Seizure

Ictal respiratory changes (IRCs) have been recognized for more than 100 years [1] and are commonly seen in generalized and focal seizures [2]. IRCs include a range of alterations, from central and obstructive apnea, tachypnoea, bradypnea to hypoventilation and hypoxemia [3]. IRCs, and most importantly respiratory depression such as hypoxemia, hypercapnia and central apnea, have attracted attention in several clinical contexts, including SUDEP [4–6] and seizure detection in the epilepsy monitoring unit [7–9].

Status epilepticus (SE) is one of the most common neurologic emergencies with an overall incidence between 14-40/100,000 people per year. [1–5] There is medical consensus that brain imaging is recommended for all children and adults with new onset localization related seizures or SE [6–9]. Computed tomography (CT) and magnetic resonance imaging (MRI) are the most commonly employed methods to evaluate patients with SE. The aim and utility of imaging studies in SE falls into four overlapping categories: diagnosis, localization, evaluating ...

Lacosamide, a novel anti-epileptic drug (AED) that enhances the slow inactivation of voltage-gated sodium channels, is widely used to treat seizures associated with focal onset epilepsy. Common adverse effects of lacosamide include dizziness, vertigo, ataxia, and diplopia [1].

Status epilepticus in children is a common and serious condition that requires urgent treatment. A number of significant developments have occurred in the past few years that have changed clinical practice– and the publication of this supplement is very timely. Advances have been made in various research areas and the thirteen articles in this supplement provide a good overview of some of these.

Sudden unexpected death in epilepsy (SUDEP) is the most important directly epilepsy-related cause of death, with an estimated incidence of 1.2 cases per 1,000 adult epilepsy patients per year [1]. Some risk factors were identified including longstanding epilepsy and frequent generalized tonic-clonic seizures [1], but it is still challenging to estimate the individual SUDEP risk. The fatal cascade leading to SUDEP mostly involves primary central apnea following generalized tonic-clonic seizures [2].

The index case is a 3-year old boy with Dravet syndrome (de novo mutation in SCN1A gene; p.Ala889Thr [A889 T] variant) born to a non-consanguineous couple of south Indian origin. After an unremarkable early infancy, he presented with infrequent unprovoked hemi-clonic and generalized tonic-clonic seizures at 5 months of age. These were relatively controlled on oral low dose valproate. He had mild delay but could walk with support and spoke 4-5 words at 18 months of age. At 18 months of ...

Brivaracetam (BRV) is the latest anti-epileptic drug (AED) approved for adjunctive therapy of focal onset seizures and was introduced to the German market in February 2016. Similarly to Levetiracetam (LEV), BRV acts through binding synaptic vesicle protein 2 A which plays a role in synaptic vesicle trafficking and is distributed almost ubiquitously in the central nervous system. Orally administered BRV is resorbed completely and quickly and is metabolized via cytochrome P450-dependent and -independent pathways with its metabolites being eliminated renally.

Convulsive status epilepticus (CSE) is a common neurologic emergency in childhood and one of the most common reasons for admission to the pediatric intensive care unit [1,2]. CSE is defined as a prolonged convulsive seizure or multiple seizures without return to the baseline level of functioning between seizures. The estimated incidence of pediatric CSE is 20 cases per 100,000 children per year with a mortality ranging from 0 to 11 % [3–14]. Mortality is higher (4-22%) with symptomatic than idiopathic ...

Previous surveys have demonstrated that areas with high onchocerciasis transmission are prone to an increased prevalence of epilepsy (1). To describe this epidemiological phenomenon, the term onchocerciasis-associated epilepsy (OAE) was proposed that includes different seizure presentations including nodding syndrome (NS) (2,3). NS was first investigated in 2001–2 in Lui and Amadi in Western Equatoria region, South Sudan, by a team led by the World Health Organization (WHO) (4). Three small case control studies (82 pairs in total) performed during these ...

Psychogenic nonepileptic seizures (PNES) are episodic in nature, and many patients are initially misdiagnosed as having epilepsy. Most patients subsequently diagnosed with PNES in specialized centers are on antiepileptic drugs (AEDs) at the time of their referral. This has cost and added adverse effects of AEDs. Recognition of PNES can be difficult even for physicians. [1] Though certain clues in the semiology could suggest that the seizure is non-epileptic, the gold-standard for its diagnosis is the demonstration of a typical ...