Cycles of self‐reported seizure likelihood correspond to yield of diagnostic epilepsy monitoring

Abstract

Objective

Video‐electroencephalography (vEEG) is an important component of epilepsy diagnosis and management. Nevertheless, inpatient vEEG monitoring fails to capture seizures in up to one third of patients. We hypothesized that personalized seizure forecasts could be used to optimize the timing of vEEG.

Methods

We used a database of ambulatory vEEG studies to select a cohort with linked electronic seizure diaries of more than 20 reported seizures over at least 8 weeks. The total cohort included 48 participants. Diary seizure times were used to detect ...

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Interictal electroencephalographic functional network topology in drug‐resistant and well‐controlled idiopathic generalized epilepsy

Abstract

Objective

The study aim was to compare interictal encephalographic (EEG) functional network topology between people with well‐controlled idiopathic generalized epilepsy (WC‐IGE) and drug‐resistant IGE (DR‐IGE).

Methods

Nineteen participants with WC‐IGE, 18 with DR‐IGE, and 20 controls underwent a resting state, 64‐channel EEG. An artifact‐free epoch was bandpass filtered into the frequency range of high and low extended alpha. Weighted functional connectivity matrices were calculated. Mean degree, degree distribution variance, characteristic path length (L), clustering coefficient, small world index (SWI), and betweenness centrality were ...

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A hypothesis for the role of axon demyelination in seizure generation

Abstract

Loss of myelin and altered oligodendrocyte distribution in the cerebral cortex are commonly observed both in postsurgical tissue derived from different focal epilepsies (such as focal cortical dysplasias and tuberous sclerosis) and in animal models of focal epilepsy. Moreover, seizures are a frequent symptom in demyelinating diseases, such as multiple sclerosis, and in animal models of demyelination and oligodendrocyte dysfunction. Finally, the excessive activity reported in demyelinated axons may promote hyperexcitability. We hypothesize that the extracellular potassium rise generated during ...

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Focal to bilateral tonic–clonic seizures are associated with widespread network abnormality in temporal lobe epilepsy

Abstract

Objective

Our objective was to identify whether the whole‐brain structural network alterations in patients with temporal lobe epilepsy (TLE) and focal to bilateral tonic–clonic seizures (FBTCS) differ from alterations in patients without FBTCS.

Methods

We dichotomized a cohort of 83 drug‐resistant patients with TLE into those with and without FBTCS and compared each group to 29 healthy controls. For each subject, we used diffusion‐weighted magnetic resonance imaging to construct whole‐brain structural networks. First, we measured the extent of alterations by performing FBTCS‐negative (FBTCS−) ...

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Accelerated long‐term forgetting in focal epilepsy: Do interictal spikes during sleep matter?

Abstract

Accelerated long‐term forgetting (ALF) is a particular form of amnesia mostly encountered in focal epilepsy, particularly in temporal lobe epilepsy. This type of memory loss is characterized by an impairment of long‐term consolidation of declarative memory, and its mechanisms remain poorly understood. In particular, the respective contribution of lesion, seizures, interictal epileptic discharges, and sleep is still debated. Here, we provide an overview of the relationships intertwining epilepsy, sleep, and memory consolidation and, based on recent findings from intracranial electroencephalographic ...

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The severe epilepsy syndromes of infancy: A population‐based study

Abstract

Objective

To study the epilepsy syndromes among the severe epilepsies of infancy and assess their incidence, etiologies, and outcomes.

Methods

A population‐based cohort study was undertaken of severe epilepsies with onset before age 18 months in Victoria, Australia. Two epileptologists reviewed clinical features, seizure videos, and electroencephalograms to diagnose International League Against Epilepsy epilepsy syndromes. Incidence, etiologies, and outcomes at age 2 years were determined.

Results

Seventy‐three of 114 (64%) infants fulfilled diagnostic criteria for epilepsy syndromes at presentation, and 16 (14%) had “variants” of epilepsy syndromes ...

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Seizures in autoimmune encephalitis—A systematic review and quantitative synthesis

Abstract

Objective

This study aimed to evaluate the proportion of patients with seizures and electroencephalography (EEG) abnormalities in autoimmune encephalitis (AE) and its most common subtypes.

Methods

This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) standards and was registered with the International Prospective Register of Systematic Reviews (PROSPERO). We searched Medline All, Embase, and PsychINFO in Ovid from inception to June 2019 for articles pertaining to AE and seizure. Included studies reported seizure and/or EEG data in cohorts of ...

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Augmented seizure susceptibility and hippocampal epileptogenesis in a translational mouse model of febrile status epilepticus

Abstract

Objective

Prolonged fever‐induced seizures (febrile status epilepticus [FSE]) during early childhood increase the risk for later epilepsy, but the underlying mechanisms are incompletely understood. Experimental FSE (eFSE) in rats successfully models human FSE, recapitulating the resulting epileptogenesis in a subset of affected individuals. However, the powerful viral and genetic tools that may enhance mechanistic insights into epileptogenesis and associated comorbidities, are better‐developed for mice. Therefore, we aimed to determine if eFSE could be generated in mice and if it provoked enduring ...

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Predicting mood decline following temporal lobe epilepsy surgery in adults

Abstract

Objective

To develop a model to predict the probability of mood decline in adults following temporal lobe resection for the treatment of pharmacoresistant epilepsy.

Methods

Variable selection was performed on 492 patients from the Cleveland Clinic using best subsets regression. After completing variable selection, a subset of variables was requested from four epilepsy surgery centers across North America (n = 100). All data were combined to develop a final model to predict postoperative mood decline (N = 592). Internal validation with bootstrap resampling was performed. A clinically ...

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Antibody Prevalence in Epilepsy before Surgery (APES) in drug‐resistant focal epilepsy

Abstract

Objective

There is a growing recognition of immune‐mediated causes in patients with focal drug‐resistant epilepsy (DRE); however, they are not systematically assessed in the pre‐surgical diagnostic workup. Early diagnosis and initiation of immunotherapy is associated with a favorable outcome in immune‐mediated seizures. Patients with refractory focal epilepsy with neuronal antibodies (Abs) tend to have a worse surgical prognosis when compared to other etiologies.

Methods

We studied the prevalence of serum Abs in patients ≥18 years of age with DRE of unknown cause before surgery. ...

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