Sudden unexpected death in epilepsy in patients treated with brain-responsive neurostimulation

Summary

Objective

To study the incidence and clinical features of sudden unexpected death in epilepsy (SUDEP) in patients treated with direct brain-responsive stimulation with the RNS System.

Methods

All deaths in patients treated in clinical trials (N = 256) or following U.S. Food and Drug Administration (FDA) approval (N = 451) through May 5, 2016, were adjudicated for SUDEP.

Results

There were 14 deaths among 707 patients (2208 postimplantation years), including 2 possible, 1 probable, and 4 definite SUDEP events. The ...

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Respiratory dysfunction progresses with age in Kcna1-null mice, a model of sudden unexpected death in epilepsy

Summary

Objective

Increased breathing rate, apnea, and respiratory failure are associated with sudden unexpected death in epilepsy (SUDEP). We recently demonstrated the progressive nature of epilepsy and mortality in Kcna1−/− mice, a model of temporal lobe epilepsy and SUDEP. Here we tested the hypothesis that respiratory dysfunction progresses with age in Kcna1−/− mice, thereby increasing risk of respiratory failure and sudden death (SD).

Methods

Respiratory parameters were determined in conscious mice at baseline and following increasing doses of methacholine (MCh) ...

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Respiratory dysfunction progresses with age in Kcna1-null mice, a model of sudden unexpected death in epilepsy

Summary

Objective

Increased breathing rate, apnea, and respiratory failure are associated with sudden unexpected death in epilepsy (SUDEP). We recently demonstrated the progressive nature of epilepsy and mortality in Kcna1−/− mice, a model of temporal lobe epilepsy and SUDEP. Here we tested the hypothesis that respiratory dysfunction progresses with age in Kcna1−/− mice, thereby increasing risk of respiratory failure and sudden death (SD).

Methods

Respiratory parameters were determined in conscious mice at baseline and following increasing doses of methacholine (MCh) ...

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Generalized nonmotor (absence) seizures—What do absence, generalized, and nonmotor mean?

Summary

Objective

Clinical absences are now classified as “generalized nonmotor (absence) seizures” by the International League Against Epilepsy (ILAE). The aim of this paper is to critically review the concept of absences and to put the accompanying focal and motor symptoms into the context of the emerging pathophysiological knowledge.

Methods

For this narrative review we performed an extensive literature search on the term “absence,” and analyzed the plethora of symptoms observed in clinical absences.

Results

Arising from the localization and the ...

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Measurement in pediatric epilepsy self-management: A critical review

Summary

Given the paucity of information available regarding self-management, the aims of this paper are to synthesize the literature on factors associated with and measures to assess self-management in pediatric epilepsy. Inclusion criteria: youth birth to 18 years with a seizure disorder or an epilepsy diagnosis and/or their caregivers, published 1985-2014 in English, and conducted in countries with a very high human development index. The review was conducted in 6 phases: (1) identification of bibliographical search criteria and ...

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Measurement in pediatric epilepsy self-management: A critical review

Summary

Given the paucity of information available regarding self-management, the aims of this paper are to synthesize the literature on factors associated with and measures to assess self-management in pediatric epilepsy. Inclusion criteria: youth birth to 18 years with a seizure disorder or an epilepsy diagnosis and/or their caregivers, published 1985-2014 in English, and conducted in countries with a very high human development index. The review was conducted in 6 phases: (1) identification of bibliographical search criteria and ...

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Seizure onset predicts its type

Summary

Objective

Epilepsy is characterized by transient alterations in brain synchronization resulting in seizures with a wide spectrum of manifestations. Seizure severity and risks for patients depend on the evolution and spread of the hypersynchronous discharges. With standard visual inspection and pattern classification, this evolution could not be predicted early on. It is still unclear to what degree the seizure onset zone determines seizure severity. Such information would improve our understanding of ictal epileptic activity and the existing electroencephalogram ...

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Mood disorders in familial epilepsy: A test of shared etiology

Summary

Objective

Mood disorders are the most common comorbid conditions in epilepsy, but the cause remains unclear. One possible explanation is a shared genetic susceptibility to epilepsy and mood disorders. We tested this hypothesis by evaluating lifetime prevalence of mood disorders in relatives with and without epilepsy in families containing multiple individuals with epilepsy, and comparing the findings with rates from a general population sample.

Methods

The Composite International Diagnostic Interview was administered to 192 individuals from 60 families, including ...

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Mood disorders in familial epilepsy: A test of shared etiology

Summary

Objective

Mood disorders are the most common comorbid conditions in epilepsy, but the cause remains unclear. One possible explanation is a shared genetic susceptibility to epilepsy and mood disorders. We tested this hypothesis by evaluating lifetime prevalence of mood disorders in relatives with and without epilepsy in families containing multiple individuals with epilepsy, and comparing the findings with rates from a general population sample.

Methods

The Composite International Diagnostic Interview was administered to 192 individuals from 60 families, including ...

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Defining the phenotypic spectrum of SLC6A1 mutations

Summary

Objective

Pathogenic SLC6A1 variants were recently described in patients with myoclonic atonic epilepsy (MAE) and intellectual disability (ID). We set out to define the phenotypic spectrum in a larger cohort of SCL6A1-mutated patients.

Methods

We collected 24 SLC6A1 probands and 6 affected family members. Four previously published cases were included for further electroclinical description. In total, we reviewed the electroclinical data of 34 subjects.

Results

Cognitive development was impaired in 33/34 (97%) subjects; 28/34 had mild to moderate ID, with ...

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