Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

Many seizing neonates fail to respond to first-line anticonvulsant medications. Phenobarbital, an allosteric modulator of GABA_A receptors, has low efficacy in treating neonatal seizures and causes neuronal apoptosis. Yet, it is one of the most used anticonvulsants in this age group. In neonatal mice, phenobarbital’s poor effectiveness is due in part to high intraneuronal chloride concentration, which causes GABA to exert depolarizing actions. Therefore, another approach to treat neonatal seizures could be to use anticonvulsants that do not rely on ...

Abstract

Abstract

Objective

Epilepsy monitoring unit (EMU) admissions are critical for presurgical evaluation of drug-resistant epilepsy but may be non-diagnostic if an insufficient number of seizures are recorded. Seizure forecasting algorithms have shown promise for estimating the likelihood of seizures as a binary event in individual patients, but methods to predict how many seizures will occur remain elusive. Such methods could increase the diagnostic yield of EMU admissions and help patients mitigate seizure-related morbidity. Here, we evaluated the performance of a state-space method ...

Abstract

Objective

Epilepsy is characterized by spontaneous seizures that recur at unexpected times. Nonetheless, using years-long electroencephalographic (EEG) recordings, we previously found that patient-reported seizures consistently occur when interictal epileptiform activity (IEA) cyclically builds up over days. This multidien (multiday) interictal–ictal relationship, which is shared across patients, may bear phasic information for forecasting seizures, even if individual patterns of seizure timing are unknown. To test this rigorously in a large retrospective dataset, we pretrained algorithms on data recorded from a group of ...

Abstract

Objective

Prolonged postictal generalized electroencephalographic suppression (PGES) is a potential biomarker for sudden unexpected death in epilepsy (SUDEP), which may be associated with dysfunctional autonomic responses and serotonin signaling. To better understand molecular mechanisms, PGES duration was correlated to 5HT1A and 5HT2A receptor protein expression and RNAseq from resected hippocampus and temporal cortex of temporal lobe epilepsy patients with seizures recorded in preoperative evaluation.

Methods

Analyses included 36 cases (age = 14–64 years, age at epilepsy onset = 0–51 years, epilepsy duration = 2–53 years, PGES duration = 0–93 s), with 13 cases in all ...

Abstract

Posttraumatic epilepsy (PTE) is a well-known chronic complication following traumatic brain injury (TBI). Despite some evidence that age at the time of injury may influence the likelihood of PTE, the incidence of PTE in pediatric populations remains unclear. We therefore conducted a systematic review to determine the overall reported incidence of PTE, and explore potential risk factors associated with PTE after pediatric TBI. A comprehensive literature search of the PubMed, Embase, and Web of Science databases was conducted, including randomized ...

Abstract

Objective

Lacosamide is increasingly being prescribed to pregnant women, although its effects on the developing fetus have not been fully clarified yet. Previously, we have shown that several antiseizure medications, particularly valproate, can affect the expression of carriers of essential compounds in placental cells. Here, our aim was to assess the effect of short ex vivo exposure of human placentas to lacosamide on the expression of carriers of essential nutrients required by the human fetus.

Methods

Placentas were obtained from cesarean deliveries of ...

Abstract

Surgery can cure or significantly improve both the frequency and the intensity of seizures in patients with medication-refractory epilepsy. The set of diagnostic and therapeutic interventions involved in the path from initial consultation to definitive surgery is complex and includes a multidisciplinary team of neurologists, neurosurgeons, neuroradiologists, and neuropsychologists, supported by a very large epilepsy-dedicated clinical architecture. In recent years, new practices and technologies have emerged that dramatically expand the scope of interventions performed. Stereoelectroencephalography has become widely adopted for ...

Abstract

Objective

With the advent of ultra-long-term recordings for monitoring of epilepsies, the interpretation of results of isolated EEG recordings covering only selected brain regions attracts considerable interest. In this context, the question arises whether detected ictal EEG patterns correspond to clinically manifest seizures or rather to purely electrographic events, i.e. subclinical events.

Methods

The analysis of EEG patterns from 268 clinical seizures and 252 subclinical electrographic events from 50 patients undergoing video-EEG monitoring. Features extracted included predominant frequency band, duration, association with rhythmic ...

Abstract

Objective

Many early-onset epilepsies present as Developmental and Epileptic Encephalopathy associating refractory seizures, altered psychomotor development and disorganized interictal cortical activity. Abnormal upregulation of specific NMDA receptor subunits is being disentangled as one of the mechanisms of severe early-onset epilepsies. In Tuberous sclerosis complex, upregulation of the GluN2C subunit of the NMDA receptor with slow deactivation kinetic results in increased neuronal excitation and synchronization.

Methods

Starting from an available GluN2C/D antagonist, NMDA receptor modulating compounds were developed and screened using a patch clamp ...