Spike patterns surrounding sleep and seizures localize the seizure‐onset zone in focal epilepsy

Abstract

Objective

Interictal spikes help localize seizure generators as part of surgical planning for drug-resistant epilepsy. However, there are often multiple spike populations whose frequencies change over time, influenced by brain state. Understanding state changes in spike rates will improve our ability to use spikes for surgical planning. Our goal was to determine the effect of sleep and seizures on interictal spikes, and to use sleep and seizure-related changes in spikes to localize the seizure-onset zone (SOZ).

Methods

We performed a retrospective analysis of ...

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Levetiracetam as a first line antiseizure medication in WHO grade 2 glioma: time to seizure freedom and rates of treatment failure

Abstract

Objective

The high seizure burden seen in WHO grade 2 gliomas is well documented. This study aims to identify factors which influence the probability of seizure freedom (12 months of seizure remission) and treatment failure (ASM cessation or introduction of an alternative) in patients with WHO grade 2 glioma.

Methods

This is a retrospective observational analysis of patients from a regional UK neurosurgical centre with histologically proven (n=146) WHO grade 2 glioma and brain tumour related epilepsy. Statistical analyses using both Kaplan-Meier and ...

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Gain of function SCN1A disease‐causing variants: expanding the phenotypic spectrum and functional studies guiding the choice of effective antiseizure medication

Abstract

Objectives

To refine the spectrum of SCN1A-epileptic disorders other than Dravet syndrome (DS) and genetic epilepsy with febrile seizures plus (GEFS+) and optimize anti-seizure management by correlating phenotype-genotype relationship and functional consequences of SCN1A variants in a cohort of patients.

Methods

Sixteen probands carrying SCN1A pathogenic variants were ascertained via a national collaborative network. We also performed a literature review including individuals with SCN1A variants causing non-DS and non-GEFS+ phenotypes and compared the features of the two cohorts. Whole-cell patch-clamp experiments were performed ...

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Temporal trends in the cost and use of first‐line treatments for infantile epileptic spasms syndrome

Abstract

Objective

To describe the temporal trends in the cost and use of adrenocorticotropic hormone (ACTH), oral prednisolone, and vigabatrin, the first-line treatments for infantile epileptic spasms syndrome (IESS).

Methods

Retrospective observational study using the MarketScan Commercial database from 2006 to 2020. We identified patients with IESS diagnosed between birth and 18 months of age who received at least one of the first-line treatments within 60 days of diagnosis. Costs were adjusted for inflation using the Gross Domestic Product Implicit Price Deflator.

Results

1,131 patients received at ...

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How patients’ psycho‐social profile contributes to decision making in epilepsy surgery: A prospective study

Abstract

Objective

Identifying factors associated with surgical decision making is important to understand reasons for underutilization of epilepsy surgery. Neurologists’ recommendations for surgery and patients’ acceptance of these recommendations depend on clinical epilepsy variables, e.g., lateralization and localization of seizure onset zones. Moreover, previous research shows associations with demographic factors, e.g., age and sex. Here, we investigate the relevance of patients’ psycho-social profile for surgical decision making.

Methods

We prospectively studied 296 patients from two large German epilepsy-centers. Multiple logistic regression analyses were used ...

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Traumatic brain injury, stroke, and epilepsy: A mediation study in a Danish nationwide cohort

Abstract

Objective

Traumatic brain injury (TBI) and stroke are well-known causes of acquired epilepsy. TBI is also a risk factor for stroke, and injury-induced stroke may indirectly convey a proportion of the epilepsy risk following TBI. We studied the extent to which the effect of TBI on epilepsy operated through intermediary stroke.

Methods

We analyzed a nationwide, matched, register-based cohort of adults ≥$$ ge $$ 40 years of age whose first TBI at Danish hospitals was recorded between 2004 and 2016. A matched reference population ...

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Evaluating whole‐brain tissue‐property changes in MRI‐negative pharmacoresistant focal epilepsies using MR fingerprinting

Abstract

Objective

We aim to quantify whole-brain tissue-property changes in patients with magnetic resonance imaging (MRI)–negative pharmacoresistant focal epilepsy by three-dimensional (3D) magnetic resonance fingerprinting (MRF).

Methods

We included 30 patients with pharmacoresistant focal epilepsy and negative MRI by official radiology report, as well as 40 age- and gender-matched healthy controls (HCs). MRF scans were obtained with 1 mm3 isotropic resolution. Quantitative T1 and T2 relaxometry maps were reconstructed from MRF and registered to the Montreal Neurological Institute (MNI) space. A two-sample t test was ...

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A randomized, open‐label, two‐treatment crossover study to evaluate the effect of food on the pharmacokinetics of diazepam nasal spray in healthy adults

Abstract

Objective

The pharmacokinetics of oral diazepam are affected by food, but food-effect studies have not been conducted for diazepam nasal spray because it is believed that most absorption occurs via the nasal mucosa. However, gastrointestinal side effects reported with nasal diazepam suggest that at least a portion of the drug may be absorbed enterally and thus subject to food effects. The objective of this study was to evaluate the possible effects of food on the pharmacokinetics of diazepam nasal spray in ...

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Prospective, longitudinal, multicenter study on the provision of information regarding sudden unexpected death in epilepsy to adults with epilepsy

Abstract

Objective

Despite increased awareness of the serious epilepsy complication sudden unexpected death in epilepsy (SUDEP), a substantial population of people with epilepsy (PWE) remain poorly informed. Physicians indicate concern that SUDEP information may adversely affect patients’ health and quality of life. We examined SUDEP awareness and the immediate and long-term effects of providing SUDEP information to PWE.

Methods

Baseline knowledge and behaviors among PWE and behavioral adjustments following the provision of SUDEP information were evaluated in a prospective, multicenter survey using the following ...

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