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Epilepsia

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https://www.readbyqxmd.com/read/28426130/length-of-stay-for-patients-undergoing-invasive-electrode-monitoring-with-stereoelectroencephalography-and-subdural-grids-correlates-positively-with-increased-institutional-profitability
#1
Alvin Y Chan, Sohayla Kharrat, Kelly Lundeen, Lilit Mnatsakanyan, Mona Sazgar, Indranil Sen-Gupta, Jack J Lin, Frank P K Hsu, Sumeet Vadera
OBJECTIVE: Lowering the length of stay (LOS) is thought to potentially decrease hospital costs and is a metric commonly used to manage capacity. Patients with epilepsy undergoing intracranial electrode monitoring may have longer LOS because the time to seizure is difficult to predict or control. This study investigates the effect of economic implications of increased LOS in patients undergoing invasive electrode monitoring for epilepsy. METHODS: We retrospectively collected and analyzed patient data for 76 patients who underwent invasive monitoring with either subdural grid (SDG) implantation or stereoelectroencephalography (SEEG) over 2 years at our institution...
April 20, 2017: Epilepsia
https://www.readbyqxmd.com/read/28418198/stress-is-associated-with-an-increased-risk-of-recurrent-seizures-in-adults
#2
Elisa Baldin, W Allen Hauser, Alison Pack, Dale C Hesdorffer
OBJECTIVE: The literature is sparse on the complex interrelationships between stressors, depression, anxiety disorders, and epilepsy. We hypothesized that a relationship exists between stress and epilepsy. We evaluated whether markers of stress are associated with seizure recurrence in a low income community-based cohort of adults with single unprovoked seizure or newly diagnosed epilepsy. METHODS: We ascertained adult residents of Northern Manhattan and Harlem, New York City, with a first unprovoked seizure or newly diagnosed epilepsy, between December 2010 and January 2013...
April 18, 2017: Epilepsia
https://www.readbyqxmd.com/read/28401998/early-discontinuation-of-antiseizure-medications-in-neonates-with-hypoxic-ischemic-encephalopathy
#3
Mark P Fitzgerald, Sudha Kilaru Kessler, Nicholas S Abend
OBJECTIVE: Neonates with hypoxic-ischemic encephalopathy (HIE) managed with therapeutic hypothermia (TH) often experience acute symptomatic seizures, prompting treatment with antiseizure medications (ASMs). Because the risk of seizure occurrence after hospital discharge is unknown, the optimal ASM treatment duration is unclear. We aimed to determine the risk of seizure occurrence after hospital discharge and the impact of ASM treatment duration on this outcome. METHODS: We performed a single-center, retrospective study of consecutive neonates with HIE managed with TH who received ASMs for acute symptomatic seizures from June 2010 through December 2014...
April 12, 2017: Epilepsia
https://www.readbyqxmd.com/read/28401986/auditory-processing-following-infantile-spasms-an-event-related-potential-study
#4
Tangunu Fosi, Klaus Werner, Stewart G Boyd, Michelle De Haan, Rod C Scott, Brian G Neville
OBJECTIVES: To investigate acoustic auditory processing in patients with recent infantile spasms (IS). METHODS: Patients (n = 22; 12 female; median age 8 months; range 5-11 months) had normal preceding development, brain magnetic resonance imaging (MRI), and neurometabolic testing (West syndrome of unknown cause, uWS). Controls were healthy babies (n = 22; 11 female; median age 6 months; range 3-12 months). Event-related potentials (ERPs) and psychometry (Bayley Scales of Infant Development, Second Edition, BSID-II) took place at a month following IS remission...
