Metabolomic characterization of human hippocampus from drug-resistant epilepsy with mesial temporal seizure

Summary

Objective

Within a complex systems biology perspective, we wished to assess whether hippocampi with established neuropathological features have distinct metabolome. Apparently normal hippocampi with no signs of sclerosis (noHS), were compared to hippocampal sclerosis (HS) type 1 (HS1) and/or type 2 (HS2). Hippocampus metabolome from patients with epilepsy-associated neuroepithelial tumors (EANTs), namely, gangliogliomas (GGs) and dysembryoplastic neuroepithelial tumors (DNTs), was also compared to noHS epileptiform tissue.

Methods

All patients underwent standardized temporal lobectomy. We applied 1H high-resolution magic angle ...

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The incidence and significance of periictal apnea in epileptic seizures

Summary

Objective

The aim of this study was to investigate periictal central apnea as a seizure semiological feature, its localizing value, and possible relationship with sudden unexpected death in epilepsy (SUDEP) pathomechanisms.

Methods

We prospectively studied polygraphic physiological responses, including inductance plethysmography, peripheral capillary oxygen saturation (SpO2), electrocardiography, and video electroencephalography (VEEG) in 473 patients in a multicenter study of SUDEP. Seizures were classified according to the International League Against Epilepsy (ILAE) 2017 seizure classification based on the most prominent ...

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Long-term surveillance of SUDEP in drug-resistant epilepsy patients treated with VNS therapy

Summary

Objective

Limited data are available regarding the evolution over time of the rate of sudden unexpected death in epilepsy patients (SUDEP) in drug-resistant epilepsy. The objective is to analyze a database of 40 443 patients with epilepsy implanted with vagus nerve stimulation (VNS) therapy in the United States (from 1988 to 2012) and assess whether SUDEP rates decrease during the postimplantation follow-up period.

Methods

Patient vital status was ascertained using the Centers for Disease Control and Prevention’s National Death Index (NDI). ...

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Long-term surveillance of SUDEP in drug-resistant epilepsy patients treated with VNS therapy

Summary

Objective

Limited data are available regarding the evolution over time of the rate of sudden unexpected death in epilepsy patients (SUDEP) in drug-resistant epilepsy. The objective is to analyze a database of 40 443 patients with epilepsy implanted with vagus nerve stimulation (VNS) therapy in the United States (from 1988 to 2012) and assess whether SUDEP rates decrease during the postimplantation follow-up period.

Methods

Patient vital status was ascertained using the Centers for Disease Control and Prevention’s National Death Index (NDI). ...

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Return to driving after a diagnosis of epilepsy: A prospective registry study

Summary

Objective

To determine the frequency and predictors of return to driving within 1 year after a diagnosis of epilepsy.

Methods

SEISMIC (the Sydney Epilepsy Incidence Study to Measure Illness Consequences) was a prospective, multicenter, community-wide study of people of all ages with newly diagnosed epilepsy in Sydney, Australia. Demographic, socioeconomic, and clinical characteristics and driving status were obtained as soon as possible after baseline registration with a diagnosis of epilepsy. Multivariate logistic regression was used to determine predictors of ...

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Sudden unexpected death in epilepsy in patients treated with brain-responsive neurostimulation

Summary

Objective

To study the incidence and clinical features of sudden unexpected death in epilepsy (SUDEP) in patients treated with direct brain-responsive stimulation with the RNS System.

Methods

All deaths in patients treated in clinical trials (N = 256) or following U.S. Food and Drug Administration (FDA) approval (N = 451) through May 5, 2016, were adjudicated for SUDEP.

Results

There were 14 deaths among 707 patients (2208 postimplantation years), including 2 possible, 1 probable, and 4 definite SUDEP events. The ...

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Respiratory dysfunction progresses with age in Kcna1-null mice, a model of sudden unexpected death in epilepsy

Summary

Objective

Increased breathing rate, apnea, and respiratory failure are associated with sudden unexpected death in epilepsy (SUDEP). We recently demonstrated the progressive nature of epilepsy and mortality in Kcna1−/− mice, a model of temporal lobe epilepsy and SUDEP. Here we tested the hypothesis that respiratory dysfunction progresses with age in Kcna1−/− mice, thereby increasing risk of respiratory failure and sudden death (SD).

Methods

Respiratory parameters were determined in conscious mice at baseline and following increasing doses of methacholine (MCh) ...

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Respiratory dysfunction progresses with age in Kcna1-null mice, a model of sudden unexpected death in epilepsy

Summary

Objective

Increased breathing rate, apnea, and respiratory failure are associated with sudden unexpected death in epilepsy (SUDEP). We recently demonstrated the progressive nature of epilepsy and mortality in Kcna1−/− mice, a model of temporal lobe epilepsy and SUDEP. Here we tested the hypothesis that respiratory dysfunction progresses with age in Kcna1−/− mice, thereby increasing risk of respiratory failure and sudden death (SD).

Methods

Respiratory parameters were determined in conscious mice at baseline and following increasing doses of methacholine (MCh) ...

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Generalized nonmotor (absence) seizures—What do absence, generalized, and nonmotor mean?

Summary

Objective

Clinical absences are now classified as “generalized nonmotor (absence) seizures” by the International League Against Epilepsy (ILAE). The aim of this paper is to critically review the concept of absences and to put the accompanying focal and motor symptoms into the context of the emerging pathophysiological knowledge.

Methods

For this narrative review we performed an extensive literature search on the term “absence,” and analyzed the plethora of symptoms observed in clinical absences.

Results

Arising from the localization and the ...

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Measurement in pediatric epilepsy self-management: A critical review

Summary

Given the paucity of information available regarding self-management, the aims of this paper are to synthesize the literature on factors associated with and measures to assess self-management in pediatric epilepsy. Inclusion criteria: youth birth to 18 years with a seizure disorder or an epilepsy diagnosis and/or their caregivers, published 1985-2014 in English, and conducted in countries with a very high human development index. The review was conducted in 6 phases: (1) identification of bibliographical search criteria and ...

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