Long-term seizure outcome and antiseizure medication use in autoimmune encephalitis

Epileptic seizures are a common symptom in the acute stage of autoimmune encephalitis (AE), conceptually these are regarded as acute-symptomatic seizures [1]. In a few cases only, beyond the acute phase of AE, autoimmune-associated epilepsy (AAE) with recurrent unprovoked seizures develops. AAE may occur more frequently in patients with antibodies targeting glutamic acid decarboxylase (GAD) [2,3], with onconeural protein antibodies (e.g., Hu, Ma2, collapsing response mediator protein 5/CV2) [4], and with Rasmussen encephalitis [5].

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Surgical Treatment of Nonlesional Temporal Lobe Epilepsy

Epilepsy surgery is an effective therapeutic option for patients with focal seizures who do not respond to appropriate treatment with antiepileptic drugs (AEDs) [1]. Patients with temporal lobe epilepsy (TLE) are the most common surgical candidates. Anterior temporal lobectomy (ATL), which removes the anterior portion of temporal lobe along with the hippocampus and amygdala, has been the standard surgical technique when MRI indicates the mesial temporal area as being the only epileptogenic area [2–4].

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Longitudinal changes in gray and white matter microstructure during epileptogenesis in pilocarpine-induced epileptic rats

Diffusion-weighted magnetic resonance imaging (MRI) has provided a noninvasive insight into the microstructural characteristics of tissue and anatomical connectivity without exogenous contrast agents. In particular, the tensor model [1] has been extensively used in the field of epilepsy for assessing hippocampal cell death, gliosis, and even axonal plasticity in humans [2,3] and experimental animals [4–8]. One of the most commonly derived diffusion tensor imaging (DTI) measures is fractional anisotropy (FA), which may be interpreted as a marker to identify subtly ...

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Brain functional connectivity patterns in focal cortical dysplasia related epilepsy

Focal cortical dysplasia (FCD), often caused by abnormal neuronal growth, is strongly associated with epilepsy and neurodevelopmental disorders [1,2]. Drug-resistant epilepsy is a common characteristic in FCD [3]. Local lesions have been clearly linked to seizure onset, and anomalies in gray matter structure and interhemispheric connections are often observed beyond the primary lesion [4,5].

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Longitudinal analysis of interictal electroencephalograms in patients with temporal lobe epilepsy with hippocampal sclerosis

Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy in adults [1]. One of the main causes of TLE is hippocampal sclerosis (HS) [2]. TLE has a constellation of signs and symptoms, but the main criterion for diagnosis is the presence of characteristic seizure semiology [3]. The clinical definition of TLE with HS (TLE-HS) is based on electroencephalograms (EEGs), video EEGs, magnetic resonance imaging (MRI) findings, and neuropsychological tests [2].

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Improving surgical outcome with electric source imaging and high field magnetic ressonance imaging

Epilepsy is a disease that affects more than 50 million people in the world, with a higher prevalence in low-income countries [1]. Although several anti-seizure medicines are available for treatment [2], more than one-third of the patients with epilepsy present recurrent, drug-resistant seizures [3,4]. These uncontrollable seizures promote significant damage to life quality [5] and increase the chance of sudden unexpected death [6]. Surgery is the most effective and definitive treatment available for focal drug-resistant epilepsy [7].

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Non-epileptic paroxysmal events in paediatric patients: a single tertiary centre study in Egypt

Paroxysmal events are considered fairly common medical emergencies, accounting for at least 4% of all emergency calls worldwide, especially in the paediatric population [1]. Paroxysmal events called “seizures” are defined as episodes with suddenly occurring symptoms that alternate with symptom-free periods. They often last for a short period of time and manifest as alterations in consciousness, motor, sensory, autonomic, and/or cognitive symptoms or signs [2]. Paroxysmal events can be classified into 3 major categories; namely epileptic seizures, non-epileptic seizures (NES), ...

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Neuropathology of the 21th century for the Latin American epilepsy community

In 1825, Camille Bouchet and Jean-Baptiste Cazauvieilh published gross neuroanatomy-pathological findings from postmortem studies of several epilepsy cases [1,2]. Some years later, Wilhelm Sommer focused on histopathology findings of the human hippocampus in a series of 90 patients with epilepsy. He thoroughly described the common pattern of pyramidal neuronal cell loss in CA1 with concomitant gliosis as a structural correlate of the tissue hardening (sclerosis) [3]. Shortly after, hippocampal sclerosis was associated with different neuronal cell loss patterns throughout all ...

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Epilepsy, dissociative seizures, and mixed: associations with time to video-EEG

Video-electroencephalographic monitoring (VEM) is critical to the evaluation and treatment of patients with medication resistant epilepsy, defined by failure of two adequate trials of tolerated, appropriately-chosen antiseizure medications (ASM) at appropriate doses [1,2]. While some studies demonstrated that early surgical therapy for epilepsy may be more effective, the time from first seizure to VEM (TVEM) remains around 20 years and VEM remains underutilized [3–20]. For comparison, it typically takes 9 years to meet the definition of medication resistant epilepsy [13].

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