Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

Recent studies highlight the amygdala’s crucial role in temporal lobe epilepsy (TLE), particularly in magnetic resonance imaging-negative cases and new TLE subtypes with structural amygdala changes. This study aims to investigate the electrophysiological properties and connectivity patterns of the amygdaloid complex in TLE patients using stereoelectroencephalography (SEEG).

Methods

From March 2020 to December 2023, we collected data from nine patients with drug-resistant TLE who underwent SEEG with dual amygdala trajectories: dorsal amygdala (DA) targeting medial and central nuclei, and ventral amygdala (VA) ...

Abstract

The detection of transient peri-ictal magnetic resonance imaging (MRI) abnormalities has been variable after epileptic seizures. The most common reason for this variability is that abnormalities may disappear if the interval between seizure and scan acquisition is prolonged using conventional high-field systems. Here, we deployed a portable ultra-low-field MRI system in the presurgical evaluation at the bedside of individuals with epilepsy. We hypothesized that this novel technology enables rapid postictal scans and reliably shows focal peri-ictal MRI abnormalities in the ...

Abstract

Objective

Heterozygous gain-of-function (GOF) variants in KCNQ2 and KCNQ3, encoding the voltage-gated potassium channel subunits Kv7.2 and Kv7.3, lead to neurodevelopmental disorders for which no established treatments are available. Amitriptyline, an antidepressant, blocks Kv7.2/Kv7.3 and has previously been reported to be effective in a single individual with a KCNQ2 GOF variant. We designed a retrospective, single-arm, multicenter study to investigate the effects of amitriptyline in a real-world setting.

Methods

We used a 7-point Likert scale to measure seizure frequency, clinical examination, motor function, ...

Abstract

Objective

The drug-resistant epilepsy associated with Lennox–Gastaut syndrome (LGS) has a long-term effect on patients and is difficult to treat with conventional pharmacological and nonpharmacological therapies. Our objective is to demonstrate that adjunctive vagus nerve stimulation (VNS) can help manage the seizures associated with LGS.

Methods

CORE-VNS (NCT03529045) is a prospective, multicenter, multinational observational study to collect data on seizure and nonseizure outcomes following treatment with VNS. Participants were identified as having a documented LGS diagnosis and received initial VNS implants. Baseline seizure ...

Abstract

Electroencephalography (EEG) has been instrumental in epilepsy research for the past century, both for basic and translational studies. Its contributions have advanced our understanding of epilepsy, shedding light on the pathophysiology and functional organization of epileptic networks, and the mechanisms underlying seizures. Here we re-examine the historical significance, ongoing relevance, and future trajectories of EEG in epilepsy research. We describe traditional approaches to record brain electrical activity and discuss novel cutting-edge, large-scale techniques using micro-electrode arrays. Contemporary EEG studies explore ...

Abstract

Objective

The relationship between sleep and epilepsy is important but imperfectly understood. We sought to understand the mechanisms that explain the differences in sleep homeostasis observed in children with epilepsy.

Methods

We used a neural mass model to replicate sleep electroencephalography (EEG) recorded from 15 children with focal lesional epilepsies and 16 healthy age-matched controls. Different parameter sets were recovered in the model for each subject.

Results

The model revealed that sleep EEG differences are driven by enhanced firing rates in the neuronal populations of ...

Abstract

Objective

First unprovoked seizures and acute seizures are common and can develop into epilepsy. The risk of epilepsy following these seizures in community samples is not well established, and it is unclear whether the probability of subsequent unprovoked seizures following these seizures reaches the International League Against Epilepsy’s threshold of 60%.

Methods

We followed participants initially classified as having first unprovoked seizures, having acute seizures, or without seizures in a community-based survey conducted in 2003 to estimate the subsequent risk of epilepsy in ...

Abstract

Objective

The proportion of patients with epilepsy who have a non-intravenous rescue benzodiazepine (non-IV-rBZD) available for seizure emergencies is unknown. This study aims to describe prescription patterns from 2006 to 2022, factors associated with prescription, and the impact of recently introduced intranasal benzodiazepines on prescription and cost.

Methods

Retrospective analysis of the MarketScan Database, a claims database of privately insured patients in the United States.

Results

Among 213 384 patients (53% female, median (p₂₅-p₇₅) age: 33 (17–50) years) with epilepsy taking long-term anti-seizure medications with follow-up ...

Abstract

Objective

In 2021, the US Food and Drug Administration issued a safety warning concerning lamotrigine use in patients with underlying cardiac disorders. This warning was based on in vitro data that predicted class Ib antiarrhythmic activity for lamotrigine. Therefore, we investigated the proarrhythmic potential of lamotrigine in the murine heart and compared its effect with flecainide.

Methods

Murine hearts were perfused with clinically relevant concentrations of lamotrigine 3.8 μg/mL (15 μmol·L⁻¹) or flecainide .4 μg/mL (1 μmol·L⁻¹).

Results

Ex vivo electrocardiography revealed a high prevalence of ventricular tachycardia (VT) in ...