Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

Visual assessment of magnetic resonance imaging (MRI) from the Human Epilepsy Project 1 (HEP1) found 18% of participants had atrophic brain changes relative to age without known etiology. Here, we identify the underlying factors related to brain volume differences in people with focal epilepsy enrolled in HEP1.

Methods

Enrollment data for participants with complete records and brain MRIs were analyzed, including 391 participants aged 12–60 years. HEP1 excluded developmental or cognitive delay with intelligence quotient <70, and participants reported any formal learning disability ...

Abstract

Objective

We designed a quality improvement (QI) project to improve rates of documented folic acid supplementation counseling for adolescent females with epilepsy, consistent with a quality measure from the American Academy of Neurology and American Epilepsy Society. Our SMART aim was to increase the percentage of visits at which folic acid counseling was addressed from our baseline rate of 23% to 50% by July 1, 2020.

Methods

This initiative was conducted in female patients ≥12 years old with epilepsy who were prescribed daily antiseizure medication ...

Abstract

Objective

More than one-third of mesial temporal lobe epilepsy (MTLE) patients are resistant to current anti-seizure medications (ASMs), while half experience mild-to-moderate adverse effects of ASMs. There is therefore a strong need to develop and test novel ASMs. The objective of this work is to evaluate the pharmacokinetics and neurological toxicity of E2730, a novel uncompetitive inhibitor of GABA transporter-1 (GAT-1), and to test its seizure suppression effects in a chronic rat model of MTLE.

Methods

We first examined plasma levels and adverse ...

Abstract

Objective

To report a retrospective, single-center experience with a novel deep brain stimulation (DBS) device capable of chronic local field potential (LFP) recording in drug-resistant epilepsy (DRE) and explore potential electrophysiological biomarkers that may aid DBS programming and outcome tracking.

Methods

Five patients with DRE underwent thalamic DBS, targeting either the bilateral anterior (ANT; n=3) or centromedian (CM; n=2) nuclei. Post-operative electrode lead localizations were visualized in Lead-DBS software. Local field potentials recorded over 12-18 months were tracked and changes in power were ...

Abstract

Objective

Neurosurgery is a safe and effective form of treatment for select children with drug-resistant epilepsy. Still, there is concern that it remains underutilized, and that seizure freedom rates have not improved over time. We investigated referral and surgical practices, patient characteristics, and postoperative outcomes over the past two decades.

Methods

We performed a retrospective cohort study of children referred for epilepsy surgery at a tertiary center between 2000 and 2018. We extracted information from medical records and analyzed temporal trends using regression ...

Abstract

Febrile seizures affect 2-5% of U.S. children and are considered benign although associated with an increased risk of epilepsy and rarely, sudden unexplained death. We compared rates of mortality, neurodevelopmental disorders, and neuropathology in young children with simple and complex febrile seizures to healthy controls.

We systematically reviewed studies of 3–72-month-old children with simple or complex febrile seizures < 30 minutes. We searched studies with outcome measures on mortality, neurodevelopment, or neuropathology through July 18, 2022. Bias risk was assessed per study ...

Abstract

Seizures beget seizures is a long-standing theory that proposed that seizure activity can impact on the structural and functional properties of the brain circuits in ways that contribute to epilepsy progression and the future occurrence of seizures. Originally proposed by Gowers, this theory continues to be quoted in the pathophysiology of epilepsy. We critically review the existing data and observations on the consequences of recurrent seizures on brain networks and highlight a range of factors that speak for and against ...

Abstract

Objective

The cognitive profile of juvenile absence epilepsy (JAE) remains largely uncharacterized. This study aimed to: (i) elucidate the neuropsychological profile of JAE; (ii) identify familial cognitive traits, by investigating unaffected JAE siblings; (iii) establish the clinical meaningfulness of JAE-associated cognitive traits; (iv) determine whether cognitive traits across the idiopathic generalized epilepsy (IGE) spectrum are shared or syndrome-specific, by comparing JAE to juvenile myoclonic epilepsy (JME); and (v) identify relationships between cognitive abilities and clinical characteristics.

Methods

We investigated 123 participants: 23 patients ...