Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objectives

Minimally invasive MR-guided laser interstitial thermal therapy (MRgLITT) has been proposed as an alternative to open epilepsy surgery, to address concerns regarding the risk of open surgery. Our primary hypothesis was seizure freedom one-year after MRgLITT was noninferior to open surgery in children with drug-resistant epilepsy (DRE). The secondary hypothesis was MRgLITT has fewer complications and shorter hospitalization than surgery. The primary objective was to compare seizure outcome of MRgLITT to open surgery in children with DRE. The secondary objective ...

Abstract

Objective

To characterize somatic symptoms and related disorders (SSD) in epilepsy.

Methods

Adults with epilepsy under active follow-up at a tertiary epilepsy centre were consecutively enrolled. The diagnosis of SSD was performed by an experienced psychologist based on the structured clinical interview for DSM-5. Detailed social/demographic data, epilepsy features, psychiatric features, life quality, disability and economic burden were collected and compared between people with SSD and those without. Bodily distress syndrome checklist (BDS-checklist), Somatic Symptom Disorder–B Criteria Scale (SSD-12), Patient Health Questionnaire-9 (PHQ-9) ...

Abstract

Objective

Persons with drug-resistant epilepsy may benefit from epilepsy surgery and should undergo presurgical testing to determine potential candidacy and appropriate intervention. Institutional expertise can influence use and availability of evaluations and epilepsy surgery candidacy. This census survey study aims to examine the influence of geographic region and other center characteristics on presurgical testing for medically intractable epilepsy.

Methods

We analyzed annual report and supplemental survey data reported in 2020 from 206 adult epilepsy center directors and 136 pediatric epilepsy center directors in ...

Abstract

Objective

The risk of seizure following BNT162b2 and CoronaVac vaccinations has been sparsely investigated. This study aimed to evaluate this association.

Method

Patients who had their first seizure-related hospitalization between February 23, 2021 and January 31, 2022, were identified in Hong Kong. All seizure episodes happening on the day of vaccination (day 0) were excluded, since clinicians validated that most of the cases on day 0 were syncopal episodes. Within-individual comparison using a modified self-controlled case series analysis was applied to estimate the ...

Abstract

Objective

Epilepsy with eyelid myoclonia (EEM) has been associated with marked clinical heterogeneity. Early epilepsy onset has been recently linked to lower chances of achieving sustained remission and to a less favorable neuropsychiatric outcome. However, much work is still needed to better delineate this epilepsy syndrome.

Methods

In this multicenter retrospective cohort study, we included 267 EEM patients from 9 countries. Data about electroclinical and demographic features, intellectual functioning, migraine with or without aura, family history of epilepsy and epilepsy syndromes in relatives ...

Abstract

Anti-Hu–associated neurologic autoimmunity most often occurs in the context of small cell lung cancer and typically presents with peripheral neuropathy, cerebellar ataxia, and/or limbic encephalitis. Extra-limbic encephalitis causing seizures is a rare disease manifestation, with only sparse reports in the literature. Herein we present a patient with seizures in anti-Hu–associated extra-limbic encephalitis, and review the literature for other cases to more fully characterize this entity. Among 27 patients we identified, the median age was 46 years (range: 2–69 years) and 18 of ...

Abstract

Objective

Childhood trauma has been implicated as a risk factor for the aetiology of psychogenic non-epileptic seizures (PNES). Relatively little attention has been paid to whether profiles of specific trauma types differ between patients with epilepsy and PNES. Investigating childhood trauma profiles in these patient groups may identify psychological vulnerabilities the predispose to developing PNES, and aid early diagnoses, prevention, and treatment.

Methods

Data were collected from two cohorts (n
_{Retrospective}
=203; n
_Prospective=209) admitted to video-EEG monitoring units in Melbourne Australia. The ...

Abstract

Objective

Visual review of intracranial EEG (iEEG) is often an essential component for defining the zone of resection for epilepsy surgery. Unsupervised approaches using machine and deep learning are being employed to identify seizure onset zones (SOZ). This prompts a more comprehensive understanding of the reliability of visual review as a reference standard. We sought to summarize existing evidence on the reliability of visual review of iEEG in defining the SOZ for patients undergoing surgical work-up and understand its implication on ...

Abstract

Acquiring drug sensitivity profiles is challenging in rare epilepsies. Anecdotal evidence suggests that anti-seizure medications that block sodium channels as their primary mechanism of action exacerbate seizures in HCN1 developmental and epileptic encephalopathies (DEE), while sodium valproate is effective for some patients. The Hcn1 M294L heterozygous knock-in (Hcn1^M294L) mouse carries the homologue of the recurrent gain-of-function HCN1 M305L pathogenic variant and recapitulates the seizure and some behavioural phenotypes observed in patients. We used this mouse model to study drug efficacy ...

Abstract

Objective

To determine whether an ictal electroencephalographic (EEG) recording as part of presurgical evaluation of children with a demarcated single unilateral magnetic resonance imaging (MRI) lesion is indispensable for surgical decision-making, we investigated the relationship of interictal/ictal EEG and seizure semiology with seizure-free outcome.

Methods

Data were obtained retrospectively from consecutive patients (≤18 years old) undergoing epilepsy surgery with a single unilateral MRI lesion at our institution over a 6-year period. Video-telemetry EEG (VT-EEG) was classified as concordant or nonconcordant/noninformative in relation to the ...