Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

Cognitive deficits are one of the most debilitating comorbidities in epilepsy and other neurodegenerative, neuropsychiatric, and neurodevelopmental brain disorders. Current diagnostic and therapeutic options are limited and lack objective measures of the underlying neural activities. In this study, electrophysiological biomarkers that reflect cognitive functions in clinically validated batteries were determined to aid diagnosis and treatment in specific brain regions.

Methods

We employed the Cambridge Neuropsychological Test Automated Battery (CANTAB) tasks to probe memory and executive functions in 86 patients with epilepsy undergoing ...

Abstract

Objective

Epilepsy surgery outcomes tend to be judged by the percentage in seizure reduction without considering the effect on specific seizure types, particularly tonic–clonic seizures, which produce the greatest morbidity and mortality. We assess how often focal to bilateral tonic–clonic seizures (BTCS) stop and how often they appear de novo after epilepsy surgery.

Methods

Analysis of a prospectively maintained epilepsy surgery database between 1986 and 2022 that characterizes the burden of BTCS after resective epilepsy surgery. Patients were stratified according to presence or ...

Abstract

Contemporary studies report nonconvulsive status epilepticus (NCSE) in Creutzfeldt–Jakob disease (CJD), based on benzodiazepine (BZP)-responsive epileptiform discharges on the electroencephalogram (EEG), with the following false syllogism: (1) intravenous (IV) administration of BZPs usually suppress ictal activity in NCSE; (2) in CJD, periodic sharp wave complexes (PSWCs) are suppressed by IV BZPs; (3) therefore, these patients have NCSE. This is a simplistic and invalid conclusion, because authors of 20th-century science reports have clearly shown that IV BZPs, short-acting barbiturates, and drugs ...

Abstract

Objective

Somatic variants causing epilepsy are challenging to detect, as they are only present in a subset of brain cells (e.g., mosaic), resulting in low variant allele frequencies. Traditional methods relying on surgically resected brain tissue are limited to patients undergoing brain surgery. We developed an improved protocol to detect somatic variants using DNA from stereoelectroencephalographic (SEEG) depth electrodes, enabling access to a larger patient cohort and diverse brain regions. This protocol mitigates issues of contamination and low yields by purifying ...

Abstract

Objective

The 5xFAD mouse model of Alzheimer disease (AD) recapitulates amyloid-beta (Aβ) deposition and pronounced seizure susceptibility observed in patients with AD. Forty-hertz audiovisual stimulation is a noninvasive technique that entrains gamma neural oscillations and can reduce Aβ pathology and modulate glial expression in AD models. We hypothesized that 40-Hz sensory stimulation would improve seizure susceptibility in 5xFAD mice and this would be associated with reduction of plaques and modulation of glial phenotypes.

Methods

5xFAD mice and wild-type (WT) littermates received 1 h/day 40-Hz ...

Abstract

Objective

Focal cortical dysplasia (FCD) is a common cause of drug-resistant focal epilepsy but can be challenging to detect visually on magnetic resonance imaging. Three artificial intelligence models for automated FCD detection are publicly available (MAP18, deepFCD, MELD) but have only been compared on single-center data. Our first objective is to compare them on independent multicenter test data. Additionally, we train and compare three new models and make them publicly available.

Methods

We retrospectively collected FCD cases from four epilepsy centers. We chose ...

Abstract

Objective

This study aimed to investigate two key aspects of scalp high-frequency oscillations (HFOs) in pediatric focal lesional epilepsy: (1) the stability of scalp HFO spatial distribution across consecutive nights, and (2) the variation in scalp HFO rates in response to changes in antiseizure medication (ASM).

Methods

We analyzed 81 whole-night scalp electroencephalography (EEG) recordings from 20 children with focal lesional epilepsy. We used a previously validated automated HFO detector to assess scalp HFO rates (80–250 Hz) during non–rapid eye movement (NREM) sleep. The ...

Abstract

Objective

The most common medically resistant epilepsy (MRE) involves the temporal lobe (TLE), and children designated as temporal plus epilepsy (TLE+) have a five-times increased risk of postoperative surgical failure. This retrospective, blinded, cross-sectional study aimed to correlate visual and computational analyses of magnetoencephalography (MEG) virtual sensor waveforms with surgical outcome and epilepsy classification (TLE and TLE+).

Methods

Patients with MRE who underwent MEG and iEEG monitoring and had at least 1 year of postsurgical follow-up were included in this retrospective analysis. User-defined ...

Abstract

Objective

Fenfluramine (FFA), stiripentol (STP), and cannabidiol (CBD) are approved add-on therapies for seizures in Dravet syndrome (DS). We report on the long-term safety and health care resource utilization (HCRU) of patients with DS treated with FFA under an expanded access program (EAP).

Methods

A cohort of 124 patients received FFA for a median of 2.8 years (34.4 months). We compared data on safety and HCRU during FFA treatment with those from a same pre-treatment period. Echocardiography was conducted every 6 months. Information collected included gender, ...