Narrative analysis of written accounts about living with epileptic or psychogenic nonepileptic seizures

Epilepsy is a disorder of the brain characterised by abnormal neuronal activity [1]. Psychogenic nonepileptic seizures (PNES) are episodes of impaired self-control, which superficially resemble epileptic seizures. However, most PNES are considered as a dissociative psychological response to aversive stimuli [2]. Epilepsy and PNES are two of the three most common reasons why patients present with transient loss of consciousness [3].

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Sulthiame add-on therapy in children with Lennox-Gastaut syndrome: A study of 44 patients

Lennox-Gastaut syndrome (LGS) is a paediatric epilepsy syndrome described as a triad consisting of multiple seizure types, such as tonic –mostly occurring at night–, atonic, and atypical absence seizures, intellectual disability or regression, and abnormal electroencephalography (EEG) findings with a symptom onset before 12-24 months of age [1]. The EEG abnormalities consist primarily of an interictal pattern of diffuse, slow spike-wave complexes at 2.5 Hz during wakefulness and paroxysmal fast rhythms (10–20 Hz) during sleep, mainly in the non-rapid eye movement phase, ...

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Long-term seizure outcome in pediatric patients with focal cortical dysplasia undergoing tailored and standard surgical resections

Focal cortical dysplasia (FCD) is a subgroup of cortical malformations characterized by abnormal regional neuronal migration and differentiation that result in aberrant cortical organization. [1] It is the most common anatomo-pathological feature in patients undergoing epilepsy surgery in childhood [2]. Prevalence figures have been rising over recent years due to improved MRI quality, but, even with the best methodology currently available, the sensitivity and specificity of imaging findings are limited and a diagnosis of FCD requires histological confirmation.

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Subcortical SISCOM hyperperfusion: should we pay more attention to it?

Ictal-interictal single photon emission computed tomography (SPECT) with co-registration to MRI (SISCOM) has proven its value in localizing epileptogenic zones [1–7]. This non-invasive tool remains crucial in challenging cases such as extra-temporal and/or non-lesional epilepsies [8]. Cerebral blood flow changes demonstrated during seizures reflect brain activation and its pathways of spread [9,10]. Its usefulness to establish sites for intracranial implantation and improve surgical outcome is now widely recognized [11,12].

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Cross-sensitivity of Psychiatric and Behavioral Side Effects with Antiepileptic Drug Use

It is well established in the literature that psychiatric and behavioral side effects (PBSE) are common in patients using antiepileptic drugs (AED) [1–4]. These adverse effects can range from minor behavioral changes to debilitating depressive symptoms and even suicidality [1–6]. PBSEs may oftentimes lead to discontinuation of medication, and it has been reported by several studies that previous psychiatric history is a highly important independent predictor of PBSE incidence in epilepsy patients using AEDs [1–4].

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Analysis of fractional anisotropy and mean diffusivity in refractory and non-refractory idiopathic generalized epilepsies

Idiopathic generalized epilepsy (IGE) patients usually present normal neuroimaging findings and adequate seizure control if treated with an appropriate antiepileptic drug regimen. Abnormalities in conventional neuroimaging in IGE patients usually represent incidental findings, not related to epilepsy pathophysiology. A significant minority of IGE patients present breakthrough seizures despite appropriate treatment [1]. These patients usually receive higher antiepileptic drug loads.

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Status epilepticus prevention, ambulatory monitoring, early seizure detection and prediction in at-risk patients

Status epilepticus (SE) is a time-sensitive and life-threatening medical emergency. The occurrence of seizures and SE appears often random and difficult to predict, reducing the quality of life in patients with epilepsy and their families [1]. Here, we summarize the literature on ambulatory seizure detection (focusing on detection modalities and devices for ambulatory monitoring), seizure prediction (focusing on patterns of epileptic seizure and SE occurrence as well as EEG features), and tentatively SE prevention (using closed-loop warning and treatment systems ...

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