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Epilepsia

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https://www.readbyqxmd.com/read/29226305/association-between-scalp-and-intracerebral-electroencephalographic-seizure-onset-patterns-a-study-in-different-lesional-pathological-substrates
#1
Hideaki Tanaka, Hui Ming Khoo, François Dubeau, Jean Gotman
OBJECTIVE: Our purpose was to determine the correlation between scalp electroencephalography (EEG) and intracerebral EEG (iEEG) seizure-onset patterns in patients with focal lesional epilepsy to determine whether scalp seizure-onset patterns can be specific to intracerebral seizure-onset patterns and to lesion type. METHODS: We retrospectively analyzed 61 patients with focal epilepsy and a structural magnetic resonance imaging (MRI)-visible lesion, who first underwent extensive scalp recordings and then iEEG studies (stereo-EEG) for presurgical evaluation, and who showed an iEEG seizure onset in the lesional/perilesional area...
December 11, 2017: Epilepsia
https://www.readbyqxmd.com/read/29218816/long-term-adherence-with-psychiatric-treatment-among-patients-with-psychogenic-nonepileptic-seizures
#2
Benjamin Tolchin, Barbara A Dworetzky, Gaston Baslet
We conducted a prospective cohort study, examining long-term adherence with psychiatric treatment among patients with psychogenic nonepileptic seizures (PNES). Subjects diagnosed with documented PNES were scheduled for 4 psychiatric visits. Survival analysis was performed, and covariates were assessed for association with time to nonadherence using Cox proportional hazard regression analysis. One hundred twenty-three subjects were recruited and followed for up to 17 months. Eighty percent of subjects attended the first outpatient visit, 42% attended the second, 24% attended the third, and only 14% remained adherent through the fourth visit...
December 7, 2017: Epilepsia
https://www.readbyqxmd.com/read/29218705/randomized-controlled-study-comparing-the-efficacy-of-rapid-and-slow-withdrawal-of-antiepileptic-drugs-during-long-term-video-eeg-monitoring
#3
Shambhu Kumar, Bhargavi Ramanujam, P S Chandra, Deepa Dash, Santosh Mehta, Sharma Anubha, Renjith Appukutan, Manit Kumar Rana, Manjari Tripathi
OBJECTIVE: Antiepileptic drugs (AEDs) are routinely withdrawn during long-term video-electroencephalography (EEG) monitoring (LTM), to record sufficient number of seizures. The efficacy of rapid and slow AED taper has never been compared in a randomized control trial (RCT), which was the objective of this study. METHODS: In this open-label RCT, patients aged 2-80 years with drug-resistant epilepsy (DRE) were randomly assigned (1:1) to rapid and slow AED taper groups...
December 7, 2017: Epilepsia
https://www.readbyqxmd.com/read/29218702/deep-brain-stimulation-for-drug-resistant-epilepsy
#4
REVIEW
Michael C H Li, Mark J Cook
OBJECTIVES: To review clinical evidence on the antiepileptic effects of deep brain stimulation (DBS) for drug-resistant epilepsy, its safety, and the factors influencing individual outcomes. METHODS: A comprehensive search of the medical literature (PubMed, Medline) was conducted to identify relevant articles investigating DBS therapy for drug-resistant epilepsy. Reference lists of these articles were used to source further articles. RESULTS: Stimulation of the anterior nucleus of the thalamus (ANT) and hippocampus (HC) has been shown to decrease the frequency of refractory seizures...
December 7, 2017: Epilepsia
https://www.readbyqxmd.com/read/29218701/a-longitudinal-cohort-study-on-the-impact-of-the-clobazam-shortage-on-patients-with-epilepsy
#5
Sara Lukmanji, Khara M Sauro, Colin B Josephson, K Chelsea Altura, Samuel Wiebe, Nathalie Jetté
OBJECTIVE: Drug shortages are occurring at an increasing rate. From May to October 2016, there was a shortage of a level I critical antiepileptic drug, clobazam. We aimed to study the impact of this shortage on patients with epilepsy. METHODS: Adult patients from Calgary's Comprehensive Epilepsy Program who were taking clobazam were approached to participate in the study. Baseline data from the clinic prospective registry included clinical variables and presurvey patient-reported outcomes (PROs) such as the Global Assessment of Severity of Epilepsy, the Global Assessment of Disability Associated with Seizures, and the Quality of Life in Epilepsy questionnaire...
