Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

Traumatic brain injury (TBI) is a leading cause of long-term disability, and infections such as pneumonia represent a common and serious complication for patients with TBI in the acute and subacute post-injury period. Although the acute effects of infections have been documented, their long-term consequences on neurological and behavioral recovery as well as the potential precipitation of seizures after TBI remain unclear. This study aimed to investigate the chronic effects of Klebsiella pneumoniae infection following TBI, focusing on post-traumatic seizure ...

Abstract

Objective

The pulvinar is increasingly recognized as a promising target for neuromodulation in drug-resistant epilepsy (DRE). Despite growing interest, empirical evidence substantiating the efficacy and mechanism of its deep brain stimulation (DBS) in patients with epilepsy remains scarce. This study endeavors to address this knowledge gap by investigating the electrophysiological properties of pulvinar.

Methods

We enrolled 35 patients with DRE who underwent stereoelectroencephalography with electrodes extended to the pulvinar and analyzed the pulvinar’s involvement in seizures originating from different brain lobes. Repeated single ...

Abstract

Objective

Seizure unpredictability is a significant burden in the lives of people with epilepsy. Previously published approaches to seizure forecasting analyzed intracranial electroencephalography (iEEG) recordings and showed that seizures can be forecast above chance levels. Although passive observation of the brain might provide some insights, repeated active perturbation of the cortex and measuring the cortical response may provide more direct information about time-varying cortical excitability. The aim of this study is to investigate whether seizures can be forecast by stimulating the ...

Abstract

Objective

Lennox–Gastaut syndrome (LGS) is a childhood onset developmental and epileptic encephalopathy characterized by multiple seizure types that are often refractory to traditional antiseizure medications. Neuromodulation therapies including vagus nerve stimulation (VNS), deep brain stimulation (DBS), and responsive neurostimulation (RNS) have emerged as potential treatment options, but their comparative efficacy remains unclear.

Methods

We conducted a systematic review and meta-analysis of studies reporting outcomes of neuromodulation therapies in patients with LGS. A comprehensive search of electronic databases was performed through July 26, 2024. ...

Abstract

Objective

Establishing the prevalence of epilepsy in Uganda is crucial to inform interventions and public policy. We conducted a nationwide survey to determine epilepsy prevalence.

Methods

From January 2019 to July 2022, a door-to-door survey was conducted across all four regions of Uganda, targeting a nationally representative sample of households. Trained field teams identified and interviewed heads of households to obtain demographic information, and three household members were randomly selected for epilepsy screening. A two-part survey, adapted from a validated standardized epilepsy questionnaire ...

Abstract

Objective

Interictal high-frequency oscillations (HFOs) are a promising neurophysiological biomarker of the epileptogenic zone (EZ). However, objective criteria for distinguishing pathological from physiological HFOs remain elusive, hindering clinical application. We investigated whether the distinct mechanisms underlying pathological and physiological HFOs are encapsulated in their signal morphology in intracranial electroencephalographic (iEEG) recordings and whether this distinction could be captured by a deep generative model.

Methods

In a retrospective cohort of 185 epilepsy patients who underwent iEEG monitoring, we analyzed 686 410 HFOs across 18 265 brain ...

Abstract

Objective

In patients with intractable epilepsy, accurate diaries of seizure occurrence and timing can substantially inform management. Wearable devices that provide confirmation of seizure occurrence complement such diaries, which are frequently incomplete and/or inaccurate. Here, we combined seizure diaries and longitudinally deployed wrist-worn device recordings to evaluate whether wearable recordings contain information that can discriminate between days containing seizure-related activity and those without.

Methods

Patients with focal seizures were prospectively enrolled in a clinical trial to test the effectiveness of eslicarbazepine acetate as ...

Abstract

Disinhibition of the mechanistic target of rapamycin (mTOR) pathway has been observed in patients with loss-of-function variants in the disheveled, Egl-10, and pleckstrin domain-containing protein 5 (DEPDC5), and nitrogen permease regulator-like proteins 2 and 3 (NPRL2, and NPRL3) genes, which encode the components of GTPase activating protein Activity Toward Rags Complex 1 (GATOR1) complex. Everolimus, a synthetic mTOR inhibitor, has shown efficacy in treating seizures in patients with DEPDC5 epilepsy, but seemed to worsen seizures in the one published patient with ...

Abstract

Objective

Benzodiazepine immediate-use seizure medications (ISMs; also called rescue therapies) are used to treat seizure clusters/acute repetitive seizures in patients with epilepsy. In the United States, diazepam nasal spray is an approved ISM for patients ≥2 years of age. The primary objective was to assess diazepam nasal spray pharmacokinetics (PK) in patients 2–5 years of age; safety and tolerability were secondary objectives.

Methods

This Phase 1/2a, open-label, single-dose, PK study with a 180-day open-label safety period enrolled patients with epilepsy 2–5 years of age. Diazepam nasal ...

Abstract

Objective

Newer antiseizure medications (ASMs), such as lacosamide and brivaracetam, have promising retention in clinical trials but real-world data on their effectiveness when used as first or second treatments is missing. Because newer ASMs are often reserved for severe cases, such knowledge accumulates slowly. We utilized nationwide “big data” and aimed to evaluate real-world retention of these ASMs when used early in the disease course.

Methods

We used longitudinal national register data to identify all adults with incident ASM-treated epilepsy in Sweden from ...