Seizure

The treatment for patients with status epilepticus (SE) consists of the following steps: treating early-stage SE for more than 5 min; treating established-stage SE with benzodiazepines for 30 min or longer; and treating refractory-stage SE with antiepileptic drugs for 60 min or longer. The first-line drugs used in the first step are benzodiazepines, such as lorazepam or diazepam (DZP), which stop the seizure immediately. However, these drugs are considered effective for approximately 20 min and unsuitable for the second and ...

A regular twelve-lead electrocardiogram (EKG) can be a beneficial tool in the neurology clinic to help uncover causes of some clinical presentations such as loss of consciousness [1]. However, since it only lasts for a few seconds, it is poorly sensitive for capturing paroxysmal arrhythmias [2]. A single lead EKG is routinely recorded simultaneously with electroencephalogram (EEG). This rather extended monitoring can be more helpful in capturing different cardiac arrhythmias [3-5]. Such arrhythmias can be related to the patient’s presentation ...

The thalamocortical network appears to play a pivotal role in ictogenesis [1], and seizure-induced MRI lesions may involve the thalamus [2,3]. Cerebral lesions are usually considered epileptogenic only when the cortex is involved. Seizures induced by thalamic lesions, however, have been seldom reported. Rare reports describe thalamic lesions leading to refractory focal epilepsy with spike-wave discharges lateralized to the side of the thalamic lesions, [4] clinical features compatible with idiopathic generalized epilepsy (IGE), [5,6] and acute symptomatic generalized tonic-clonic seizures ...

Lamotrigine (LTG) is a frequently prescribed antiepileptic and mood-stabilizing drug, which is associated with cutaneous adverse drug reactions (cADRs). The clinical spectrum of these reactions is wide and ranges from the common mild maculopapular exanthema (MPE) to drug reactions with eosinophilia and systemic symptoms (DRESS) and the rare and life-threatening blistering reactions, such as Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) [1,2]. Although MPE is not a severe adverse reaction by itself, it is still a major cause ...

Surgical management of drug-resistant epilepsy is a well-established method and the lateralization of language and/or memory is essential to avoid resection of the eloquent cortex. The Wada test was developed in the 1960s to determine the lateralization of language and memory by injecting a short-acting anaesthetic drug into the carotid artery, narcotising one single hemisphere and testing the performance of the other isolated hemisphere [1]. Originally, sodium amytal was used, but after its production was stopped in the mid-2000s, it ...

Psychogenic non-epileptic seizures (PNES) are episodes that superficially resemble epileptic seizures but are not caused by abnormal electrical discharges in the brain. Instead, they are typically triggered by oftentimes unconscious emotional distress and dysregulation. Furthermore, other psychiatric comorbidities including mood, anxiety, and post-traumatic disorders often accompany the disorder [1].

In the last few years, advances in next-generation sequencing (NGS) led to a significant increase of the number of genes associated with monogenic epilepsies, and expanded the phenotypes of known genes. Most of them encode for ion channels, however there is growing evidence for the dysfunction of genes implicated in synaptic, regulatory, and developmental functions in childhood-onset epileptic syndromes. The identification of genes and the ensuing functional and pharmacological studies have opened new perspectives in the treatment of epilepsies, that ...

Stroke is the leading cause of epilepsy and ranks among the top causes of death [1]. The overall incidence of post-stroke epilepsy (PSE), which is the main type of newly diagnosed epilepsy in elderly patients, is 3%-45% [2,3]. Therefore, the diagnosis and treatment of PSE has been extensively investigated.

Poststroke seizures are a common complication of stroke. Overall, 2.3-10% of patients with stroke will develop seizures, most of them during the acute phase [1,3], currently associated with increased acute morbidity and mortality [3].

Epilepsy is a neurological disorder that affects nearly 50 million people worldwide, characterized by an enduring predisposition to generate unprovoked recurrent seizures [1]. About 30% of patients with epilepsy do not achieve complete seizure control, despite receiving adequate antiseizure drug (ASD) treatment [2,3]. It is known that more severe epilepsies are more difficult to control. Indeed, recurrent and high frequency severe seizures are hypothesized to facilitate the drug resistant phenotype in epilepsy [4,5] and status epilepticus [6,7].