Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Seizures are a common and challenging symptom in brain tumors, affecting approximately 60% of patients. Tumor-related epilepsy (TRE) in glioma patients requires personalized and dynamic management in a multidisciplinary environment, especially for its intricate pathophysiology and unpredictable disease evolution. This investigation provides an updated overview about the pathophysiological mechanisms and treatment options of TRE associated with gliomas, based on expert contributions belonging to different areas. By combining the most recent discoveries and expert opinions, this study seeks to provide useful ...

Abstract

Objectives

Health disparities impact access to epilepsy care in the United States, but how these factors contribute to recurrent emergency department (ED) visits is unclear. We hypothesized that people who (1) were uninsured or had public health insurance, (2) belonged to minoritized racial/ethnic groups, or (3) resided in low-income zip codes were more likely to have frequent ED visits for seizure or epilepsy.

Methods

This was a retrospective cohort study of adult patients presenting to the ED in four U.S. states (Florida, Maryland, ...

Abstract

Objective

Photosensitive epilepsy (PSE) is a reflex epilepsy, where abnormal electroencephalographic (EEG) responses are induced by photic stimulation. Photosensitivity is classified into four types based on the propagation of the brain’s response to visual stimuli. Here, we aimed to describe the underlying dynamical mechanisms of PSE and different photosensitivity types.

Methods

This retrospective study included healthy controls (HC), PSE patients, and non-PSE patients with epilepsy (PWE). All participants were stimulated with flickering white light (1–60 Hz) under 10–20 EEG monitoring.

Results

We observed significantly higher occipital ...

Abstract

Febrile infection-related epilepsy syndrome (FIRES) is a rare presentation of refractory status epilepticus following a febrile illness with resulting refractory epilepsy. Evidence supports the presence of immune dysregulation in patients with FIRES, but a monogenic basis for FIRES has not been identified in most cases. We present a case of a previously healthy 16-year-old male with FIRES who was found to have a de novo predicted damaging missense variant in CSF1R on clinical whole genome sequencing, a gene encoding a ...

Abstract

Objective

Drug-resistant epilepsy (DRE) affects >25 million people worldwide and is often associated with neuroinflammation. Increasing evidence links deficiency or malfunctioning of the enzyme phosphoglycerate dehydrogenase (PHGDH), which converts 3-phosphoglycerate to generate serine and the neurotransmitter glycine, with (drug-resistant) epilepsy. Moreover, PHGDH, which is primarily expressed in astrocytes within the brain, has been identified as a critical enzyme in driving macrophage polarization toward an anti-inflammatory state. Hence, PHGDH activators may be beneficial for treating DRE by exhibiting both antiseizure and anti-inflammatory ...

Abstract

Objective

The thalamus participates in seizure propagation and is a target for neuromodulation in epilepsy. Although thalamic connectivity changes have been reported in adults with temporal lobe epilepsy (TLE), pediatric TLE is distinct, characterized by greater etiological diversity and impact on brain maturation. This study applied a novel gradient mapping technique to investigate whole-brain thalamic connectivity patterns in children with TLE.

Methods

Sixty-two children with TLE (ages 5–18) and 61 controls (ages 6–20) underwent a covert verb generation task functional magnetic resonance imaging ...

Abstract

Objective

Developmental and epileptic encephalopathy type 1 (DEE1) is a rare drug-resistant pediatric epilepsy caused by trinucleotide repeat expansions in the X-linked ARX gene, leading to elongation of the first polyalanine tract. It presents with early onset tonic seizures or spasms, developmental and cognition delay, and high risk of premature mortality. We evaluated the therapeutic potential of highly purified cannabidiol (CBD) in Arx
^(GCG)7/Y mice, a genetic DEE1 model that replicates key features of the human condition.

Methods

Arx
^(GCG)7/Y mice received daily ...

Abstract

Objective

Closed-loop neurostimulation is a promising treatment for drug-resistant focal epilepsy. A major challenge is fast and reliable seizure detection via electroencephalography (EEG). Although many approaches have been published, they often lack statistical power and practical utility. The use of various EEG preprocessing parameters and performance metrics hampers comparability. Additionally, the critical issue of energy consumption for an application in medical devices is rarely considered. Addressing these points, we present a systematic analysis of the impact of EEG preprocessing parameters on ...

Abstract

Objective

Patients with drug-resistant epilepsy, including Dravet syndrome, are frequently prescribed multiple antiseizure medications. Nevertheless, people with Dravet syndrome often have inadequate seizure control, and there is an ongoing unmet clinical need to identify novel therapeutics. As a proof-of-principle study to further validate and characterize the Scn1a
^A1783V/WT
mouse model and identify a drug-testing paradigm with face, construct, and predictive validity, we assessed the efficacy of subchronic administration of stiripentol add-on to clobazam and valproic acid at clinically relevant doses ...