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https://www.readbyqxmd.com/read/28202220/diagnostic-yield-of-ambulatory-eegs-in-the-elderly
#1
Benjamin Tolchin, Jong Woo Lee, Milena Pavlova, Barbara A Dworetzky, Rani A Sarkis
OBJECTIVE: The diagnostic yield of ambulatory EEG in the elderly is not known. We sought to determine diagnostic yield and identify factors predicting diagnostic findings in this elderly population. METHODS: We reviewed 156 consecutive 24-72h ambulatory EEGs performed on patients aged 60 or older. RESULTS: Of the 156 studies, 58 studies (37%) revealed potentially diagnostic findings: either epileptiform discharges, an epileptic seizure, or a typical nonepileptic event...
January 29, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28185785/can-antibiotics-cause-a-psychosis-case-report-and-review-of-the-literature
#2
Duy Ly, Lynn E DeLisi
It is relatively unknown that some of the possible side effects of antibiotic treatment can be transient psychotic episodes and other encephalopathies such as seizure disorders. Since these are rare events, there have not been many studies about them, nor is there a clear understanding of the underlying basis for these symptoms. This phenomenon was recently brought to our attention by a patient whose case history is discussed here. For the past few years, he has been diagnosed at different times with schizophrenia, schizoaffective disorder, bipolar disorder with psychosis, temporal lobe epilepsy, and psychogenic nonepileptic seizures...
February 6, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28139826/neonatal-nonepileptic-myoclonus-is-a-prominent-clinical-feature-of-kcnq2-gain-of-function-variants-r201c-and-r201h
#3
Sarah B Mulkey, Bruria Ben-Zeev, Joost Nicolai, John L Carroll, Sabine Grønborg, Yong-Hui Jiang, Nishtha Joshi, Megan Kelly, David A Koolen, Mohamad A Mikati, Kristen Park, Phillip L Pearl, Ingrid E Scheffer, Rebecca C Spillmann, Maurizio Taglialatela, Silvia Vieker, Sarah Weckhuysen, Edward C Cooper, Maria Roberta Cilio
OBJECTIVE: To analyze whether KCNQ2 R201C and R201H variants, which show atypical gain-of-function electrophysiologic properties in vitro, have a distinct clinical presentation and outcome. METHODS: Ten children with heterozygous, de novo KCNQ2 R201C or R201H variants were identified worldwide, using an institutional review board (IRB)-approved KCNQ2 patient registry and database. We reviewed medical records and, where possible, interviewed parents and treating physicians using a structured, detailed phenotype inventory focusing on the neonatal presentation and subsequent course...
January 31, 2017: Epilepsia
https://www.readbyqxmd.com/read/28131930/the-approach-to-patients-with-psychogenic-nonepileptic-seizures-in-epilepsy-surgery-centers-regarding-diagnosis-treatment-and-education
#4
Kette D Valente, Luciano De Paola, Andre Palmini, Eduardo Faveret, Gerardo Maria de Araujo-Filho, Helio van der Linden, Marino M Bianchin, Roger Walz, Rudá Alessi, Tonicarlo Velasco, Wagner A Teixeira, W Curt LaFrance
Previous studies, using surveys, provided an understanding about how health-care providers address patients with PNES. To date, there is limited information on the management of patients with PNES by tertiary referral centers for epilepsy. In this study, we surveyed 11 Brazilian epilepsy center directors about diagnosis, treatment, education and research on PNES. Respondents reported that patients with PNES represented 10-20% of all adult patients recorded by video-EEG (VEEG). All respondents recognized VEEG as the method to confirm the diagnosis, and 81...
January 26, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28109986/comparative-prediction-of-nonepileptic-events-using-mmpi-2-clinical-scales-harris-lingoes-subscales-and-restructured-clinical-scales
#5
Karim Z Yamout, Robin J Heinrichs, Lyle E Baade, Dana K Soetaert, Kore K Liow
The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) is a psychological testing tool used to measure psychological and personality constructs. The MMPI-2 has proven helpful in identifying individuals with nonepileptic events/nonepileptic seizures. However, the MMPI-2 has had some updates that enhanced its original scales. The aim of this article was to test the utility of updated MMPI-2 scales in predicting the likelihood of non-epileptic seizures in individuals admitted to an EEG video monitoring unit...
