Seizure

Epilepsy is now recognized as a network disorder and this conceptualization is central to the ILAE Classification System [1–4]. In clinical practice this framework requires the clinician to think broadly in terms of the range of deficits that can be associated with focal-onset epilepsies, including temporal lobe epilepsy (TLE) and frontal lobe epilepsy (FLE). Pre-surgical decision-making has traditionally focused on the localization and lateralization of function, which is seemingly juxtaposed to the network approach.

About 30–40% of epilepsy patients whose seizures cannot be controlled with two well-tolerated, appropriately chosen, and used antiepileptic drugs (AEDs) are considered to have drug-resistant epilepsy (DRE) [1]. Even with adequate access to surgical treatment and further AEDs trials, 61.1% of patients with DRE have ongoing seizures [2]. Vagus nerve stimulation (VNS) was approved by the Food and Drug Administration (FDA) as adjunct therapy to reduce the frequency of seizures in adults with DRE [3].

Oral lacerations are widely recognized as potential complications of seizures. These are mostly minor injuries requiring some degree of pain control, but occasionally require repair or result in more serious complications [1,2]. Diagnostic value of ictal tongue biting has been extensively evaluated, demonstrating good positive predictive value of lateralized tongue-biting for epileptic seizure versus paroxysmal non-epileptic seizures [3,4,5].

The need to address key limitations in validation studies is highlighted in order to support future assessments of SDD fitness for ASM clinical trial use. In tandem, a stepwise framework to streamline device testing is put forth. These suggestions provide a starting point for establishing SDD reporting requirements before device integration into ASM clinical trials.

The overall incidence of epilepsy is approximately 37.4 cases per 100,000 population per year and is increasing in older individuals [1,2]. New epilepsy diagnoses in the elderly population have increased by 3.5 cases per 100,000 over the last 25 years, and are now situated at 30 cases per 100,000 per year [2,3].

Tremor is defined as an involuntary, rhythmical, oscillatory movement of a body part produced by either synchronous or alternating contractions of antagonist muscles [1]. As one of the most common neurological symptoms, tremor was frequently seen in patients with epilepsy (PWE). According to the Epilepsy Comorbidities and Health (EPIC) Survey, 9.3% of the respondents with epilepsy reported perceived movement disorder/tremor, more than twice as prevalent as those without epilepsy [2].

Patients with tuberous sclerosis complex (TSC) usually present with epileptic spams and/or focal seizures and can be good candidates for epilepsy surgery [1]. Typical absence seizures (TAS) are generalized with sudden onset and termination, lasting a few seconds, and electrographically defined by a unique EEG signature: diffuse, regular, >2.5-Hz spike-and-wave discharges (SWD). Some data suggest a focal origin for thesegeneralized SWD, in particular, from themesial or polar aspects of the frontal lobe.

Epilepsy is a common neurological disorder associated with recurrent and sudden excessive electrical discharges in a group of brain neurons that can disrupt the patient’s behavior and function temporarily [1]. Common treatments for epilepsy (medication and surgery), that often come with several side effects, are not able to control seizures in almost 25% of the patients. These patients must live with seizures that can happen anytime and anywhere [2]. Since epileptic seizures are related to the electrical activity of the ...

A 26-year old warehouse employee first presented with subacute, holocephalic headache of moderate intensity, dizziness, and a “red, flickering pixel” in his right visual field, followed by two bilateral tonic-clonic seizures a few days later. The initial clinical examination, EEG, brain MRI and blood work were unremarkable except for rhabdomyolysis (CK ˜10.000 U/l; upper limit of normal is 190 U/l), which was considered as complication associated with tonic-clonic seizures. During the following months, the patient suffered from intermittend fluctuating right ...

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an autosomal dominant small vessel disease caused by mutations of the NOTCH3 gene [1]. Clinical manifestations of CADASIL include headaches, recurrent ischaemic strokes, and progressive cognitive decline. Seizures are an uncommon symptom and were previously reported as occurring late in the disease course, after onset of stroke [1]. We report a CADASIL family with epilepsy as an early symptom due to a novel NOTCH3 mutation.