Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Noninvasive wearable devices have great potential to aid the management of epilepsy, but these devices must have robust signal quality, and patients must be willing to wear them for long periods of time. Automated machine learning classification of wearable biosensor signals requires quantitative measures of signal quality to automatically reject poor‐quality or corrupt data segments. In this study, commercially available wearable sensors were placed on patients with epilepsy undergoing in‐hospital or in‐home electroencephalographic (EEG) monitoring, and healthy volunteers. Empatica E4 ...

Abstract

Reliably detecting focal seizures without secondary generalization during daily life activities, chronically, using convenient portable or wearable devices, would offer patients with active epilepsy a number of potential benefits, such as providing more reliable seizure count to optimize treatment and seizure forecasting, and triggering alarms to promote safeguarding interventions. However, no generic solution is currently available to reach these objectives. A number of biosignals are sensitive to specific forms of focal seizures, in particular heart rate and its variability for ...

Abstract

Objective

To determine the role of aquaporin‐4 (AQP4) in posttraumatic epileptogenesis using long‐term video‐electroencephalographic (vEEG) recordings. Here, differences in EEG were analyzed between wild‐type (WT) and AQP4 knockout (KO) mice and between mice with and without posttraumatic epilepsy (PTE).

Methods

WT and AQP4 KO mice were subjected to a single controlled cortical impact traumatic brain injury (TBI) in the frontal cortex, and vEEG was recorded in the ipsilateral hippocampus at 14, 30, 60, and 90 days postinjury (dpi). Intrahippocampal electrical stimulation was also used ...

Abstract

Objective

Brain tissue oxygen (partial oxygen pressure [pO₂]) levels are tightly regulated to stay within the normoxic zone, with deviations on either side resulting in impaired brain function. Whereas pathological events such as ischemic attacks and brief seizures have previously been shown to result in pO₂ levels well below the normoxic zone, oxygen levels during prolonged status epilepticus (SE) and the subsequent endogenous kindling period are unknown.

Methods

We utilized two models of acquired temporal lobe epilepsy in rats: intrahippocampal kainic acid infusion ...

Abstract

Our objective was to undertake a systematic review ascertaining the accuracy of using administrative healthcare data to identify epilepsy cases. We searched MEDLINE and Embase from 01/01/1975 to 03/07/2018 for studies evaluating the diagnostic accuracy of routinely collected healthcare data in identifying epilepsy cases. Any disease coding system in use since the International Classification of Diseases, Ninth Revision (ICD‐9) was permissible. Two authors independently screened studies, extracted data, and quality‐assessed studies. We assessed positive predictive value (PPV), sensitivity, negative predictive ...

Abstract

Objective

We aimed to describe the extent of neurodevelopmental impairments and identify the genetic etiologies in a large cohort of patients with epilepsy with myoclonic atonic seizures (MAE).

Methods

We deeply phenotyped MAE patients for epilepsy features, intellectual disability, autism spectrum disorder, and attention‐deficit/hyperactivity disorder using standardized neuropsychological instruments. We performed exome analysis (whole exome sequencing) filtered on epilepsy and neuropsychiatric gene sets to identify genetic etiologies.

Results

We analyzed 101 patients with MAE (70% male). The median age of seizure onset was 34 months (range ...

Abstract

Vagus nerve stimulation (VNS) is often used for patients with drug‐resistant epilepsy. Although this intervention may improve seizure control and mood, a number of factors must be considered when patients with VNS near end of life. We reviewed relevant literature to create a proposed guideline for management of patients with VNS in palliative care and after death. VNS has multiple possible side effects, including cough and swallowing difficulties. For patients with neurologic disease in palliative care, such adverse effects can ...

Abstract

Objective

Activity‐dependent changes have been reported in animal models and in human epileptic specimens and could potentially be used as tissue biomarkers to evaluate the propensity of a tissue to generate seizure activity. In this context, cAMP‐response element binding protein (CREB) activation was specifically reported in human epileptic foci and related mainly to interictal spike activity. To get further insights into CREB activation in human epilepsy, we analyzed pCREB expression on brain tissue samples from patients who underwent surgery for drug‐resistant ...

Abstract

Objective

To define the phenotypic spectrum of phosphatidylinositol glycan class A protein (PIGA )‐related congenital disorder of glycosylation (PIGA‐CDG) and evaluate genotype‐phenotype correlations.

Methods

Our cohort encompasses 40 affected males with a pathogenic PIGA variant. We performed a detailed phenotypic assessment, and in addition, we reviewed the available clinical data of 36 previously published cases and assessed the variant pathogenicity using bioinformatical approaches.

Results

Most individuals had hypotonia, moderate to profound global developmental delay, and intractable seizures. We found that PIGA‐CDG spans from a ...