Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Advances in genetics may enable a deeper understanding of disease mechanisms and promote a shift to more personalised medicine in the epilepsies. At present, understanding of consequences of genetic variants mainly relies on preclinical functional work; tools for acquiring similar data from the living human brain are needed. Transcranial magnetic stimulation (TMS), in particular paired‐pulse TMS protocols which depend on the function of cortical GABAergic interneuron networks, has the potential to become such a tool. For this report, we identified ...

Abstract

Objective

To define left temporal lobe regions where surgical resection produces a persistent postoperative decline in naming visual objects.

Methods

Pre‐ and postoperative brain magnetic resonance imaging data and picture naming (Boston Naming Test) scores were obtained prospectively from 59 people with drug‐resistant left temporal lobe epilepsy. All patients had left hemisphere language dominance at baseline and underwent surgical resection or ablation in the left temporal lobe. Postoperative naming assessment occurred approximately 7 months after surgery. Surgical lesions were mapped to a standard template, ...

Abstract

Objectives

The current coronavirus disease 2019 (COVID‐19) pandemic stresses an urgency to accelerate much‐needed health service reform. Rapid and courageous changes being made to address the immediate impact of the pandemic are demonstrating that the means and technology to enable new models of health care exist. For example, innovations such as electronic patient portals (ePortal) can facilitate (a) radical reform of outpatient care; (b) cost containment in the economically constrained aftermath of the pandemic; (c) environmental sustainability by reduction of unnecessary ...

Abstract

Objective

Magnetic resonance imaging (MRI)–guided laser interstitial thermal therapy (MRg‐LITT) is an alternative to open epilepsy surgery. We assess safety and effectiveness of MRg‐LITT for extratemporal lobe epilepsy (ETLE) in patients who are considered less favorable for open resection.

Methods

We retrospectively reviewed sequential cases of patients with focal ETLE who underwent MRg‐LITT between 2012 and 2019. Epileptogenic zones were determined from standard clinical and imaging data ± stereoelectroencephalography (SEEG). Standard stereotactic techniques, MRI thermometry, and a commercial laser thermal therapy system were used for ...

Abstract

Objective

One of the greatest challenges of achieving successful surgical outcomes in patients with epilepsy is the ability to properly localize the seizure onset zone (SOZ). Many techniques exist for localizing the SOZ, including intracranial electroencephalography, magnetoencephalography, and stereoelectroencephalography. Recently, resting‐state functional magnetic resonance imaging (rs‐fMRI) in conjunction with independent component analysis (ICA) has been utilized for presurgical planning of SOZ resection, with varying results. In this meta‐analysis, we analyze the current role of rs‐fMRI in identifying the SOZ for presurgical ...

Abstract

Epilepsy is a heterogeneous condition with disparate etiologies and phenotypic and genotypic characteristics. Clinical and research aspects are accordingly varied, ranging from epidemiological to molecular, spanning clinical trials and outcomes, gene and drug discovery, imaging, electroencephalography, pathology, epilepsy surgery, digital technologies, and numerous others. Epilepsy data are collected in the terabytes and petabytes, pushing the limits of current capabilities. Modern computing firepower and advances in machine and deep learning, pioneered in other diseases, open up exciting possibilities for epilepsy too. ...

Abstract

Objective

Stress is a known trigger for seizures in patients with epilepsy (PWE). However, the association between stress and seizures has not been thoroughly investigated. In December 2019, an outbreak of coronavirus disease (COVID‐19) occurred in Wuhan, Hubei province, China, causing tremendous collateral stress. This study was designed to evaluate the influence of the COVID‐19 outbreak on seizures in PWE in the most severely affected area, Wuhan, and its surrounding cities.

Methods

In this single‐center, cross‐sectional study, PWE were surveyed via online questionnaires ...

Abstract

Objective

Seizure detection is a major facet of electroencephalography (EEG) analysis in neurocritical care, epilepsy diagnosis and management, and the instantiation of novel therapies such as closed‐loop stimulation or optogenetic control of seizures. It is also of increased importance in high‐throughput, robust, and reproducible pre‐clinical research. However, seizure detectors are not widely relied upon in either clinical or research settings due to limited validation. In this study, we create a high‐performance seizure‐detection approach, validated in multiple data sets, with the intention ...