CONCLUSION: Hadley type IIA odontoid fractures are inherently unstable and impede proper realignment. These fractures have a significantly increased risk for secondary loss of reduction and bony nonunion, particularly after nonoperative management. Early surgery should be considered to avoid further complications.”
“Currently, similar to 20 genetic variants are known to cause Mendelian forms of human epilepsy, leaving a vast heritability undefined. Rodent models for genetically complex epilepsy have been studied for many years, but only

recently have strong candidate genes emerged, including Cacna1 g in the GAERS rat model of absence epilepsy and Kcnj10 in HM781-36B order the low seizure threshold of DBA/2 mice. In parallel, a growing number of mouse mutations studied on multiple strain backgrounds reveal the impact of genetic selleck compound modifiers on seizure severity, incidence or form – perhaps mimicking the complexity seen in humans. The field of experimental genetics in rodents is poised to study discrete epilepsy mutations on a diverse choice of strain backgrounds to develop better models and identify modifiers. But, it must find the right balance between embracing the strain diversity available, with the ability to detect and characterize

genetic effects. Using alternative strain backgrounds when studying epilepsy many mutations will enhance the modeling of epilepsy as a complex genetic disease.”
“BACKGROUND: There is still some reluctance to refer pediatric patients for epilepsy surgery, despite evidence of success in retrospective series.

OBJECTIVE: To describe surgical experience and long-term outcome in pediatric temporal lobe epilepsy (TLE) at a single institution.

METHODS: Retrospective review of pediatric (<18-years-old) TLE patients who underwent surgery between November 1996 and December 2006 at Cleveland Clinic Epilepsy Center. Cox proportional hazard modeling was used to assess outcome predictors.

RESULTS: One hundred thirty pediatric patients met study criteria. Mean

time between seizure onset and surgery was 6.3 years. Invasive evaluation was used in 32 patients (24.5%). Hippocampal sclerosis was present in 70 patients (53.8%), either alone or associated in dual pathology. The complication rate was 7%. The seizure-freedom rates at 1, 2, 5, and 12 years were 76%, 72%, 54%, and 41%, respectively (Kaplan-Meier). With the use of the Engel outcome classification, 98 (75.3%) patients were class I, 11 (8.5%) class II, 9 (7%) class III, and 12 (9.2%) were class IV at last follow-up. Only 4 (3.1%) patients underwent reoperations. Antiepileptic drugs (AEDs) were discontinued in 36 patients (28.3%) in a mean period of 18 months (SD +/- 17 months; range, 6-102 months).