Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

We assessed mortality, sudden unexpected death in epilepsy (SUDEP), and standardized mortality ratio (SMR) among adults treated with cenobamate during the cenobamate clinical development program.

Methods

We retrospectively analyzed deaths among all adults with uncontrolled focal (focal to bilateral tonic-clonic [FBTC], focal impaired awareness, focal aware) or primary generalized tonic-clonic (PGTC) seizures who received ≥1 dose of adjunctive cenobamate in completed and ongoing phase 2 and 3 clinical studies. In patients with focal seizures from completed studies, median baseline seizure frequencies ranged ...

Abstract

Epilepsy is a common neurological disorder, affecting patients of all ages, reducing the quality of life and associated with several comorbidities. Sleep impairment is a frequent condition in patients with epilepsy (PWE), and the relation between sleep and epilepsy has been considered bidirectional since one can significantly influence the other, and vice versa. The orexin system has been described more than 20 years ago and is implicated in several neuro-biological functions, other than in controlling the sleep-wake cycle. Considering the relation ...

Abstract

Objective

KCNA1 mutations are associated with a rare neurological movement disorder known as episodic ataxia type 1 (EA1), and epilepsy is a common comorbidity. Current medications only provide partial relief to ataxia and/or seizures, making new drugs needed. Here, we characterized zebrafish kcna1a
^-/-
as a model of EA1 with epilepsy and compared the efficacy of the first-line therapy carbamazepine in kcna1a
^-/-
zebrafish to Kcna1
^-/-
rodents.

Methods

CRISPR/Cas9 mutagenesis was used to introduce a mutation in the sixth ...

Abstract

Objective

Previous studies suggest that intermittent deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) affects physiological sleep architecture. Here, we investigated the impact of continuous ANT-DBS on sleep in epilepsy patients in a multicenter cross-over study in ten patients.

Methods

We assessed sleep stage distribution, delta power, delta energy, and total sleep time (TST) in standardized 10/20 polysomnography (PSG) investigations before and 12 months after DBS lead implantation.

Results

In contrast to previous studies, we found no disruption of sleep architecture ...

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 ...

Abstract

Objective

Electronic medical records allow for retrospective clinical research with large patient cohorts. However, epilepsy outcomes are often contained in free text notes that are difficult to mine. We recently developed and validated novel natural language processing (NLP) algorithms to automatically extract key epilepsy outcome measures from clinic notes. In this study, we assessed the feasibility of extracting these measures to study the natural history of epilepsy at our center.

Methods

We applied our previously validated NLP algorithms to extract seizure freedom, seizure ...

Abstract

Objective

We aimed to identify corticothalamic areas and electrical stimulation paradigms that optimally enhance breathing.

Methods

Twenty-nine patients with medically intractable epilepsy were prospectively recruited in an epilepsy monitoring unit while undergoing stereoelectroencephalographic evaluation. Direct electrical stimulation in cortical and thalamic regions was carried out using low (<1 Hz) and high (≥10 Hz) frequencies, and low (<5 mA) and high (≥5 mA) current intensities, with pulse width of .1 ms. Electrocardiography, arterial oxygen saturation (SpO₂), end-tidal carbon dioxide (ETCO₂), oronasal airflow, and abdominal and thoracic plethysmography were ...

Abstract

We describe an electrical running down phenomenon and also a consistent spectral change (in the aperiodic component of the power spectrum) derived from chronic interictal electrocorticography (ECoG), after surgery in a patient with drug-resistant epilepsy. These data were recorded using a closed-loop neurostimulation system that was implanted after resection. The patient has been seizure-free for 2.5 years since resection without requiring the neurostimulator to be turned on. Concurrently, there was an exponential decrease in the number of epileptiform electrographic detections recorded ...

Abstract

Objective

Posttraumatic epilepsy (PTE) develops in as many as one third of severe traumatic brain injury (TBI) patients, often years after injury. Analysis of early electroencephalographic (EEG) features, by both standardized visual interpretation (viEEG) and quantitative EEG (qEEG) analysis, may aid early identification of patients at high risk for PTE.

Methods

We performed a case–control study using a prospective database of severe TBI patients treated at a single center from 2011 to 2018. We identified patients who survived 2 years postinjury and matched patients ...