SEEG‐guided radiofrequency ablation of the epileptogenic zone as a treatment and predictor of future success of further surgical intervention

Abstract

Objective:

Stereoelectroencephalography (SEEG)-guided radiofrequency ablation (RFA) is increasingly being used as a treatment for drug-resistant localization-related epilepsy. The aim of this study is to analyze the successes and failures using RFA and how response correlates with surgical epilepsy treatment outcomes.

Methods:

We retrospectively reviewed 62 patients who underwent RFA via SEEG electrodes. After excluding 5, the remaining 57 were classified into subgroups based on procedures and outcomes. Forty patients (70%) underwent a secondary surgical procedure, of whom 32 were delayed: 26 laser interstitial ...

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Functional evaluation of epilepsy‐associated KCNT1 variants in multiple cellular systems reveals a predominant gain of function impact on channel properties

Abstract

Objective

Gain of function variants in the sodium-activated potassium channel KCNT1 have been associated with pediatric epilepsy disorders. Here, we systematically examine a spectrum of KCNT1 variants and establish their impact on channel function in multiple cellular systems.

Methods

KCNT1 variants identified from published reports and genetic screening of pediatric epilepsy patients were expressed in Xenopus oocytes and HEK cell lines. Variant impact on current magnitude, current–voltage relationships, and sodium ion modulation were examined.

Results

We determined basic properties of KCNT1 in Xenopus oocyte and ...

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A longitudinal cohort study of mediators of health‐related quality of life after pediatric epilepsy surgery or medical treatment

Abstract

Objectives

The purpose of this longitudinal cohort study was to examine the variables that influence health-related quality of life (HRQOL) after epilepsy surgery in children. We examined whether treatment type (surgical vs medical therapy) and seizure control are related to other variables that have been shown to influence HRQOL, namely depressive symptoms in children with epilepsy or their parents, and the availability of family resources.

Methods

In total, 265 children with drug-resistant epilepsy were recruited from eight epilepsy centers across Canada at the ...

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Risk of Recurrence in Patients with an Unprovoked Tonic‐Clonic Seizure and Generalized Epileptiform Discharges on EEG

Abstract

Objective

The decision to initiate treatment in patients with a first unprovoked seizure remains controversial. Studies have reported a recurrence rate ranging from 21-50%, but most have included patients with different etiologies, EEG findings, and seizure types. This study aimed to determine the risk of recurrence in patients with a first unprovoked generalized tonic-clonic (GTC) seizure with evidence of generalized spike-wave discharges (GSWD) on EEG and compare the efficacy of antiseizure medications (ASM) in preventing recurrence.

Methods

This prospective study included consecutive patients ...

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A novel KCNC1 gain‐of‐function variant causing developmental and epileptic encephalopathy: “Precision medicine” approach with fluoxetine

Abstract

Variable phenotypes, including developmental encephalopathy with (DEE) or without seizures and myoclonic epilepsy and ataxia due to potassium channel mutation, are caused by pathogenetic variants in KCNC1, encoding for Kv3.1 channel subunits. In vitro, channels carrying most KCNC1 pathogenic variants display loss-of-function features. Here, we describe a child affected by DEE with fever-triggered seizures, caused by a novel de novo heterozygous missense KCNC1 variant (c.1273G>A; V425M). Patch-clamp recordings in transiently transfected CHO cells revealed that, compared to wild-type, Kv3.1 V425M ...

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Neurofilament light chain — a possible fluid biomarker in the intrahippocampal kainic acid mouse model for chronic epilepsy?

Abstract

Objective

In the management of epilepsy, there is an ongoing quest to discover new biomarkers to improve the diagnostic process, the monitoring of disease progression, and the evaluation of treatment responsiveness. In this regard, biochemical traceability in biofluids is notably absent in contrast to other diseases. In the present preclinical study, we investigated the potential of neurofilament light chain (NfL) as possible diagnostic and response fluid biomarker for epilepsy.

Methods

We gained insights into NfL levels during the various phases of the intrahippocampal ...

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The Impact of Sociodemographic Disadvantage on Neurobehavioral Outcomes in Children with Newly Diagnosed Seizures and their Unaffected Siblings over 36 months

Abstract

Objective

To determine the short and longer-term impact of sociodemographic disadvantage on the emotional-behavioral status of youth with new-onset epilepsy and their unaffected siblings at the time of diagnosis and the subsequent 3 years.

Methods

312 youth with newly diagnosed epilepsies and 223 unaffected siblings, age 6-16 years, were independently assessed regarding their emotional and behavioral status by their parents and teachers at baseline, at 18 and at 36 months later; and the youth with seizures also completed self-report measures of depression, anxiety and hostility ...

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Pediatric epilepsy surgery from 2000 to 2018: Changes in referral and surgical volumes, patient characteristics, genetic testing, and post‐surgical outcomes

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 post-operative 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 ...

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Affordability of newer anti‐seizure medications in Asian resource‐limited countries

Abstract

Objective

One of the objectives of the Intersectoral Global Action Plan (IGAP) on epilepsy and other neurological disorders for 2022 to 2031 is to ensure at least 80% of people with epilepsy (PWE) will have access to appropriate, affordable, and safe anti-seizure medications (ASMs) by 2031. However, ASM affordability is a significant issue in low-and-middle-income countries, preventing PWE from accessing optimal treatment. This study aimed to determine the affordability of the newer (second and third-generation) ASMs in resource-limited countries in Asia.

Methods

We ...

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