Epilepsia. Official Journal of the International League Against Epilepsy

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 ...

Abstract

Objective

A large‐scale, double‐blind trial (SP0993; NCT01243177) demonstrated that lacosamide was noninferior to controlled‐release carbamazepine (carbamazepine‐CR) in terms of efficacy, and well tolerated as first‐line monotherapy in patients (≥16 years of age) with newly diagnosed epilepsy. We report primary safety outcomes from the double‐blind extension of the noninferiority trial (SP0994; NCT01465997) and post hoc analyses of pooled long‐term safety and efficacy data from both trials.

Methods

Patients were randomized 1:1 to lacosamide or carbamazepine‐CR. Doses were escalated (lacosamide: 200/400/600 mg/d; carbamazepine‐CR: 400/800/1200 mg/d) based on seizure ...

Abstract

Objective

We evaluated the impact of monitoring indication, early electroencephalography (EEG), and clinical features on seizure risk in all neonates undergoing continuous EEG (cEEG) monitoring following a standardized monitoring protocol.

Methods

All cEEGs from unique neonates 34‐48 weeks postmenstrual age monitored from 1/2011‐10/2017 (n = 291) were included. We evaluated the impact of cEEG monitoring indication (acute neonatal encephalopathy [ANE], suspicious clinical events [SCEs], or other high‐risk conditions [OHRs]), age, medication status, and early EEG abnormalities (including the presence of epileptiform discharges and abnormal background continuity, ...

Abstract

This study aimed to compare three commonly used analysis methods for clinical trials in epilepsy in terms of statistical efficiency, nonefficacious exposure, and cost. A realistic seizure diary simulator was employed to produce 102 000 trials, which were analyzed by the 50%‐responder rate method (RR50), median percentage change (MPC), and time to prerandomization (TTP). Half the trials compared a placebo to a drug that was 20% better, and the other half compared two placebos. The former were used to calculate statistical ...

Abstract

Objective

Status epilepticus (SE) is the most common neurologic emergency in childhood. This study aimed to report on a large cohort of pediatric patients with SE, applying the International League Against Epilepsy (ILAE) Classification for SE to identify prognostic factors.

Methods

We included 173 children treated at “Bambino Gesù” Children’s Hospital in Rome for SE exceeding 30 minutes (mean age 4.43 ± 4.93 years old, median 2.28, interquartile range [IQR] 0.41‐7.32; follow‐up for a mean of 4.9 ± 3.4 years, median 8.75, IQR 4,58‐12.63). A multivariate model was constructed to ...

Abstract

Objective

Novel treatments are needed to control treatment‐resistant status epilepticus (SE). We present a summary of clinical cases where oral topiramate (TPM) was used in refractory SE (RSE) and superrefractory SE (SRSE).

Methods

A review of medical records was carried out to detect TPM administration in SE patients treated in Frankfurt and Marburg between 2011 and 2016. The primary outcome question concerned SE resolution after TPM initiation.

Results

In total, TPM was used in 106 of 854 patients having a mean age of 67.4 ± 18.1 years, 61 ...

Abstract

Objective

Interictal epileptiform anomalies such as epileptiform discharges or high‐frequency oscillations show marked variations across the sleep‐wake cycle. This study investigates which state of vigilance is the best to localize the epileptogenic zone (EZ) in interictal intracranial electroencephalography (EEG).

Methods

Thirty patients with drug‐resistant epilepsy undergoing stereo‐EEG (SEEG)/sleep recording and subsequent open surgery were included; 13 patients (43.3%) had good surgical outcome (Engel class I). Sleep was scored following standard criteria. Multiple features based on the interictal EEG (interictal epileptiform discharges, high‐frequency oscillations, ...