Seizure

Febrile seizures (FS), which are accompanied by a fever greater than 38 °C with no other seizure-provoking causes, are the most common type of seizure in childhood. FS are seen in children younger than 5 years of age and are classified as either simple or complex [1–3]. Simple FS are generalized (i.e., without a focal component) tonic–clonic seizures, which last for a maximum of 15 minutes. On the other hand, complex FS are prolonged (>15 minutes), focal, or occur more than once in ...

Epilepsy affects 68 million people worldwide [1]. In high-income countries, poorly controlled epilepsy is generally a feature of complicated cases of antiepileptic drug (AED) resistance, for which treatment options include surgery, non-pharmacological treatments, and molecular “precision therapies” [2,3]. However, the state of poorly controlled epilepsy differs dramatically in low- and middle-income countries (LMICs), where the global burden of epilepsy is concentrated and 80% of people with epilepsy (PWE) live [4,5].

Psychogenic non-epileptic seizures (PNESs) are paroxysmal episodes clinically mimicking epileptic seizures (ES), without neurobiological origin and lack of electroencephalographic (EEG) correlations. Approximately 25-30 % of patients referred to tertiary epilepsy centers for drug-resistant epilepsy are diagnosed with PNES [1,2]. Misdiagnosis of PNES as ES could be hazardous due to the potential side effects of antiepileptic drugs (AEDs), which may aggravate the condition. Moreover, the failure to recognize the psychologic nature of these events could delay appropriate treatment.

Surgery is potentially curative for refractory focal epilepsy [1]. Rigorous presurgical evaluation is required for the selection of surgical candidates and for identifying the epileptogenic zone (EZ), since the precise localization of the epileptic focus is a prerequisite for good surgical outcome [2,3].

Benign adult familial myoclonus epilepsy (BAFME) has an autosomal dominant trait, and its primary symptoms are cortical tremor (tremulous myoclonus) mimicking essential tremor and infrequent generalized seizures [1,2]. In Japan, BAFME has been described throughout the late 20th century and has been referred to as cortical tremor [1], BAFME [2], familial cortical myoclonic tremor [3], familial cortical tremor with epilepsy [4], and familial adult myoclonic epilepsy (FAME) [5]. Many similar case reports followed after 2000 in Europe, where different names ...

Epidemiological studies have demonstrated that elderly people are markedly more prone to status epilepticus (SE), with higher associated mortality, than are younger adults [1–6]. As the global population is rapidly aging, SE in the elderly is becoming increasingly common, particularly in developed countries. The majority of recent studies on SE in the elderly have focused only on cohorts of elderly patients [7–11]; only two recent studies have directly compared elderly and younger patients with SE in order to identify the ...

Sudden unexpected death in epilepsy (SUDEP) is an important cause of mortality in patients with epilepsy. Potential mechanisms include respiratory dysregulation, arousal impairments, autonomic dysfunction, ictal or postictal arrhythmia, and neurogenic cardiopulmonary dysfunction. Pacemaker implantation has been proposed as an intervention that may lessen the risk of SUDEP among patients with ictal asystole [1]. However, the efficacy of this intervention is unclear, and the relationship between ictal asystole and SUDEP is unknown.

Antiepileptic drugs (AEDs) play a vital role in epilepsy management. Despite ample experience with two generations of AEDs, current medications still fail to control seizures in 20-30% of all epilepsy patients [1,2]. Temporal lobe epilepsy (TLE), especially when lesional, is often associated with drug resistance [1,3,4]. Patients with mesial temporal sclerosis (MTS) are more likely to develop drug-refractory epilepsy [1,5]; although one third of patients in the general TLE population develops drug resistance, the proportion is twice as high in ...

Childhood Absence Epilepsy (CAE) is a form of pediatric idiopathic generalized epilepsy that occurs in children of school age with a peak at 6–7 years. It has a strong genetic predisposition and appears more frequently in girls than boys. It is characterized by very frequent typical absences [1]. According to some authors perioral myoclonia and single myoclonic jerks of the limbs, head or trunk during absence are possible [2] while Panayiotopoulos considers them as exclusion criteria [3]. The ictal EEG ...

Semiological seizure evaluation is mainly based on manual video analysis, inhering a high rate of diagnostic inaccuracy [1]. Ictal sound and speech manifestations are also frequent symptoms of focal seizures, but audio analyses have rarely been performed and observer independent audio analysis tools are as yet missing.