BackgroundWhen glioma patients experience long-term seizure freedom the question arises whether antiepileptic drugs (AEDs) should be continued. As no prospective studies exist on seizure recurrence... Show moreBackgroundWhen glioma patients experience long-term seizure freedom the question arises whether antiepileptic drugs (AEDs) should be continued. As no prospective studies exist on seizure recurrence in glioma patients after AED withdrawal, we evaluated the decision-making process to withdraw AEDs in glioma patients, and seizure outcome after withdrawal.MethodsPatients with a histologically confirmed low grade or anaplastic glioma were included. Eligible patients were seizure free1year from the date of last antitumor treatment, or 2years since the last seizure when seizures occurred after the end of the last antitumor treatment. Patients and neuro-oncologists made a shared decision on the preferred AED treatment (i.e. AED withdrawal or continuation). Primary outcomes were: (1) outcome of the shared decision-making process and (2) rate of seizure recurrence.ResultsEighty-three patients fulfilled all eligibility criteria. However, in 12/83 (14%) patients, the neuro-oncologist had serious objections to AED withdrawal. Therefore, 71/83 (86%) patients were analyzed; In 46/71 (65%) patients it was decided to withdraw AED treatment. In the withdrawal group, 26% (12/46) had seizure recurrence during follow-up. Seven of these 12 patients (58%) had tumor progression, of which three within 3months after seizure recurrence. In the AED continuation group, 8% (2/25) of patients had seizure recurrence of which one had tumor progression.ConclusionIn 65% of patients a shared decision was made to withdraw AEDs, of which 26% had seizure recurrence. AED withdrawal should only be considered in carefully selected patients with a presumed low risk of tumor progression. Show less
In this paper I peruse a specific cinematic example of an uncertain-image, i.e.that of the film Creative Control (Dickinson 2016). My interest in this film lies not,or at least not per se, or not... Show moreIn this paper I peruse a specific cinematic example of an uncertain-image, i.e.that of the film Creative Control (Dickinson 2016). My interest in this film lies not,or at least not per se, or not solely, in its representationalism, but rather in itscapturing of various kinds of uncertainty, to which I will here attend bysituating the film against the backdrop of three different, yet interrelated,problematics related to the ubiquitous presence of digital imagingtechnologies: i.e., first, the concerns over digital or immaterial labour and theloss of eros; second, the use of contemporary cinematics (and thesuperimposition effect in particular) to address these and other issues relatedto living in ‘information-intensive mixed-reality environments;’ and third, thefilm’s own suggestive counter-image, which is that of the characters’ partlydefection, and, arguably, that of the image’s own withdrawal from the world. Show less
Dijkstra, B.A.G.; Kamal, R.; Noorden, M.S. van; Haan, H. de; Loonen, A.J.M.; Jong, C.A.J. de 2017
