Seizure

The prevalence of epilepsy in patients with multiple sclerosis (MS) is three to six times the prevalence in the general adult population[1]. While 1-1.5% of the general population have seizures, approximately 2-5% of people with MS have seizures. The cumulative incidence of epilepsy is also higher rising with increasing disease duration [2]. Mechanisms resulting in increased seizure risk are not fully understood. Seizures occur at different MS stages, perhaps suggesting different pathophysiology and management approach[3,4].

Seizure is a common symptom of autoimmune encephalitis [1], and in the latest International League Against Epilepsy (ILAE) classifications guideline of epilepsy, immune etiology was listed as one of six etiologies [2]. In recent decades, the term “autoimmune epilepsy” has been increasingly used in publications; however, some are controversial, as “autoimmune epilepsy” has been applied to seizures in the acute phase of immune-mediated encephalitis [3–5]. Epilepsy is a chronic brain disorder that is different from seizures; therefore, some experts emphasize ...

Juvenile myoclonic epilepsy (JME) is an idiopathic epilepsy (IGE) syndrome with well-defined clinical and electrophysiological features. Reflex epileptic mechanisms, such as photosensitivity, are also closely related to the nature of JME and are important for understanding JME pathogenesis [1,2].

Letter to the Editor

An EEG (electroencephalogram) is crucial for diagnosing, monitoring, and syndromic classification of epilepsy [1]. In individuals experiencing seizures, an epileptiform EEG displaying generalized spike and wave discharges predicts a five-year recurrence risk of 58%, compared to 26% for those with a non-epileptiform EEG [2]. A single 30-minute outpatient EEG reveals interictal epileptiform discharges (IEDs) in 29-56% of epilepsy patients, increasing to 82% with repeated EEGs [3–5]. The cumulative yield after a second and third EEG following a first unprovoked seizure ...

We acknowledge Dr Finsterer’s detailed remarks and thoughts on our paper [1,2]. In the following, we would like to comment on the various limitations and considerations raised in his letter.

Epilepsy surgery is an effective treatment option for drug-resistant focal epilepsy (FE), provided that the patient is a suitable candidate for the procedure [1]. Typically, individuals undergo evaluation in an Epilepsy Monitoring Unit (EMU) to determine their eligibility for surgery [2]. Long term Video-EEG monitoring (LTM) is an essential component of this presurgical evaluation [3]. The goal is to capture several seizures to verify that they are stereotypical and that the epilepsy is unifocal [4].

Status epilepticus (SE) is a life-threating condition with overall mortality approaching 20%, in which generalized convulsive status epilepticus (CSE) represents about 45–74% of all cases. [1,2] SE was originally defined as recurrent seizures without recovery between seizure activities or a seizure with 5 minutes or more of continuous clinical seizure with or without electrographic seizure activity; although, it was not practical in real clinical settings. In 2015, the International League Against Epilepsy proposed a new definition of SE: 5 minutes ...

Epilepsy is a spontaneous and serious neurological disorder that presents with recurrent seizures and affects around 50 million people globally [1]. Unfortunately, despite recent advances in the development of antiseizure medications (ASMs), drug-resistant epilepsy (DRE) still affects 20% to 30% of patients with epilepsy (PWE) [1–3]. Patients with DRE bear significant economic, social, physical, and psychological burdens, but it takes a long time to identify DRE after repetitive ASMs trial, identifying patients at high risk of developing DRE early may ...

We read with great interest the article by María José Jiménez-Villegas and appreciate the author’s updated narrative review about the first unprovoked seizure (US) in children and adults [1]. We would like to add some concerns about nonconvulsive status epilepticus (NCSE) in children.