Seizure

The coronavirus disease 2019 (COVID-19) pandemic has caused disproportionate morbidity and mortality in older adults, especially those with pre-existing conditions.[1],[2],[3] While certain pre-existing conditions such as diabetes and cardiovascular disease have been associated with COVID-19 severity in older adults,[2] the contribution of other chronic diseases to mortality and morbidity have been less well studied. There is little work investigating how neurological conditions, specifically epilepsy, affect older adults with COVID-19.

Epilepsy, a neurological illness, impacted the world [1]. The reported lifetime prevalence of active epilepsy is 7.60 per 1000 individuals [2]. In 2019, it was estimated that there were 52.51 million people worldwide living with epilepsy (GBD estimate for 2019). In population studies in high-income nations, epilepsy has a standardized mortality rate of 2–7 times greater than the overall population [3]. In 2016, over 126 000 epilepsy-related deaths and 5.9 million years of life were lost (YLLs) [3].

Dravet syndrome (DS) is a rare but severe encephalopathy with onset of seizures in a normal infant before the age of one year in a fever context. Infants develop prolonged febrile unilateral, asymmetric or apparently generalized seizures. From the second year of life on, psychomotor delays appear and refractory epilepsy develops, with several seizure types. There is no epileptic spasm, and tonic seizures are infrequent in this syndrome. No characteristic MRI change has been described. Molecular genetic analysis has shown ...

The operational seizure classification by the ILAE in 2017 divides seizures into those with focal, generalized, or unknown onset [1]. Correct classification of seizures is the prerequisite to make the correct diagnosis of the epilepsy type. The ILAE defines focal seizures as “originating within networks limited to one hemisphere” whereas generalized seizures “engage bilateral networks from onset” [1]. In genetic generalized epilepsies (GGEs), however, up to one in four myoclonic seizures is asymmetrical [2,3], and at onset, every other generalized ...

To assess the efficacy and safety of stereoelectroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC), using diffusion spectrum imaging (DSI) tractography to preoperatively delineate the optic radiation (OR) and reduce the risk of visual field defects (VFDs) where the epileptogenic zones (EZs) are located in or close to the eloquent visual areas.

Anti-seizure medication (ASM) is the first-line symptomatic treatment of epilepsy. Understandingly, patients’ and their caregivers’ primary hope and expectation regarding treatment aim is seizure control. Next in line, however, is the anticipation that seizure control will not be achievable only at the cost of adverse side effects. [1] Although patients might be willing to accept side effects in the prospect of becoming seizure free, this willingness is slight, and it is particularly low with regard to psychiatric and cognitive side ...

Mucopolysaccharidosis type II (MPS II) or Hunter syndrome is an X-linked lysosomal storage disease caused by a deficiency of the enzyme iduronate-2-sulfatase, which leads to the pathological accumulation of glycosaminoglycans in organs and tissues throughout the body, causing progressive multisystemic dysfunction. MPS II occurs predominantly in males and has an estimated prevalence of 1 in 100 000 male live births. The clinical presentation of MPS II is highly variable, and the disease is associated with a broad spectrum of severity.

Down Syndrome (DS) is the most frequent genetic-based cause of intellectual disability all over the world. DS can be caused by trisomy of chromosome 21 as well as balanced or non-balanced translocation involving the same chromosome [1]. Neurological comorbidities are frequently reported in individuals with DS, among which epilepsy is one of the most reported, accounting for about 26% of all affected individuals [2].

Peri-ictal water drinking (PIWD) is the act of drinking water during an electroclinical seizure or up to two-minutes postictally [1,2]. PIWD is uncommon, although it has been reported in both children and adults with epilepsy, particularly with temporal lobe epilepsy (TLE). The current literature on PIWD consists solely of cases recorded with scalp-EEG [2]. PIWD has been associated with a localizing and lateralizing value, over the non-dominant temporal lobe. In this case, an evaluation using stereoelectroencephalography (SEEG) recordings was utilized ...

One-third of the patients with focal epilepsy are refractory to medical treatment and require surgical management [1]. Epilepsy surgery, done after meticulous pre-surgical evaluation leads to seizure freedom in about two-thirds of the patients with temporal lobe epilepsy and more than half of the patients with extra temporal lobe epilepsy [2]. Resection of epileptogenic zone (EZ) is the most important predictor of post-operative seizure outcome. Identification of EZ remains to be one of the greatest challenges in epilepsy surgery.