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Miriam Rubinchik-Stern, Miriam Shmuel, Jacob Bar, Michal Kovo, Sara Eyal
OBJECTIVE: In utero exposure to valproic acid (VPA) has been associated with worse pregnancy outcomes compared to all other antiepileptic drugs. We have previously shown that VPA alters the expression of placental transporters for hormones and nutrients in vitro and in pregnant mice. Here, our aim was to characterize the effects of short exposure to VPA on the expression of carriers for compounds essential for fetal development in human placentas ex vivo, under controlled conditions...
April 17, 2018: Epilepsia
Evy Cleeren, Cindy Casteels, Karolien Goffin, Michel Koole, Koen Van Laere, Peter Janssen, Wim Van Paesschen
OBJECTIVE: We investigated changes in the endocannabinoid system and glucose metabolism during temporal lobe epileptogenesis. METHODS: Because it is rarely possible to study epileptogenesis in humans, we applied the electrical amygdala kindling model in nonhuman primates to image longitudinal changes in type 1 cannabinoid receptor (CB1R) binding and cerebral glucose metabolism. Two rhesus monkeys received [18 F]-MK-9470 and fluorodeoxyglucose-positron emission tomography ([18 F]-FDG -PET) scans in each of the 4 kindling stages to quantify relative changes over time of CB1R binding and cerebral glucose metabolism in vivo...
April 17, 2018: Epilepsia
Antonio Leo, Giada Giovannini, Emilio Russo, Stefano Meletti
Status epilepticus (SE) is typically defined as a prolonged self-sustaining seizure or repeated seizures showing an incomplete recovery between them. SE represents a medical emergency often associated with significant disability, morbidity, and mortality. Despite the clinical impact, the mechanisms underlying the transition from self-limited seizures to protracted, medically refractory seizures are not completely understood. About 40% of patients in established SE are refractory to antiepileptic drugs (first-line treatment); therefore, there is a need for more efficacious drugs...
April 17, 2018: Epilepsia
Olafur Sveinsson, Tomas Andersson, Sofia Carlsson, Torbjörn Tomson
OBJECTIVE: Given the increasing attention being paid to potential strategies for sudden unexpected death in epilepsy (SUDEP) prevention, we analyzed the circumstances of SUDEP and its incidence in relation to time of year, week, and day. METHODS: Prospective case-series based on persons with an all International Classification of Diseases (ICD-10) code for epilepsy in the Swedish Patient Registry 1998-2005, who were alive on June 30, 2006 (n = 60 952). Linkage to the National Cause-of-Death Registry identified all deaths from July 2006 through December 2011, with epilepsy mentioned on death certificate, together with deaths during 2008 (n = 3166)...
April 17, 2018: Epilepsia
Anna Rosati, Lucrezia Ilvento, Riccardo Rizzi, Viola Doccini, Maria Carmela Leo, Alessandra Pugi, Salvatore De Masi, Renzo Guerrini
OBJECTIVE: To assess long-term efficacy and tolerability of lacosamide (LCM) as adjunctive treatment through a retrospective study in children and adolescents with refractory epilepsies. METHODS: All patients consecutively treated with LCM as add-on for refractory focal and generalized epilepsy and followed at the Neuroscience Center of Excellence of the Meyer Children's Hospital of Florence between January 2011 and September 2015 were included in the study. Responder rate, relapse-free survival, and retention rate were calculated...
April 17, 2018: Epilepsia
Christopher Alan Reid, Ben Rollo, Steven Petrou, Samuel F Berkovic
Epilepsy has a strong genetic component, with an ever-increasing number of disease-causing genes being discovered. Most epilepsy-causing mutations are germ line and thus present from conception. These mutations are therefore well positioned to have a deleterious impact during early development. Here we review studies that investigate the role of genetic lesions within the early developmental window, specifically focusing on genetic generalized epilepsy (GGE). Literature on the potential pathogenic role of sub-mesoscopic structural changes in GGE is also reviewed...
April 16, 2018: Epilepsia
Leone Ridsdale, Gabriella Wojewodka, Emily J Robinson, Adam J Noble, Myfanwy Morgan, Stephanie J C Taylor, Paul McCrone, Mark P Richardson, Gus Baker, Sabine Landau, Laura H Goldstein
OBJECTIVE: Epilepsy is one of the most common neurological conditions affecting about 1% of adults. Up to 40% of people with epilepsy (PWE) report recurring seizures while on medication. And optimal functioning requires good self-management. Our objective was to evaluate a group self-management education courses for people with epilepsy and drug-resistant seizures by means of a multicenter, pragmatic, parallel group, randomized controlled trial. METHODS: We recruited adults with epilepsy, having ≥2 seizures in the prior 12 months, from specialist clinics...