December 7, 2017: Epilepsia
https://www.readbyqxmd.com/read/29214651/electroencephalography-and-behavior-patterns-during-experimental-status-epilepticus
#6
Ewa Lewczuk, Suchitra Joshi, John Williamson, Mouna Penmetsa, Sarah Shan, Jaideep Kapur
OBJECTIVE: To characterize the evolution of behavioral and electrographic seizures in an experimental electrical stimulation-based model of status epilepticus (SE) in C57Bl/6 mice, and to relate SE to various outcomes, including death and epileptogenesis. METHODS: SE was induced by continuous hippocampal stimulation and was evaluated by review of electroencephalographic recordings, spectral display, and behavior. RESULTS: Seizures were initially locked to the electrical trains but later became independent of them...
December 6, 2017: Epilepsia
https://www.readbyqxmd.com/read/29214639/cannabinoids-for-epilepsy-what-do-we-know-and-where-do-we-go
#7
REVIEW
Martin J Brodie, Elinor Ben-Menachem
Over the past decade there has been an increasing interest in using cannabinoids to treat a range of epilepsy syndromes following reports of some remarkable responses in individual patients. The situation is complicated by the fact that these agents do not appear to work via their attachment to endogenous cannabinoid receptors. Their pharmacokinetics are complex, and bioavailability is variable, resulting in difficulty in developing a suitable formulation for oral delivery. Drug interactions also represent another complication in their everyday use...
December 6, 2017: Epilepsia
https://www.readbyqxmd.com/read/29210066/the-interictal-mesial-temporal-lobe-epilepsy-network
#8
Suganya Karunakaran, Matthew J Rollo, Kamin Kim, Jessica A Johnson, Giridhar P Kalamangalam, Behnaam Aazhang, Nitin Tandon
OBJECTIVE: Identification of patient-specific epileptogenic networks is critical to designing successful treatment strategies. Multiple noninvasive methods have been used to characterize epileptogenic networks. However, these methods lack the spatiotemporal resolution to allow precise localization of epileptiform activity. We used intracranial recordings, at much higher spatiotemporal resolution, across a cohort of patients with mesial temporal lobe epilepsy (MTLE) to delineate features common to their epileptogenic networks...
December 5, 2017: Epilepsia
https://www.readbyqxmd.com/read/29205291/interactive-effects-of-seizure-frequency-and-lateralization-on-intratemporal-effective-connectivity-in-temporal-lobe-epilepsy
#9
Chang-Hyun Park, Yun Seo Choi, Hyeon Jin Kim, Hwa-Kyung Chung, A-Reum Jung, Jeong Hyun Yoo, Hyang Woon Lee
OBJECTIVE: Patients with temporal lobe epilepsy (TLE) show brain connectivity changes in association with cognitive impairment. Seizure frequency and lateralization are 2 important clinical factors that characterize epileptic seizures. In this study, we sought to examine an interactive effect of the 2 seizure factors on intratemporal effective connectivity based on resting-state functional magnetic resonance imaging (rsfMRI) in patients with TLE. METHODS: For rsfMRI data acquired from 48 TLE patients and 45 healthy controls, we applied stochastic dynamical causal modeling to infer effective connectivity between 3 medial temporal lobe (MTL) regions, including the hippocampus (Hipp), parahippocampal gyrus (PHG), and amygdala (Amyg), ipsilateral to the seizure focus...
December 4, 2017: Epilepsia
https://www.readbyqxmd.com/read/29205319/atypical-presentations-of-dysembryoplastic-neuroepithelial-tumors
#10
Jessica Stark, Elliott Friedman, Stephen Thompson, Gretchen Von Allmen, Meenakshi Bhattacharjee, Nitin Tandon
Dysembryoplastic neuroepithelial tumors (DNETs) are World Health Organization grade 1 neoplasms, typically present as isolated cortical lesions with no associated edema. We present 3 rare cases of DNETs that were atypical in location (all were subcortical and 1 was bilateral), 2 of which displayed substantial growth over time. All 3 cases presented with seizures that were not well controlled on medications, followed by a successful cure of the epilepsy when these lesions were removed. These cases uniquely illustrate that DNETs can be present throughout the brain and may generate seizures even in a subcortical location, possibly due to containing neurons with the potential for aberrant microcircuitry...
December 3, 2017: Epilepsia
https://www.readbyqxmd.com/read/29205292/brain-regions-and-epileptogenicity-influence-epileptic-interictal-spike-production-and-propagation-during-nrem-sleep-in-comparison-with-wakefulness
#11
Isabelle Lambert, Nicolas Roehri, Bernard Giusiano, Romain Carron, Fabrice Wendling, Christian Benar, Fabrice Bartolomei
OBJECTIVE: Non-rapid eye movement (NREM) sleep is known to be a brain state associated with an activation of interictal epileptic activity. The goal of this work was to quantify topographic changes occurring during NREM sleep in comparison with wakefulness. METHOD: We studied intracerebral recordings of 20 patients who underwent stereo-electroencephalography (SEEG) during presurgical evaluation for pharmacoresistant focal epilepsy. We measured the number of interictal spikes (IS) and quantified the co-occurrence of IS between brain regions during 1 hour of NREM sleep and 1 hour of wakefulness...
