Eslicarbazepine acetate (ESL)

is a novel voltage-gated sodium channel-blocking agent with presumed good safety and efficacy for adjunctive treatment of patients with drug-resistant partial epilepsy. ESL is a prodrug of eslicarbazepine (the active entity responsible for MEK162 pharmacologic effects), and is rapidly and extensively hydrolyzed during first pass by liver esterases after oral administration. The half-life of eslicarbazepine at steady-state plasma concentrations is 20-24 hours, compatible with once-daily administration. ESL 800 mg and 1200 mg significantly reduces seizure frequency and shows a favorable safety profile in adult patients with drug-resistant partial-onset seizures, as demonstrated in previous Phase II and III trials. In children, ESL showed a clear dose-dependent decrease in seizure Anlotinib cell line frequency with good tolerability. The most commonly reported adverse events associated with ESL are dizziness, somnolence, nausea, diplopia, headache, vomiting, blurred vision, vertigo, and

fatigue. In conclusion, these characteristics suggest that ESL might be a valid and well tolerated treatment option for patients with drug-resistant partial-onset epilepsy. The convenience of once-daily dosing and a short, simple titration regimen would be of special interest for children, although conclusive published data are lacking to date. Hence, there is an urgent need to establish the therapeutic value of ESL in this special population in the near future.”
“Objective

In this case report, we present a novel, minimally invasive image-guided approach to drainage of a petrous apex lesion. Patient(s)

A 34-year-old man diagnosed with a petrous apex lesion consistent with cholesterol granuloma. The granuloma was large and caused mild compression of the brainstem with associated neurologic symptoms

and seizure-like activity.

Interventions

Based on the anatomic location of the lesion, it was determined that the treatment plan would be to surgically drain the lesion via 2 linear paths-one Selleck DAPT after an infralabyrinthine approach and the other a subarcuate approach. Customized microstereotactic frames that mount on bone-implanted markers and constrain the drill along the desired path were used to accurately drill these desired paths and avoid damage to surrounding critical structures. After a simple mastoidectomy, the petrous apex was successfully reached without damage to vital adjacent structures by drilling the 2 linear channels using 2 custom microstereotactic frames.

Main Outcome Measures

Viscous brown liquid and debris was recovered by irrigating through one of the channels and suctioning through the other.

Results

Drainage of the petrous apex was successfully performed via 2 linear channels without any complications. Custom microstereotactic frames were used to accurately drill those linear channels. Postoperative CT ensured no complications.