Seizures and memory impairment induced by patient‐derived anti‐N‐methyl‐D‐aspartate receptor antibodies in mice are attenuated by anakinra, an interleukin‐1 receptor antagonist

Abstract

Objective

Neuroinflammation associated with anti‐N‐methyl‐D‐aspartate receptor (NMDAR) encephalitis may facilitate seizures. We previously showed that intraventricular administration of cerebrospinal fluid from patients with anti‐NMDAR encephalitis to mice precipitates seizures, thereby confirming that antibodies are directly pathogenic. To determine whether interleukin (IL)‐1‐mediated inflammation exacerbates autoimmune seizures, we asked whether blocking the effects of IL‐1 by anakinra, a selective IL‐1 receptor antagonist, blunts antibody‐induced seizures.

Methods

We infused C57BL/6 mice intraventricularly with purified serum IgG from patients with anti‐NMDAR encephalitis or monoclonal anti‐NMDAR IgG; subdural ...

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Relation between coffee consumption and risk of seizure‐related respiratory dysfunction in patients with drug‐resistant focal epilepsy

Abstract

Objective

Caffeine is an antagonist of the adenosine pathway, which is involved in regulation of breathing. Extracellular concentrations of adenosine are increased in the immediate aftermath of a seizure. Seizure‐related overstimulation of adenosine receptors might promote peri‐ictal apnea. However, the relation between caffeine consumption and risk of seizure‐related respiratory dysfunction in patients with drug‐resistant focal epilepsy remains unknown.

Methods

We performed a cross‐sectional analysis of data collected in patients included in the SAVE study in Lyon’s epilepsy monitoring unit at the Adult Epilepsy ...

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Diagnosing cognitive disorders in older adults with epilepsy

Abstract

Objective

To characterize the nature and prevalence of cognitive disorders in older adults with temporal lobe epilepsy (TLE) and compare their cognitive profiles to patients with amnestic mild cognitive impairment (ie, aMCI).

Methods

Seventy‐one older patients with TLE, 77 aMCI, and 69 normal aging controls (NACs), all 55‐80 years of age, completed neuropsychological measures of memory, language, executive function, and processing speed. An actuarial neuropsychological method designed to diagnose MCI was applied to individual patients to identify older adults with TLE who met diagnostic ...

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Seizure‐related deaths in children: The expanding spectrum

Abstract

Although seizures are common in children, they are often overlooked as a potential cause of death. Febrile and nonfebrile seizures can be fatal in children with or without an epilepsy diagnosis and may go unrecognized by parents or physicians. Sudden unexpected infant deaths, sudden unexplained death in childhood, and sudden unexpected death in epilepsy share clinical, neuropathological, and genetic features, including male predominance, unwitnessed deaths, death during sleep, discovery in the prone position, hippocampal abnormalities, and variants in genes regulating ...

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The ups and downs of alkyl‐carbamates in epilepsy therapy: How does cenobamate differ?

Abstract

Since 1955, several alkyl‐carbamates have been developed for the treatment of anxiety and epilepsy, including meprobamate, flupirtine, felbamate, retigabine, carisbamate, and cenobamate. They have each enjoyed varying levels of success as antiseizure drugs; however, they have all been plagued by the emergence of serious and sometimes life‐threatening adverse events. In this review, we compare and contrast their predominant molecular mechanisms of action, their antiseizure profile, and where possible, their clinical efficacy. The preclinical, clinical, and mechanistic profile of the prototypical ...

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Brief potentially ictal rhythmic discharges and paroxysmal fast activity as scalp electroencephalographic biomarkers of seizure activity and seizure onset zone

Abstract

Objective

The electroencephalographic (EEG) terms “brief potentially ictal rhythmic discharges” (BIRDs) and “paroxysmal fast activity” (PFA) are considered distinct entities; however, their definitions overlap, and they may have similar clinical significance. We investigated their clinical significance and their association with seizures and the seizure onset zone (SOZ).

Methods

We retrospectively identified an adult cohort (July 2015 to March 2018) whose long‐term (>12 h) EEGs in any setting reported BIRDs (>4 Hz, lasting .5–10 s) and/or PFA. Different frequency cutoffs for PFA (>13 Hz or ≥8 Hz) were tested ...

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Symptomatology of carbamazepine‐ and oxcarbazepine‐induced hyponatremia in people with epilepsy

Abstract

Objective

To ascertain whether adverse effects experienced by people taking carbamazepine or oxcarbazepine could be attributed to carbamazepine‐ or oxcarbazepine‐induced hyponatremia (COIH).

Methods

We performed an observational study, collecting data between 2017 and 2019 on serum sodium levels and adverse effects retrospectively in people with epilepsy while receiving treatment with either carbamazepine (CBZ) or oxcarbazepine (OXC). We defined hyponatremia as sodium level ≤134 mEq/L and severe hyponatremia as sodium level ≤128 mEq/L. Adverse effects experienced were compared between groups of individuals with and without hyponatremia.

Results

A ...

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Long‐term chemogenetic suppression of seizures in a multifocal rat model of temporal lobe epilepsy

Summary

Objective

One third of epilepsy patients do not become seizure‐free using conventional medication. Therefore, there is a need for alternative treatments. Preclinical research using designer receptors exclusively activated by designer drugs (DREADDs) has demonstrated initial success in suppressing epileptic activity. Here, we evaluated whether long‐term chemogenetic seizure suppression could be obtained in the intraperitoneal kainic acid rat model of temporal lobe epilepsy, when DREADDs were selectively expressed in excitatory hippocampal neurons.

Methods

Epileptic male Sprague Dawley rats received unilateral hippocampal injections of adeno‐associated ...

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