April 12, 2017: Epilepsia
https://www.readbyqxmd.com/read/28401980/the-impact-of-nonadherence-to-antiseizure-drugs-on-seizure-outcomes-in-an-animal-model-of-epilepsy
#5
Kyle E Thomson, Avani C Modi, Tracy A Glauser, Joseph R Rausch, H Steve White
OBJECTIVE: Nonadherence to prescribed dosing regimens is a significant problem in the treatment of pediatric and adult chronic epilepsy, and can result in severe consequences to patient outcomes. In this first-of-kind preclinical study, the impact of nonadherence on seizure control was studied by simulating human patterns of nonadherence in an animal epilepsy model. METHODS: In study 1, three different patterns of nonadherence were modeled in newly diagnosed epileptic rats treated with carbamazepine: perfect adherence (100% of pellets contained carbamazepine), variable nonadherence (50% of pellets contained carbamazepine with different dosing patterns between animals), and complete nonadherence (0% of pellets contained carbamazepine)...
April 12, 2017: Epilepsia
https://www.readbyqxmd.com/read/28398014/brain-responsive-neurostimulation-in-patients-with-medically-intractable-mesial-temporal-lobe-epilepsy
#6
Eric B Geller, Tara L Skarpaas, Robert E Gross, Robert R Goodman, Gregory L Barkley, Carl W Bazil, Michael J Berg, Gregory K Bergey, Sydney S Cash, Andrew J Cole, Robert B Duckrow, Jonathan C Edwards, Stephan Eisenschenk, James Fessler, Nathan B Fountain, Alicia M Goldman, Ryder P Gwinn, Christianne Heck, Aamar Herekar, Lawrence J Hirsch, Barbara C Jobst, David King-Stephens, Douglas R Labar, James W Leiphart, W Richard Marsh, Kimford J Meador, Eli M Mizrahi, Anthony M Murro, Dileep R Nair, Katherine H Noe, Yong D Park, Paul A Rutecki, Vicenta Salanova, Raj D Sheth, Donald C Shields, Christopher Skidmore, Michael C Smith, David C Spencer, Shraddha Srinivasan, William Tatum, Paul C Van Ness, David G Vossler, Robert E Wharen, Gregory A Worrell, Daniel Yoshor, Richard S Zimmerman, Kathy Cicora, Felice T Sun, Martha J Morrell
OBJECTIVE: Evaluate the seizure-reduction response and safety of mesial temporal lobe (MTL) brain-responsive stimulation in adults with medically intractable partial-onset seizures of mesial temporal lobe origin. METHODS: Subjects with mesial temporal lobe epilepsy (MTLE) were identified from prospective clinical trials of a brain-responsive neurostimulator (RNS System, NeuroPace). The seizure reduction over years 2-6 postimplantation was calculated by assessing the seizure frequency compared to a preimplantation baseline...
April 11, 2017: Epilepsia
https://www.readbyqxmd.com/read/28398008/source-localization-of-ictal-epileptic-activity-based-on-high-density-scalp-eeg-data
#7
Petros Nemtsas, Gwenael Birot, Francesca Pittau, Christoph M Michel, Karl Schaller, Serge Vulliemoz, Vasilios K Kimiskidis, Margitta Seeck
OBJECTIVE: Electrical source imaging (ESI) is a well-established approach to localizing the epileptic focus in drug-resistant focal epilepsy. So far, ESI has been used primarily on interictal events. Emerging evidence suggests that ictal ESI is also feasible and potentially useful. We aimed to investigate the diagnostic accuracy of ESI on ictal events using high-density electroencephalography (EEG). METHODS: We performed ictal ESI on 14 patients (9 with temporal lobe epilepsy) admitted for presurgical evaluation who presented seizures during a long-term (≥18 h) high-density EEG recording (13 with 256 electrodes and one with 128 electrodes), and subsequently 8 of them underwent epilepsy surgery (postoperative follow-up >1 year)...
April 11, 2017: Epilepsia
https://www.readbyqxmd.com/read/28397999/scalp-eeg-ictal-gamma-and-beta-activity-during-infantile-spasms-evidence-of-focality
#8
Hiroki Nariai, Jules Beal, Aristea S Galanopoulou, Wenzhu B Mowrey, Stephan Bickel, Yoshimi Sogawa, Rana Jehle, Shlomo Shinnar, Solomon L Moshé
OBJECTIVE: We investigated temporal and spatial characteristics of ictal gamma and beta activity on scalp EEG during spasms in patients with West syndrome (WS) to evaluate potential focal cortical onset. METHODS: A total of 1,033 spasms from 34 patients with WS of various etiologies were analyzed on video-electroencephalography (EEG) using time-frequency analysis. Ictal gamma (35-90 Hz) and beta (15-30 Hz) activities were correlated with visual symmetry of spasms, objective EMG (electromyography) analysis, and etiology of WS...
