Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

This study was undertaken to better understand the long-term palliative and disease-modifying effects of surgical resection beyond seizure freedom, including frequency reduction and both late recurrence and remission, in patients with drug-resistant epilepsy.

Methods

This retrospective database-driven cohort study included all patients with >9 years of follow-up at a single high-volume epilepsy center. We included patients who underwent lobectomy, multilobar resection, or lesionectomies for drug-resistant epilepsy; we excluded patients who underwent hemispherectomies. Our main outcomes were (1) reduction in frequency of disabling seizures ...

Abstract

Objective

Interictal spikes help localize seizure generators as part of surgical planning for drug-resistant epilepsy. However, there are often multiple spike populations whose frequencies change over time, influenced by brain state. Understanding state changes in spike rates will improve our ability to use spikes for surgical planning. Our goal was to determine the effect of sleep and seizures on interictal spikes, and to use sleep and seizure-related changes in spikes to localize the seizure-onset zone (SOZ).

Methods

We performed a retrospective analysis of ...

Abstract

Objective

The high seizure burden seen in WHO grade 2 gliomas is well documented. This study aims to identify factors which influence the probability of seizure freedom (12 months of seizure remission) and treatment failure (ASM cessation or introduction of an alternative) in patients with WHO grade 2 glioma.

Methods

This is a retrospective observational analysis of patients from a regional UK neurosurgical centre with histologically proven (n=146) WHO grade 2 glioma and brain tumour related epilepsy. Statistical analyses using both Kaplan-Meier and ...

Abstract

Objectives

To refine the spectrum of SCN1A-epileptic disorders other than Dravet syndrome (DS) and genetic epilepsy with febrile seizures plus (GEFS+) and optimize anti-seizure management by correlating phenotype-genotype relationship and functional consequences of SCN1A variants in a cohort of patients.

Methods

Sixteen probands carrying SCN1A pathogenic variants were ascertained via a national collaborative network. We also performed a literature review including individuals with SCN1A variants causing non-DS and non-GEFS+ phenotypes and compared the features of the two cohorts. Whole-cell patch-clamp experiments were performed ...

Abstract

Objective

To describe the temporal trends in the cost and use of adrenocorticotropic hormone (ACTH), oral prednisolone, and vigabatrin, the first-line treatments for infantile epileptic spasms syndrome (IESS).

Methods

Retrospective observational study using the MarketScan Commercial database from 2006 to 2020. We identified patients with IESS diagnosed between birth and 18 months of age who received at least one of the first-line treatments within 60 days of diagnosis. Costs were adjusted for inflation using the Gross Domestic Product Implicit Price Deflator.

Results

1,131 patients received at ...

Abstract

Objective

Identifying factors associated with surgical decision making is important to understand reasons for underutilization of epilepsy surgery. Neurologists’ recommendations for surgery and patients’ acceptance of these recommendations depend on clinical epilepsy variables, e.g., lateralization and localization of seizure onset zones. Moreover, previous research shows associations with demographic factors, e.g., age and sex. Here, we investigate the relevance of patients’ psycho-social profile for surgical decision making.

Methods

We prospectively studied 296 patients from two large German epilepsy-centers. Multiple logistic regression analyses were used ...

Abstract

Objective

Traumatic brain injury (TBI) and stroke are well-known causes of acquired epilepsy. TBI is also a risk factor for stroke, and injury-induced stroke may indirectly convey a proportion of the epilepsy risk following TBI. We studied the extent to which the effect of TBI on epilepsy operated through intermediary stroke.

Methods

We analyzed a nationwide, matched, register-based cohort of adults ≥$$ ge $$ 40 years of age whose first TBI at Danish hospitals was recorded between 2004 and 2016. A matched reference population ...

Abstract

Objective

We aim to quantify whole-brain tissue-property changes in patients with magnetic resonance imaging (MRI)–negative pharmacoresistant focal epilepsy by three-dimensional (3D) magnetic resonance fingerprinting (MRF).

Methods

We included 30 patients with pharmacoresistant focal epilepsy and negative MRI by official radiology report, as well as 40 age- and gender-matched healthy controls (HCs). MRF scans were obtained with 1 mm³ isotropic resolution. Quantitative T1 and T2 relaxometry maps were reconstructed from MRF and registered to the Montreal Neurological Institute (MNI) space. A two-sample t test was ...

Abstract

Objective

The pharmacokinetics of oral diazepam are affected by food, but food-effect studies have not been conducted for diazepam nasal spray because it is believed that most absorption occurs via the nasal mucosa. However, gastrointestinal side effects reported with nasal diazepam suggest that at least a portion of the drug may be absorbed enterally and thus subject to food effects. The objective of this study was to evaluate the possible effects of food on the pharmacokinetics of diazepam nasal spray in ...