Seizure

Epilepsy is one of the most common neurological diseases with an apparent genetic predisposition, and the incidence rate in men is normally higher than that in women [1]. Moreover, several studies have reported that children have a higher incidence rate of epilepsy than adults [2–3]. During epileptogenesis, overexcitatory neurons in local lesions cause paroxysmal abnormal high-frequency discharges, and the discharges spread to the surrounding area, leading to abrupt, recrudescent and ephemeral brain dysfunction [4].

Depending on the suspected etiology of an epileptic seizure, a lumbar puncture for CSF analysis is recommended to exclude potentially treatable causes, such as intrathecal infections or autoimmune inflammation [1]. Routine diagnostics include analysis of cell count as well as protein and lactate levels [1,2]. Here, pathologically altered CSF parameters may indicate a specific etiology of the epileptic seizure, especially in infectious or autoimmune CNS disorders [1]. On the other hand, pathologic CSF findings, e.g., persistent intrathecal immunoglobulin synthesis or ...

This is the first report of opsoclonus seizures due to left posterior cortex epilepsy, which was documented with oculogram (see supplementary discussion) [1], scalp, and subdural EEG. The child has been seizure free for 44 months after resection of the left posterior temporal cortex. Review of literature and the index case support posterior cortex as the epileptogenic zone of ictal opsoclonus.

Genetic testing in individuals with epilepsy has been broadly adapted as a diagnostic standard for many epilepsy syndromes. Establishing a genetic diagnosis permits genetic counseling, provides therapeutic guidance, gives reassurance to individuals and caretakers, and might avert further potentially harmful diagnostic explorations [1] In the last decade, the advent of personalized treatment approaches for certain genetic syndromes has further increased the appeal of genetic testing. [2, 3]

The YWHAG gene (OMIM∗ 605356) resides on Chr 7q11.23 and encodes the tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein gamma (14-3-3γ), which is highly expressed in the brain. This protein regulates neuronal migration and its abnormal activity may cause morphological defects in the developing cortex. The scientific interest in the YWHAG gene firstly started in 1999, when the clinical influence was presumed due to the YWHAG location at the most telomeric end of the deletion region founded in Williams–Beuren syndrome (WBS) [1].

Perampanel (PER) is an adjunctive treatment option for focal epileptic seizures with or without secondary generalization in patients with epilepsy aged ≥4 years and for primary generalized tonic-clonic seizures in patients with idiopathic generalized epilepsy aged ≥7 years (EU) or ≥12 years (USA). In the USA PER can also be prescribed as monotherapy for focal epileptic seizures. It was first approved in Europe and the USA in 2012. PER is a selective non-competitive antagonist of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors.

HIV CNS viral escape syndrome is quite uncommon. It is characterized by high HIV viral load in the CSF despite having a low serum viral load [1]. The neurological manifestations of CNS viral escape syndrome that have been reported include insidious or acute onset of headache, tremors, cognitive impairment, focal neurologic deficit, seizures, behavioral disturbance, and dysarthria [1]. We report a unique case of HIV CNS escape syndrome in a 47-year-old female with controlled HIV who presented with new-onset refractory ...

We have read with great interest the article ‘Real-life experience with brivaracetam in 101 patients with difficult-to-treat epilepsy–A monocenter survey’ (Steinhoff et al.; 2017 May; 48:11–14).[1] However, we wish to complement this article’s use of laboratory testing for brivaracetam and levetiracetam analysis.

The relation between sleep and epilepsy has been widely investigated since epilepsy may alter sleep, and sleep deprivation may induce epileptic seizures [1]. Sleep disturbances are frequently reported by patients with epilepsy, as well as daytime sleepiness, which is particularly prevalent in those who are treated with more than one antiseizure medication (ASM) [2]. Several lines of evidence suggested an association between sleep and epilepsy, and the numerous questionnaire-based and polysomnographic studies investigating nocturnal sleep in patients with epilepsy hypothesized ...

The COVID-19 epidemic erupted in 2019 has increased mortality worldwide, especially in European countries [1]. The best established risk factors for death due to COVID-19 are older age, hypertension, diabetes, obesity, and malignancy [2, 3, 4].