December 3, 2017: Epilepsia
https://www.readbyqxmd.com/read/29193044/accumulation-of-rest-deficiency-precedes-sudden-death-of-epileptic-kv1-1-knockout-mice-a-model-of-sudden-unexpected-death-in-epilepsy
#12
Shruthi H Iyer, Stephanie A Matthews, Timothy A Simeone, Rama Maganti, Kristina A Simeone
OBJECTIVE: Chronic sleep deficiency is associated with early mortality. In the epileptic population, there is a higher prevalence of sleep disorders, and individuals with severe refractory epilepsy are at greater risk of premature mortality than the general population. Sudden unexpected death in epilepsy affects 1:1000 cases of epilepsy each year. Ketogenic diet (KD) treatment is one of the few effective options for refractory seizures. Despite KD reducing seizures and increasing longevity in Kv1...
November 28, 2017: Epilepsia
https://www.readbyqxmd.com/read/29178251/seizure-and-cognitive-outcomes-after-resection-of-glioneuronal-tumors-in-children
#13
Andrew M Faramand, Nicola Barnes, Sue Harrison, Roxanna Gunny, Tom Jacques, Zubair M Tahir, Sophia M Varadkar, Helen J Cross, William Harkness, Martin M Tisdall
OBJECTIVE: Glioneuronal tumors (GNTs) are well-recognized causes of chronic drug-resistant focal epilepsy in children. Our practice involves an initial period of radiological surveillance and antiepileptic medications, with surgery being reserved for those with radiological progression or refractory seizures. We planned to analyze the group of patients with low-grade GNTs, aiming to identify factors affecting seizure and cognitive outcomes. METHODS: We retrospectively reviewed the medical records of 150 children presenting to Great Ormond Street Hospital with seizures secondary to GNTs...
November 26, 2017: Epilepsia
https://www.readbyqxmd.com/read/29171013/severe-infantile-onset-developmental-and-epileptic-encephalopathy-caused-by-mutations-in-autophagy-gene-wdr45
#14
Gemma L Carvill, Aijie Liu, Simone Mandelstam, Amy Schneider, Amy Lacroix, Matthew Zemel, Jacinta M McMahon, Luis Bello-Espinosa, Mark Mackay, Geoffrey Wallace, Michaela Waak, Jing Zhang, Xiaoling Yang, Stephen Malone, Yue-Hua Zhang, Heather C Mefford, Ingrid E Scheffer
Heterozygous de novo variants in the autophagy gene, WDR45, are found in beta-propeller protein-associated neurodegeneration (BPAN). BPAN is characterized by adolescent onset dementia and dystonia; 66% patients have seizures. We asked whether WDR45 was associated with developmental and epileptic encephalopathy (DEE). We performed next generation sequencing of WDR45 in 655 patients with developmental and epileptic encephalopathies. We identified 3/655 patients with DEE plus 4 additional patients with de novo WDR45 pathogenic variants (6 truncations, 1 missense); all were female...
November 24, 2017: Epilepsia
https://www.readbyqxmd.com/read/29171003/inhibition-of-monoacylglycerol-lipase-terminates-diazepam-resistant-status-epilepticus-in-mice-and-its-effects-are-potentiated-by-a-ketogenic-diet
#15
Gaetano Terrone, Alberto Pauletti, Alessia Salamone, Massimo Rizzi, Bianca R Villa, Luca Porcu, Mark J Sheehan, Edward Guilmette, Christopher R Butler, Justin R Piro, Tarek A Samad, Annamaria Vezzani
OBJECTIVE: Status epilepticus (SE) is a life-threatening and commonly drug-refractory condition. Novel therapies are needed to rapidly terminate seizures to prevent mortality and morbidity. Monoacylglycerol lipase (MAGL) is the key enzyme responsible for the hydrolysis of the endocannabinoid 2-arachidonoylglycerol (2-AG) and a major contributor to the brain pool of arachidonic acid (AA). Inhibiting of monoacylglycerol lipase modulates synaptic activity and neuroinflammation, 2 mediators of excessive neuronal activation underlying seizures...
