Can we use intraoperative high‐frequency oscillations to guide tumor‐related epilepsy surgery?

Abstract

Objective

In people with low‐grade intrinsic brain tumors, an epileptic focus is often located close to the lesion. High‐frequency oscillations (HFOs) in electrocorticography (ECoG) might help to delineate this focus. We investigated the relationship between HFOs and low‐grade brain tumors and their potential value for tumor‐related epilepsy surgery.

Methods

We analyzed pre‐ and postresection intraoperative ECoG in 41 patients with refractory epilepsy and a low‐grade lesion. Electrodes were designated as overlying the tumor, adjacent resected tissue (peritumoral), or outside the resection bed using ...

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Near SUDEP during bilateral stereo‐EEG monitoring characterized by diffuse postictal EEG suppression

Abstract

Sudden unexpected death in epilepsy (SUDEP) is the most common cause of death in patients with refractory epilepsy. The pathophysiology of SUDEP is unknown. Postictal phenomena such as postconvulsive immobility (PI), postictal generalized electroencephalography (EEG) suppression (PGES), arousal deficits, cardiac arrhythmias, central apneas, and obstructive apneas due to laryngospasms have been suggested to contribute to SUDEP. We present, to our knowledge, the first case of a near‐SUDEP event in a patient undergoing intracranial, stereotactic EEG (sEEG) monitoring. This case spotlights potential ...

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Value of initial C‐reactive protein levels in status epilepticus outcome prediction

Abstract

The role of neuroinflammation in the pathophysiology of seizures is increasingly recognized, and the evaluation of potential biochemical markers of inflammatory processes in seizures and status epilepticus (SE), such as C‐reactive protein (CRP), has gained attention. The present study assessed the first CRP level obtained in an SE episode regarding its value for SE outcome prediction. Among 362 admissions for SE during the study period, 231 episodes satisfied the inclusion criteria. Higher initial CRP concentrations were independently associated with in‐hospital ...

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Elevated blood purine levels as a biomarker of seizures and epilepsy

Abstract

Objective

There is a major unmet need for a molecular biomarker of seizures or epilepsy that lends itself to fast, affordable detection in an easy‐to‐use point‐of‐care device. Purines such as adenosine triphosphate and adenosine are potent neuromodulators released during excessive neuronal activity that are also present in biofluids. Their biomarker potential for seizures and epilepsy in peripheral blood has, however, not yet been investigated. The aim of the present study was to determine whether blood purine nucleoside measurements can serve as ...

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Seizures and memory impairment induced by patient‐derived anti‐N‐methyl‐D‐aspartate receptor antibodies in mice are attenuated by anakinra, an interleukin‐1 receptor antagonist

Abstract

Objective

Neuroinflammation associated with anti‐N‐methyl‐D‐aspartate receptor (NMDAR) encephalitis may facilitate seizures. We previously showed that intraventricular administration of cerebrospinal fluid from patients with anti‐NMDAR encephalitis to mice precipitates seizures, thereby confirming that antibodies are directly pathogenic. To determine whether interleukin (IL)‐1‐mediated inflammation exacerbates autoimmune seizures, we asked whether blocking the effects of IL‐1 by anakinra, a selective IL‐1 receptor antagonist, blunts antibody‐induced seizures.

Methods

We infused C57BL/6 mice intraventricularly with purified serum IgG from patients with anti‐NMDAR encephalitis or monoclonal anti‐NMDAR IgG; subdural ...

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Relation between coffee consumption and risk of seizure‐related respiratory dysfunction in patients with drug‐resistant focal epilepsy

Abstract

Objective

Caffeine is an antagonist of the adenosine pathway, which is involved in regulation of breathing. Extracellular concentrations of adenosine are increased in the immediate aftermath of a seizure. Seizure‐related overstimulation of adenosine receptors might promote peri‐ictal apnea. However, the relation between caffeine consumption and risk of seizure‐related respiratory dysfunction in patients with drug‐resistant focal epilepsy remains unknown.

Methods

We performed a cross‐sectional analysis of data collected in patients included in the SAVE study in Lyon’s epilepsy monitoring unit at the Adult Epilepsy ...

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Seizure‐related deaths in children: The expanding spectrum

Abstract

Although seizures are common in children, they are often overlooked as a potential cause of death. Febrile and nonfebrile seizures can be fatal in children with or without an epilepsy diagnosis and may go unrecognized by parents or physicians. Sudden unexpected infant deaths, sudden unexplained death in childhood, and sudden unexpected death in epilepsy share clinical, neuropathological, and genetic features, including male predominance, unwitnessed deaths, death during sleep, discovery in the prone position, hippocampal abnormalities, and variants in genes regulating ...

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Diagnosing cognitive disorders in older adults with epilepsy

Abstract

Objective

To characterize the nature and prevalence of cognitive disorders in older adults with temporal lobe epilepsy (TLE) and compare their cognitive profiles to patients with amnestic mild cognitive impairment (ie, aMCI).

Methods

Seventy‐one older patients with TLE, 77 aMCI, and 69 normal aging controls (NACs), all 55‐80 years of age, completed neuropsychological measures of memory, language, executive function, and processing speed. An actuarial neuropsychological method designed to diagnose MCI was applied to individual patients to identify older adults with TLE who met diagnostic ...

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The ups and downs of alkyl‐carbamates in epilepsy therapy: How does cenobamate differ?

Abstract

Since 1955, several alkyl‐carbamates have been developed for the treatment of anxiety and epilepsy, including meprobamate, flupirtine, felbamate, retigabine, carisbamate, and cenobamate. They have each enjoyed varying levels of success as antiseizure drugs; however, they have all been plagued by the emergence of serious and sometimes life‐threatening adverse events. In this review, we compare and contrast their predominant molecular mechanisms of action, their antiseizure profile, and where possible, their clinical efficacy. The preclinical, clinical, and mechanistic profile of the prototypical ...

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