In‐hospital and home‐based long‐term monitoring of focal epilepsy with a wearable electroencephalographic device: Diagnostic yield and user experience

Abstract

Objective

The aim is to report the performance of an electroencephalogram (EEG) seizure-detector algorithm on data obtained with a wearable device (WD) in patients with focal refractory epilepsy and their experience.

Methods

Patients used a WD, the Sensor Dot (SD), to measure two channels of EEG using dry electrode patches during presurgical evaluation and at home for up to 8 months. An automated seizure detection algorithm flagged EEG regions with possible seizures, which we reviewed to evaluate the algorithm’s diagnostic yield. In addition, we ...

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Preclinical pharmacokinetics and tolerability of a novel meglumine‐based parenteral solution of topiramate and topiramate combinations for treatment of status epilepticus

Abstract

Objective

For an anti-seizure medication (ASM) to be effective in status epilepticus (SE), the drug should be administered intravenously (i.v.) to provide quick access to the brain. However, poor aqueous solubility is a major problem in the development of parenteral drug solutions. Given its multiple mechanisms of action, topiramate (TPM) is a promising candidate for the treatment of established or refractory SE, as supported by clinical studies using nasogastric tube TPM administration. However, TPM is not clinically available as a solution ...

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History of FAME/BAFME around the world

Abstract

FAME/BAFME (Familial adult myoclonus epilepsy/Benign adult familial myoclonic epilepsy) has emerged as specific and recognizable epilepsy syndrome with autosomal dominant inheritance found around the world. Here, we trace the history of this syndrome. Initially it was likely conflated with other familial myoclonus epilepsies, especially the progressive myoclonus epilepsies. As the progressive myoclonus epilepsies became better understood clinically and genetically, this group began to stand out and was first recognized as such in Japan. Subsequently, families were recognized around the world ...

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A retrospective non‐interventional study evaluating the pharmacokinetic interactions between cenobamate and clobazam

Abstract

Cenobamate is an antiseizure medication (ASM) approved for treatment of partial onset seizures in adults. As both inductor and inhibitor of hepatic enzymes, cenobamate affects metabolism of other ASMs, amongst which is clobazam. To our knowledge, the extent of interaction between cenobamate and clobazam and its clinical significance have not been studied yet. In this retrospective study we assessed serum concentrations of clobazam and N- desmethylclobazam in 5 patients before and after co-medication with cenobamate and calculated the percentage increase ...

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Transcranial Direct Current Stimulation for Focal Status Epilepticus or Lateralized Periodic Discharges in Four Patients in a Critical Care Setting

Abstract

Objective

Transcranial direct current stimulation (tDCS) has been advocated for various neurological conditions, including epilepsy. A 1-4 mA cathodal current applied to the scalp over a seizure focus can reduce spikes and seizures. This series of four patients with focal status epilepticus is among the first case series to demonstrate benefit of tDCS in the critical care setting.

Methods

Patients in the intensive care unit were referred for tDCS treatment when focal status or clinically-relevant lateralized periodic discharges did not resolve with conventional ...

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Associations between testing and treatment pathways in lesional temporal or extratemporal epilepsy: A census survey of NAEC center directors

Abstract

Objective

The evaluation to determine candidacy and treatment for epilepsy surgery in persons with drug-resistant epilepsy (DRE) is not uniform. Many non-invasive and invasive tests are available to ascertain an appropriate treatment strategy. This study examines expert response to clinical vignettes of MRI-positive lesional focal cortical dysplasia in both temporal and extratemporal epilepsy to identify associations in evaluations and treatment choice.

Methods

We analyzed annual report data and a supplemental epilepsy practice survey reported in 2020 from 206 adult and 136 pediatric epilepsy ...

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A Core outcome set for childhood epilepsy treated with ketogenic diet therapy (CORE‐KDT study): international parent and health professional consensus

Abstract

Objective

Ketogenic diet therapy (KDT) can result in benefits (seizure and non-seizure related) for children with drug resistant epilepsy. However, clinical trials report a wide range of outcomes making synthesis of evidence difficult, and do not adequately reflect parent views on important outcomes for their child. To address this, we established the first international parent, health professional and researcher consensus to develop a core outcome set, guided by the Core Outcome Measures in Effectiveness Trials (COMET) Initiative (COMET registration #1116).

Methods

Ethical approval ...

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Putative roles for homeostatic plasticity in epileptogenesis

Abstract

Homeostatic plasticity allows neural circuits to maintain an average activity level while preserving the ability to learn new associations and efficiently transmit information. This dynamic process usually protects the brain from excessive activity, like seizures. However, in certain contexts, homeostatic plasticity might produce seizures, either in response to an acute provocation or more chronically as a driver of epileptogenesis. Here, we review three seizure conditions in which homeostatic plasticity likely plays an important role: acute drug withdrawal seizures, posttraumatic or ...

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How patients’ psycho‐social profiles contribute to decision‐making in epilepsy surgery: A prospective study

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, for example, lateralization and localization of seizure onset zones. Moreover, previous research shows associations with demographic factors, for example, 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 ...

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Childhood trauma in patients with epileptic vs nonepileptic seizures

Abstract

Objective

Childhood trauma has been implicated as a risk factor for the etiology of psychogenic nonepileptic seizures (PNES). Relatively little attention has been paid to whether profiles of specific trauma types differ between patients with epilepsy and PNES. Investigating childhood trauma profiles in these patient groups may identify psychological vulnerabilities that predispose to developing PNES, and aid early diagnoses, prevention, and treatment.

Methods

Data were collected from two cohorts (n
Retrospective = 203; n
Prospective = 209) admitted to video–electroencephalography (EEG) monitoring units in Melbourne Australia. The ...

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