November 24, 2017: Epilepsia
https://www.readbyqxmd.com/read/29171011/stroke-like-migraine-attacks-after-radiation-therapy-a-misnomer
#16
Emily Peien Fan, Gabriel Heiber, Elizabeth E Gerard, Stephan Schuele
OBJECTIVE: To understand the frequency of electrographic and clinical seizures in patients with stroke-like migraine attacks after radiation therapy (SMART), and determine whether SMART warrants comprehensive electroencephalographic (EEG) monitoring and aggressive seizure management. METHODS: We searched our magnetic resonance brain imaging report database for all patients between January 2013 and December 2015 for suspected SMART syndrome. Clinical inclusion criteria were further applied as follows: inpatient adults (>18 years of age) with history of cranial radiation presenting with acute neurologic deficits as primary admission reason who lacked evidence of recurrent or new brain malignancy, stroke, or infectious agents in cerebrospinal fluid...
November 23, 2017: Epilepsia
https://www.readbyqxmd.com/read/29171006/bad-knockout-provides-metabolic-seizure-resistance-in-a-genetic-model-of-epilepsy-with-sudden-unexplained-death-in-epilepsy
#17
Jeannine Foley, Veronica Burnham, Meghan Tedoldi, Nika N Danial, Gary Yellen
Metabolic alteration, either through the ketogenic diet (KD) or by genetic alteration of the BAD protein, can produce seizure protection in acute chemoconvulsant models of epilepsy. To assess the seizure-protective role of knocking out (KO) the Bad gene in a chronic epilepsy model, we used the Kcna1(-/-) model of epilepsy, which displays progressively increased seizure severity and recapitulates the early death seen in sudden unexplained death in epilepsy (SUDEP). Beginning on postnatal day 24 (P24), we continuously video monitored Kcna1(-/-) and Kcna1(-/-) Bad(-/-) double knockout mice to assess survival and seizure severity...
November 23, 2017: Epilepsia
https://www.readbyqxmd.com/read/29152735/6%C3%A2-hz-corneal-kindling-in-mice-triggers-neurobehavioral-comorbidities-accompanied-by-relevant-changes-in-c-fos-immunoreactivity-throughout-the-brain
#18
Giulia Albertini, Laura Walrave, Thomas Demuyser, Ann Massie, Dimitri De Bundel, Ilse Smolders
OBJECTIVE: Besides seizures, patients with epilepsy are affected by a variety of cognitive and psychiatric comorbidities that further impair their quality of life. The present study provides an in-depth characterization of the behavioral alterations induced by 6 Hz corneal kindling. Furthermore, we correlate these behavioral changes to alterations in c-Fos protein expression throughout the brain following kindling. METHODS: Adolescent male Naval Medical Research Institute (NMRI) mice were kindled via repetitive subconvulsive 6 Hz corneal stimulations until they reached the fully kindled state (defined as 10 consecutive generalized seizures)...
November 20, 2017: Epilepsia
https://www.readbyqxmd.com/read/29152734/access-to-diagnostic-and-therapeutic-facilities-for-psychogenic-nonepileptic-seizures-an-international-survey-by-the-ilae-pnes-task-force-2nd-revision
#19
Coraline Hingray, Wissam El-Hage, Rod Duncan, David Gigineishvili, Kousuke Kanemoto, W Curt LaFrance, Alejandro de Marinis, Ravi Paul, Chrisma Pretorius, José F Téllez Zenteno, Hannah Wiseman, Markus Reuber
OBJECTIVE: Studies from a small number of countries suggest that patients with psychogenic nonepileptic seizures (PNES) have limited access to diagnostic and treatment services. The PNES Task Force of the International League Against Epilepsy (ILAE) carried out 2 surveys to explore the diagnosis and treatment of PNES around the world. METHODS: A short survey (8 questions) was sent to all 114 chapters of the ILAE. A longer survey (36 questions) was completed by healthcare professionals who see patients with seizures...
November 20, 2017: Epilepsia
https://www.readbyqxmd.com/read/29150855/thalamic-volume-reduction-in-drug-naive-patients-with-new-onset-genetic-generalized-epilepsy
#20
Suejen Perani, Tim M Tierney, Maria Centeno, Elhum A Shamshiri, Siti N Yaakub, Jonathan O'Muircheartaigh, David W Carmichael, Mark P Richardson
OBJECTIVE: Patients with genetic generalized epilepsy (GGE) have subtle morphologic abnormalities of the brain revealed with magnetic resonance imaging (MRI), particularly in the thalamus. However, it is unclear whether morphologic abnormalities of the brain in GGE are a consequence of repeated seizures over the duration of the disease, or are a consequence of treatment with antiepileptic drugs (AEDs), or are independent of these factors. Therefore, we measured brain morphometry in a cohort of AED-naive patients with GGE at disease onset...
November 18, 2017: Epilepsia
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