April 11, 2017: Epilepsia
https://www.readbyqxmd.com/read/28397967/the-association-between-dementia-and-epilepsy-a-systematic-review-and-meta-analysis
#9
Ann Subota, Tram Pham, Nathalie Jetté, Khara Sauro, Diane Lorenzetti, Jayna Holroyd-Leduc
OBJECTIVE: Dementia is among the top 15 conditions with the most substantial increase in burden of disease in the past decade, and along with epilepsy, among the top 25 causes of years lived with disability worldwide. The epidemiology of dementia in persons with epilepsy, and vice versa, is not well characterized. The purpose of this systematic review was to examine the prevalence, incidence, and reported risk factors for dementia in epilepsy and epilepsy in dementia. METHODS: Embase, PsycINFO, MEDLINE, and the Cochrane databases were searched from inception...
April 11, 2017: Epilepsia
https://www.readbyqxmd.com/read/28387951/brain-responsive-neurostimulation-in-patients-with-medically-intractable-seizures-arising-from-eloquent-and-other-neocortical-areas
#10
Barbara C Jobst, Ritu Kapur, Gregory L Barkley, Carl W Bazil, Michel J Berg, Gregory K Bergey, Jane G Boggs, Sydney S Cash, Andrew J Cole, Michael S Duchowny, Robert B Duckrow, Jonathan C Edwards, Stephan Eisenschenk, A James Fessler, Nathan B Fountain, Eric B Geller, Alica M Goldman, Robert R Goodman, Robert E Gross, Ryder P Gwinn, Christianne Heck, Aamr A Herekar, Lawrence J Hirsch, David King-Stephens, Douglas R Labar, W R Marsh, Kimford J Meador, Ian Miller, Eli M Mizrahi, Anthony M Murro, Dileep R Nair, Katherine H Noe, Piotr W Olejniczak, Yong D Park, Paul Rutecki, Vicenta Salanova, Raj D Sheth, Christopher Skidmore, Michael C Smith, David C Spencer, Shraddha Srinivasan, William Tatum, Paul Van Ness, David G Vossler, Robert E Wharen, Gregory A Worrell, Daniel Yoshor, Richard S Zimmerman, Tara L Skarpaas, Martha J Morrell
OBJECTIVE: Evaluate the seizure-reduction response and safety of brain-responsive stimulation in adults with medically intractable partial-onset seizures of neocortical origin. METHODS: Patients with partial seizures of neocortical origin were identified from prospective clinical trials of a brain-responsive neurostimulator (RNS System, NeuroPace). The seizure reduction over years 2-6 postimplantation was calculated by assessing the seizure frequency compared to a preimplantation baseline...
April 7, 2017: Epilepsia
https://www.readbyqxmd.com/read/28387933/wonoep-appraisal-development-of-epilepsy-biomarkers-what-we-can-learn-from-our-patients
#11
REVIEW
Sergiusz Jozwiak, Albert Becker, Carlos Cepeda, Jerome Engel, Vadym Gnatkovsky, Gilles Huberfeld, Mehmet Kaya, Katja Kobow, Michele Simonato, Jeffrey A Loeb
OBJECTIVE: Current medications for patients with epilepsy work in only two of three patients. For those medications that do work, they only suppress seizures. They treat the symptoms, but do not modify the underlying disease, forcing patients to take these drugs with significant side effects, often for the rest of their lives. A major limitation in our ability to advance new therapeutics that permanently prevent, reduce the frequency of, or cure epilepsy comes from a lack of understanding of the disease coupled with a lack of reliable biomarkers that can predict who has or who will get epilepsy...
