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Jesse Elliott, Deirdre DeJean, Tammy Clifford, Doug Coyle, Beth K Potter, Becky Skidmore, Christine Alexander, Alexander E Repetski, Vijay Shukla, Bláthnaid McCoy, George A Wells
OBJECTIVE: To assess the benefits and harms of cannabis-based products for pediatric epilepsy. METHODS: We identified in this living systematic review randomized controlled trials (RCTs) and nonrandomized studies (NRSs) involving children with epilepsy treated with cannabis-based products. We searched MEDLINE, Embase, PsycINFO, Cochrane Library, and gray literature (April 25, 2018). The primary outcome was seizure freedom; secondary outcomes were seizure frequency (total, ≥50% reduction), quality of life, sleep, status epilepticus, death, gastrointestinal adverse events, and visits to the emergency room...
December 4, 2018: Epilepsia
Chih-Wan Lin, Wei-I Huang, Pi-Hui Chao, Wen-Wen Chen, Fei-Yuan Hsiao
OBJECTIVE: After discovering the association between the HLA-B*15:02 allele and carbamazepine-related severe cutaneous adverse reactions (SCARs), particularly in Southeastern Asian populations, clinical strategies to prevent carbamazepine-related SCARs have changed. We aimed to investigate 10-year trends in carbamazepine use and carbamazepine-related SCARs and to examine the patterns and determinants of HLA-B*15:02 screening in Taiwan. METHODS: A nationwide study was performed using Taiwan's National Health Insurance Research Database...
November 26, 2018: Epilepsia
Cong Chen, Hong Li, Fang Ding, Linglin Yang, Peiyu Huang, Shan Wang, Bo Jin, Cenglin Xu, Yi Wang, Meiping Ding, Zhong Chen, Shuang Wang
OBJECTIVE: The epileptogenic network underlying secondarily generalized tonic-clonic seizures (sGTCS) in mesial temporal lobe epilepsy (mTLE) is not well understood. Here, we investigated alterations in the probabilistic hippocampal-thalamic pathway (pHTP) underlying sGTCS using diffusion tensor imaging and resting-state functional magnetic resonance imaging in a cohort of TLE patients with hippocampal sclerosis (HS). METHODS: We consecutively recruited 51 unilateral TLE-HS patients (26 with and 25 without sGTCS) and 22 healthy controls...
November 26, 2018: Epilepsia
Carolina Gomis-Pérez, Janire Urrutia, Anna Marcé-Grau, Covadonga Malo, Eduardo López-Laso, Ana Felipe-Rucián, Miquel Raspall-Chaure, Alfons Macaya, Alvaro Villarroel
OBJECTIVE: To gain insight into the mechanisms underlying KCNQ2 encephalopathy by examining the electrophysiologic properties of mutant Kv7.2 channels in different multimeric configurations. METHODS: We analyzed the genotype-phenotype relationship in 4 patients with KCNQ2 encephalopathy and performed electrophysiologic analysis of M-currents mediated by homomeric Kv7.2 or heteromeric Kv7.2/Kv7.3 channels. RESULTS: Negligible or no current was recorded in cells expressing homomeric E130K, W270R, or G281R de novo mutants, and it was reduced by more than 90% for the L243F maternally inherited mutant...
November 26, 2018: Epilepsia
Markus Leitinger, Eugen Trinka, Giada Giovannini, Georg Zimmermann, Cristina Florea, Alexandra Rohracher, Gudrun Kalss, Caroline Neuray, Rudolf Kreidenhuber, Julia Höfler, Giorgi Kuchukhidze, Claudia Granbichler, Judith Dobesberger, Helmut F Novak, Georg Pilz, Stefano Meletti, Uwe Siebert
OBJECTIVE: In 2015, the International League Against Epilepsy (ILAE) proposed a new definition of status epilepticus (SE): 5 minutes of ongoing seizure activity to diagnose convulsive SE (CSE, ie, bilateral tonic-clonic SE) and 10 minutes for focal SE and absence SE, rather than the earlier criterion of 30 minutes. Based on semiology, several types of SE with prominent motor phenomena at any time (including CSE) were distinguished from those without (ie, nonconvulsive SE, NCSE). We present the first population-based incidence study applying the new 2015 ILAE definition and classification of SE and report the impact of the evolution of semiology and level of consciousness (LOC) on outcome...