April 16, 2018: Epilepsia
Anny Reyes, Brianna M Paul, Anisa Marshall, Yu-Hsuan A Chang, Naeim Bahrami, Leena Kansal, Vicente J Iragui, Evelyn S Tecoma, Tamar H Gollan, Carrie R McDonald
OBJECTIVE: Bilingual healthy adults have been shown to exhibit an advantage in executive functioning (EF) that is associated with microstructural changes in white matter (WM) networks. Patients with temporal lobe epilepsy (TLE) often show EF deficits that are associated with WM compromise. In this study, we investigate whether bilingualism can increase cognitive reserve and/or brain reserve in bilingual patients with TLE, mitigating EF impairment and WM compromise. METHODS: Diffusion tensor imaging was obtained in 19 bilingual and 26 monolingual patients with TLE, 12 bilingual healthy controls (HC), and 21 monolingual HC...
April 16, 2018: Epilepsia
Amanda S Lindy, Mary Beth Stosser, Elizabeth Butler, Courtney Downtain-Pickersgill, Anita Shanmugham, Kyle Retterer, Tracy Brandt, Gabriele Richard, Dianalee A McKnight
OBJECTIVE: We evaluated >8500 consecutive, unselected patients with epilepsy and neurodevelopmental disorders who underwent multigene panel testing to determine the average age at molecular diagnosis and diagnostic yield of 70 genes. METHODS: We reviewed molecular test results for 70 genes known to cause epilepsy and neurodevelopmental disorders using next generation sequencing (NGS) and exon-level array comparative genomic hybridization (aCGH). A positive result was defined as the presence of 1 or 2 pathogenic or likely pathogenic (P/LP) variants in a single gene, depending on the mode of inheritance of the associated disorder...
April 14, 2018: Epilepsia
Evelien E Geertsema, Roland D Thijs, Therese Gutter, Ben Vledder, Johan B Arends, Frans S Leijten, Gerhard H Visser, Stiliyan N Kalitzin
People with epilepsy need assistance and are at risk of sudden death when having convulsive seizures (CS). Automated real-time seizure detection systems can help alert caregivers, but wearable sensors are not always tolerated. We determined algorithm settings and investigated detection performance of a video algorithm to detect CS in a residential care setting. The algorithm calculates power in the 2-6 Hz range relative to 0.5-12.5 Hz range in group velocity signals derived from video-sequence optical flow...
April 11, 2018: Epilepsia
Una Avdic, Matilda Ahl, Deepti Chugh, Idrish Ali, Karthik Chary, Alejandra Sierra, Christine T Ekdahl
OBJECTIVE: Status epilepticus (SE) is an abnormally prolonged epileptic seizure that if associated with convulsive motor symptoms is potentially life threatening for a patient. However, 20%-40% of patients with SE lack convulsive events and instead present with more subtle semiology such as altered consciousness and less motor activity. Today, there is no general consensus regarding to what extent nonconvulsive SE (NCSE) is harmful to the brain, which adds uncertainty to stringent treatment regimes...
April 10, 2018: Epilepsia
David J Thurman, Charles E Begley, Arturo Carpio, Sandra Helmers, Dale C Hesdorffer, Jie Mu, Kamadore Touré, Karen L Parko, Charles R Newton
Among the causes of epilepsy are several that are currently preventable. In this review, we summarize the public health burden of epilepsy arising from such causes and suggest priorities for primary epilepsy prevention. We conducted a systematic review of published epidemiologic studies of epilepsy of 4 preventable etiologic categories-perinatal insults, traumatic brain injury (TBI), central nervous system (CNS) infection, and stroke. Applying consistent criteria, we assessed the quality of each study and extracted data on measures of risk from those with adequate quality ratings, summarizing findings across studies as medians and interquartile ranges...
April 10, 2018: Epilepsia
Bo Jin, Balu Krishnan, Sophie Adler, Konrad Wagstyl, Wenhan Hu, Stephen Jones, Imad Najm, Andreas Alexopoulos, Kai Zhang, Jianguo Zhang, Meiping Ding, Shuang Wang, Zhong Irene Wang
OBJECTIVE: Focal cortical dysplasia (FCD) is a major pathology in patients undergoing surgical resection to treat pharmacoresistant epilepsy. Magnetic resonance imaging (MRI) postprocessing methods may provide essential help for detection of FCD. In this study, we utilized surface-based MRI morphometry and machine learning for automated lesion detection in a mixed cohort of patients with FCD type II from 3 different epilepsy centers. METHODS: Sixty-one patients with pharmacoresistant epilepsy and histologically proven FCD type II were included in the study...
