Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

To evaluate how the challenges in the recruitment and retention of participants in clinical trials for focal-onset epilepsy have changed over time.

Methods

In this systematic analysis of randomized clinical trials of adjunct antiseizure medications for medication-resistant focal-onset epilepsy, we evaluated how the number of participants, sites, and countries has changed since the first such trial in 1990. We also evaluated the proportion of participants who completed each trial phase and their reasons for early trial exit. We analyzed these trends using ...

Abstract

Objective

The present study was aimed at investigating the effects of anti-seizure medications (ASMs), patient demographic characteristics, and the seizure type and frequency on the development of congenital malformations (CMs) in the infants of pregnant women with epilepsy (PWWE).

Methods

PWWE followed up at the neurology outpatient clinic of 21 centers between 2014 and 2019 were included in this prospective study. The follow-up of PWWE was conducted using structured, general pregnant follow-up forms prepared by the Pregnancy and Epilepsy Study Committee. The newborns ...

Abstract

Objective

Social determinants of health, including the effects of neighborhood disadvantage, impact epilepsy prevalence, treatment, and outcomes. This study characterized the association between aberrant white matter connectivity in temporal lobe epilepsy (TLE) and disadvantage using a US census-based neighborhood disadvantage metric, the Area Deprivation Index (ADI), derived from measures of income, education, employment, and housing quality.

Methods

Participants including 74 TLE patients (47 male, mean age = 39.2 years) and 45 healthy controls (27 male, mean age = 31.9 years) from the Epilepsy Connectome Project were classified into ADI-defined ...

Abstract

Objective

To develop a multi-modal machine learning (ML) approach for predicting incident depression in adults with epilepsy.

Methods

We randomly selected 200 patients from the Calgary Comprehensive Epilepsy Program registry and linked their registry-based clinical data to their first-available clinical electroencephalogram (EEG) and magnetic resonance imaging (MRI) study. We excluded patients with a clinical or Neurological Disorders Depression Inventory for Epilepsy (NDDI-E)-based diagnosis of major depression at baseline. The NDDI-E was used to detect incident depression over a median of 2.4 years follow-up (IQR ...

Abstract

Objective

Historically, about half of those with newly diagnosed epilepsy have responded to and tolerated the first antiseizure medication (ASM), but there is little contemporary real-world data. Third-generation ASMs have improved tolerability and are increasingly used according to prescription data. We aimed to describe current ASM selection and retention in adult-onset focal epilepsy in western Sweden.

Methods

A multicenter retrospective cohort study performed at five public neurology care providers in western Sweden (nearly complete coverage in the area). We reviewed 2607 medical charts ...

Abstract

Eslicarbazepine acetate (ESL) is a new antiseizure medication (ASM) approved as an adjunctive therapy or monotherapy for focal onset seizures. We performed this study to explore the potential efficacy and safety of ESL oral loading in selected patients with epilepsy. Thirty adult patients with status epilepticus or acute repetitive seizures were enrolled, and ESL was administered at a single loading dosage of 30 mg/kg. Plasma levels of an active metabolite of ESL, monohydroxy derivative (MHD), were measured at 2, 4, 6, ...

Abstract

Objective

Focal cortical dysplasia (FCD) is the most common etiology of surgically-remediable epilepsy in children. Eighty-seven percent of patients with FCD develop epilepsy (75% is pharmacoresistant epilepsy [PRE]). Focal to bilateral tonic–clonic (FTBTC) seizures are associated with worse surgical outcomes. We hypothesized that children with FCD-related epilepsy with FTBTC seizures are more likely to develop PRE due to lesion interaction with restricted cortical neural networks.

Methods

Patients were selected retrospectively from radiology and surgical databases from Children’s National Hospital. Inclusion criteria: 3T magnetic ...

Abstract

Objective

Nonconvulsive status epilepticus (NCSE) is a frequent condition in the neurocritical care unit (NCCU) patient population, with high morbidity and mortality. We aimed to assess the validity of available outcome prediction scores for prognostication in an NCCU patient population in relation to their admission reason (NCSE vs. non-NCSE related).

Methods

All 196 consecutive patients diagnosed with NCSE during the NCCU stay between January 2010 and December 2020 were included. Demographics, Simplified Acute Physiology Score II (SAPS II), NCSE characteristics, and in-hospital and ...

Abstract

Objective

Individuals with epilepsy often have memory difficulties, and older adults with epilepsy are especially vulnerable, due to the additive effect of aging. The goal of this study was to assess factors that are associated with 24-hour memory retention in older adults with epilepsy.

Methods

55 adults with epilepsy, all over age 50, performed a declarative memory task involving the recall of the positions of 15 card pairs on a computer screen prior to a 24-hour ambulatory EEG. We assessed the percentage of ...