Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

The objective of this study was to identify risk factors associated with surgery-related neurological morbidity in patients with drug-resistant epilepsy undergoing supra-sylvian operculo-insular resections. As secondary outcomes, we also analyzed the risk factors for ischemic lesions (IL) of corona radiata and seizure recurrence.

Methods:

A retrospective analysis was conducted on a cohort of patients underwent supra-sylvian operculo-insular resections for drug-resistant epilepsy. The association of several presurgical, surgical and post-surgical factors with both primary (persistent neurological deficits) and secondary (structural abnormalities on postoperative ...

Abstract

Seizures, anti-seizure medications and the reproductive systems are reciprocally entwined. In Section 1 of this review, we outline how seizures may affect the hypothalamic-pituitary-gonadal axis thereby altering sex-steroids, while changes in sex-steroids across the menstrual cycle and changes in pharmacokinetics during pregnancy may alter seizure susceptibility. The literature indicates that females with epilepsy experience increased rates of menstrual disturbances and reproductive endocrine disorders. The latter include polycystic ovary syndrome, especially for females on valproate. Studies of fertility have yielded mixed ...

Abstract

Unintentional misinterpretation of research in published biomedical reports that is not based on statistical flaws is often under-recognized, despite its possible impact on science, clinical practice, and public health. Important causes of such misinterpretation of scientific data, resulting in either false-positive or false-negative conclusions, include design-associated errors and hidden (or latent) variables that are not easily recognized during data analysis. Furthermore, cognitive biases, such as the inclination to seek patterns in data whether they exist or not, may lead to ...

Abstract

The devastating developmental and epileptic encephalopathy of infantile epileptic spasms syndrome (IESS) has numerous causes, including, but not limited to, brain injury, metabolic, and genetic conditions. Given the stereotyped electrophysiologic, age-dependent, and clinical findings, there likely exists one or more final common pathway in the development of IESS. The identity of this final common pathway is unknown, but it may represent a novel therapeutic target for infantile spasms. Previous research on IESS has largely focused on identifying the neuroanatomical substrate ...

Abstract

Objective

Home monitoring of 3 Hz spike-wave discharges (SWD) in patients with refractory absence epilepsy could improve clinical care by replacing the inaccurate seizure diary with objective counts. We investigated the use and performance of the Sensor Dot (Byteflies) wearable in persons with absence epilepsy in their home environment.

Methods

Thirteen participants (median age = 22 y; 11 female) were enrolled at the university hospitals Leuven and Freiburg. At home, participants had to attach the Sensor Dot and behind-the-ear electrodes to record two-channel EEG, accelerometry ...

Abstract

Objective

Temporal coordination between oscillations enables intercortical communication and is implicated in cognition. Focal epileptic activity can affect distributed neural networks and interfere with these interactions. Refractory pediatric epilepsies are often accompanied by substantial cognitive comorbidity, but mechanisms and predictors remain mostly unknown. Here, we investigate oscillatory coupling across large-scale networks in the developing brain.

Methods

We analyzed large-scale intracranial electroencephalographic recordings in children with medically refractory epilepsy undergoing presurgical workup (n = 25, aged 3–21 years). Interictal epileptiform discharges (IEDs), pathologic high-frequency oscillations (HFOs), and ...

Abstract

Recent morphometric magnetic resonance imaging (MRI) studies suggested the possibility that valproate (VPA) use is associated with parieto-occipital cortical thinning in patients with heterogeneous epilepsy syndromes. In this study, we examined the effect of VPA on the brain volume using a large number of homogenous patients with idiopathic generalized epilepsy. Voxel-based morphometry was used to compare regional gray matter (GM) volume between 112 patients currently taking VPA (VPA+ group), 81 patients not currently taking VPA (VPA– group), and 120 healthy ...

Abstract

Artificial intelligence (AI) allows data analysis and integration at an unprecedented granularity and scale. Here we review the technological advances, challenges and future perspectives of using AI for electro-clinical phenotyping of animal models and patients with epilepsy. In translational research AI models accurately identify behavioral states in animal models of epilepsy, allowing identification of correlations between neural activity and interictal and ictal behavior. Clinical applications of AI-based automated and semi-automated analysis of audio and video recordings of people with epilepsy, ...

Abstract

Objectives

Although hemispheric surgeries are among the most effective procedures for drug-resistant epilepsy (DRE) in the pediatric population, there is a large variability in seizure outcomes at the group level. A recently developed HOPS score provides individualized estimation of likelihood of seizure freedom to complement clinical judgement. The objective of this study was to develop a freely accessible online calculator that accurately predicts the probability of seizure freedom for any patient at 1-, 2-, and 5-years post-hemispherectomy.

Methods

Retrospective data of all pediatric ...