Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

To determine whether automated, electronic alerts increased referrals for epilepsy surgery.

Methods

We conducted a prospective, randomized controlled trial of a natural language processing–based clinical decision support system embedded in the electronic health record (EHR) at 14 pediatric neurology outpatient clinic sites. Children with epilepsy and at least two prior neurology visits were screened by the system prior to their scheduled visit. Patients classified as a potential surgical candidate were randomized 2:1 for their provider to receive an alert or standard of ...

Abstract

Improved quality of life (QoL) is an important outcome goal following epilepsy surgery. This study aims to quantify change in QoL for adults with drug-resistant epilepsy (DRE) who undergo epilepsy surgery, and to explore clinicodemographic factors associated with these changes. We conducted a systematic review and meta-analysis using Medline, Embase, and Cochrane Central Register of Controlled Trials. All studies reporting pre- and post-epilepsy surgery QoL scores in adults with DRE via validated instruments were included. Meta-analysis assessed the postsurgery change ...

SUMMARY

Cannabidiol (CBD) Expanded Access Program (EAP), initiated in 2014, provided CBD (Epidiolex®) to patients with treatment-resistant epilepsy (TRE). In the final pooled analysis of 892 patients treated through January 2019 (median exposure 694 days), CBD treatment was associated with a 46%–66% reduction in median monthly total (convulsive plus nonconvulsive) seizure frequency. CBD was well tolerated, and adverse events were consistent with previous findings. We used pooled EAP data to investigate the effectiveness of add-on CBD therapy for individual convulsive seizure types ...

Abstract

Objective

Managing the progress of drug-resistant epilepsy patients implanted with the responsive neurostimulation (RNS) system requires the manual evaluation of hundreds of hours of intracranial recordings. The generation of these large amounts of data and the scarcity of experts’ time for evaluation, necessitates the development of automatic tools to detect intracranial electroencephalographic seizure patterns (iESPs) with expert-level accuracy. We developed an intelligent system for identifying the presence and onset time of iESPs in intracranial EEG (iEEG) recordings from the RNS device.

Methods

An ...

Abstract

Sleep and wake are defined through physiological and behavioral criteria and can be typically separated into NREM sleep stages N1, N2, and N3, REM sleep and wake. Sleep and wake states are not homogenous in time. Their properties vary during the night and day cycle. Given that brain activity changes as a function of NREM, REM, and wake during the night and day cycle, are seizures more likely to occur during NREM, REM, or wake at a specific time? More ...

Abstract

Mental health comorbidities are prevalent and problematic in patients with seizures but often suboptimally managed. To address common gaps in care, the Integrated Mental Health Care Pathways Task Force of the International League Against Epilepsy (ILAE) Psychiatry Commission was tasked with providing education and guidance on the integration of mental health management (e.g., screening, referral, treatment) into routine seizure care. This report aims to describe a variety of established services in this area, with a specific focus on psychological care ...

Abstract

Objective

Identifying abnormalities in interictal intracranial EEG, by comparing patient data to a normative map, has shown promise for the localization of epileptogenic tissue and prediction of outcome. The approach typically uses short interictal segments of around one minute. However, the temporal stability of findings has not been established.

Methods

Here, we generated a normative map of iEEG in non-pathological brain tissue from 249 patients. We computed regional band power abnormalities in a separate cohort of 39 patients for the duration of their ...