Seizure

Astrocytes are the most abundant glial cells in the central nervous system (CNS), and provide trophic and metabolic support to neurons in the brain [1]. Dysfunctional astrocytes have been associated with many brain diseases such as Alzheimer’s [2], Huntington’s [3] and Parkinson’s diseases [4], and epilepsy [5,6]. Their normal morphology and function are maintained by the astrocytic intercellular communication, especially the direct cytoplasmic sharing via gap junctions [5]. These pores, formed by two connexin (Cx) hexamers docking to each other ...

Cerebral Hyperperfusion Syndrome (CHS) is a relatively rare and disabling complication following carotid artery stenting (CAS) characterized by headache, seizures and focal neurological deficit. Radiological features include cerebral edema or intracerebral hemorrhage and it can be diagnosed with transcranial doppler (TCD), brain computed tomography (CT) or magnetic resonance imaging (MRI). Although pathophysiological mechanisms underlying CHS are still unknown, an increased regional cerebral blood flow secondary to impaired autoregulation of cerebrovascular system has been proposed [1].

Aicardi-Goutières syndrome (AGS) is a rare hereditary leukodystrophy, named after Jean Aicardi and Françoise Goutières, who first described it in 1984 1. To date, causative mutations have been identified in seven genes: TREX1, RNASEH2B, RNASEH2C, RNASEH2A, ADAR1, SAMHD1, IFIH1 2. The disease pathophysiology is based on a “fundamental link between nucleic acid metabolism, innate immune sensors and type I interferon induction” 3.

Poor management of epilepsy may result in repeated seizures and increased hospital admissions [1,2]. Around 3% epilepsy patients leave hospital against medical advice which is strongly related to higher 30-day readmissions [3]. Proper discharge planning is vital to reduce medication errors, repeated seizures, and other adverse health outcomes. Thus, it is prudent to examine the trends and factors associated with discharges against medical advice (DAMA) among those living with epilepsy to inform future interventions to reduce the occurrence of DAMA.

Dissociative seizures (DS), also known as psychogenic nonepileptic seizures, are episodes of impaired awareness and motor control that can superficially resemble epileptic seizures or syncope. They are, however, the result of complex neurocognitive dysfunction that remains to be elucidated [1]. In one of the first large treatise on the topic from 1859 (421 cases of “hysteria”, 305 with seizures), Pierre Briquet identified emotional stressors such as domestic violence and child maltreatment as common predisposing factors [2].

Juvenile absence epilepsy (JAE) is characterized as frequent absence seizures onset in adolescence, often triggered by photic stimulation or hyperventilation [1]. Electroencephalography (EEG) typically shows generalized spike-wave discharges (GSWDs) at three times per second. JAE is a syndrome of genetic generalized epilepsy, also called idiopathic generalized epilepsy. Patients with JAE are thought to have high probability of generalized tonic-clonic seizures (GTCS) occurrence [1]. Antiepileptic drugs are usually effective, but remission rates after drug withdrawal are relatively low [2,3].

The assessment of a first ever seizure has long been a staple of neurological practice. The emergence of data showing that the risk of recurrence following a single unprovoked seizure was highest in the first 3-6 months1,2, prompted the publication in the United Kingdom of NICE guidelines3 (2012) in which a recommendation was made for a suspected first epileptic seizure or a new diagnosis of epilepsy to be seen by a neurologist or preferably a neurologist specialising in epilepsy within ...

There are over 45.9 million people living with epilepsy worldwide [1]. Around 30 % of patients with epilepsy are drug-resistant [2]. Decreased quality of life, medication side effects, psychiatric comorbidities, and increased health-care utilization are burdens of living with epilepsy [3,4]. Individuals with drug-resistant epilepsy (DRE) are at higher risk of epilepsy-related morbidity and mortality [5,6]. Epilepsy surgery remains the cornerstone of DRE management, but treatment options are limited for patients whose seizures have difficult to localize onset zones, when ...

Febrile seizures (FSs) occur during a febrile episode without evidence of a central nervous system infection [1]. FSs cause significant morbidity and economic burden. Overall, 3%–5% of children experience FSs before the age of 7 years. FSs recur in 20%–30% of patients during subsequent febrile episodes [2]. Patients with FSs are often hospitalized [3].

An American Academy of Neurology subcommittee on quality measures in epilepsy identified documenting seizure type and current seizure frequency in medical records as one of eight quality measurements [1]. Current standard practice for capturing this information is limited to patient and caregiver-reported outcomes, which may include active means like seizure diaries. Unfortunately, because patients only recognize half of seizures that occur, patient reports of seizure activity and motor manifestations are unreliable [2–4].