Epileptic seizure semiology in infants and children

Epileptic seizure semiology (SS) in infants and children are more elementary compared to that of adolescents and adults. The added difficulty of reliably assessing the level of consciousness provides even less opportunities to observe localizing or lateralizing signs. On the extreme end, SS may be generalized in a setting of a focal lesion or may show focal signs with misleading localization values (Jayakar and Duchowny, 1990; Duchowny et al. 1992; Brockhaus and Elger 1995). We review SS of patients aged ...

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Medical management of status epilepticus: emergency room to intensive care unit

That status epilepticus (SE) requires emergency treatment has been embedded in practice for decades, and the 2015 ILAE definition [1] emphasises both the need for rapid initiation of treatment and the risk of permanent damage if seizures are not promptly controlled. There are however many types of SE, and it is recognized that outcome is also significantly influenced by seizure type and etiology, as well as the patient’s age and comorbidities. In this review we will focus on the management ...

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Prevalence and risk factors for hyponatremia in adult epilepsy patients: Large-scale cross-sectional cohort study

Hyponatremia is a frequent adverse event in patients using antiepileptic drugs (AEDs), and a low serum sodium level can lead to fatigue, headache, vomiting, anorexia, and coma. The normal range of serum sodium is 135-145 mEq/L, while the mean serum sodium level is 129 ± 3.3 mEq/L in patients with symptomatic hyponatremia and it falls to 119 ± 9.1 mEq/L in patients with hyponatremia who develop neurological symptoms [1].

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A Tiered Strategy for Investigating Status Epilepticus

In status epilepticus the imperative to start anti-seizure therapy, initially subjugates the need to investigate the cause. Once treatment is initiated this balance shifts in favour of identifying: the causes and consequences of the seizure; the factors that predetermined the occurrence of status epilepticus; and finally the prognosis of this acute episode. Just as there are multiple causes of seizures and epilepsy, there are a vast number of causes of status epilepticus. We discuss the more common and the more ...

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Seasonal Distribution of Febrile Seizure and the Relationship with Respiratory and Enteric Viruses in Korean Children Based on Nationwide Registry Data

Febrile seizure is a benign convulsive disorder that affects 2–8% of children between the ages of 6 months and 5 years [1,2] This disease is preceded by or accompanied with fever in the absence of other causes, such as central nervous system infection or metabolic disease [3]. The etiology of febrile seizures remains unclear, although fever, age, and genetic predisposition have been identified as major factors. In addition, multifactorial models based on genetic and environmental causes have been proposed recently ...

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Personality profiles differ between patients with epileptic seizures and patients with psychogenic non-epileptic seizures

Psychogenic non-epileptic seizures (PNES) are episodes of abnormal limb movements that resemble epileptic seizures (ES), but are not associated with organic aetiologies, and presumably manifest due to psychological distress [1]. Similarities in presentation to ES mean that patients with PNES are often misdiagnosed with epilepsy, resulting in multiple financial, social, emotional and health implications [2–6].

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Epilepsy, cerebral calcifications, and gluten-related disorders: are anti-transglutaminase 6 antibodies the missing link?

Gluten-related disorders (GRDs) are a group of immune-mediated diseases with several clinical manifestations triggered by gluten ingestion (1). The three main forms of GRDs are celiac disease (CD), wheat allergy (WA) and non-celiac gluten-sensitivity (NCGS) [1,2]. GRDs often present extraintestinal symptoms. Neurological manifestations have been reported in 10 to 22% of patients with coeliac disease (CD) and include gluten ataxia, polyneuropathy, myopathy, epilepsy, leukoencephalopathy, and headache [3].

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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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