Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Status epilepticus (SE) is a common, life-threatening neurologic emergency. Understanding population-level outcomes after SE requires a validated case definition, yet International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes of SE have not been well-validated in US populations since adoption in 2015. We aimed to determine whether the ICD-10-CM code-based definitions accurately identify SE in the in-hospital setting. The population included all ages (excluding neonates) admitted to a Mount Sinai Health System (MSHS) intensive care unit (ICU) in 2019. ...

Abstract

Objective

Vitamin D has demonstrated potential anticonvulsant effects in experimental and pilot clinical studies; the results of these remain inconclusive. This study aims to investigate the efficacy and safety of adjunctive Vitamin D supplementation in reducing seizure frequency, modulating vitamin D receptor (VDR) activity, and altering the putative biomarkers of epileptogenesis in persons with drug-resistant epilepsy (DRE).

Methods

This double-blind, placebo-controlled, parallel-group, adjunctive trial recruited patients from a tertiary care hospital in India. Adult persons with DRE and serum Vitamin D levels <30 ng/mL, ...

Abstract

Rationale

Data on weight changes associated with Cenobamate (CNB) in patients with epilepsy is scarce. We performed a case-control study because of concern for clinically significant weight loss.

Methods

All patients exposed to CNB between its May in February 2020 until October 2023 with at least 180 days of exposure were evaluated. Baseline weight was assessed as the closest within 90 days prior to initiation of CNB. Trough and peak weights during CNB exposure and concomitant antiseizure medications (ASMs) were obtained.

Results

A total of 332 patients ...

Abstract

Epilepsy is a chronic neurological condition marked by recurrent, uncontrolled seizures. Identifying comorbidities in epilepsy is critical for preventing mortality. Among these, the autonomic nervous system’s role in epilepsy often manifests as cardiac disorders. Patients with epilepsy (PWE), particularly those with poorly controlled seizures, have a higher prevalence of cardiac pathologies compared to the general population. Investigating the connection between seizures and cardiac deaths is crucial for addressing seizure-related cardiac complications. Notably, 80% of individuals with epilepsy exhibit cardiovascular comorbidities, ...

Abstract

Cardiovascular impairment in people with epilepsy (PWE) has been attracting medical interest. This study investigated the myocardial strain of the four cardiac chambers of individuals with temporal lobe epilepsy, without known heart disease, compared to an age-, sex-, and body mass index-matched control group. Eighty-six individuals (43 with epilepsy and 43 controls) underwent clinical evaluation, electrocardiography, and transthoracic echocardiography. Individuals with epilepsy had reduced left ventricular ejection fraction (p = .001), left ventricular longitudinal strain (p = .011), right ventricular strain (p = .024), left atrial ...

Abstract

Objective

De novo somatic mutations in mTOR pathway genes during fetal development lead to focal malformation of cortical development (FMCD) and epilepsy. This FMCD is characterized by misplacement of enlarged pyramidal neurons displaying increased mTOR activity. Whether these neurons display enhanced excitability has remained an open question. Several lines of evidence in experimental murine FMCD suggest that FMCD neurons display a complex set of alterations, including dendrite hypertrophy associated with decreased rheobase but opposing changes in excitability due to the abnormal ...

Abstract

Objective

This study was undertaken to investigate the concordance between magnetoencephalographic (MEG) and interictal stereoelectroencephalographic (SEEG) high-frequency oscillations (HFOs) and their impact on surgical outcomes.

Methods

Thirty focal epilepsy patients who underwent SEEG and resection surgery were selected for HFO time-lag analysis. HFOs were automatically extracted from SEEG recordings to determine their time stamps. The difference of first HFO stamp between each channel was calculated, and a matrix was built based on the time differences. Channels with time differences exceeding the threshold were ...

Abstract

Objective

Drug-resistant focal epilepsy is associated with abnormalities in the brain in both gray matter (GM) and superficial white matter (SWM). However, it is unknown if both types of abnormalities are important in supporting seizures. Here, we test if surgical removal of GM and/or SWM abnormalities relates to post-surgical seizure outcome in people with temporal lobe epilepsy (TLE).

Methods

We analyzed structural imaging data from 143 patients with TLE (pre-op diffusion magnetic resonance imaging and pre-op T1-weighted MRI) and 97 healthy controls. We ...

Abstract

Objective

To evaluate the ability of magnetoencephalography (MEG) to detect the activity of a deep brain structure, particularly the hippocampus, using simultaneous stereotactic electroencephalography (SEEG) and MEG recordings.

Methods

We included six patients with intractable temporal lobe epilepsy who underwent simultaneous SEEG and MEG. We recorded SEEG spikes and examined the MEG waveforms. We defined S-MEG spikes as MEG spikes synchronized with SEEG spikes in the deep brain structures. We examined the proportion of S-MEG spikes relative to SEEG spikes, the amplitude of ...