Seizure‐induced microvascular injury is associated with impaired neurovascular coupling and blood–brain barrier dysfunction

Summary

Objective

Blood–brain barrier (BBB) impairment, redistribution of pericytes, and disturbances in cerebral blood flow may contribute to the increased seizure propensity and neurological comorbidities associated with epilepsy. However, despite the growing evidence of postictal disturbances in microcirculation, it is not known how recurrent seizures influence pericytic membrane currents and subsequent vasodilation.

Methods

Here, we investigated successive changes in capillary neurovascular coupling and BBB integrity during recurrent seizures induced by 4‐aminopyridine or low‐Mg2+ conditions. To avoid the influence of arteriolar dilation and cerebral blood ...

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Spontaneous epileptiform activity in a rat model of bilateral subcortical band heterotopia

Summary

Objective

Malformations of cortical development are common causes of intellectual disability and epilepsy, yet there is a crucial lack of relevant preclinical models associating seizures and cortical malformations. Here, we describe a novel rat model with bilateral subcortical band heterotopia (SBH) and examine whether this model develops spontaneous epileptic seizures.

Methods

To generate bilateral SBH in rats, we combined RNAi‐mediated knockdown of Dcx and in utero electroporation with a tripolar electrode configuration enabling simultaneous transfection of the two brain hemispheres. To determine whether ...

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Cannabidiol reduces seizures and associated behavioral comorbidities in a range of animal seizure and epilepsy models

Summary

Objective

Epilepsy is a progressive neurological disease characterized by recurrent seizures and behavioral comorbidities. We investigated the antiseizure effect of cannabidiol (CBD) in a battery of acute seizure models. Additionally, we defined the disease‐modifying potential of chronic oral administration of CBD on associated comorbidities in the reduced intensity status epilepticus–spontaneous recurrent seizures (RISE‐SRS) model of temporal lobe epilepsy (TLE).

Methods

We evaluated the acute antiseizure effect of CBD in the maximal electroshock seizure, 6‐Hz psychomotor seizure, and pentylenetetrazol acute seizure tests, as well ...

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Localization yield and seizure outcome in patients undergoing bilateral SEEG exploration

Summary

Objective

We aimed to determine the rates and predictors of resection and seizure freedom after bilateral stereo‐electroencephalography (SEEG) implantation.

Methods

We reviewed 184 patients who underwent bilateral SEEG implantation (2009‐2015). Noninvasive and invasive evaluation findings were collected. Outcomes of interest included subsequent resection and seizure freedom. Statistical analyses employed multivariable logistic regression and proportional hazard modeling. Preoperative and postoperative seizure frequency, severity, and quality of life scales were also compared.

Results

Following bilateral SEEG implantation, 106 of 184 patients (58%) underwent resection. Single seizure type ...

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Illness severity scoring in status epilepticus—When STESS meets APACHE II, SAPS II, and SOFA

Summary

Objective

To characterize a critically ill cohort with status epilepticus (SE) by the illness severity scoring systems SAPS II (Simplified Acute Physiology Score II), APACHE II (Acute Physiology and Chronic Health Evaluation II), and SOFA (Sequential Organ Failure Assessment), and to compare their performance with the STESS (Status Epilepticus Severity Score) for outcome prediction.

Methods

The prospective cohort study was carried out at the University Hospital Basel, a Swiss tertiary academic medical care center. Consecutive adult SE patients hospitalized in the intensive care ...

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Do neurologists agree in diagnosing drug resistance in adults with focal epilepsy?

Summary

Objective

To evaluate interrater agreement in categorizing treatment outcomes and drug responsiveness status according to the International League Against Epilepsy (ILAE) definition of drug‐resistant epilepsy.

Methods

A total of 1053 adults with focal epilepsy considered by the investigators to meet ILAE criteria for drug resistance were enrolled consecutively at 43 centers and followed up prospectively for 18‐34 months. Treatment outcomes for all antiepileptic drugs (AEDs) used up to enrollment (retrospective assessment), and on an AED newly introduced at enrollment, were categorized by individual investigators ...

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Long‐term cannabidiol treatment in patients with Dravet syndrome: An open‐label extension trial

Summary

Objective

Add‐on cannabidiol (CBD) significantly reduced seizures associated with Dravet syndrome (DS) in a randomized, double‐blind, placebo‐controlled trial: GWPCARE1 Part B (NCT02091375). Patients who completed GWPCARE1 Part A (NCT02091206) or Part B, or a second placebo‐controlled trial, GWPCARE2 (NCT02224703), were invited to enroll in a long‐term open‐label extension trial, GWPCARE5 (NCT02224573). We present an interim analysis of the safety, efficacy, and patient‐reported outcomes from GWPCARE5.

Methods

Patients received a pharmaceutical formulation of highly purified CBD in oral solution (100 mg/mL), titrated from 2.5 ...

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Differences in pediatric and adult epilepsy surgery: A comparison at one center from 1990 to 2014

Summary

Objective

Surgical volumes at large epilepsy centers are decreasing. Pediatric cohorts, however, show a trend toward more resections and superior outcome. Differences in pediatric and adult epilepsy surgery were investigated in our cohort.

Methods

The Bethel database between 1990 and 2014 was retrospectively analyzed.

Results

A total of 1916 adults and 1300 children underwent presurgical workup. The most common etiologies were medial temporal sclerosis (35.4%) in adults, and focal cortical dysplasias (21.1%) and diffuse hemispheric pathologies (14.7%) in children. Only 1.4% of the total cohort ...

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