January 18, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28092837/differential-diagnosis-of-a-paroxysmal-neurological-event-do-neurologists-know-how-to-clinically-recognize-it
#6
Aleksandar J Ristić, Ksenija Mijović, Zoran Bukumirić, Nikola Vojvodić, Slavko Janković, Vladimir Baščarević, Tijana Đukić, Dragoslav Sokić
PURPOSE: To investigate ability to recognize paroxysmal neurological events (PNE) based on video-recorded events alone in a group of physicians treating prevalent neurological conditions. METHODS: Total of 12 patients' videos (6 epileptic seizures (ES), 4 psychogenic nonepileptic seizures (PNES), 2 other nonepileptic seizures (oNES)) were selected. Videos were displayed once to physicians blind to clinical data and final diagnosis. Physicians determined their clinical choice: ES, PNES, oNES, and I don't know (IDK)...
January 13, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28090678/the-epileptic-and-nonepileptic-spectrum-of-paroxysmal-dyskinesias-channelopathies-synaptopathies-and-transportopathies
#7
REVIEW
Roberto Erro, Kailash P Bhatia, Alberto J Espay, Pasquale Striano
Historically, the syndrome of primary paroxysmal dyskinesias was considered a group of disorders as a result of ion channel dysfunction. This proposition was primarily based on the discovery of mutations in ion channels, which caused other episodic neurological disorders such as epilepsy and migraine and also supported by the frequent association between paroxysmal dyskinesias and epilepsy. However, the discovery of the genes responsible for the 3 classic forms of paroxysmal dyskinesias disproved this ion channel theory...
January 16, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/28087824/neuropathology-of-sudep-role-of-inflammation-blood-brain-barrier-impairment-and-hypoxia
#8
Zuzanna Michalak, Dima Obari, Matthew Ellis, Maria Thom, Sanjay M Sisodiya
OBJECTIVE: To seek a neuropathologic signature of sudden unexpected death in epilepsy (SUDEP) in a postmortem cohort by use of immunohistochemistry for specific markers of inflammation, gliosis, acute neuronal injury due to hypoxia, and blood-brain barrier (BBB) disruption, enabling the generation of hypotheses about potential mechanisms of death in SUDEP. METHODS: Using immunohistochemistry, we investigated the expression of 6 markers (CD163, human leukocyte antigen-antigen D related, glial fibrillary acid protein, hypoxia-inducible factor-1α [HIF-1α], immunoglobulin G, and albumin) in the hippocampus, amygdala, and medulla in 58 postmortem cases: 28 SUDEP (definite and probable), 12 epilepsy controls, and 18 nonepileptic sudden death controls...
February 7, 2017: Neurology
https://www.readbyqxmd.com/read/28042592/paroxysmal-nonepileptic-events-in-glut1-deficiency
#9
Joerg Klepper, Baerbel Leiendecker, Christin Eltze, Nicole Heussinger
View Supplementary Video Movement disorders are a major feature of Glut1 deficiency. As recently identified in adults with paroxysmal exercise-induced dystonia, similar events were reported in pediatric Glut1 deficiency. In a case series, parent videos of regular motor state and paroxysmal events were requested from children with Glut1 deficiency on clinical follow-up. A questionnaire was sent out to 60 families. Videos of nonparoxysmal/paroxysmal states in 3 children illustrated the ataxic-dystonic, choreatiform, and dyskinetic-dystonic nature of paroxysmal events...
November 2016: Movement Disorders Clinical Practice
https://www.readbyqxmd.com/read/28039841/how-reliable-is-ictal-duration-to-differentiate-psychogenic-nonepileptic-seizures-from-epileptic-seizures
#10
Udaya Seneviratne, Erica Minato, Eldho Paul
We sought to investigate (1) differences in ictal duration between psychogenic nonepileptic seizures (PNES) and epileptic seizures (ES), (2) the odds of being PNES when seizures last ≥5min, and (3) the value of ictal duration as a diagnostic test to differentiate PNES from ES. We retrospectively reviewed video-EEG recordings and tabulated ictal durations of all PNES and ES. We estimated the mean ictal durations of PNES and ES using linear mixed models. The odds of being PNES when seizures last ≥5min were estimated using logistic regression...
