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Epilepsy Research

Fang Yuan, Fang Yang, Wen Li, Xiai Yang, Qiong Gao, Lijie Bi, Yongli Jiang, Wen Jiang
OBJECTIVES: To investigate clinical characteristics and outcomes of nonconvulsive status epilepticus (NCSE) after convulsive status epilepticus (CSE) and determine risk factors for unfavorable outcomes. METHODS: We reviewed consecutive patients with NCSE after CSE over eight years in the neurological intensive care unit. Clinical presentations and the Salzburg EEG criteria for NCSE were used to identify patients with NCSE after CSE. Demographics, clinical features, and anti-epileptic treatment responses were collected and analyzed...
March 12, 2018: Epilepsy Research
Rui-Fang Wang, Guo-Fang Xue, Christian Hölscher, Miao-Jing Tian, Peng Feng, Ji-Ying Zheng, Dong-Fang Li
Glucagon-like peptide-1(GLP-1) is a growth factor that has neuroprotective and anti-inflammatory properties. The protease resistant GLP-1 analogue liraglutide has been shown to be neuroprotective in previous studies in animal models of Alzheimer's disease or Parkinson's disease. Status epilepticus (SE) is a complex disorder, involving many underlying pathological processes, including excitotoxic and chronic inflammatory events. The present pilot study aims to investigate whether liraglutide alleviates the chronic inflammation response and mitochondrial stress induced by SE in the lithium-pilocarpine animal model...
March 9, 2018: Epilepsy Research
Emily C Mahoney, Andrew Zeng, Wilson Yu, Mackenzie Rowe, Siddhartha Sahai, Paul J Feustel, Adolfo Ramirez-Zamora, Julie G Pilitsis, Damian S Shin
Approximately 30% of individuals with epilepsy are refractory to antiepileptic drugs and currently approved neuromodulatory approaches fall short of providing seizure freedom for many individuals with limited utility for generalized seizures. Here, we expand on previous findings and investigate whether ventral pallidum deep brain stimulation (VP-DBS) can be efficacious for various acute seizure phenotypes. For rats administered pilocarpine, we found that VP-DBS (50 Hz) decreased generalized stage 4/5 seizure median frequency from 9 to 6 and total duration from 1667 to 264 s even after generalized seizures emerged...
March 9, 2018: Epilepsy Research
Ariana Sherdil, Stéphan Chabardès, Isabelle Guillemain, Sandrine Michallat, Shivadatta Prabhu, Karine Pernet-Gallay, Olivier David, Brigitte Piallat
PURPOSE: Our objective was to propose a new on demand non-human primate model of mesial temporal lobe seizures suitable for pre-clinical innovative therapeutic research. METHODS: Five macaques were stereotaxically implanted unilaterally with a deep recording electrode in the hippocampus. For each experiment, penicillin was injected into the hippocampus and animals were monitored during five consecutive hours. A total of 12-27 experiments with a mean cumulative dose of 162644 ± 70190 UI of penicillin have been performed per animal Injections were repeated at least once a week over a period of 98-276 days...
March 9, 2018: Epilepsy Research
Eimer Maloney, Ronan N McGinty, Daniel J Costello
PURPOSE: Reporting of 'real-world' data on efficacy and tolerability of antiepileptic medications helps to inform physicians on how newer medications perform in the clinical setting, outside of the strict regimens of clinical trials. We report our experience of prescribing lacosamide monotherapy to a diverse range of patients at our epilepsy centre. METHODS: We performed a single-centre, retrospective review of all patients who had been prescribed lacosamide monotherapy over the last 8 years...
March 8, 2018: Epilepsy Research
Philippe Desmarais, Catherine Miville, Ángela Milán-Tomás, Quoc Dinh Nguyen, Carmen Ojeda-López, Mario Masellis, Sandra E Black, Danielle Molinari Andrade, Nathan Herrmann
OBJECTIVES: To analyze age representation trends over time in antiepileptic drug (AED) trials and to assess trial design elements as possible barriers to enrollment of elderly patients. MATERIALS AND METHODS: We searched MEDLINE, EMBASE, and PsycINFO, and meta-analyzed demographic data of cohorts enrolled in randomized controlled trials (RCTs) of AEDs published since 1991. Data analysis included trends of age representation over time and trial design elements associated with average age of enrolled cohorts...
March 6, 2018: Epilepsy Research
Fiona M Baumer, Brenda E Porter
BACKGROUND: Sunflower Syndrome describes reflex seizures - typically eyelid myoclonia with or without absence seizures - triggered when patients wave their hands in front of the sun. While valproate has been recognized as the best treatment for photosensitive epilepsy, many clinicians now initially treat with newer medications; the efficacy of these medications in Sunflower Syndrome has not been investigated. We reviewed all cases of Sunflower Syndrome seen at our institution over 15 years to describe the clinical course, electroencephalogram (EEG), and treatment response in these patients...
