Epilepsia. Official Journal of the International League Against Epilepsy

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 ...

Abstract

Objective

Dissociative traits represent a disturbance in selfhood that may predispose to, and trigger, functional seizures (FSs). The predictive representation and control of the internal physiological state of the body (interoception) are proposed to underpin the integrity of the sense of self (“minimal selfhood”). Therefore, discrepancies between objective and subjective aspects of interoception may relate to symptom expression in patients with FSs. Here, we tested whether individual differences in trait measures of interoception relate to dissociative symptoms, and whether state interoceptive ...

Abstract

Noninvasive wearable devices have great potential to aid the management of epilepsy, but these devices must have robust signal quality, and patients must be willing to wear them for long periods of time. Automated machine learning classification of wearable biosensor signals requires quantitative measures of signal quality to automatically reject poor‐quality or corrupt data segments. In this study, commercially available wearable sensors were placed on patients with epilepsy undergoing in‐hospital or in‐home electroencephalographic (EEG) monitoring, and healthy volunteers. Empatica E4 ...

Abstract

Reliably detecting focal seizures without secondary generalization during daily life activities, chronically, using convenient portable or wearable devices, would offer patients with active epilepsy a number of potential benefits, such as providing more reliable seizure count to optimize treatment and seizure forecasting, and triggering alarms to promote safeguarding interventions. However, no generic solution is currently available to reach these objectives. A number of biosignals are sensitive to specific forms of focal seizures, in particular heart rate and its variability for ...

Abstract

Objective

To determine the role of aquaporin‐4 (AQP4) in posttraumatic epileptogenesis using long‐term video‐electroencephalographic (vEEG) recordings. Here, differences in EEG were analyzed between wild‐type (WT) and AQP4 knockout (KO) mice and between mice with and without posttraumatic epilepsy (PTE).

Methods

WT and AQP4 KO mice were subjected to a single controlled cortical impact traumatic brain injury (TBI) in the frontal cortex, and vEEG was recorded in the ipsilateral hippocampus at 14, 30, 60, and 90 days postinjury (dpi). Intrahippocampal electrical stimulation was also used ...

Abstract

Objective

Brain tissue oxygen (partial oxygen pressure [pO₂]) levels are tightly regulated to stay within the normoxic zone, with deviations on either side resulting in impaired brain function. Whereas pathological events such as ischemic attacks and brief seizures have previously been shown to result in pO₂ levels well below the normoxic zone, oxygen levels during prolonged status epilepticus (SE) and the subsequent endogenous kindling period are unknown.

Methods

We utilized two models of acquired temporal lobe epilepsy in rats: intrahippocampal kainic acid infusion ...

Abstract

Our objective was to undertake a systematic review ascertaining the accuracy of using administrative healthcare data to identify epilepsy cases. We searched MEDLINE and Embase from 01/01/1975 to 03/07/2018 for studies evaluating the diagnostic accuracy of routinely collected healthcare data in identifying epilepsy cases. Any disease coding system in use since the International Classification of Diseases, Ninth Revision (ICD‐9) was permissible. Two authors independently screened studies, extracted data, and quality‐assessed studies. We assessed positive predictive value (PPV), sensitivity, negative predictive ...