November 26, 2018: Epilepsia
Marina Trivisano, Nicola Pietrafusa, Alessandra Terracciano, Carla Marini, Davide Mei, Francesca Darra, Patrizia Accorsi, Domenica Battaglia, Lorella Caffi, Maria P Canevini, Simona Cappelletti, Elisabetta Cesaroni, Luca de Palma, Paola Costa, Raffaella Cusmai, Lucio Giordano, Annarita Ferrari, Elena Freri, Lucia Fusco, Tiziana Granata, Tommaso Martino, Massimo Mastrangelo, Stefania M Bova, Lucio Parmeggiani, Francesca Ragona, Federico Sicca, Pasquale Striano, Luigi M Specchio, Ilaria Tondo, Elena Zambrelli, Nelia Zamponi, Caterina Zanus, Clementina Boniver, Marilena Vecchi, Carlo Avolio, Bernardo Dalla Bernardina, Enrico Bertini, Renzo Guerrini, Federico Vigevano, Nicola Specchio
OBJECTIVE: PCDH19-related epilepsy is an epileptic syndrome with infantile onset, characterized by clustered and fever-induced seizures, often associated with intellectual disability (ID) and autistic features. The aim of this study was to analyze a large cohort of patients with PCDH19-related epilepsy and better define the epileptic phenotype, genotype-phenotype correlations, and related outcome-predicting factors. METHODS: We retrospectively collected genetic, clinical, and electroencephalogram (EEG) data of 61 patients with PCDH19-related epilepsy followed at 15 epilepsy centers...
November 19, 2018: Epilepsia
Emmely Rodin, Martin H Krogstad, Preben Aukland, Martin Lando, Harald S Møller, Joanna Gesche, Thomas Krøigård, Christoph P Beier
OBJECTIVE: To determine annual incidence, etiology, severity, and short- and long-term mortality of first-time, nonanoxic status epilepticus (SE) in adults in a population-based retrospective cohort study. METHODS: We systematically identified all episodes of SE in the year 2014 on the island of Funen. Patients with SE due to anoxia, patients with recurrent SE, and patients <18 years old were excluded. Nonconvulsive SE in coma was diagnosed according to the Salzburg criteria...
November 13, 2018: Epilepsia
Linda Kalilani, Xuezheng Sun, Barbara Pelgrims, Matthias Noack-Rink, Vicente Villanueva
OBJECTIVE: The definition of drug-resistant epilepsy (DRE) affects case identification and treatment, and impacts prevalence or incidence estimates and health burden estimation in epidemiology. The objective of this systematic review is to evaluate the consistency between definitions of DRE in the literature and the official definition in the International League Against Epilepsy (ILAE) guidelines, and to estimate the incidence, prevalence, and risk factors for DRE. METHODS: MEDLINE and EMBASE were searched for observational studies of DRE published between January 1980 and July 2015...
November 13, 2018: Epilepsia
Stanislas Lagarde, Sinziana Buzori, Agnès Trebuchon, Romain Carron, Didier Scavarda, Mathieu Milh, Aileen McGonigal, Fabrice Bartolomei
OBJECTIVE: In this study, we seek to analyze the determinants of the intracranial electroencephalography seizure onset pattern (SOP) and the impact of the SOP in predicting postsurgical seizure outcome. METHODS: To this end, we analyzed 820 seizures from 252 consecutive patients explored by stereo-electroencephalography (total of 2148 electrodes), including various forms of focal refractory epilepsies. We used a reproducible method combining visual and time-frequency analyses...
