Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

Prolonged fever‐induced seizures (febrile status epilepticus [FSE]) during early childhood increase the risk for later epilepsy, but the underlying mechanisms are incompletely understood. Experimental FSE (eFSE) in rats successfully models human FSE, recapitulating the resulting epileptogenesis in a subset of affected individuals. However, the powerful viral and genetic tools that may enhance mechanistic insights into epileptogenesis and associated comorbidities, are better‐developed for mice. Therefore, we aimed to determine if eFSE could be generated in mice and if it provoked enduring ...

Abstract

Objective

To develop a model to predict the probability of mood decline in adults following temporal lobe resection for the treatment of pharmacoresistant epilepsy.

Methods

Variable selection was performed on 492 patients from the Cleveland Clinic using best subsets regression. After completing variable selection, a subset of variables was requested from four epilepsy surgery centers across North America (n = 100). All data were combined to develop a final model to predict postoperative mood decline (N = 592). Internal validation with bootstrap resampling was performed. A clinically ...

Abstract

Objective

There is a growing recognition of immune‐mediated causes in patients with focal drug‐resistant epilepsy (DRE); however, they are not systematically assessed in the pre‐surgical diagnostic workup. Early diagnosis and initiation of immunotherapy is associated with a favorable outcome in immune‐mediated seizures. Patients with refractory focal epilepsy with neuronal antibodies (Abs) tend to have a worse surgical prognosis when compared to other etiologies.

Methods

We studied the prevalence of serum Abs in patients ≥18 years of age with DRE of unknown cause before surgery. ...

Abstract

Objective

To determine if three different commercially available seizure‐detection software packages (Besa 2.0, Encevis 1.7, and Persyst 13) accurately detect seizures with high sensitivity, high specificity, and short detection delay in epilepsy patients undergoing long‐term video–electroencephalography (EEG) monitoring (VEM).

Methods

Comparison of sensitivity (detection rate), specificity (false alarm rate), and detection delay of three commercially available seizure‐detection software packages in 81 randomly selected patients with epilepsy undergoing long‐term VEM.

Results

Detection rates on a per‐patient basis were not significantly different between Besa (mean 67.6%, range ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...