treatment, and at 30 and 60 days follow-up. Descriptive statistics, k-related samples, Friedman's test, and relative risk (RR) estimation were used for analysis. Results: We included twenty-eight subjects (3d n = 12, 5d n = 8, placebo n = 8), 16/28 (57%) men, age 37.8(±10.9) years old. There was a significant reduction of the frequency of SZs at one (p = 0.001) and two (p = 0.0001) months following cathodal tDCS compared to baseline in the 3 arms (p = 0.0001). The mean reduction of SZ frequency at two months in both active groups was significantly higher than placebo (−48% vs. −6.25%, p

Introduction The cardinal sign of essential tremor (ET) and Parkinson Disease (PD) is tremor, which is part of the diagnostic criteria. But, in early stages of the disease and in atypical presentations it is difficult to evaluate the tremors, the clinical examination has an extensive variability and it has been poorly studied. Accelerometers can quantify and differentiate the tremor, but, rarely have they been used in daily living conditions. The objective was to design a supervised learning algorithm that can detect, quantify, and differentiate the movements of a portable accelerometer in ET and PD during controlled and daily living conditions. Methods A descriptive and comparative clinical study. It enrolled 30 ET and 30 PD patients. The clinical and sociodemographic variables (age, sex, HY dominant frequency and harmonic. An algorithm was designed (rate 0.1 with a 1000 trees). Inferential statistics was used, and a normalized confusion matrix was calculated, sensitivity, specificity, and accuracy. Results Performance was classified in the normalized confusion matrix which allowed the distinction of tremor from no tremor in ET (86%) and PD (71%). The mathematical tree algorithm of decisions showed in: PD sensitivity: 65.4–69.8%, specificity: 72.8–90.9% and accuracy: 71.3–85.1%. In ET sensitivity: 77.6–93.8%, specificity 80.5–96.2% and accuracy: 79.5–95.6%. Being better in ET than in PD. Conclusion The tree algorithm of decisions in accelerometers allows the detection, quantification, and differentiation of the tremors of ET and PD during daily living conditions.