Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

Epilepsy is common and carries substantial morbidity, and therefore identifying cost‐effective health interventions is essential. Cost‐utility analysis is a widely used method for such analyses. For this, health conditions are rated in terms of utilities, which provide a standardized score to reflect quality of life. Utilities are obtained either indirectly using quality of life questionnaires, or directly from patients or the general population. We sought to describe instruments used to estimate utilities in epilepsy populations, and how results differ according ...

Abstract

Objective

Delay to resective epilepsy surgery results in avoidable disease burden and increased risk of mortality. The objective was to prospectively validate a natural language processing (NLP) application that uses provider notes to assign epilepsy surgery candidacy scores.

Methods

The application was trained on notes from (1) patients with a diagnosis of epilepsy and a history of resective epilepsy surgery and (2) patients who were seizure‐free without surgery. The testing set included all patients with unknown surgical candidacy status and an upcoming neurology ...

Abstract

Objective

Temporal lobe epilepsy is a common form of epilepsy that might be amenable to surgery. However, magnetic resonance imaging (MRI)‐negative hippocampal sclerosis (HS) can hamper early diagnosis and surgical intervention for patients in clinical practice, resulting in disease progression. Our aim was to automatically detect and evaluate the structural alterations of HS.

Methods

Eighty patients with pharmacoresistant epilepsy and histologically proven HS and 80 healthy controls were included in the study. Two automated classifiers relying on clinically empirical and radiomics features were ...

Abstract

Objective

The endocannabinoid system (ECS) is comprised of cannabinoid receptors 1 and 2 (CB1R and CB2R), endogenous ligands, and regulatory enzymes, and serves to regulate several important physiological functions throughout the brain and body. Recent evidence suggests that the ECS may be a promising target for the treatment of epilepsy, including epilepsy subtypes that arise from mutations in the voltage‐gated sodium channel SCN1A. The objective of this study was to explore the effects of modulating CB2R activity on seizure susceptibility.

Methods

We examined ...

Abstract

Objective

To screen a library of potential therapeutic compounds for a woman with Lennox‐Gastaut syndrome due to a Y302C GABRB3 (c.905A>G) mutation.

Methods

We compared the electrophysiological properties of cells with wild‐type or the pathogenic GABRB3 mutation.

Results

Among 1320 compounds, multiple candidates enhanced GABRB3 channel conductance in cell models. Vinpocetine, an alkaloid derived from the periwinkle plant with anti‐inflammatory properties and the ability to modulate sodium and channel channels, was the lead candidate based on efficacy and safety profile. Vinpocetine was administered as a ...

Abstract

Objective

Much evidence suggests that the subiculum plays a significant role in the regulation of epileptic activity. Lactate acts as a neuroprotective agent against many conditions that cause brain damage. During epileptic seizures, lactate formation reaches up to ~6 mmol/L in the brain. We investigated the effect of lactate on subicular pyramidal neurons after induction of epileptiform activity using 4‐aminopyridine (4‐AP‐0Mg²⁺) in an in vitro epilepsy model in rats. The signaling mechanism associated with the suppression of epileptiform discharges by lactate was also ...

Abstract

Objective

Cortical spreading depolarization (SD) and seizures are often co‐occurring electrophysiological phenomena. However, the cross‐layer dynamics of SD during seizures and the effect of SD on epileptic activity across cortical layers remain largely unknown.

Methods

We explored the spatial‐temporal dynamics of SD and epileptic activity across layers of the rat barrel cortex using direct current silicone probe recordings during flurothyl‐induced seizures.

Results

SD occurred in half of the flurothyl‐evoked seizures. SD always started from the superficial layers and spread downward either through all cortical layers ...

Abstract

Objective

To evaluate the localization value and prognostic significance of subclinical seizures (SCSs) on scalp video‐electroencephalography monitoring (VEEG) in comparison to clinical seizures (CSs) in patients who had epilepsy surgery.

Methods

We included 123 consecutive patients who had SCSs and CSs during scalp‐VEEG evaluation. All patients had subsequent epilepsy surgery and at least 1‐year follow‐up. Concordance between SCSs and CSs was summarized into five categories: complete, partial, overlapping, no concordance, or indeterminate. Using the same scheme, we analyzed the relationship between resection and ...