November 13, 2018: Epilepsia
Nicholas H Couturier, Dominique M Durand
OBJECTIVE: Low-frequency fiber-tract stimulation has been shown to be effective in treating mesial temporal lobe epilepsies through activation of the hippocampal commissure in rodents and human patients. The corpus callosum is a major pathway connecting the two hemispheres of the brain; however, few experiments have documented corpus callosum stimulation. The objective is to determine the efficacy of corpus callosum stimulation at low frequencies to suppress cortical seizures. METHODS: 4-Aminopyridine was injected in the primary motor cortex of 24 rats under anesthesia...
November 13, 2018: Epilepsia
Helen O'Reilly, Christin Eltze, Kate Bennett, Kristien Verhaert, Rebecca Webb, Anna Merrett, Rod C Scott, Andrea Whitney, J Helen Cross, Michelle de Haan
OBJECTIVE: Onset of epilepsy before 2 years of age is associated with poor cognitive outcome; however, the natural course of the range of epilepsies that occur at this age is unknown. The aim of this prospective community-based study was to investigate the neuropsychological development of infants with newly diagnosed epilepsy longitudinally and to identify the clinical factors that predict long-term impairment. METHODS: Sixty-six infants <24 months of age were enrolled in the baseline phase of this study; 40 were seen again at 1-year follow-up and 40 at 3-year follow-up...
November 5, 2018: Epilepsia
Hiroshi Baba, Keisuke Toda, Tomonori Ono, Ryoko Honda, Shiro Baba
OBJECTIVE: This retrospective study was designed to assess the impact of corpus callosotomy (CC) in patients with intractable West syndrome (WS) without lesions on magnetic resonance imaging (MRI). METHODS: This study involved 56 patients with WS who underwent CC between January 2000 and December 2014. Seizure outcomes and changes in psychomotor development were analyzed. RESULTS: Mean age at the onset of epilepsy and at the time of CC was 5...
November 5, 2018: Epilepsia
Eric P Borrelli, Erica Y Lee, Andrew M Descoteaux, Stephen J Kogut, Aisling R Caffrey
OBJECTIVE: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and potentially fatal adverse skin reactions that are most commonly triggered by certain medications. One class of medications that has been highly associated with SJS/TEN reactions is antiepileptic drugs (AEDs). We sought to quantify the risk of SJS/TEN associated with AEDs as a class, as well as individual AEDs, in the United States. METHODS: An analysis was performed of the US Food and Drug Administration Adverse Event Reporting System (FAERS) from July 2014 through December 2017...
November 5, 2018: Epilepsia
Elisabeth Schmid, Aljoscha Thomschewski, Alexandra Taylor, Georg Zimmermann, Margarita Kirschner, Teia Kobulashvili, Francesco Brigo, Matea Rados, Christoph Helmstaedter, Kees Braun, Eugen Trinka
OBJECTIVE: The European Union-funded E-PILEPSY project was launched to develop guidelines and recommendations for epilepsy surgery. In this systematic review, we aimed to assess the diagnostic accuracy of functional magnetic resonance imaging (fMRI), Wada test, magnetoencephalography (MEG), and functional transcranial Doppler sonography (fTCD) for memory and language decline after surgery. METHODS: The literature search was conducted using PubMed, Embase, and CENTRAL...
October 30, 2018: Epilepsia
Varina L Boerwinkle, Stephen T Foldes, Salvatore J Torrisi, Hamy Temkit, William D Gaillard, John F Kerrigan, Virendra R Desai, Jeffrey S Raskin, Aditya Vedantam, Randa Jarrar, Korwyn Williams, Sandi Lam, Manish Ranjan, Janna S Broderson, David Adelson, Angus A Wilfong, Daniel J Curry
OBJECTIVE: The purpose of this study is to investigate the outcomes of epilepsy surgery targeting the subcentimeter-sized resting state functional magnetic resonance imaging (rs-fMRI) epileptogenic onset zone (EZ) in hypothalamic hamartoma (HH). METHODS: Fifty-one children with HH-related intractable epilepsy received anatomical MRI-guided stereotactic laser ablation (SLA) procedures. Fifteen of these children were control subjects (CS) not guided by rs-fMRI. Thirty-six had been preoperatively guided by rs-fMRI (RS) to determine EZs, which were subsequently targeted by SLA...
