Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

The term neurovascular unit (NVU) describes the structural and functional liaison between specialized brain endothelium, glial and mural cells, and neurons. Within the NVU, the blood-brain barrier (BBB) is the microvascular structure regulating neuronal physiology, immune cross-talk, and its properties adapt to brain aging. Here, we analyze a research framework where NVU dysfunction, caused by acute insults or disease progression in the aging brain, represents a converging mechanism underlying late-onset seizures or epilepsy and neurological or neurodegenerative sequelae. Alongside, seizure ...

Abstract

Objective

To evaluate the pharmacokinetics, safety, and tolerability of brivaracetam (BRV) as 15-min intravenous (IV) infusion and bolus (≤2-min injection).

Methods

EP0065 (ClinicalTrials.gov: NCT03405714) was a Phase 2, multicenter, open-label trial in patients ≥1 month to <16 years of age with epilepsy. Patients received up to 5 mg/kg/day BRV (not exceeding 200 mg/day). Enrollment was sequential by descending age, depending on safety review. Outcomes included BRV plasma concentrations before and after IV administration, treatment-emergent adverse events (TEAEs), and discontinuations due to TEAEs.

Results

Fifty patients were enrolled, received BRV, ...

Abstract

Objective

Neuroimaging and genetic testing have been proposed for diagnostic evaluation of infantile spasms (IS), establishing etiology in ~60% of multicenter IS cohorts. A retrospective analysis of the yield of diagnostic etiology following an institutionally established guideline for investigation/treatment of IS was conducted, and the association between etiological subgroups and sustained response to standard treatment was evaluated.

Methods:

Etiology of IS, neuroimaging, and genetic results were extracted from clinical records. Etiology was categorized as acquired or non-acquired, the latter including syndromic patients, non-syndromic ...

Summary

Objective

To evaluate the accuracy of a semiautomated classification of nocturnal seizures using a hybrid system consisting of an artificial intelligence-based algorithm, which selects epochs with potential clinical relevance to be reviewed by human experts.

Methods

Consecutive patients with nocturnal motor seizures admitted for video-EEG long-term monitoring (LTM) were prospectively recruited. We determined the extent of data reduction by using the algorithm, and we evaluated the accuracy of seizure-classification from the hybrid system compared with the gold standard of LTM.

Results

Forty consecutive patients (24 ...

Abstract

Objective

Global action for epilepsy requires information on the cost of epilepsy, which is currently unknown for most countries and regions of the world. To address this knowledge gap, the International League Against Epilepsy Commission on Epidemiology formed the Global Cost of Epilepsy Task Force.

Methods

We completed a systematic search of the epilepsy cost-of-illness literature and identified studies that provided a comprehensive set of direct health care and/or indirect costs, followed standard methods of case identification and cost estimation, and used data ...

Abstract

Objective

To evaluate direct user experience with wearable seizure detection devices in the home environment.

Methods

A structured online questionnaire was completed by 242 users (175 caregivers and 67 persons with epilepsy), most of the patients (87.19%) having tonic–clonic seizures.

Results

The vast majority of the users were overall satisfied with the wearable device, considered that using the device was easy, and agreed that the use of the device improved their quality of life (median = 6 on 7-point Likert scale). A high retention rate ...

Abstract

Objective

This study was undertaken to quantify epilepsy-related costs of illness (COI) in Germany and identify cost-driving factors.

Methods

COI were calculated among adults with epilepsy of different etiologies and severities. Multiple regression analysis was applied to determine any epilepsy-related and sociodemographic factors that serve as cost-driving factors.

Results

In total, 486 patients were included, with a mean age of 40.5 ± 15.5 years (range = 18–83 years, 58.2% women). Mean 3-month COI were estimated at €4911, €2782, and €2598 for focal, genetic generalized, and unclassified epilepsy, respectively. The ...

Abstract

Objective

As a key member of the transient receptor potential (TRP) superfamily, TRP canonical 3 (TRPC3) regulates calcium homeostasis and contributes to neuronal excitability. Ablation of TRPC3 lessens pilocarpine-induced seizures in mice, suggesting that TRPC3 inhibition might represent a novel antiseizure strategy. Among current TRPC3 inhibitors, pyrazole 3 (Pyr3) is most selective and potent. However, Pyr3 only provides limited benefits in pilocarpine-treated mice, likely due to its low metabolic stability and potential toxicity. We recently reported a modified pyrazole compound 20 (or JW-65) ...

Abstract

Objective

Epilepsy is common in patients with PIGN diseases due to biallelic variants; however, limited epilepsy phenotyping data have been reported. We describe the epileptology of PIGN encephalopathy.

Methods

We recruited patients with epilepsy due to biallelic PIGN variants and obtained clinical data regarding age at seizure onset/offset and semiology, development, medical history, examination, electroencephalogram, neuroimaging, and treatment. Seizure and epilepsy types were classified.

Results

Twenty six patients (13 female) from 26 families were identified, with mean age 7 years (range = 1 month to 21 years; three ...

Summary

Objective

Our primary goal was to measure the accuracy of fully automated absence seizure detection, using a wearable EEG device. As a secondary goal, we also tested the feasibility of automated behavioral testing triggered by the automated detection.

Methods

We conducted a phase-3 clinical trial (NCT04615442), with a prospective, multicenter, blinded study design. The input was the one-channel EEG recorded with dry electrodes embedded into a wearable headband device connected to a smartphone. The seizure detection algorithm was developed using artificial intelligence (convolutional ...