Seizure

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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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.

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 ...

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.

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].

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 ...

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 ...

Fixation-off sensitivity (FOS) is a rare phenomenon of electroencephalogrpahy (EEG) induced by elimination of central vision/fixation [1]. FOS is characterized by

Autonomic changes during epileptic seizures are well-established phenomena. Cardiorespiratory symptoms are the most prominent: tachycardia, facial flushing, hyperventilation and apnoe usually accompany complex partial and generalized tonic-clonic seizures, especially those of temporal lobe origin [1]. In our previous study, we recorded at least one vegetative sign in 86% of the patients with temporal lobe seizures [2]. These symptoms are probably directly caused by the epileptic activity of the central autonomic network [3].