Clinical adult outcome 11–30 years after pediatric epilepsy surgery: Complications and other surgical adverse events, seizure control, and cure of epilepsy

Abstract

Objective

Pediatric epilepsy surgery promises seizure freedom or even cure of epilepsy. We evaluated the long-term (≥10 years) adult clinical outcome including surgery-related adverse events and complications, which are generally underreported.

Methods

A monocentric, single-arm, questionnaire study in now adult patients who underwent epilepsy surgery during childhood. A novel ad hoc parental/patient questionnaire, which addressed diverse outcome domains was applied.

Results

From a total of 353 eligible patients, 203 could be contacted (3 patients died of causes unknown) and 101 (50%) returned appropriately filled-in surveys. No ...

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Intrinsic and secondary epileptogenicity in focal cortical dysplasia type II

Abstract

Objective

Favorable seizure outcome is reported following resection of bottom-of-sulcus dysplasia (BOSD). We assessed the distribution of epileptogenicity and dysplasia in and around BOSD to better understand this clinical outcome and the optimal surgical approach.

Methods

We studied 27 children and adolescents with MRI-positive BOSD who underwent epilepsy surgery, 85% became seizure-free post resection (median 5.0 years follow-up). All patients had resection of the dysplastic sulcus and 11 had additional resection of the gyral crown (GC) or adjacent gyri (AG). Markers of epileptogenicity were ...

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Does the ketogenic ratio matter when using ketogenic diet therapy in pediatric epilepsy?

Abstract

The ketogenic diet (KD) is a widely used therapeutic option for individuals with medically refractory epilepsy. As the diet’s name implies, ketosis is a historically important component of the diet, but it is not well understood how important ketosis is for seizure control. The ketogenic ratio is defined as the ratio of fat to carbohydrate plus protein by weight in the diet (grams). Traditionally, the classic KD contains a 4:1 ratio, and a very high proportion of fat in the ...

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Verbal fluency fMRI detects anti‐seizure effects and affective side effects of perampanel in people with focal epilepsy

SUMMARY

Perampanel, a non-competitive antagonist of the post-synaptic a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic (AMPA) receptor, is effective for controlling focal to bilateral tonic-clonic seizures but also known to increase feelings of anger. Using statistical parametric mapping–derived measures of activation and task-modulated functional connectivity (psychophysiologic interaction), we investigated 14 people with focal epilepsy who had verbal fluency fMRI twice, before and after the add-on treatment of perampanel. For comparison, we included 28 people with epilepsy, propensity-matched for clinical characteristics, who had two scans but no change ...

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Attitudes towards persons with epilepsy as friends. Results of a factorial survey

Abstract

Objective

Discrimination against persons with epilepsy (PWE) may still persist. The aim of the study was to examine whether epilepsy is an obstacle to desired friendship.

Methods

A factorial survey (vignettes), which is less biased by social desirability, was applied to PWE, their relatives, and lay persons. The vignettes described a person who was varied by the dimensions of age (younger, same age, older), gender (male, female), disease (healthy, mild epilepsy, severe epilepsy [generalized tonic-clonic seizures], diabetes), origin (German, non-German), contact (phone/internet, activities ...

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Task‐based functional magnetic resonance imaging prediction of postsurgical cognitive outcomes in temporal lobe epilepsy: A systematic review, meta‐analysis, and new data

Abstract

Task-based functional magnetic resonance imaging (tfMRI) has developed as a common alternative in epilepsy surgery to the intracarotid amobarbital procedure (IAP), also known as the Wada procedure. Prior studies have implicated tfMRI as a comparable predictor of postsurgical cognitive outcomes. However, the predictive validity of tfMRI has not been established. This preregistered systematic review and meta-analysis (CRD42020183563) synthesizes the literature predicting postsurgical cognitive outcomes in temporal lobe epilepsy (TLE) using tfMRI. PubMed and PsychINFO literature databases were queried for English-language ...

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Epilepsy in Cerebral Amyloid Angiopathy: an observational retrospective study of a large population

Abstract

Objective

Cerebral amyloid angiopathy (CAA) is a major cause of spontaneous intracranial haemorrhage in older adults. Epilepsy represents a possible sequelae of the disease. To date studies on epilepsy in CAA are missing and the few data available mainly focus on CAA-related inflammation (CAA-ri), the inflammatory form of the disease.

Methods

In this retrospective observational study, we consecutively recruited CAA patients observed in a time span of ten years, collecting demographic, clinical, and instrumental data. Significant baseline characteristics were ...

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Duration of epileptic seizure types: a data‐driven approach

Abstract

Objective

To determine duration of epileptic seizure types in patients who did not undergo withdrawal of antiseizure medication.

Methods

From a large, structured database of 11,919 consecutive, routine video-electroencephalograpy (EEG) recordings, labelled using the SCORE (Standardised Computer-Based Organised Reporting of EEG) system, we extracted and analysed 2,742 seizures. For each seizure type we determined median duration and range after removal of outliers (2.5-97.5 percentile). We used surface electromyography (EMG) for accurate measurement of short motor seizures.

Results

Myoclonic seizures last <150 ms, epileptic spasms 0.4-2 ...

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Interictal HFO and FDG‐PET correlation predicts surgical outcome following SEEG

Abstract

Objective

This study aimed to investigate the quantitative relationship between interictal 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and interictal high frequency oscillations (HFOs) from stereoelectroencephalography (SEEG) recordings in refractory epilepsy patients.

Methods

We retrospectively included 32 patients. FDG-PET data were quantified through statistical parametric mapping (SPM) t-test modeling with normal controls. Interictal SEEG segments with four 10-min segments were randomly selected. HFO detection and classification procedures were automatically performed. Channel-based HFOs separating ripple (80-250Hz) and fast ripple (FR, 250-500Hz) counts were correlated with the ...

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