Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

Humans use a complex system of protective cognitive biases or “positive illusions” that foster emotional well‐being and subjective quality of life. This study examined the role of positive illusions in patient adjustment to drug‐resistant epilepsy and its surgical treatment.

Methods

One hundred fifty people participated, including 93 focal epilepsy patients being evaluated for surgery and 57 sociodemographically matched healthy controls. We purpose‐built computer software, “Living With Epilepsy,” to assess the impact of positive illusions on patient perceptions of their current life, and ...

Abstract

Objective

To analyze longitudinal seizure outcomes following epilepsy surgery, including reoperations, in patients with intractable focal epilepsy.

Methods

Clinicoradiological characteristics of patients who underwent epilepsy surgery from 1995 to 2016 with follow‐up of ≥1 year were reviewed. In patients undergoing reoperations, the latest resection was considered the index surgery. The primary outcome was complete seizure freedom (Engel I) at last follow‐up. Potentially significant outcome variables were first identified using univariate analyses and then fit in multivariate Cox proportional hazards models.

Results

Of 898 patients fulfilling study ...

Abstract

Objective

The use of the Internet for health‐related questions is increasing, but it is not clear whether individuals can understand the information available online. Most health organizations recommend that health educational materials (HEMs) be written below the sixth grade reading level. This study was designed to evaluate the readability level of available online HEMs pertaining to traumatic brain injury (TBI), epilepsy, and posttraumatic epilepsy (PTE).

Methods

This cross‐sectional readability assessment included HEMs from TBI and epilepsy stakeholder organizations and those obtained from four ...

Abstract

Objective

To pinpoint the earliest cellular defects underlying seizure onset (epileptogenic period) during perinatal brain development in a new zebrafish model of Dravet syndrome (DS) and to investigate potential disease‐modifying activity of the 5HT₂ receptor agonist fenfluramine.

Methods

We used CRISPR/Cas9 mutagenesis to introduce a missense mutation, designed to perturb ion transport function in all channel isoforms, into scn1lab, the zebrafish orthologue of SCN1A (encoding voltage‐gated sodium channel alpha subunit 1). We performed behavioral analysis and electroencephalographic recordings to measure convulsions and epileptiform ...

Abstract

Objective

Voltage‐gated sodium channels (SCNs) share similar amino acid sequence, structure, and function. Genetic variants in the four human brain‐expressed SCN genes SCN1A/2A/3A/8A have been associated with heterogeneous epilepsy phenotypes and neurodevelopmental disorders. To better understand the biology of seizure susceptibility in SCN‐related epilepsies, our aim was to determine similarities and differences between sodium channel disorders, allowing us to develop a broader perspective on precision treatment than on an individual gene level alone.

Methods

We analyzed genotype‐phenotype correlations in large SCN‐patient cohorts and ...

Abstract

Objective

The microscopic review of hematoxylin‐eosin–stained images of focal cortical dysplasia type IIb and cortical tuber of tuberous sclerosis complex remains challenging. Both entities are distinct subtypes of human malformations of cortical development that share histopathological features consisting of neuronal dyslamination with dysmorphic neurons and balloon cells. We trained a convolutional neural network (CNN) to classify both entities and visualize the results. Additionally, we propose a new Web‐based deep learning application as proof of concept of how deep learning could enter ...

Abstract

Objective

Electroencephalographic seizures (ESs) are common in encephalopathic critically ill children, but ES identification with continuous electroencephalography (EEG) monitoring (CEEG) is resource‐intense. We aimed to develop an ES prediction model that would enable clinicians to stratify patients by ES risk and optimally target limited CEEG resources. We aimed to determine whether incorporating data from a screening EEG yielded better performance characteristics than models using clinical variables alone.

Methods

We performed a prospective observational study of 719 consecutive critically ill children with acute encephalopathy ...

Abstract

Excess mortality due to epilepsy is greatest among young adults. However, the relative proportions of sudden unexpected death in epilepsy (SUDEP) and other epilepsy‐related causes of death are not well defined. We prospectively adjudicated cause of death in all 18‐ to 45‐year‐olds with a history of seizure/epilepsy who underwent medicolegal investigation in San Diego County between 2014 and 2017. We identified 108 decedents with definite or probable epilepsy; 62% died from an epilepsy‐related cause. SUDEP accounted for 42.6% (N = 46) of ...