The repertoire of seizure onset patterns in human focal epilepsies: Determinants and prognostic values

Summary

Objective

In this study, we seek to analyze the determinants of the intracranial electroencephalography seizure onset pattern (SOP) and the impact of the SOP in predicting postsurgical seizure outcome.

Methods

To this end, we analyzed 820 seizures from 252 consecutive patients explored by stereo‐electroencephalography (total of 2148 electrodes), including various forms of focal refractory epilepsies. We used a reproducible method combining visual and time‐frequency analyses.

Results

We described eight SOPs: low‐voltage fast activity (LVFA), preictal spiking followed by LVFA, burst of polyspikes followed by LVFA, ...

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The epidemiology of drug‐resistant epilepsy: A systematic review and meta‐analysis

Summary

Objective

The definition of drug‐resistant epilepsy (DRE) affects case identification and treatment, and impacts prevalence or incidence estimates and health burden estimation in epidemiology. The objective of this systematic review is to evaluate the consistency between definitions of DRE in the literature and the official definition in the International League Against Epilepsy (ILAE) guidelines, and to estimate the incidence, prevalence, and risk factors for DRE.

Methods

MEDLINE and EMBASE were searched for observational studies of DRE published between January 1980 and July 2015. ...

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Stevens‐Johnson syndrome and toxic epidermal necrolysis with antiepileptic drugs: An analysis of the US Food and Drug Administration Adverse Event Reporting System

Summary

Objective

Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and potentially fatal adverse skin reactions that are most commonly triggered by certain medications. One class of medications that has been highly associated with SJS/TEN reactions is antiepileptic drugs (AEDs). We sought to quantify the risk of SJS/TEN associated with AEDs as a class, as well as individual AEDs, in the United States.

Methods

An analysis was performed of the US Food and Drug Administration Adverse Event Reporting System (FAERS) from July ...

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Cognitive outcomes following epilepsy in infancy: A longitudinal community‐based study

Summary

Objective

Onset of epilepsy before 2 years of age is associated with poor cognitive outcome; however, the natural course of the range of epilepsies that occur at this age is unknown. The aim of this prospective community‐based study was to investigate the neuropsychological development of infants with newly diagnosed epilepsy longitudinally and to identify the clinical factors that predict long‐term impairment.

Methods

Sixty‐six infants <24 months of age were enrolled in the baseline phase of this study; 40 were seen again at 1‐year follow‐up and ...

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Surgical and developmental outcomes of corpus callosotomy for West syndrome in patients without MRI lesions

Summary

Objective

This retrospective study was designed to assess the impact of corpus callosotomy (CC) in patients with intractable West syndrome (WS) without lesions on magnetic resonance imaging (MRI).

Methods

This study involved 56 patients with WS who underwent CC between January 2000 and December 2014. Seizure outcomes and changes in psychomotor development were analyzed.

Results

Mean age at the onset of epilepsy and at the time of CC was 5.1 and 22.6 months, respectively. Mean duration of epilepsy before CC was 17.6 months. Video‐electroencephalography (EEG) monitoring showed ...

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Epilepsy surgery in Panama: Establishment of a successful hybrid program as a model for small middle‐income countries

Summary

Objective

The majority of the 65 million people worldwide with epilepsy live in low‐ and middle‐income countries. Many of these countries have inadequate resources to serve the large patient population affected by epilepsy. Panama is a middle‐income country that currently has only 2 facilities that can provide basic epilepsy services and no epilepsy surgery services. To address this need, a group of Panamanian physicians partnered with U.S. epilepsy health care providers to test a hybrid epilepsy surgery program, combining resources and ...

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Response to treatment schedules after the first antiepileptic drug failed

Summary

Objective

After the failure of the first antiepileptic drug (AED) at doses > 50% defined daily dose (DDD), there are three options for patients with epilepsy: combination therapy, alternative therapy, and increased dosage of the first AED. However, present studies have not provided evidence for which option is best. Therefore, we conducted this retrospective observational cohort study to compare the effects of three treatment schedules.

Methods

Patients diagnosed with newly diagnosed epilepsy at the epilepsy clinic of West China Hospital between August 2006 ...

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Evolution and course of early life developmental encephalopathic epilepsies: Focus on Lennox‐Gastaut syndrome

Summary

Objectives

Developmental encephalopathic epilepsies (DEEs) are characterized by refractory seizures, disability, and early death. Opportunities to improve care and outcomes focus on West syndrome/infantile spasms (WS/IS). Lennox‐Gastaut syndrome (LGS) is almost as common but receives little attention. We examined initial presentations of DEEs and their evolution over time to identify risk and indicators of developing LGS.

Methods

Data are from the Connecticut Study of Epilepsy, a prospective, longitudinal study of 613 children with newly diagnosed epilepsy recruited in 1993‐1997. Central review of medical ...

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No latency to dentate granule cell epileptogenesis in experimental temporal lobe epilepsy with hippocampal sclerosis

Summary

Objective

To determine when spontaneous granule cell epileptiform discharges first occur after hippocampal injury, and to identify the postinjury “latent” period as either a “silent” gestational state of epileptogenesis or a subtle epileptic state in gradual transition to a more obvious epileptic state.

Methods

Nonconvulsive status epilepticus evoked by perforant path stimulation in urethane‐sedated rats produced selective and extensive hippocampal injury and a “latent” period that preceded the onset of the first clinically obvious epileptic seizures. Continuous granule cell layer depth recording and ...

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A novel GABAergic dysfunction in human Dravet syndrome

Summary

Objective

Dravet syndrome is a rare neurodevelopmental disease, characterized by general cognitive impairment and severe refractory seizures. The majority of patients carry the gene mutation SCN1A, leading to a defective sodium channel that contributes to pathogenic brain excitability. A γ‐aminobutyric acid (GABAergic) impairment, as in other neurodevelopmental diseases, has been proposed as an additional mechanism, suggesting that seizures could be alleviated by GABAergic therapies. However, up to now the physiological mechanisms underlying the GABAergic dysfunction in Dravet syndrome are still unknown ...

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