April 7, 2017: Epilepsia
https://www.readbyqxmd.com/read/28387929/placental-passage-of-antiepileptic-drugs-at-delivery-and-neonatal-outcomes
#12
Anna M Bank, Zachary N Stowe, D Jeffrey Newport, James C Ritchie, Page B Pennell
Children of women treated with antiepileptic drugs (AEDs) are at increased risk of adverse outcomes detectable in the neonatal period, which may be associated with the amount of AEDs in the fetal circulation. Placental passage of AEDs can be measured by calculating the ratio of umbilical cord to maternal AED concentrations collected at delivery. The aims of this study were to determine the umbilical cord concentrations and umbilical-to-maternal ratios for AEDs, and whether higher cord concentrations are associated with increased risk of neonatal complications...
April 7, 2017: Epilepsia
https://www.readbyqxmd.com/read/28378900/psychiatric-lifetime-diagnoses-are-associated-with-a-reduced-chance-of-seizure-freedom-after-temporal-lobe-surgery
#13
Steffi C Koch-Stoecker, Christian G Bien, Reinhard Schulz, Theodor W May
OBJECTIVE: To examine whether psychiatric comorbidity is a predictor of long-term seizure outcome following temporal lobe epilepsy surgery. METHODS: A sample of 434 adult patients who received temporal lobe resection to treat epilepsy between 1991 and 2009 and were psychiatrically assessed before surgery were followed for 2 years to assess seizure outcome. Stepwise multivariate logistic regression analyses were used to assess the impact of psychiatric variables on complete seizure freedom (Engel class IA), and freedom from disabling seizures (Engel class I)...
April 5, 2017: Epilepsia
https://www.readbyqxmd.com/read/28378878/network-evolution-in-mesial-temporal-lobe-epilepsy-revealed-by-diffusion-tensor-imaging
#14
Helen Wang, Yuegao Huang, Daniel Coman, Reshma Munbodh, Roni Dhaher, Hitten P Zaveri, Fahmeed Hyder, Tore Eid
OBJECTIVE: The objective of the present study is to identify novel, time-indexed imaging biomarkers of epileptogenesis in mesial temporal lobe epilepsy (MTLE). METHODS: We used high-resolution brain diffusion tensor imaging (DTI) of the translationally relevant methionine sulfoximine (MSO) brain infusion model of MTLE. MSO inhibits astroglial glutamine synthetase, which is deficient in the epileptogenic hippocampal formation of patients with MTLE. MSO-infused (epileptogenic) rats were compared with phosphate-buffered saline (PBS)-infused (nonepileptogenic) rats at early (3-4 days) and late (6-9 weeks) time points during epileptogenesis...
April 5, 2017: Epilepsia
https://www.readbyqxmd.com/read/28378439/social-outcomes-of-young-adults-with-childhood-onset-epilepsy-a-case-sibling-control-study
#15
Christine B Baca, Frances Barry, Barbara G Vickrey, Rochelle Caplan, Anne T Berg
OBJECTIVE: We aimed to compare long-term social outcomes in young adults with childhood-onset epilepsy (cases) with neurologically normal sibling controls. METHODS: Long-term social outcomes were assessed at the 15-year follow-up of the Connecticut Study of Epilepsy, a community-based prospective cohort study of children with newly diagnosed epilepsy. Young adults with childhood-onset epilepsy with complicated (abnormal neurologic exam findings, abnormal brain imaging with lesion referable to epilepsy, intellectual disability (ID; IQ < 60) or informative history of neurologic insults to which the occurrence of epilepsy might be attributed), and uncomplicated epilepsy presentations were compared to healthy sibling controls...
April 4, 2017: Epilepsia
https://www.readbyqxmd.com/read/28378422/derivation-and-initial-validation-of-a-surgical-grading-scale-for-the-preliminary-evaluation-of-adult-patients-with-drug-resistant-focal-epilepsy
#16
Patricia Dugan, Chad Carlson, Nathalie Jetté, Samuel Wiebe, Marjorie Bunch, Ruben Kuzniecky, Jacqueline French
OBJECTIVE: Presently, there is no simple method at initial presentation for identifying a patient's likelihood of progressing to surgery and a favorable outcome. The Epilepsy Surgery Grading Scale (ESGS) is a three-tier empirically derived mathematical scale with five categories: magnetic resonance imaging (MRI), electroencephalography (EEG), concordance (between MRI and EEG), semiology, and IQ designed to stratify patients with drug-resistant focal epilepsy based on their likelihood of proceeding to resective epilepsy surgery and achieving seizure freedom...
