Seizure

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].

New-onset refractory status epilepticus (NORSE) is an increasingly recognized syndrome requiring aggressive antiepileptic management. A wide range of etiologies are associated with NORSE, including atypical infections and antibody mediated disorders [1].

The notion of epilepsy as a network disease is rapidly gaining traction, particularly in the domains of whole brain networks as measured with MRI, MEG and EEG[1]. This concept is illustrated by the growing recognition that lesional focal epilepsies are disorders that widely disrupt neural systems that are outside of the lesion, but which are part of a brain network that have capacity to generate seizures[2]. However, the network concept can be applied far more broadly than the level of ...

Epilepsy is a prevalent chronic neurologic disease that affects over 50 million people worldwide.[1] Mortality in epilepsy populations is three times higher compared to the general population and death causes are mainly epilepsy-related.[2] Moreover, the condition poses a high societal burden, ranking fifth amongst neurological disorders in disability-adjusted life years (DALY).[3]

Perampanel (PER) is a first-in-class selective, non-competitive antagonist of the glutamate α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor that has demonstrated broad-spectrum anticonvulsant activity [1,2]. In Europe, once-daily PER is indicated for the adjunctive treatment of focal-onset seizures (FOS), including focal to bilateral tonic-clonic seizures (FBTCS), and for primary generalized tonic-clonic seizures in patients over 12 years of age [3].

Our patient is a 2-year-old male with previously undiagnosed long chain 3-hydroxyacylCoA dehydrogenase deficiency (LCHAD). He presented with neuronal injury secondary to hypoglycemia. Upon arrival to our medical center, he was unresponsive, sedated and intubated. Continuous EEG monitoring was begun to evaluate for presence of seizures and the patient was treated with levetiracetam for seizure prophylaxis and midazolam for sedation. He was not treated with a paralytic agent. Approximately 24 h following injury, EEG recording showed a subclinical seizure with left ...

Narrative Medicine (NM) is a communication therapy that engages the patient’s story of illness or injury and treatment in the context of their identity, values, fears, and hopes. The NM practitioner invites the patient to put significant experiences into words and share in a dialogue where unstated concerns can be given voice and new insights can be discovered. Patients may also respond to prompts for journal writing that may be discussed with the NM provider and in workshop groups. NM ...

We describe a case of intracranial dural arteriovenous fistula (dAVFs) in left parieto-insulo-occipital regions and left cerebellum presenting with acute myelopathy followed by focal status epilepticus in a two-step clinical course.

Fırat et al. [1] discussed the potential drug-drug interactions between antiepileptic drugs and therapeutic drugs currently used in the management of coronavirus disease 2019 (COVID-19). This piece of discussion is relevant and indeed is of utmost importance given that clinicians specialized in the management of COVID-19 may not be familiar with the use of antiepileptic drugs and thus they may be of little knowledge how best to manage the potential drug-drug interactions involving antiepileptic drugs and the therapeutic drugs for ...

Tuberous sclerosis complex (TSC) is a well-known autosomal dominant multisystem disorder characterized by hamartomas in different organs.1 Mutations in TSC1 and TSC2 genes encoding hamartin and tuberin, respectively, suppress the mammalian target of rapamycin (mTOR) inhibition leading to the disruption of the regulation of cell proliferation and differentiation.1 The neurological complications of TSC, includes epilepsy, cognitive impairment, and autism, and about 75% of patients had pharmacoresistant epilepsy.