October 30, 2018: Epilepsia
Rita Yu, Hae-Jeong Park, Hojin Cho, Ara Ko, Chongwon Pae, Maeng-Keun Oh, Hoon-Chul Kang, Heung Dong Kim, Eun-Kyung Park, Kyu-Won Shim, Dong Suk Kim, Joon Soo Lee
OBJECTIVE: With the recognition of epilepsy as a network disease that disrupts the organizing ability of resting-state brain networks, vagus nerve stimulation (VNS) may control epileptic seizures through modulation of functional connectivity. We evaluated preoperative 2-deoxy-2[18 F]fluoro-D-glucose (FDG) positron emission tomography (PET) in VNS-implanted pediatric patients with refractory epilepsy to analyze the metabolic connectivity of patients and its prognostic role in seizure control...
October 28, 2018: Epilepsia
R Maarten van Dijk, Valentina Di Liberto, Matthias Brendel, Ann Marie Waldron, Christina Möller, Franz Josef Gildehaus, Barbara von Ungern-Sternberg, Magdalena Lindner, Sibylle Ziegler, Rainer Hellweg, Peter Gass, Peter Bartenstein, Heidrun Potschka
OBJECTIVE: In patients with epilepsy, psychiatric comorbidities can significantly affect the disease course and quality of life. Detecting and recognizing these comorbidities is central in determining an optimal treatment plan. One promising tool in detecting biomarkers for psychiatric comorbidities in epilepsy is positron emission tomography (PET). METHODS: Behavioral and biochemical variables were cross-correlated with the results from two μPET scans using the tracers [18 F]fluoro-2-deoxy-D-glucose ([18 F]FDG) and 2'-methoxyphenyl-(N-2'-pyridinyl)-p-18 F-fluoro-benzamidoethylpiperazine ([18 F]MPPF) to explore potential biomarkers for neurobehavioral comorbidities in an electrically induced post-status epilepticus rat model of epilepsy...
October 28, 2018: Epilepsia
Brenda Marrero-Rosado, Marcio de Araujo Furtado, Caroline R Schultz, Michael Stone, Erica Kundrick, Katie Walker, Sean O'Brien, Fu Du, Lucille A Lumley
OBJECTIVE: Exposure to chemical warfare nerve agents (CWNAs), such as soman (GD), can induce status epilepticus (SE) that becomes refractory to benzodiazepines when treatment is delayed, leading to increased risk of epileptogenesis, severe neuropathology, and long-term behavioral and cognitive deficits. Rodent models, widely used to evaluate novel medical countermeasures (MCMs) against CWNA exposure, normally express plasma carboxylesterase, an enzyme involved in the metabolism of certain organophosphorus compounds...
October 25, 2018: Epilepsia
Pierre Bourdillon, Michel Cucherat, Jean Isnard, Karine Ostrowsky-Coste, Hélène Catenoix, Marc Guénot, Sylvain Rheims
OBJECTIVE: Despite the increasing number of studies reporting results of stereo-electroencephalography (SEEG)-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC) in the treatment of patients with drug-resistant focal epilepsy, the exact efficacy of this approach remains unclear. The seizure-freedom rate varies greatly across studies and the factors associated with efficacy have not been formally investigated. METHODS: All prospective or retrospective studies reporting efficacy and/or safety of SEEG-guided RF-TC in patients with drug-resistant focal epilepsy were included...
October 21, 2018: Epilepsia
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