Status Epilepticus Special Edition

One of the rare joys of compiling a special edition for a Journal is being able to write a more informal prologue. On putting this collection of manuscripts together, I was reminded of a comment made to me by a rather portly, now rather famous, London nephrologist while I was a junior doctor. Over a mouthful of lunch, he told/ instructed me that there were only two things that necessitated running from the canteen. The first was a cardiac arrest, ...

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Insomnia symptoms and obesity are associated with aggression independent of depression in patients with epilepsy

Aggression can be defined as “overt motor behavior enacted with the intent to do harm or injury to a person or object, with the expectation that harm will occur” [1]. Interictal aggression related to epilepsy has been well described in the literature and is not a new concept. Although interictal dysphoric disorder, a mood disorder found in persons with epilepsy (PWE), has been a matter of debate [2], a symptom cluster characterized by periodical mood changes and outbursts of irritability ...

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New-onset refractory status epilepticus: a retrospective cohort study

Status epilepticus (SE) is a neurological emergency with more than 180 described causes; common causes include medication change or noncompliance in patients with known epilepsy, toxic-metabolic disturbances, sedative/hypnotic withdrawal, acute/remote stroke, and brain tumor [1]. The term new-onset refractory SE (NORSE) is applied to a patient without a prior diagnosis of epilepsy or other preexisting relevant neurological disorder, with new onset of refractory SE (RSE) that does not respond to first- and second-line antiseizure drugs and no clear acute or ...

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Socioeconomic outcome and access to care in adults with epilepsy in Sweden: a nationwide cohort study

An association between socioeconomic status (SES) and epilepsy has been demonstrated in both insurance-based and public health-care systems. A US survey in 2010 by the Centre for Disease Control and Prevention demonstrated that the prevalence of active epilepsy is 1% in the US, but 1.9% in low-income US households [1]. A geographical correlation between socioeconomic deprivation and prevalence of epilepsy has been disclosed in the UK [2]. Data also indicate that SES is associated with the severity of epilepsy.

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Seizure outcome and prognostic factors for surgical management of hypothalamic hamartomas in children

Hypothalamic hamartomas (HH) are rare (1:200000) congenital heterotopic and non-neoplastic lesions [1]. They can be attached to the hypothalamus at the inferior part of the third ventricle or to its wall, to the tuber cinereum, or to the mammillary bodies. HH are composed of mixed neuronal and glial cells that usually take the form of nodules. They can be isolated or associated with other brain lesions, or be part of a genetic syndrome, especially Pallister-Hall syndrome. The usual clinical presentation ...

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Predicting First Attendance at Psychiatry Appointments in Patients with Dissociative Seizures

Patients with functional disorders, including dissociative (non-epileptic) seizures (also called psychogenic non-epileptic seizures), are often considered ‘difficult to help’ by neurologists [1]. There is evidence that consultations in which neurologist explain this diagnosis are often challenging for doctor and patient [2,3]. A range of different issues can contribute to these difficulties. These include factors pertaining to doctors, such as problems communicating the diagnosis, ambivalent attitudes towards the diagnosis, issues around raising the relevance of psychological factors in relation to a ...

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Long Term Sequelae of Amygdala Enlargement in Temporal Lobe Epilepsy

Mesial temporal lobe epilepsy (mTLE) is major contributor to the group of drug resistant epilepsies and is one of the leading indications for epilepsy surgery, the most common pathology being hippocampal sclerosis (HS) [1]. There is a significant group of patients with mTLE that do not have any lesions on MRI, called “non-lesional” or “MRI-negative [2]. These patients pose a challenge for treatment in terms of difficult presurgical work-up, frequently warranting intracranial EEG recordings. There is evidence that non-lesional patients ...

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Monocarboxylate Transporter-1 Deficiency Results in Severe Metabolic Acidosis with Ketogenic Diet in Early Onset Absence Epilepsy: Case Report

Ketogenic diet (KD) is commonly used in drug-resistant epilepsy, but is contraindicated in some metabolic disorders (i.e. defects in carnitine pathways and beta-oxidation).1 SLC16A1 (OMIM 600682) encodes monocarboxylate transporter-1 (MCT1), involved in transmembrane transport of ketone bodies, lactate and pyruvate. Individuals with loss-of-function SLC16A1 variants are prone to recurrent metabolic ketoacidosis.2 Here, we present a girl with epilepsy and a likely pathogenic SLC16A1 variant who developed severe metabolic acidosis on KD; MCT1 haploinsufficiency may explain her metabolic response and her ...

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Factorial validity of a neuropsychological test battery and its ability to discern temporal lobe epilepsy from frontal lobe epilepsy – a retrospective study

In the diagnosis and treatment of epilepsy, neuropsychology makes an important contribution to the comprehensive characterization of patients. Through the administration of standardized psychometric tests, cognitive and behavioral strengths and deficits of patients can be detected and quantified. Neuropsychological assessments not only provide useful information regarding the functionality of affected brain structures and networks, but can also be used to examine psychosocial difficulties of epilepsy patients as well as potential cognitive side effects of antiepileptic drugs [1–2].

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