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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Systematic analysis and comparison of commercial seizure‐detection software

Abstract

Objective

To determine if three different commercially available seizure‐detection software packages (Besa 2.0, Encevis 1.7, and Persyst 13) accurately detect seizures with high sensitivity, high specificity, and short detection delay in epilepsy patients undergoing long‐term video–electroencephalography (EEG) monitoring (VEM).

Methods

Comparison of sensitivity (detection rate), specificity (false alarm rate), and detection delay of three commercially available seizure‐detection software packages in 81 randomly selected patients with epilepsy undergoing long‐term VEM.

Results

Detection rates on a per‐patient basis were not significantly different between Besa (mean 67.6%, range ...

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Preictal state detection using prodromal symptoms: A machine learning approach

Abstract

A reliable identification of a high‐risk state for upcoming seizures may allow for preemptive treatment and improve the quality of patients’ lives. We evaluated the ability of prodromal symptoms to predict preictal states using a machine learning (ML) approach. Twenty‐four patients with drug‐resistant epilepsy were admitted for continuous video‐electroencephalographic monitoring and filled out a daily four‐point questionnaire on prodromal symptoms. Data were then classified into (1) a preictal group for questionnaires completed in a 24‐h period prior to at least ...

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Complex effects of eslicarbazepine on inhibitory micro networks in chronic experimental epilepsy

Summary

Objective

Many antiseizure drugs (ASDs) act on voltage‐dependent sodium channels, and the molecular basis of these effects is well established. In contrast, how ASDs act on the level of neuronal networks is much less understood.

Methods

In the present study, we determined the effects of eslicarbazepine (S‐Lic) on different types of inhibitory neurons, as well as inhibitory motifs. Experiments were performed in hippocampal slices from both sham‐control and chronically epileptic pilocarpine‐treated rats.

Results

We found that S‐Lic causes an unexpected reduction of feed‐forward inhibition in ...

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