Seizure

Approximately 600,000 people in the UK have epilepsy. [1] While epilepsy can occur at any age, there are two main peaks of diagnosis: in childhood and in people over 65. In the UK, there are nearly 12 million people aged 65 and above [2]. With increasing longevity, the number of people with epilepsy over 65 is likely to keep increasing [3]. The annual incidence of epilepsy in the UK is 86 per 100,000 for people aged 65–69 years and 135 ...

People with epilepsy (PWE) are more likely to develop psychiatric comorbidities than the general population [1–3]]· Previous studies exploring links between epilepsy and psychiatry have essentially focused on depression and psychosis. Anxiety has been described as the forgotten psychiatric comorbidity in PWE [4]· For a long time, anxiety disorders were considered as the second most frequent psychiatric comorbidity after depression in PWE but anxiety disorders are now recognized as being more prevalent than depression in this population [5–8]·.

The question whether self limited, epileptic seizures damage brain cells in humans has been debated for decades [1]. Severe, prolonged and repetitive seizures most certainly do so, while brief seizures such as typical, generalized absence seizures probably do not. Cell death in brief, self-limited and single seizures is difficult if not impossible to rule out, since a certain amount of dead or dying cells will be found in any tissue obtained for investigation [1]. CSF and serum measurements of cerebral ...

Infantile spasms is a common developmental epileptic encephalopathy, characterised by epileptic spasms, in patients less than two years of age. Most patients show hypsarrhythmia on electroencephalography (EEG) and developmental delay [1–3]. The standard treatments for infantile spasms are adrenocorticotropic hormone (ACTH), vigabatrin (VGB), and prednisolone; their efficacies are 40–76%, 36–54%, and 39–70%, respectively [4–8]. In 2017, the International League Against Epilepsy proposed a new classification that incorporates aetiologies into the diagnosis [9].

Viral encephalitis (VE) or bacterial meningoencephalitis (BME) in early childhood may cause brain injury and neurological sequelae, including epilepsy. Postencephalitic epilepsy (PEE) characterized by epileptic spasms (ES) is a rare but serious condition; there is an urgent need to develop new methods to evaluate the characteristics of these children and select appropriate treatments.

Astrocytes are the most abundant glial cells in the central nervous system (CNS), and provide trophic and metabolic support to neurons in the brain [1]. Dysfunctional astrocytes have been associated with many brain diseases such as Alzheimer’s [2], Huntington’s [3] and Parkinson’s diseases [4], and epilepsy [5,6]. Their normal morphology and function are maintained by the astrocytic intercellular communication, especially the direct cytoplasmic sharing via gap junctions [5]. These pores, formed by two connexin (Cx) hexamers docking to each other ...

Cerebral Hyperperfusion Syndrome (CHS) is a relatively rare and disabling complication following carotid artery stenting (CAS) characterized by headache, seizures and focal neurological deficit. Radiological features include cerebral edema or intracerebral hemorrhage and it can be diagnosed with transcranial doppler (TCD), brain computed tomography (CT) or magnetic resonance imaging (MRI). Although pathophysiological mechanisms underlying CHS are still unknown, an increased regional cerebral blood flow secondary to impaired autoregulation of cerebrovascular system has been proposed [1].

Aicardi-Goutières syndrome (AGS) is a rare hereditary leukodystrophy, named after Jean Aicardi and Françoise Goutières, who first described it in 1984 1. To date, causative mutations have been identified in seven genes: TREX1, RNASEH2B, RNASEH2C, RNASEH2A, ADAR1, SAMHD1, IFIH1 2. The disease pathophysiology is based on a “fundamental link between nucleic acid metabolism, innate immune sensors and type I interferon induction” 3.

Poor management of epilepsy may result in repeated seizures and increased hospital admissions [1,2]. Around 3% epilepsy patients leave hospital against medical advice which is strongly related to higher 30-day readmissions [3]. Proper discharge planning is vital to reduce medication errors, repeated seizures, and other adverse health outcomes. Thus, it is prudent to examine the trends and factors associated with discharges against medical advice (DAMA) among those living with epilepsy to inform future interventions to reduce the occurrence of DAMA.

Dissociative seizures (DS), also known as psychogenic nonepileptic seizures, are episodes of impaired awareness and motor control that can superficially resemble epileptic seizures or syncope. They are, however, the result of complex neurocognitive dysfunction that remains to be elucidated [1]. In one of the first large treatise on the topic from 1859 (421 cases of “hysteria”, 305 with seizures), Pierre Briquet identified emotional stressors such as domestic violence and child maltreatment as common predisposing factors [2].