January 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28027373/new-onset-seizure-in-adults-and-adolescents-a-review
#11
REVIEW
Jay R Gavvala, Stephan U Schuele
Importance: Approximately 8% to 10% of the population will experience a seizure during their lifetime. Only about 2% to 3% of patients go on to develop epilepsy. Understanding the underlying etiology leading to an accurate diagnosis is necessary to ensure appropriate treatment and that patients with low risk for recurrence are not treated unnecessarily. Observations: Patients can present with new-onset seizure for a variety of reasons such as acute symptomatic seizures due to acute brain injury or metabolic derangements, or unprovoked seizures that are the initial manifestation of epilepsy...
27, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28007363/an-emergency-medicine-focused-review-of-seizure-mimics
#12
James Webb, Brit Long, Alex Koyfman
BACKGROUND: Seizures result in a change in motor, sensory, and behavioral symptoms caused by abnormal neurologic electrical activity. The symptoms share similar presentations of several other conditions, leading to difficulties in diagnosis and frequent improper management. OBJECTIVE: This review evaluates adult patients with suspected seizure, signs and symptoms of seizure, mimics of seizure, and an approach to management of seizure mimics. DISCUSSION: A seizure is caused by abnormal neurologic electrical activity resulting in altered motor, sensory, and behavioral symptoms...
December 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27988107/understanding-psychogenic-nonepileptic-seizures-phenomenology-semiology-and-the-integrative-cognitive-model
#13
Markus Reuber, Richard J Brown
Psychogenic Nonepileptic Seizures (PNES) are one of the commonest differential diagnoses of epilepsy. This paper provides a narrative review of what has been learnt in the last 25 years regarding the visible manifestations, physiological features, subjective experiences and interactional aspects of PNES. We then explore how current insights into PNES semiology and phenomenology map onto the Integrative Cognitive Model (ICM), a new account of these phenomena that unifies previous approaches within a single explanatory framework...
November 15, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27955838/risk-factors-for-diagnostic-delay-in-psychogenic-nonepileptic-seizures-among-children-and-adolescents
#14
Kette D Valente, Ruda Alessi, Silvia Vincentiis, Bernardo Dos Santos, Patricia Rzezak
BACKGROUND: This study aims to analyze a series of pediatric patients with psychogenic nonepileptic seizures (PNES) to establish the diagnostic gap and possible risk factors for the delayed diagnosis in this age group. METHODS: We evaluated all children with PNES documented by video electroencephalography. None had a previous diagnosis of PNES. In total, we included 53 children (interquartile range: 7 to 17 years; mean age 12.81 years [S.D. 3.15]; 60.4% girls) who underwent a protocol consisting of neurological and psychiatric interviews...
November 9, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27888513/decreased-allopregnanolone-levels-in-cerebrospinal-fluid-obtained-during-status-epilepticus
#15
Stefano Meletti, Chiara Lucchi, Giulia Monti, Giada Giovannini, Roberta Bedin, Tommaso Trenti, Cecilia Rustichelli, Giuseppe Biagini
Neuroactive steroids are increasingly considered as relevant modulators of neuronal activity. Especially allopregnanolone (AP) and pregnenolone sulfate (PS) have been shown to possess, respectively, anticonvulsant or proconvulsant properties. In view of the potential role of these steroids, we aimed at evaluating AP and PS levels in cerebrospinal fluid (CSF) and blood samples obtained from patients with status epilepticus (SE). To this purpose, we enrolled 41 patients affected by SE and 41 subjects investigated for nonepileptic neurologic disorders...