April 4, 2017: Epilepsia
https://www.readbyqxmd.com/read/28374950/remission-in-epilepsy-how-long-is-enough
#17
Matti Sillanpää, Dieter Schmidt, Maiju M Saarinen, Shlomo Shinnar
OBJECTIVE: The International League Against Epilepsy (ILAE) has proposed to expand the definition of remission to 10 years seizure-free with the last 5 years off antiepileptic drugs (AEDs). We examined if a 10-year remission is needed to predict the lowest recurrence risk. METHODS: The population-based study cohort consisted of 148 patients with new-onset childhood epilepsy living in the catchment area of Turku University Hospital. They were prospectively followed for 44 years (median)...
April 4, 2017: Epilepsia
https://www.readbyqxmd.com/read/28374921/intracerebral-delivery-of-the-m2-polarizing-cytokine-interleukin-13-using-mesenchymal-stem-cell-implants-in-a-model-of-temporal-lobe-epilepsy-in-mice
#18
Idrish Ali, Stephanie Aertgeerts, Debbie Le Blon, Daniele Bertoglio, Chloe Hoornaert, Peter Ponsaerts, Stefanie Dedeurwaerdere
OBJECTIVES: Neuroinflammation plays a critical role in the pathophysiology of mesial temporal lobe epilepsy. We aimed to evaluate whether intracerebral transplantation of interleukin 13-producing mesenchymal stem cells (IL-13 MSCs) induces an M2 microglia/macrophage activation phenotype in the hippocampus with an epileptogenic insult, thereby providing a neuroprotective environment with reduced epileptogenesis. METHODS: Genetically engineered syngeneic IL-13 MSCs or vehicle was injected within the hippocampus 1 week before the intrahippocampal kainic acid-induced status epilepticus (SE) in C57BL/6J mice...
April 4, 2017: Epilepsia
https://www.readbyqxmd.com/read/28369834/an-examination-of-biochemical-parameters-and-their-association-with-response-to-ketogenic-dietary-therapies
#19
Natasha E Schoeler, Gail Bell, Alan Yuen, Adam D Kapelner, Simon J R Heales, J Helen Cross, Sanjay Sisodiya
OBJECTIVE: In the absence of specific metabolic disorders, accurate predictors of response to ketogenic dietary therapies (KDTs) for treating epilepsy are largely unknown. We hypothesized that specific biochemical parameters would be associated with the effectiveness of KDT in humans with epilepsy. The parameters tested were β-hydroxybutyrate, acetoacetate, nonesterified fatty acids, free and acylcarnitine profile, glucose, and glucose-ketone index (GKI). METHODS: Biochemical results from routine blood tests conducted at baseline prior to initiation of KDT and at 3-month follow-up were obtained from 13 adults and 215 children with KDT response data from participating centers...
April 3, 2017: Epilepsia
https://www.readbyqxmd.com/read/28369748/reasons-for-discontinuation-of-reversible-contraceptive-methods-by-women-with-epilepsy
#20
Hannah B Mandle, Kaitlyn E Cahill, Kristen M Fowler, W Allen Hauser, Anne R Davis, Andrew G Herzog
OBJECTIVE: To report the reasons for discontinuation of contraceptive methods by women with epilepsy (WWE). METHODS: These retrospective data come from a web-based survey regarding the contraceptive practices of 1,144 WWE in the community, ages 18-47 years. We determined the frequencies of contraceptive discontinuations and the reasons for discontinuation. We compared risk ratios for rates of discontinuation among contraceptive methods and categories. We used chi-square analysis to test the independence of discontinuation reasons among the various contraceptive methods and categories and when stratified by antiepileptic drug (AED) categories...
April 3, 2017: Epilepsia
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