April 10, 2018: Epilepsia
Johan B A M Arends
This is a critical review and comment on the use of movement detection in epileptic seizures. The detection of rhythmic movement components, such as the clonic part of tonic-clonic seizures, is essential in all seizure detection based on movement sensors. Of the many available movement sensor types, accelerometric sensors are used most often. Eleven video-electroencephalographic (EEG) and 1 field study have been carried out. The results of these clinical trials depend on the population, study design, and seizure evolution...
April 9, 2018: Epilepsia
Jeffrey R Tenney, Darren S Kadis, William Agler, Leonid Rozhkov, Mekibib Altaye, Jing Xiang, Jennifer Vannest, Tracy A Glauser
OBJECTIVE: The understanding of childhood absence epilepsy (CAE) has been revolutionized over the past decade, but the biological mechanisms responsible for variable treatment outcomes are unknown. Our purpose in this prospective observational study was to determine how pretreatment ictal network pathways, defined using a combined electroencephalography (EEG)-functional magnetic resonance imaging (EEG-fMRI) and magnetoencephalography (MEG) effective connectivity analysis, were related to treatment response...
April 6, 2018: Epilepsia
Daniel E Payne, Philippa J Karoly, Dean R Freestone, Ray Boston, Wendyl D'Souza, Ewan Nurse, Levin Kuhlmann, Mark J Cook, David B Grayden
OBJECTIVE: We report on patient-specific durations of postictal periods in long-term intracranial electroencephalography (iEEG) recordings. The objective was to investigate the relationship between seizure duration and postictal suppression duration. METHODS: Long-term recording iEEG from 9 patients (>50 seizures recorded) were analyzed. In total, 2310 seizures were recorded during a total of 13.8 years of recording. Postictal suppression duration was calculated as the duration after seizure termination until total signal energy returned to background levels...
April 6, 2018: Epilepsia
Shilpa Pathak, James Miller, Emily C Morris, William C L Stewart, David A Greenberg
OBJECTIVE: Juvenile myoclonic epilepsy (JME) is a common adolescent-onset genetic generalized epilepsy (GGE) syndrome. Multiple linkage and association studies have found that BRD2 influences the expression of JME. The BRD2-JME connection is further corroborated by our murine model; Brd2 haploinsufficiency produces characteristics that typify the clinical hallmarks of JME. Neither we, nor several large-scale studies of JME, found JME-related BRD2 coding mutations. Therefore, we investigated noncoding BRD2 regions, seeking the origin of BRD2's JME influence...
April 2, 2018: Epilepsia
Daniel M Goldenholz, Robert Moss, David A Jost, Nathan E Crone, Gregory Krauss, Rosalind Picard, Chiara Caborni, Jose E Cavazos, John Hixson, Tobias Loddenkemper, Tracy Dixon Salazar, Laura Lubbers, Lauren C Harte-Hargrove, Vicky Whittemore, Jonas Duun-Henriksen, Eric Dolan, Nitish Kasturia, Mark Oberemk, Mark J Cook, Mark Lehmkuhle, Michael R Sperling, Patricia O Shafer
OBJECTIVE: Common data elements (CDEs) are currently unavailable for mobile health (mHealth) in epilepsy devices and related applications. As a result, despite expansive growth of new digital services for people with epilepsy, information collected is often not interoperable or directly comparable. We aim to correct this problem through development of industry-wide standards for mHealth epilepsy data. METHODS: Using a group of stakeholders from industry, academia, and patient advocacy organizations, we offer a consensus statement for the elements that may facilitate communication among different systems...
March 31, 2018: Epilepsia
Gabriele Zanirati, Pamella Nunes Azevedo, Gianina Teribele Venturin, Samuel Greggio, Allan Marinho Alcará, Eduardo R Zimmer, Paula Kopschina Feltes, Jaderson Costa DaCosta
OBJECTIVE: Temporal lobe epilepsy (TLE) is one of the most common types of epilepsy syndromes in the world. Depression is an important comorbidity of epilepsy, which has been reported in patients with TLE and in different experimental models of epilepsy. However, there is no established consensus on which brain regions are associated with the manifestation of depression in epilepsy. Here, we investigated the alterations in cerebral glucose metabolism and the metabolic network in the pilocarpine-induced rat model of epilepsy and correlated it with depressive behavior during the chronic phase of epilepsy...
March 30, 2018: Epilepsia
Sebastian Szklener, Magdalena Godek, Agnieszka Korchut, Luiza Balicka-Adamik, Robert Rejdak, Andrea O Rossetti, Konrad Rejdak
Acute repetitive seizures (ARS) pose a risk of hospital admission with status epilepticus and a mortality threat, which underscores the need for the early prediction of a clinical course. Unfortunately, little attention has been given to ARS in this context, even though we possess the appropriate predictive tools for the stages of status epilepticus. Therefore, the main aim of this study was to assess the prognostic value of the Status Epilepticus Severity Score (STESS) in the population of patients with ARS...
March 30, 2018: Epilepsia
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