Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objectives

To conduct external validation of previously published epilepsy surgery prediction tools using a large independent multicenter dataset and to assess whether these tools can stratify patients for being operated and for becoming free of disabling seizures (ILAE 1 and 2).

Methods

We analyzed a dataset of 1,562 patients, not used for tool development. We applied two scales: Epilepsy Surgery Grading Scale (ESGS) and Seizure Freedom Score (SFS), and two versions of Epilepsy Surgery Nomograms (ESNs): the original version and the modified version ...

Abstract

Objective

To assess reproducibility of the epilepsy outcome and phenotype in lateral fluid-percussion model of post-traumatic epilepsy across three study sites.

Methods

A total of 525 adult male Sprague-Dawley rats were randomized to lateral fluid-percussion -induced brain injury (FPI) or sham-operation. Of these, 264 were assigned to magnetic resonance imaging (MRI cohort, 43 sham, 221 TBI) and 261 for electrophysiological follow-up (EEG cohort, 41 sham, 220 TBI). A major effort was made to harmonize the rats, materials, equipment, procedures and monitoring systems. On ...

Abstract

Objective

Non-Hispanic (NH) Black children are less likely to receive a standard treatment course for infantile epileptic spasms syndrome (IESS) than White/NH children at pediatric tertiary care epilepsy centers in the United States. However, if inequities exist in time to diagnosis is unknown. Diagnostic delays as little as 1 week can be associated with worse developmental outcomes.

Methods

Diagnostic delays were evaluated in a retrospective cohort of 100 children with new onset IESS between January 2019 and May 2022.

Results

Children with Black, Indigenous, and ...

Abstract

Objective

There is little comparative data on the third-generation antiseizure medications (ASMs). We aimed to assess and compare the effectiveness of brivaracetam (BRV), eslicarbazepine acetate (ESL), lacosamide (LCM) and perampanel (PER) in people with epilepsy (PWE). Efficacy and tolerability were compared as secondary objectives.

Methods

A multicenter, retrospective study collecting data from 22 Italian neurology/epilepsy centres. All adult PWE who started add-on treatment with one of the studied ASMs between January 2018 and October 2021 were included. Retention rate was established as effectiveness ...

Abstract

Objective

Tuberous sclerosis complex (TSC) is a genetic disorder, characterized by tumor formation in the brain and other organs, and severe neurological symptoms, such as epilepsy. Abnormal vascular endothelial growth factor (VEGF) expression may promote angiogenesis in kidney and lung tumors in TSC and has been identified in brain specimens from TSC patients, but the role of VEGF and vascular abnormalities in neurological manifestations of TSC is poorly defined. In this study, we investigated abnormalities in brain VEGF expression, cerebral blood ...

Abstract

Objective

Quantification of the epileptogenic zone network (EZN) most frequently implies analysis of the seizure onset. However, important information can also be obtained from the postictal period, characterized by prominent changes in the EZN. We used permutation entropy (PE), a measure of signal complexity, to analyze the peri-ictal stereoelectroencephalography (SEEG) signal changes with emphasis on the postictal state. We sought to determine the best PE-derived parameter (PEDP) for identifying the EZN.

Methods

Several PEDPs were retrospectively computed on SEEG-recorded seizures of 86 patients ...

Abstract

Objective

Focal epilepsy is common in low- and middle-income countries. The frequency and nature of possible underlying structural brain abnormalities have, however, not been fully assessed.

Methods

We evaluated the possible structural causes of epilepsy in 331 people with epilepsy (240 from Kenya and 91 from South Africa) identified from community surveys of active convulsive epilepsy. Magnetic resonance imaging (MRI) scans were acquired on 1.5-Tesla scanners to determine the frequency and nature of any underlying lesions. We estimated the prevalence of these abnormalities ...

Abstract

Objective

To confirm and investigate why pathological HFOs (pHFOs), including ripples [80-200 Hz] and fast ripples [200-600 Hz], are generated during the UP-DOWN transition of the slow wave and if information transmission mediated by ripple temporal coupling is disrupted in the seizure onset zone (SOZ).

Methods

We isolated 217 total units from 175.95 iEEG contact-hours of synchronized macro- and microelectrode recordings from 6 patients. Sleep slow oscillation (0.1-2 Hz) epochs were identified in the iEEG recording. iEEG HFOs that occurred superimposed on the ...

Abstract

The effect of fenfluramine and norfenfluramine enantiomers in rodent seizure models, and their correlation with the pharmacokinetics of d– and l-fenfluramine in rats have been recently reported. To complement these findings, we investigated the pharmacokinetics of d– and l-norfenfluramine in rat plasma and brain samples. Sprague Dawley rats were injected intraperitoneally (i.p.) with 20mg/kg and 1 mg/kg l-norfenfluramine. A 1 mg/kg dose of d-norfenfluramine was used because higher doses caused severe toxicity. The concentration of each enantiomer in plasma and ...