Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

MR-guided laser interstitial thermal therapy (LITT) is increasingly used for refractory epilepsy. The goal of this investigation is to directly compare cost and short-term adverse outcomes for adult refractory epilepsy treated with temporal lobectomy and LITT, as well as identify risk factors for increased costs and adverse outcomes.

Methods

The National Inpatient Sample (NIS) was queried for patients who received LITT between 2012-2019. Patients with adult refractory epilepsy were identified. Multivariable mixed effects models were used to analyze predictors of cost, length ...

Abstract

Objective

The Salzburg criteria for nonconvulsive status epilepticus (NCSE) and the American Clinical Neurophysiology Society (ACNS) Standardized Critical Care EEG Terminology 2021 include a diagnostic trial with intravenous antiseizure medications (IV ASMs) to assess EEG and clinical response as a diagnostic criterion for definite NCSE and possible NCSE. However, how to perform this diagnostic test and assessing the EEG and clinical responses have not been operationally defined.

Methods

We performed a Delphi-process involving six experts to standardize the diagnostic administration of IV ASM ...

Abstract

Objective

Focal cortical dysplasia (FCD) is the most common etiology of surgically-remediable epilepsy in children. 87% of FCD patients develop epilepsy (75% is pharmacoresistant (PRE)). Focal to bilateral tonic-clonic (FTBTC) seizures are associated with worse surgical outcomes. We hypothesized that children with FCD-related epilepsy with FTBTC seizures are more likely to develop PRE due to lesion interaction with restricted cortical neural networks.

Methods

Patients were selected retrospectively from radiology and surgical databases from Children’s National Hospital. Inclusion criteria: 3T MRI-confirmed FCD from 1/2011-1/2020; ...

Abstract

Objectives

In October 2020 and March 2021, the Federal Drug Agency classified lamotrigine as class IB antiarrhythmic, announcing an increased risk of heart rhythm problems. We sought to investigate the nature of the arrhythmia signal with lamotrigine use compared to anticonvulsants with sodium and non-sodium blocking mechanisms.

Methods:

This retrospective pharmacovigilance case-non-case study used disproportionality analysis to detect signals of adverse reaction of interest reported with lamotrigine to the FDA adverse event reporting system between 1998 and 2022. Our regression model adjusted for ...

Abstract

Objective

Possible long-term consequences of status epilepticus (SE) include cognitive and behavioral impairment or the development of chronic epilepsy. However, these aspects have not been systematically studied in clinical practice. We aimed to evaluate long-term seizure recurrence after SE and the potential risk factors for their development.

Methods

Data were obtained from a prospective registry of all SE episodes occurring in adult patients who attended our center from February 2011 to April 2022. Clinical data, electroencephalography findings, treatment, and long-term data were prospectively ...

Abstract

Objective

Severe respiratory dysfunction induced by generalized convulsive seizures (GCS) is now thought to be a common mechanism for sudden unexpected death in epilepsy (SUDEP). In a mouse model of seizure-induced death, increased interictal respiratory variability was reported in mice that later die of respiratory arrest after GCS. We studied respiratory variability in epilepsy patients as a predictive tool for severity of postictal hypoxemia, a potential biomarker for SUDEP risk. We then explored the relationship between respiratory variability and central CO₂ ...

Abstract

Objectives

Although hemispheric surgeries are among the most effective procedures for drug-resistant epilepsy (DRE) in the pediatric population, a large variability in outcomes remains. Identifying ideal hemispherectomy candidates is imperative to maximize the potential for seizure freedom. The objective was to develop an online, freely-accesible tool that accurately predicts the probability of seizure freedom for any patient at 1-, 2-, and 5-years post-hemispherectomy to provide clinicians accessible and reliable prognostic information to complement clinical judgement.

Methods

Retrospective data of all pediatric patients with ...

Abstract

Objective

Duplication of the maternal chromosome 15q11.2-q13.1 region causes Dup15q syndrome, a highly penetrant neurodevelopmental disorder characterized by severe autism and refractory seizures. Although UBE3A, the gene encoding the ubiquitin ligase E3A, is thought to be the main driver of disease phenotypes, the cellular and molecular mechanisms that contribute to the development of the syndrome are yet to be determined. We previously established the necessity of UBE3A overexpression for the development of cellular phenotypes in human Dup15q neurons, including increased action ...

Abstract

Objective

The objective of this study was to determine areas of consensus among an international panel of experts for the clinical presentation and diagnosis of Epilepsy with Eyelid Myoclonia (EEM) (formerly known as Jeavons syndrome) to improve a timely diagnosis.

Methods

An international steering committee was convened of physicians and patients/caregivers with expertise in EEM. This committee summarized the current literature and identified an international panel of experts (comprising 25 physicians and 5 patients/caregivers). This international expert panel participated in a modified Delphi ...

Abstract

Objective

Identification of epilepsy patients with elevated risk for atrial fibrillation (AF) is critical given the heightened morbidity and premature mortality associated with this arrhythmia. Epilepsy is a worldwide health problem affecting nearly 3.4 million people in the United States alone. The potential for increased risk for AF in patients with epilepsy is not well appreciated, despite recent evidence from a national survey of 1.4 million hospitalizations indicating that AF is the most common arrhythmia in people with epilepsy.

Methods

We analyzed interlead ...