March 3, 2018: Epilepsy Research
Reinaldo Uribe-San-Martín, Ethel Ciampi, Roberta Di Giacomo, Macarena Vásquez, Claudia Cárcamo, Jaime Godoy, Giorgio Lo Russo, Laura Tassi
OBJECTIVE: Our aim in this retrospective study was to explore whether corpus callosum atrophy could predict the post-surgical seizure control in patients with temporal lobe epilepsy associated with Hippocampal Sclerosis (HS). METHODS: We used the Corpus Callosum Index (CCI) obtained from best mid-sagittal T2/FLAIR or T1-weighted MRI at two time-points, more than one year apart. CCI has been mainly used in Multiple Sclerosis (MS), but not in epilepsy, so we tested the validity of our results performing a proof of concept cohort, incorporating MS patients with and without epilepsy...
March 3, 2018: Epilepsy Research
Martin Holtkamp, Lars Büntjen, Friedhelm C Schmitt
New treatment approaches in epilepsy - such as novel antiepileptic drugs and neurostimulation - generally at first are assessed in animal models in regard to feasibility, efficacy and safety. The aim of this review was to elucidate and summarize the available literature on in vivo experimental studies on radiofrequency thermoablation and laser interstitial thermal therapy. We have found two in vivo studies on radiofrequency ablation of an acute seizure focus, one assessed the conventional transcranial and the other one a transvenous approach...
March 3, 2018: Epilepsy Research
Kun Zhu, Bo Yuan, Ming Hu, Cheng-Jun Li, Jie-Hua Xu, Gai-Feng Feng, Yong Liu, Jian-Xin Liu
Pilocarpine-induced acute seizures strongly induce aberrant hippocampal neurogenesis, characterized by increased proliferation of neural progenitors and abnormal integrations of newly generated granule cells - hilar ectopic granule cells (EGCs), mossy fibre sprouting (MFS), and hilar basal dendrites (HBDs), which may disturb hippocampal neuronal circuits and thus contribute to cognitive impairment in temporal lobe epilepsy (TLE) patients and animal models. Previous studies via ablating hippocampal neurogenesis after acute seizures produced inconsistent results regarding the development of long-term cognitive impairment...
March 3, 2018: Epilepsy Research
Alain Lekoubou, Kinfe G Bishu, Bruce Ovbiagele
BACKGROUND: Epilepsy is particularly frequent among children, yet updated and nationwide healthcare utilization estimates are scanty in the United States. OBJECTIVE: To analyze healthcare utilization among children with epilepsy. METHODS: Data on children (≤17-year-old) were extracted from the Medical Expenditure Panel Survey (MEPS) 2003-2014. Epilepsy was identified using the clinical classification code 83. Healthcare utilization (Inpatient admission, outpatient visits, prescription medication including refill, emergency room visits, and home health provider visits) was compared between children with epilepsy and those without epilepsy...
February 27, 2018: Epilepsy Research
Mitsuyo Nishimura, Tohru Okanishi, Ayataka Fujimoto, Sotaro Kanai, Yuki Sasaki, Yoichiro Homma, Hiroshi Otsubo, Hideo Enoki
OBJECTIVE: Ictal scalp EEG patterns have been reported to vary across onset regions. We assessed the sequential EEG changes during seizure events on scalp EEG, and tested our hypothesis that patients with focal seizures arising from the cortex facing the interhemispheric fissure (IHF cortex) would be specifically characterized by 3 phase-EEG patterns (3Ph-EEG). METHODS: Patient inclusion criteria were: 1) focal epilepsy and 2) ictal onset records on scalp and intracranial video-EEG...
February 20, 2018: Epilepsy Research
Jörg Wellmer
Small bottom-of-sulcus focal cortical dysplasias (BOS-FCD) type IIb are intrinsically epileptogenic lesions often responsible for pharmacoresistant epilepsy. They are increasingly well demarcated in vivo from surrounding cortex and white matter by 3 T magnetic resonance imaging (MRI). These facts and frequent seizure freedom after just narrow resections allow questioning the classical concept of epilepsy surgery in which the epileptogenic lesion is generally considered only one part of the epileptogenic zone and the resection volume categorically has to exceed lesion limits...
February 19, 2018: Epilepsy Research
Albena Vassileva, Dorien van Blooijs, Frans Leijten, Geertjan Huiskamp
The aim of this review is to evaluate whether open-loop or closed-loop neocortical electrical stimulation should be the preferred approach to manage seizures in intractable epilepsy. Twenty cases of open-loop neocortical stimulation with an implanted device have been reported, in 5 case studies. Closed-loop stimulation with an implanted device has been investigated in a larger number of patients in the RNS System clinical trials. With 230 patients enrolled at the start of the Long-term Treatment Trial, 115 remained at the last reported follow-up...
