Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

One in seven patients with focal epilepsy has a malformation of cortical development (MCD) as underlying cause. Understanding normal cortical development combined with knowledge of where, when, and what goes wrong in different types of MCD provides insight into the mechanisms of epileptogenesis. Three different steps can be distinguished in the development of the neocortex: proliferation, migration, and organization. These three steps occur at different locations, partly overlapping in time. In this review, we illustrate and correlate normal embryology to ...

Abstract

Objective(s)

Pregnancy in women with epilepsy is associated with adverse perinatal outcomes, but debate remains as to role of epilepsy or of prenatal antiseizure medication (ASM), or both. We aimed to investigate the association between maternal epilepsy and perinatal outcomes, and to explore the role of prenatal ASM exposure.

Methods

Retrospective population-based cohort study using linked routinely-collected health data (Scotland, 2009–2021). We included women with at least one singleton pregnancy. Our exposures included (1) maternal epilepsy, identified using International Classification of Diseases, Tenth ...

Abstract

Objective

Factors that can precipitate and/or prolong functional seizure events are often challenging to identify. We aimed to develop a methodology to investigate peri-ictal behaviors in subjects experiencing functional seizures and those around them in their home environment.

Methods

We conducted an iterative, four-phase process to develop a codebook for operationalizing peri-functional seizure behavior that involved observation of 37 functional seizures across 14 participants in the pre-ictal, ictal, and post-ictal phases. First, researchers reviewed and discussed the literature to devise a conceptual framework. ...

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 ...