November 26, 2016: Epilepsia
https://www.readbyqxmd.com/read/27776298/neurologists-can-identify-diagnostic-linguistic-features-during-routine-seizure-clinic-interactions-results-of-a-one-day-teaching-intervention
#16
Laura Jenkins, Jeremy Cosgrove, Paul Chappell, Ammar Kheder, Dilraj Sokhi, Markus Reuber
The diagnostic distinction between epilepsy and psychogenic nonepileptic seizures (PNES) can be challenging. Previous studies have demonstrated that experts in conversation analysis can identify linguistic and interactional features in transcripts and recordings of interviews with patients that reliably distinguish between epilepsy and PNES. In this study, ten senior neurology trainees took part in a one-day intervention workshop about linguistic and interactional differences in the conversation behavior of patients with epilepsy and those with PNES...
October 21, 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/27743551/early-childhood-trauma-and-hippocampal-volumes-in-patients-with-epileptic-and-psychogenic-seizures
#17
Benjamin Johnstone, Dennis Velakoulis, Cheng Yi Yuan, Anthony Ang, Chris Steward, Patricia Desmond, Terence J O'Brien
OBJECTIVE: Exposure to early life childhood trauma has been implicated as resulting in a vulnerability to epileptic and psychogenic nonepileptic seizures (PNES), hippocampal atrophy, and psychiatric disorders. This study aimed to explore the relationships between childhood trauma, epilepsy, PNES, and hippocampal volume in patients admitted to a video-electroencephalogram monitoring (VEM) unit. METHODS: One hundred thirty-one patients were recruited from the Royal Melbourne Hospital VEM unit...
November 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/27737716/brain-region-and-epilepsy-associated-differences-in-inflammatory-mediator-levels-in-medically-refractory-mesial-temporal-lobe-epilepsy
#18
Kenneth I Strauss, Kost V Elisevich
BACKGROUND: Epilepsy patients have distinct immune/inflammatory cell profiles and inflammatory mediator levels in the blood. Although the neural origin of inflammatory cells and mediators has been implied, few studies have measured these inflammatory components in the human brain itself. This study examines the brain levels of chemokines (8), cytokines (14), and vascular injury mediators (3) suspected of being altered in epilepsy. METHODS: Soluble protein extracts of fresh frozen resected hippocampus, entorhinal cortex, and temporal cortex from 58 medically refractory mesial temporal lobe epilepsy subjects and 4 nonepileptic neurosurgical subjects were assayed for 25 inflammation-related mediators using ultrasensitive low-density arrays...
October 13, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27723497/communicating-diagnostic-certainty-of-psychogenic-nonepileptic-seizures-a-national-study-of-provider-documentation
#19
Hamada H Altalib, Khalid Elzamzamy, Mary Jo Pugh, Javier Ballester Gonzalez, Kei-Hoi Cheung, Brenda T Fenton, Robert D Kerns, Cynthia A Brandt, W Curt LaFrance
Management of psychogenic nonepileptic seizures (PNES) requires collaboration among and between health care professionals. Although criteria are established for diagnosis of PNES, miscommunication between neurologists, primary care providers, and mental health professionals may occur if the clinical impression is not clearly articulated. We extracted progress notes from the Department of Veterans Affairs (VA) electronic health record (EHR) nationally to study veterans who were evaluated for PNES. Of the 750 patients being worked up for PNES, the majority of patients did not meet criteria for PNES (64...
October 7, 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/27723496/ictal-verbal-help-seeking-occurrence-and-the-underlying-etiology
#20
Ali A Asadi-Pooya, Marjan Asadollahi, Krzysztof Bujarski, Amin H Rabiei, Narsis Aminian, Dale Wyeth, Michael R Sperling
PURPOSE: Ictal verbal help-seeking has never been systematically studied before. In this study, we evaluated a series of patients with ictal verbal help-seeking to characterize its frequency and underlying etiology. METHODS: We retrospectively reviewed all the long-term video-EEG reports from Jefferson Comprehensive Epilepsy Center over a 12-year period (2004-2015) for the occurrence of the term "help" in the text body. All the extracted reports were reviewed and patients with at least one episode of documented ictal verbal help-seeking in epilepsy monitoring unit (EMU) were studied...
October 7, 2016: Epilepsy & Behavior: E&B
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