February 19, 2018: Epilepsy Research
X L Wu, D M Ma, W Zhang, J S Zhou, Y W Huo, M Lu, F R Tang
Gap junctions play an important role in the synchronization activity of coupled cells. Hippocampal inhibitory interneurons are involved in epileptogenesis and seizure activity, and express gap junction protein connexin (Cx) 36. Cx36 is also localized in the axons (mossy fibers) of granule cells in the dentate gyrus. While it has been documented that Cx36 is involved in epileptogenesis, there are still controversies regarding the expression levels of Cx36 at different developmental stages of human and animal models of epileptogenesis...
February 17, 2018: Epilepsy Research
Shinobu Fukumura, Masanori Sasaki, Yuko Kataoka-Sasaki, Shinichi Oka, Masahito Nakazaki, Hiroshi Nagahama, Tomonori Morita, Takuro Sakai, Hiroyuki Tsutsumi, Jeffery D Kocsis, Osamu Honmou
OBJECTIVE: Status epilepticus (SE) causes neuronal cell death, aberrant mossy fiber sprouting (MFS), and cognitive deteriorations. The present study tested the hypothesis that systemically infused mesenchymal stem cells (MSCs) reduce epileptogenesis by inhibiting neuronal cell death and suppressing aberrant MFS, leading to cognitive function preservation in a rat model of epilepsy. METHODS: SE was induced using the lithium-pilocarpine injection model. The seizure frequency was scored using a video-monitoring system and the Morris water maze test was carried out to evaluate cognitive function...
February 14, 2018: Epilepsy Research
Stephan Arnold, Vincent Badalamenti, Anyzeila Diaz, Teresa Gasalla, Cindy McShea, John Whitesides, Toufic Fakhoury
Brivaracetam (BRV), a selective, high-affinity ligand for synaptic vesicle protein 2A, is a new antiepileptic drug (AED) approved for monotherapy (in the USA) and adjunctive treatment of focal (partial-onset) seizures in adults, at a dose range of 50-200 mg/day taken in two equal doses, with a recommended starting dose of 100 mg/day. Two Phase III, randomized, double-blind, multicenter, historical-controlled, conversion-to-monotherapy studies (N01276, NCT00698581; N01306, NCT00699283) were conducted to evaluate the efficacy, safety, and tolerability of conversion to BRV 50 mg/day monotherapy in adults with uncontrolled focal seizures...
February 12, 2018: Epilepsy Research
Ara Ko, Song Ee Youn, Se Hee Kim, Joon Soo Lee, Sangwoo Kim, Jong Rak Choi, Heung Dong Kim, Seung-Tae Lee, Hoon-Chul Kang
OBJECTIVE: We performed targeted gene-panel sequencing for children with developmental and epileptic encephalopathy (DEE) and evaluated the clinical implications of genotype-phenotype correlations. METHODS: We assessed 278 children with DEE using a customized gene panel that included 172 genes, and extensively reviewed their clinical characteristics, including therapeutic efficacy, according to genotype. RESULTS: In 103 (37.1%) of the 278 patients with DEE, 35 different disease-causing monogenic mutations were identified...
February 12, 2018: Epilepsy Research
Cecilie Johannessen Landmark, Anette Huuse Farmen, Margrete Larsen Burns, Arton Baftiu, Morten I Lossius, Svein I Johannessen, Torbjörn Tomson
BACKGROUND AND PURPOSE: Use of valproate (VPA) in women of childbearing age is restricted due to dose-dependent risk of teratogenicity. The purpose of this study was to characterise pharmacokinetic variability of VPA in pregnancy, and discuss use of therapeutic drug monitoring (TDM) as guidance to exposure in women. METHOD: Measurements of trough total and unbound VPA concentrations before, during and after pregnancy, at assumed steady-state were collected from the TDM-database (2006-2016) at the National Center for Epilepsy in Norway...
February 11, 2018: Epilepsy Research
Kevin M Kelly, Peter I Jukkola, Guo Yin, Eric R Miller, Elena A Kharlamov, Deng-Shan Shiau, Roger Strong, Jaroslaw Aronowski
The mechanisms of injured brain that establish poststroke seizures and epilepsy are not well understood, largely because animal modeling has had limited development. The main objective of this study was to determine whether an arterial occlusion model of cortical stroke in young adult and aged rats was capable of generating either focal or generalized epileptic seizures within 2 months of lesioning. Four- and 20-month-old male Fischer 344 (F344) sham-operated controls and those lesioned by transient (3 h) unilateral middle cerebral artery (MCA) and common carotid artery (CCA) occlusion (MCA/CCAo) were studied by video-EEG recordings up to 2 months post-procedure...
February 10, 2018: Epilepsy Research
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