Discussing sudden unexpected death in epilepsy with children and young people with epilepsy and their parents/carers: a mixed methods systematic review

Sudden unexplained death in epilepsy (SUDEP) is commonly defined as “sudden, unexpected, witnessed or unwitnessed, nontraumatic and nondrowning death in patients with epilepsy, with or without evidence for a seizure and excluding documented status epilepticus, in which post-mortem examination does not reveal a toxicologic or anatomic cause for death” [1]. Due to difficulties with definitive diagnosis it is increasingly classified as definite, probable or possible [1]. Epilepsy is a common neurological disease in children, and whilst SUDEP is considered a ...

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STEREO-EEG ICTAL/INTERICTAL PATTERNS AND UNDERLYING PATHOLOGIES

Surgery is a reliable treatment option1–6 for drug-resistant focal epilepsies associated with cortical structural lesions.7,8 When no lesion is detected with high resolution magnetic resonance (MR), or when the lesion extension cannot be outlined by neuroimaging,9,10additional intracerebral neurophysiological information is needed, in order to identify the brain area to be resected to achieve post-surgical seizure freedom.11 Stereo-electro-encephalography (Stereo-EEG) reveals intralesional and perilesional electrical activities, which define the Stereo-EEG identified Seizure Onset Zone (SEEG-SOZ) and its network.

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Analysis of the reasons and costs of hospitalization for epilepsy patients in East China

Epilepsy is a paroxysmal disabling brain dysfunction that affects a wide range of individuals. About 50 million people suffer from epilepsy worldwide [1]. The current global prevalence of epilepsy is approximately 1% [2]. Nearly 80% of epilepsy patients are found in developing regions, such as China and India. Epilepsy patients usually respond well to the currently available anti-epileptic drugs (AEDs). Nearly 70% of these patients only require outpatient treatment. Unfortunately, the majority of patients with epilepsy in developing countries (about ...

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A pragmatic approach to intravenous anaesthetics and electroencephalographic endpoints for the treatment of refractory and super-refractory status epilepticus in critical care

Status epilepticus is a common neurological emergency, with overall mortality around 20%. Over half of cases are first time presentations of seizures. The pathological process by which spontaneous seizures are generated arises from an imbalance in excitatory and inhibitory neuronal networks, which if unchecked, can result in alterations in intracellular signalling pathways and electrolyte shifts, which bring about changes in the blood brain barrier, neuronal cell death and eventually cerebral atrophy.

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Ictal Vomiting; A dominant hemisphere phenomenon as demonstrated by intracranial depth electrode seizure mapping

Ictal vomiting can be a rare clinical manifestation of seizures. It is thought to originate in the anterior part of the temporal or insula lobes. It has been associated with the non-dominant hemisphere and has been considered a lateralising sign.1 A few cases have lateralised seizure onset to the dominant hemisphere.2 We describe a case of ictal vomiting where intracranial electroencephalography (EEG) has demonstrated seizure lateralisation to the dominant hemisphere and localisation of ictal vomiting to the dominant insula lobe.

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The transition to status epilepticus: how the brain meets the demands of perpetual seizure activity

The pathophysiology leading to the development of status epilepticus (SE) remains a topic of significant scientific interest and clinical relevance. The use of multiple experimental and computational models has shown that SE relies on a complex interaction between mechanisms that operate at both a cellular and network level. In this review, we will summarise the current knowledge on the factors that play a key role in allowing SE to develop and persist. These include pathological adaptations to changing ion dynamics, ...

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Risk factors for early-onset seizures in patients with cerebral venous sinus thrombosis: A meta-analysis of observational studies

Cerebral venous sinus thrombosis (CVST) is a subtype of cerebral stroke, with an annual incidence of approximately 3–4 cases per million population [1]. Unlike other types of stroke, CVST typically occurs in young adults (mean age at onset: 35 years) [2]. In general, patients with CVST have a fair prognosis. Previous studies have shown that 60–79% of patients achieve good functional outcomes [Modified Rankin Scale (mRS) score 0–1) [3–4]. However, occurrence of seizures in these patients may adversely affect the ...

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Chronic post-encephalitic epilepsy following Japanese encephalitis: clinical features, neuroimaging data, and outcomes

Central nervous system (CNS) infections are one of the leading causes of acquired epilepsy [1]. Patients with encephalitis have a risk of developing seizures at the acute stage, as well as later developing unprovoked seizures [2]. It is well recognized that the risk of developing unprovoked seizures in these patients is 7 to 16 times higher compared to the general population [3,4], especially in those with Herpes simplex virus and Japanese encephalitis (JE), and the odds ratio of subsequent epilepsy ...

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Epilepsy patients with and without perceived benefit from vagus nerve stimulation: A long-term observational single center study

Vagus nerve stimulation (VNS) for the treatment of epilepsy has been designed to prevent or interrupt seizures by cycling or triggered electrical stimulation of the left vagus nerve. It is an empirically based method with limited knowledge on mechanisms of action. The vagus nerve has rich afferent connections to the brain stem and mesencephalon. The effect of VNS was suggested in animal studies and subsequently supported by randomized clinical trials in uncontrolled focal onset epilepsy. These findings led to European ...

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