Potentially high-risk cardiac arrhythmias with focal to bilateral tonic–clonic seizures and generalized tonic–clonic seizures are associated with the duration of periictal hypoxemia

Summary

Objective

To investigate potentially high-risk cardiac arrhythmias (PHAs) following focal to bilateral tonic–clonic seizures (FBTCSs) and generalized tonic–clonic seizures (GTCSs) and to study the association of PHAs with seizure characteristics and the severity of associated ictal respiratory dysfunction.

Methods

Electrocardiographic (EKG) and pulse oximetry (SpO2) data were recorded concurrently with video-electroencephalographic telemetry in the epilepsy monitoring unit (EMU). One minute of preictal EKG, the ictal EKG, and 2 min of ictal/postictal data were reviewed for each seizure. Nonsustained ventricular tachycardia, ...

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Thalamocortical functional connectivity in Lennox–Gastaut syndrome is abnormally enhanced in executive-control and default-mode networks

Summary

Objective

To identify abnormal thalamocortical circuits in the severe epilepsy of Lennox–Gastaut syndrome (LGS) that may explain the shared electroclinical phenotype and provide potential treatment targets.

Methods

Twenty patients with a diagnosis of LGS (mean age = 28.5 years) and 26 healthy controls (mean age = 27.6 years) were compared using task-free functional magnetic resonance imaging (MRI). The thalamus was parcellated according to functional connectivity with 10 cortical networks derived using group-level independent component analysis. For each cortical network, ...

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Seizure outcomes in patients with anti-NMDAR encephalitis: A follow-up study

Summary

Objective

To evaluate the long-term seizure outcome and potential factors associated with seizure outcome in patients with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis.

Methods

In the setting of a prospective, single-center, longitudinal cohort study, 109 patients were evaluated with ongoing follow-up. Patients underwent clinical evaluation every 3 months. Seizure outcomes and the potential risk factors were assessed with a median follow-up of 24 months (6–60 months).

Results

Of 109 patients (47 men; 62 women) with anti-NMDAR encephalitis, 88 patients (80.7%) had reported ...

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A possible link between KCNQ2- and STXBP1-related encephalopathies: STXBP1 reduces the inhibitory impact of syntaxin-1A on M current

Summary

Objective

Kv7 channels mediate the voltage-gated M-type potassium current. Reduction of M current due to KCNQ2 mutations causes early onset epileptic encephalopathies (EOEEs). Mutations in STXBP1 encoding the syntaxin binding protein 1 can produce a phenotype similar to that of KCNQ2 mutations, suggesting a possible link between STXBP1 and Kv7 channels. These channels are known to be modulated by syntaxin-1A (Syn-1A) that binds to the C-terminal domain of the Kv7.2 subunit and strongly inhibits M current. Here, we ...

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Structural brain abnormalities in genetic generalized epilepsies: A systematic review and meta-analysis

Summary

According to the International League Against Epilepsy (ILAE) definition, no structural abnormalities are present on a standard brain magnetic resonance image in genetic generalized epilepsy (GGE) patients. However, recent studies raise contradictory evidence with increasing use of quantitative magnetic resonance imaging techniques. Following PRISMA guidelines, a systematic, quantitative review was conducted using 28 peer-reviewed, case–control studies published after 1989. Furthermore, a meta-analysis with a random-effect model revealed differences in structural brain abnormalities between GGE patients and controls. ...

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Statin treatment may lower the risk of postradiation epilepsy in patients with nasopharyngeal carcinoma

Summary

Objective

This study aimed to clarify the effect of statins on preventing the risk of postradiation epilepsy.

Methods

We performed a retrospective analysis of neurological nasopharyngeal carcinoma patients with a history of radiotherapy. Patients with a history of epilepsy before radiation and those who received prophylactically antiepileptic treatment were excluded. The demographic and clinical data of these patients were collected through chart review. We used Kaplan–Meier analysis (log-rank test) to examine the effect of statins on epilepsy-free survival. Cox ...

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Cortical light scattering during interictal epileptic spikes in frontal lobe epilepsy in children: A fast optical signal and electroencephalographic study

Summary

Objective

Interictal epileptic spikes (IES) represent a signature of the transient synchronous and excessive discharge of a large ensemble of cortical heterogeneous neurons. Epilepsy cannot be reduced to a hypersynchronous activation of neurons whose functioning is impaired, resulting on electroencephalogram (EEG) in epileptic seizures or IES. The complex pathophysiological mechanisms require a global approach to the interactions between neural synaptic and nonsynaptic, vascular, and metabolic systems. In the present study, we focused on the interaction between synaptic and ...

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The risk of Stevens-Johnson syndrome and toxic epidermal necrolysis in new users of antiepileptic drugs

Summary

Objective

Older antiepileptic drugs (AEDs) are known to cause Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN). However, evidence for newer AED is sparse. We quantified risks of SJS/TEN in association with use of all AEDs in the United Kingdom.

Methods

In a matched case-control study of 480 previously validated SJS/TEN cases (1995–2013) we used conditional logistic regression to calculate odds ratios (ORs) with 95% confidence intervals (CIs), and calculated absolute risks of SJS/TEN within separate cohorts of new users ...

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The risk of Stevens-Johnson syndrome and toxic epidermal necrolysis in new users of antiepileptic drugs

Summary

Objective

Older antiepileptic drugs (AEDs) are known to cause Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN). However, evidence for newer AED is sparse. We quantified risks of SJS/TEN in association with use of all AEDs in the United Kingdom.

Methods

In a matched case-control study of 480 previously validated SJS/TEN cases (1995–2013) we used conditional logistic regression to calculate odds ratios (ORs) with 95% confidence intervals (CIs), and calculated absolute risks of SJS/TEN within separate cohorts of new users ...

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Postnatal reduction of tuberous sclerosis complex 1 expression in astrocytes and neurons causes seizures in an age-dependent manner

Summary

Objective

Epilepsy is one of the most prominent symptoms of tuberous sclerosis complex (TSC), a genetic disorder, and may be related to developmental defects resulting from impaired TSC1 or TSC2 gene function in astrocytes and neurons. Inactivation of the Tsc1 gene driven by a glial-fibrillary acidic protein (GFAP) promoter during embryonic brain development leads to widespread pathologic effects on astrocytes and neurons, culminating in severe, progressive epilepsy in mice (Tsc1GFAP-Cre mice). However, the developmental timing and cellular specificity ...

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