Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

Temporal Lobe Epilepsy (TLE) affects brain networks and is associated with impairment of episodic memory. Temporal and extra-temporal reorganisation of memory functions are described in functional magnetic resonance imaging (fMRI) studies. Functional reorganisations have been shown at the local activation level, but network-level alterations have been under-investigated. We aim to investigate the functional anatomy of memory networks using memory fMRI and determine how this relates to memory function in TLE.

Methods

Ninety patients with unilateral TLE (43 left) and 29 controls performed ...

Abstract

Objective

Several instruments and outcomes measures have been reported in pediatric patients undergoing epilepsy surgery. The objective of this systematic review is to summarize, evaluate, and quantify outcome metrics for the surgical treatment of pediatric epilepsy that address seizure frequency, neuropsychological, and health-related quality of life (HRQL).

Methods

We performed a systematic review according to PRISMA guidelines to identify publications between 2010 and June 2021 from PubMed, Embase, and the Cochrane Database of Systematic Reviews that report clinical outcomes in pediatric epilepsy surgery.

Results

Eighty-one ...

Abstract

The genetic basis of many epilepsies is increasingly understood, giving rise to the possibility of precision treatments tailored to specific genetic etiologies. Despite this, current medical therapy for most epilepsies remains imprecise, aimed primarily at empirical seizure reduction rather than targeting specific disease processes. Intellectual and technological leaps in diagnosis over the past 10 years have not yet translated to routine changes in clinical practice. However, the epilepsy community is poised to make impressive gains in precision therapy, with continued innovation ...

Abstract

Objective

Memory deficits are frequent among patients with epilepsies affecting the temporal lobe. Hippocampal interictal epileptic discharges (hIEDs), the presumed epileptic exaggeration of sharp wave-ripples (SWRs), are known to contribute to memory dysfunction, but the potential underlying mechanism is unknown. The precise temporal coordination between hippocampal SWRs and corticothalamic spindles during sleep is critical for memory consolidation. Moreover, previous investigation indicated that hIEDs induce neocortical spindlelike oscillation. In the present study, we aimed to assess the influence of hIEDs on neocortical ...

Abstract

Clinical studies of rescue medications for seizure clusters are limited and designed to satisfy regulatory requirements, which may not fully consider the needs of the diverse patient population that experiences seizure clusters or utilize rescue medication. The purpose of this narrative review is to examine factors that contribute to, or may influence the quality of, seizure cluster research with a goal of improving clinical practice. We address five areas of unmet needs and provide advice of how they could enhance ...

Abstract

Simultaneous EEG-fMRI is a unique and non-invasive method for investigating epileptic activity. Interictal epileptiform discharge-related EEG-fMRI provides cortical and subcortical blood oxygen level-dependent (BOLD) signal changes specific to epileptic discharges. As a result, EEG-fMRI has revealed insights into generators and networks involved in epileptic activity in different types of epilepsy, demonstrating—for instance—the implication of the thalamus in human generalized spike and wave discharges and the role of the Default Mode Network (DMN) in absences and focal epilepsy, and proposed a ...

Abstract

Objectives

Non-convulsive status epilepticus (NCSE) is misdiagnosed in >50% of cases in the emergency department. Computerized tomography perfusion (CTP) has been implemented in the hyper-acute setting to detect seizure-induced hyper-perfusion. However, the diagnostic value of CTP is limited by the lack of thresholds for hyper-perfusion and high inter-rater variability. This pilot case-control study aims at identifying the diagnostic value of reverse Tmax (rTmax) in differentiating NCSE vs acute ischemic stroke in the hyper-acute setting.

Methods

We enrolled patients with NCSE (Salzburg criteria-based diagnosis) ...

Abstract

Objective

The US Food and Drug Administration recently issued a warning against the use of the antiseizure medication lamotrigine in people at risk of cardiac rhythm and conduction abnormalities. This study assessed the risk of cardiac morbidity and mortality in new users of lamotrigine.

Methods

In a Danish population-based cohort study, we followed cohort members aged ≥15 years for the first 2 years after they initiated lamotrigine therapy. The main outcomes were cardiac conduction disorders in people without pre-existing cardiac morbidity and all-cause mortality in ...

Abstract

Objective

Based on the promising results of randomized controlled trials, deep brain stimulation (DBS) and responsive neurostimulation (RNS) are used increasingly in the treatment of patients with drug-resistant epilepsy. Drug-resistant temporal lobe epilepsy (TLE) is an indication for either DBS of the anterior nucleus of the thalamus (ANT) or temporal lobe (TL) RNS, but there are no studies that directly compare the seizure benefits and adverse effects associated with these therapies in this patient population. We, therefore, examined all patients who ...