Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

Although increased mortality associated with epilepsy is well understood, data in patients after their first-ever seizure are limited. We aimed to assess mortality after a first-ever unprovoked seizure and identify causes of death (CODs) and risk factors.

Methods

A prospective cohort study was undertaken of patients with first-ever unprovoked seizure between 1999 and 2015 in Western Australia. Two age-, gender-, and calendar year-matched local controls were obtained for each patient. Mortality data, including COD, based on International Statistical Classification of Diseases and ...

Abstract

Objective

Epileptogenesis after status epilepticus (SE) has a faster onset in rats treated to reduce brain levels of the anticonvulsant neurosteroid allopregnanolone with the 5α-reductase inhibitor finasteride; however, it still has to be evaluated whether treatments aimed at increasing allopregnanolone levels could result in the opposite effect of delaying epileptogenesis. This possibility could be tested using the peripherally active inhibitor of 3β-hydroxysteroid dehydrogenase/Δ^5-4 isomerase trilostane, which has been shown repeatedly to increase allopregnanolone levels in the brain.

Methods

Trilostane (50 mg/kg) was administered subcutaneously ...

Abstract

Objective

WWOX is an autosomal recessive cause of early infantile developmental and epileptic encephalopathy (WWOX-DEE), also known as WOREE (WWOX-related epileptic encephalopathy). We analyzed the epileptology and imaging features of WWOX-DEE, and investigated genotype–phenotype correlations, particularly with regard to survival.

Methods

We studied 13 patients from 12 families with WWOX-DEE. Information regarding seizure semiology, comorbidities, facial dysmorphisms, and disease outcome were collected. Electroencephalographic (EEG) and brain magnetic resonance imaging (MRI) data were analyzed. Pathogenic WWOX variants from our cohort and the literature were ...

Abstract

Objective

Lexical retrieval deficits are characteristic of a variety of different neurological disorders. However, the exact substrates responsible for this are not known. We studied a large cohort of patients undergoing surgery in the dominant temporal lobe for medically intractable epilepsy (n = 95) to localize brain regions that were associated with anomia.

Methods

We performed a multivariate voxel-based lesion–symptom mapping analysis to correlate surgical lesions within the temporal lobe with changes in naming ability. Additionally, we used a surface-based mixed-effects multilevel analysis to estimate ...

Abstract

Objective

Improve data-driven research to inform clinical decision-making with pediatric epilepsy surgery patients by expanding the Pediatric Epilepsy Research Consortium Epilepsy Surgery Workgroup to include neuropsychological data. This paper reports on the process and initial success of this effort and characterizes the cognitive functioning of the largest multi-site pediatric epilepsy surgery cohort in the United States.

Methods

Pediatric neuropsychologists from 18 institutions completed surveys regarding neuropsychological practice and impact of involvement in the collaborative. Neuropsychological data was entered through an online database. Descriptive ...

Abstract

Objective

We aimed to assess determinants of seizure outcome following pediatric hemispherotomy in a contemporary cohort.

Methods

We retrospectively analyzed the seizure outcomes of 457 children who underwent hemispheric surgery in five European epilepsy centers between 2000 and 2016. We identified variables related to seizure outcome through multivariable regression modeling with missing data imputation and optimal group matching and further investigated the role of surgical technique by Bayes factor (BF) analysis.

Results

177 (39%) children underwent vertical and 280 (61%) lateral hemispherotomy. 344 (75%) children ...

Abstract

Objectives

To assess the temporal trends in the use of second antiseizure (ASM) regimens and compare the efficacy of substitution monotherapy and combination therapy after failure of initial monotherapy in people with epilepsy.

Methods

This was a longitudinal observational cohort study conducted at the Epilepsy Unit of the Western Infirmary in Glasgow, Scotland. We included patients who were newly treated for epilepsy with ASMs between July 1982, and October 2012. All patients were followed up for a minimum of 2 years. Seizure freedom was ...

Abstract

Due to heterogenous seizure semiology and poor contribution of scalp EEG signals, insular epilepsy requires the use of appropriate diagnostic tools for its diagnosis and characterization. The deep location of the insula also presents surgical challenges. The aim of this paper is to review current diagnostic and therapeutic tools and their contribution to the management of insular epilepsy.

Magnetic resonance imaging, isotopic imaging, neurophysiological imaging, and genetic testing should be used and interpretated with caution. Isotopic imaging and scalp electroencephalography have ...

Abstract

The hippocampal formation plays a central role in the development of temporal lobe epilepsy (TLE), a disease characterized by recurrent, unprovoked epileptic discharges. TLE is a neurologic disorder characterized by acute long-lasting seizures (i.e. abnormal electrical activity in the brain) or seizures that occur in close proximity without recovery, typically after a brain injury or status epilepticus. After status epilepticus, epileptogenic hyperexcitability develops gradually over the following months to years resulting in the emergence of chronic, recurrent seizures. Acting as ...

Abstract

Selection criteria for clinical trials for medication resistant epilepsy are used to limit variability and to ensure safety. However, it has become more challenging to recruit subjects for trials. This study investigated the impact of each inclusion and exclusion criteria on medication resistant epilepsy clinical trial recruitment at a large academic epilepsy center. We retrospectively identified all patients with medication resistant focal- or generalized-onset epilepsy who attended outpatient clinic over a consecutive 3-month period. We assessed each patient’s eligibility of ...