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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Transsylvian amygdalohippocampectomy for mesial temporal lobe epilepsy: Comparison of three different approaches

Abstract

Objective

This study’s objective was to compare the transinsular (TI‐AH), transuncus (TU‐AH), and temporopolar (TP‐AH) amygdalohippocampectomy approaches regarding seizure control, temporal stem (TS) damage, and neurocognitive decline.

Methods

We included 114 consecutive patients with unilateral hippocampal sclerosis (HS) who underwent TI‐AH, TU‐AH, or TP‐AH between 2002 and 2017. We evaluated seizure control using Engel classification. We used diffusion tensor imaging and postoperative Humphrey perimetry to assess the damage of the TS. We also performed pre‐ and postoperative memory performance and intelligence quotient (IQ).

Results

There ...

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First evidence of altered microbiota and intestinal damage and their link to absence epilepsy in a genetic animal model, the WAG/Rij rat

Abstract

Objective

A large number of studies have highlighted the important role of the gut microbiota in the pathophysiology of neurological disorders, suggesting that its manipulation might serve as a treatment strategy. We hypothesized that the gut microbiota participates in absence seizure development and maintenance in the WAG/Rij rat model and tested this hypothesis by evaluating potential gut microbiota and intestinal alterations in the model, as well as measuring the impact of microbiota manipulation using fecal microbiota transplantation (FMT).

Methods

Initially, gut microbiota composition ...

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Cost‐effectiveness of adrenocorticotropic hormone versus oral steroids for infantile spasms

Abstract

Objective

To compare the effectiveness and cost‐effectiveness of adrenocorticotropic hormone (ACTH) and oral steroids as first‐line treatment for infantile spasm resolution, we performed a systematic review, meta‐analysis, and cost‐effectiveness study.

Methods

A decision analysis model was populated with effectiveness data from a systematic review and meta‐analysis of existing literature and cost data from publicly available prices. Effectiveness was defined as the probability of clinical spasm resolution 14 days after treatment initiation.

Results

We included 21 studies with a total of 968 patients. The effectiveness of ACTH ...

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Prehospital lactate levels in blood as a seizure biomarker: A multi‐center observational study

Abstract

Objective

The objective of this study was to assess the value of prehospital measurement of lactate level in blood for diagnosis of seizures in cases of transient loss of consciousness.

Methods

Between March 2018 and September 2019, prehospital lactate was measured with a point‐of‐care device by the emergency medical services in an area serving a population of 900 000. A total of 383 cases of transient loss of consciousness were identified and categorized as tonic‐clonic seizure (TCS), other seizure, syncope, or other cause, according ...

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LMR‐101, a novel derivative of propofol, exhibits potent anticonvulsant effects and possibly interacts with a novel target on γ‐aminobutyric acid type A receptors

Abstract

Objective

LMR‐101 is a bisphenol derivative of propofol, a short‐acting general anesthetic, which is also used to manage status epilepticus (SE). We evaluated the sedative and anticonvulsant effects of LMR‐101 to discover its potential to manage epilepsy and SE in the clinic.

Methods

Comparative studies between LMR‐101 and propofol were performed in mice to elucidate an appropriate dose range for LMR‐101 that produced anticonvulsant effects without significant sedation. Then, the anticonvulsive efficacy for LMR‐101 was evaluated using seizure models induced by pentylenetetrazol and ...

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Expanding the phenotype of PIGS‐associated early onset epileptic developmental encephalopathy

Abstract

The phosphatidylinositol glycan anchor biosynthesis class S protein (PIGS) gene has recently been implicated in a novel congenital disorder of glycosylation resulting in autosomal recessive inherited glycosylphosphatidylinositol‐anchored protein (GPI‐AP) deficiency. Previous studies described seven patients with biallelic variants in the PIGS gene, of whom two presented with fetal akinesia and five with global developmental delay and epileptic developmental encephalopathy. We present the molecular and clinical characteristics of six additional individuals from five families with unreported variants in PIGS. All individuals ...

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The phenotypic spectrum of X‐linked, infantile onset ALG13‐related developmental and epileptic encephalopathy

Abstract

Objective

Asparagine‐linked glycosylation 13 (ALG13) deficiencies have been repeatedly described in the literature with the clinical phenotype of a developmental and epileptic encephalopathy (DEE). Most cases were females carrying the recurrent ALG13 de novo variant, p.(Asn107Ser), with normal transferrin electrophoresis.

Methods

We delineate the phenotypic spectrum of 38 individuals, 37 girls and one boy, 16 of them novel and 22 published, with the most common pathogenic ALG13 variant p.(Asn107Ser) and additionally report the phenotype of three individuals carrying other likely pathogenic ALG13 variants.

Results

The ...

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