LOCALIZATION VALUE OF ICTAL TURNING PRONE

Ictal turning prone (ITP) was first described by Saygi et al as an ictal feature of frontal lobe “complex partial seizures” that distinguished them from psychogenic nonepileptic seizures with otherwise similar semiology [1]. Ictal turning prone can be considered a variation on “ictal body turning along the horizontal axis” described by Leung et al as a sign that helped further localize frontal lobe complex partial seizures [2]. Ictal body turning along the horizontal axis was defined as “truncal turning without ...

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Ultra-Short Burst Suppression as a “Reset Switch” for Refractory Status Epilepticus

Based on criteria from the Neurocritical Care Society Status Epilepticus Guideline Writing Committee, status epilepticus (SE) is defined as five or more minutes of continuous seizure activity or recurrent seizure activity without returning to baseline. Patients who fail standard antiepileptic drug (AED) regimens for SE (initial benzodiazepine plus second antiepileptic drug) are considered to be in refractory status epilepticus (RSE). RSE carries a mortality that is three-fold that of non-refractory SE [1], and occurs in 23%–43% of patients with SE ...

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Seizures as a Clinical Manifestation in Somatic Autoimmune Disorders

Epilepsy is a common neurological condition with marked psychiatric and systemic comorbidity. Recent evidence suggests that systemic auto-immune disorders are often co-morbid with epilepsy [1]. A meta-analysis reported an almost 3-fold increased risk of epilepsy [odds ratio (OR): 2.66, 95% confidence interval (CI): 1.88-3.76] in people with such disorders [2]. Acute symptomatic as well as unprovoked seizures have been reported in people with autoimmune disorders. Most seizures reported are either convulsions or focal in nature [3–7].

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Substitution has better efficacy than add-on therapy for patients with focal epilepsy after their first antiepileptic drug treatments fail

Monotherapy is generally recognized as the first-line treatment option for patients with newly diagnosed epilepsy [1,2]. After monotherapy, 70-80% patients will be seizure-free and 60-70% can stop receiving treatment through 2-5 years of standard rational first monotherapy [3–5]. While, there are still 30-40% patients who cannot get seizure free by first monotherapy due to inadequate control, intolerable side effect, and some other reasons [6]. Moreover, the chance of seizure free will distinctly decline after failure of monotherapy.

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The clinical utility of ambulatory EEG in childhood

The electroencephalogram (EEG) has an important role in the assessment of paroxysmal disorders. The routine EEG is the most frequently used type, however since the duration of the recording is short (typically around 20 minutes), and interictal EEG is often normal in patients with epilepsy, the usefulness of the technique has limitations. In a recent meta-analysis, the sensitivity of a routine EEG after a first unprovoked seizure was only 17.3 (7.9, 33.8) % in adults and 57.8 (49.7, 65.6) % in ...

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Epilepsy and seizures in children with Congenital Heart Disease: a prospective study

Children with complex congenital heart disease (CHD) experience high incidence of perioperative seizures. Population-based studies also report high epilepsy co-morbidity in CHD. Given the increasing survival of patients with CHD and the interference of seizures and epilepsy with the long-term outcomes, characterizing them in this population is of high relevance. This study investigated the incidence and risk factors of perioperative clinical seizures (CS) and epilepsy in a prospective cohort of children with complex CHD who underwent cardiac surgery.

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Simultaneous scalp EEG improves seizure lateralization during unilateral intracranial EEG evaluation in temporal lobe epilepsy

Intracranial EEG (IEEG) studies are performed in patients with intractable focal epilepsy when noninvasive studies do not provide adequate information for resective epilepsy surgery. The complication risk with IEEG implantation, albeit small, increases proportional to the number of electrodes implanted, with a hemorrhage rate of 0.2% per electrode, which is one reason to limit the number of implanted electrodes [1].

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Emotional Reaction to viewing one’s own epileptic seizure

In contrast to most sufferers of chronic diseases, epilepsy patients are only partially aware of the main characteristics of their condition, as many epileptic seizures are accompanied by various degrees of clouding of consciousness and amnesia for the event [1,2]. Accordingly, many patients learn about the crucial manifestations of their disease only by reports of relatives or other bystanders. The unpredictable nature of seizures can be experienced as particularly threatening not only due to possible physical harm but also due ...

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Retention Rate of First Antiepileptic Drug in Poststroke Epilepsy: a Nationwide Study

Stroke causes 14-21% of epilepsy and is the leading cause of epilepsy after middle age.[1] Poststroke epilepsy (PSE) complicates at least 6% of infarctions and 12% of ICH, respectively.[2–4] Specific evidence to guide treatment of PSE is surprisingly scarce. Carbamazepine has been a traditional choice in focal epilepsy, but concerns that elderly patients may be vulnerable to side effects, and that induction of liver enzymes may interfere with secondary stroke prophylaxis, has led to an interest in other AEDs in ...

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