Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Patients with drug‐resistant epilepsy (DRE) rarely achieve seizure freedom with medical therapy alone. Despite being safe and effective for select patients with DRE, epilepsy surgery remains heavily underutilized. Multiple studies have indicated that the overall rates of surgery in patients with DRE have stagnated in recent years and may be decreasing, even when hospitalizations for epilepsy‐related problems are on the rise. Ultimately, many patients with DRE who might otherwise benefit from surgery continue to have intractable seizures, lacking access to ...

Abstract

Objective

To characterize the presence and nature of discrete behavioral phenotypes and their correlates in a cohort of youth with new and recent onset focal and generalized epilepsies.

Methods

The parents of 290 youth (age = 8‐18 years) with epilepsy (n = 183) and typically developing participants (n = 107) completed the Child Behavior Checklist for children aged 6‐18 from the Achenbach System of Empirically Based Assessment. The eight behavior problem scales were subjected to hierarchical clustering analytics to identify behavioral subgroups. To characterize the external validity ...

Abstract

Objective

We aim to evaluate the impact of zonisamide (ZNS) compared to topiramate (TPM) on cognition in patients with epilepsy. Although the risk of cognitive side effects has been clearly demonstrated for TPM, comparable side effects in ZNS have been suggested but evidence from studies is inconclusive.

Methods

In this retrospective observational study, we analyzed patients’ records from before and after introduction or withdrawal of ZNS vs TPM. Data were gathered during routine clinical care protocols. Standardized monitoring of executive functions (EpiTrack), verbal ...

Abstract

Seizures are a well‐recognized and often prominent manifestation of autoimmune encephalitic syndromes. Progress in detection of pathogenic neural autoantibodies has led to increased awareness of autoimmune causes of seizures. Clinical studies of patients with these autoantibodies have improved our understanding of the seizure characteristics, treatments, and seizure prognosis in these disorders. The International League Against Epilepsy (ILAE) Autoimmunity and Inflammation Taskforce proposes conceptual definitions for two main diagnostic entities: (a) acute symptomatic seizures secondary to autoimmune encephalitis, and (b) autoimmune‐associated ...

Abstract

Objective

This study estimated trajectories of health‐related quality of life (HRQOL) over a 10‐year period among children newly diagnosed with epilepsy. We also modeled the characteristics of children, parents, and families associated with each identified trajectory.

Methods

Data came from the HERQULES (Health‐Related Quality of Life in Children With Epilepsy Study), a Canada‐wide prospective cohort study of children (aged 4‐12 years) with newly diagnosed epilepsy. Parents reported on their children’s HRQOL at diagnosis, and at 0.5‐, 1‐, 2‐, 8‐, and 10‐year follow‐ups using the ...

Abstract

Objective

This retrospective, cross‐sectional study evaluated the feasibility and potential benefits of incorporating deep‐learning on structural magnetic resonance imaging (MRI) into planning stereoelectroencephalography (sEEG) implantation in pediatric patients with diagnostically complex drug‐resistant epilepsy. This study aimed to assess the degree of colocalization between automated lesion detection and the seizure onset zone (SOZ) as assessed by sEEG.

Methods

A neural network classifier was applied to cortical features from MRI data from three cohorts. (1) The network was trained and cross‐validated using 34 patients with ...

Abstract

Objective

A relationship between seizure activity and hallucinations is well established. The psychopathologic significance of hallucinations in individuals with seizures, however, is unclear. In this study, we assessed the prevalence of auditory and visual hallucinations in individuals who reported a seizure history and investigated their relationship with a number of mental disorders, suicidal ideation, and suicide attempts.

Methods

Data were from the “Adult Psychiatric Morbidity Survey,” a population‐based cross‐sectional survey. Auditory and visual hallucinations were assessed using the Psychosis Screening Questionnaire. Mental health ...

Abstract

Besides triggering alarms, wearable seizure detection devices record a variety of biosignals that represent biomarkers of seizure severity. There is a need for automated seizure characterization, to identify high‐risk seizures. Wearable devices can automatically identify seizure types with the highest associated morbidity and mortality (generalized tonic‐clonic seizures), quantify their duration and frequency, and provide data on postictal position and immobility, autonomic changes derived from electrocardiography/heart rate variability, electrodermal activity, respiration, and oxygen saturation. In this review, we summarize how these ...

Abstract

Objective

To assess the effectiveness and tolerability of perampanel (PER) monotherapy in routine clinical practice for the treatment of focal onset and generalized tonic‐clonic seizures (GTCS).

Methods

This multicenter, retrospective, observational study was conducted in patients aged ≥12 years treated with PER as primary monotherapy or converted to PER monotherapy by progressive reduction of background antiepileptic drugs. Outcomes included retention, responder, and seizure‐free rate after 3, 6, and 12 months and tolerability throughout the follow‐up.

Results

A total of 98 patients (mean age = 49.6 ± 21.7 years, 51% female) with ...

Abstract

Objective

People with epilepsy (PWE) are frequently unable to recall the core manifestation of their disease, epileptic seizures. This means that seizure frequency is often underestimated by practitioners and that seizure classification based on reports of patients or their relatives is difficult because seizure semiology remains unclear. The purpose of this study, therefore, was to prospectively explore patients’ memory regarding seizure elements and to assess the role of seizure types.

Method

Ninety patients diagnosed with focal epilepsy undergoing diagnostic electroencephalography (EEG)–video monitoring were ...