Two main focal seizure patterns revealed by intracerebral electroencephalographic biomarker analysis

Summary

Objective

Long‐term recording with intracerebral electrodes is commonly utilized to identify brain areas responsible for seizure generation (epileptogenic zone) and to tailor therapeutic surgical resections in patients with focal drug‐resistant epilepsy. This invasive diagnostic procedure generates a wealth of data that contribute to understanding human epilepsy. We analyze intracerebral signals to identify and classify focal ictal patterns.

Methods

We retrospectively analyzed stereo‐electroencephalographic (EEG) data in a cohort of patients either cryptogenic (magnetic resonance imaging negative) or presenting with noncongruent anatomoelectroclinical data. A computer‐assisted ...

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Diagnostic and prognostic value of noninvasive long‐term video‐electroencephalographic monitoring in epilepsy surgery: A systematic review and meta‐analysis from the E‐PILEPSY consortium

Summary

Objective

The European Union–funded E‐PILEPSY network (now continuing within the European Reference Network for rare and complex epilepsies [EpiCARE]) aims to harmonize and optimize presurgical diagnostic procedures by creating and implementing evidence‐based guidelines across Europe. The present study evaluates the current evidence on the diagnostic accuracy of long‐term video‐electroencephalographic monitoring (LTM) in identifying the epileptogenic zone in epilepsy surgery candidates.

Methods

MEDLINE, Embase, CENTRAL, and ClinicalTrials.gov were searched for relevant articles. First, we used random‐effects meta‐analytical models to calculate pooled estimates of sensitivity ...

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Neurocognition in childhood epilepsy: Impact on mortality and complete seizure remission 50 years later

Summary

Objective

To study associations of the severity of impairment in childhood neurocognition (NC) with long‐term mortality and complete seizure remission.

Methods

A population‐based cohort of 245 subjects with childhood onset epilepsy was followed up for 50 years (median = 45, range = 2‐50). Childhood NC before age 18 years was assessed as a combination of formal intelligence quotient scores and functional criteria (school achievement, working history, and psychoneurological development). Impaired NC was categorized with respect to definitions of intellectual functioning in International Classification ...

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Prolonged status epilepticus: Early recognition and prediction of full recovery in a 12‐year cohort

Summary

Objectives

Early identification of patients who are at risk of prolonged status epilepticus (SE) and patients with high chances of full recovery despite prolonged SE may urge clinicians to intensify treatment rather than to withdraw care. We aimed to develop prediction models based on readily available clinical parameters to predict prolonged SE at seizure onset and to identify patients with high chances for full recovery.

Methods

From 2005 to 2016, all adult SE patients treated at the University Hospital Basel, a Swiss medical ...

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Postictal electroencephalographic (EEG) suppression: A stereo‐EEG study of 100 focal to bilateral tonic–clonic seizures

Summary

Objectives

We aimed to describe intracerebral aspects of postictal generalized electroencephalography suppression (PGES) following focal to bilateral tonic–clonic (“secondarily generalized tonic–clonic”) seizures (GTCS) recorded using stereoelectroencephalographic (SEEG), and to correlate these with electroclinical features.

Methods

Three independent observers scored semiologic and SEEG features. Patient and epilepsy characteristics were collected. Descriptive statistics and multivariate analysis were performed. The operational definition of PGES on SEEG used strict criteria (absence of visible signal at 20 μV/mm amplitude, in all readable channels). Postictal regional suppression (RS) was identified ...

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Defining the electroclinical phenotype and outcome of PCDH19‐related epilepsy: A multicenter study

Summary

Objective

PCDH19‐related epilepsy is an epileptic syndrome with infantile onset, characterized by clustered and fever‐induced seizures, often associated with intellectual disability (ID) and autistic features. The aim of this study was to analyze a large cohort of patients with PCDH19‐related epilepsy and better define the epileptic phenotype, genotype‐phenotype correlations, and related outcome‐predicting factors.

Methods

We retrospectively collected genetic, clinical, and electroencephalogram (EEG) data of 61 patients with PCDH19‐related epilepsy followed at 15 epilepsy centers. All consecutively performed EEGs were analyzed, totaling 551. We ...

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High long‐term mortality after incident status epilepticus in adults: Results from a population‐based study

Summary

Objective

To determine annual incidence, etiology, severity, and short‐ and long‐term mortality of first‐time, nonanoxic status epilepticus (SE) in adults in a population‐based retrospective cohort study.

Methods

We systematically identified all episodes of SE in the year 2014 on the island of Funen. Patients with SE due to anoxia, patients with recurrent SE, and patients <18 years old were excluded. Nonconvulsive SE in coma was diagnosed according to the Salzburg criteria. Etiology, semiology, modified Rankin Scale (mRS) at discharge, survival, and the Status Epilepticus ...

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Corpus callosum low‐frequency stimulation suppresses seizures in an acute rat model of focal cortical seizures

Summary

Objective

Low‐frequency fiber‐tract stimulation has been shown to be effective in treating mesial temporal lobe epilepsies through activation of the hippocampal commissure in rodents and human patients. The corpus callosum is a major pathway connecting the two hemispheres of the brain; however, few experiments have documented corpus callosum stimulation. The objective is to determine the efficacy of corpus callosum stimulation at low frequencies to suppress cortical seizures.

Methods

4‐Aminopyridine was injected in the primary motor cortex of 24 rats under anesthesia. Recording electrodes ...

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