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Objective
Bilateral tonic–clonic seizures with focal semiology or focal interictal electroencephalography (EEG) can occur in both focal and generalized epilepsy types, leading to diagnostic errors and inappropriate therapy. We investigated the prevalence and prognostic values of focal features in patients with idiopathic generalized epilepsy (IGE), and we propose a decision flowchart to distinguish...
Objective
This study was undertaken to conduct external validation of previously published epilepsy surgery prediction tools using a large independent multicenter dataset and to assess whether these tools can stratify patients for being operated on and for becoming free of disabling seizures (International League Against Epilepsy stage 1 and 2).
Methods
We analyzed a dataset of 1562 patients, not...
Phase 2 studies showed that focal seizures could be detected by algorithms using heart rate variability (HRV) in patients with marked autonomic ictal changes. However, wearable surface electrocardiographic (ECG) devices use electrode patches that need to be changed often and may cause skin irritation. We report the first study of automated seizure detection using a subcutaneously implantable cardiac...
Objective
The objective of this study was 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‐electroencephalographic long‐term...
Objective
Our primary goal was to measure the accuracy of fully automated absence seizure detection, using a wearable electroencephalographic (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...
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...
Objective
This study was undertaken to establish whether advanced workup including long‐term electroencephalography (LT‐EEG) and brain magnetic resonance imaging (MRI) provides an additional yield for the diagnosis of new onset epilepsy (NOE) in patients presenting with a first seizure event (FSE).
Methods
In this population‐based study, all adult (≥16 years) patients presenting with FSE in the...
Objective
The Salzburg criteria for nonconvulsive status epilepticus (NCSE) and the American Clinical Neurophysiology Society (ACNS) Standardized Critical Care EEG Terminology 2021 include a diagnostic trial with intravenous (IV) antiseizure medications (ASMs) to assess electroencephalographic (EEG) and clinical response as a diagnostic criterion for definite NCSE and possible NCSE. However, how...
This article provides recommendations on the minimum standards for recording routine (“standard”) and sleep electroencephalography (EEG). The joint working group of the International Federation of Clinical Neurophysiology (IFCN) and the International League Against Epilepsy (ILAE) developed the standards according to the methodology suggested for epilepsy‐related clinical practice guidelines by the...
Objective
To determine the duration of epileptic seizure types in patients who did not undergo withdrawal of antiseizure medication.
Methods
From a large, structured database of 11 919 consecutive, routine video‐electroencephalograpy (EEG) recordings, labeled using the SCORE (Standardized Computer‐Based Organized Reporting of EEG) system, we extracted and analyzed 2742 seizures. For each seizure...
Objective
Postictal generalized electroencephalography (EEG) suppression (PGES) is a surrogate marker of sudden unexpected death in epilepsy (SUDEP). It is still unclear which ictal phenomena lead to prolonged PGES and increased risk of SUDEP. Semiology features of generalized convulsive seizure (GCS type 1) have been reported as a predictor of prolonged PGES. Progressive slowing of clonic phase...
Objectives
High counts of averaged interictal epileptiform discharges (IEDs) are key components of accurate interictal electric source imaging (ESI) in patients with focal epilepsy. Automated detections may be time‐efficient, but they need to identify the correct IED types. Thus we compared semiautomated and automated detection of IED types in long‐term video‐EEG (electroencephalography) monitoring...
Objective
To evaluate the diagnostic performance of artificial intelligence (AI)–based algorithms for identifying the presence of interictal epileptiform discharges (IEDs) in routine (20‐min) electroencephalography (EEG) recordings.
Methods
We evaluated two approaches: a fully automated one and a hybrid approach, where three human raters applied an operational IED definition to assess the automated...
The objective of this clinical practice guideline is to provide recommendations on the indications and minimum standards for inpatient long‐term video‐electroencephalographic monitoring (LTVEM). The Working Group of the International League Against Epilepsy and the International Federation of Clinical Neurophysiology develop guidelines aligned with the Epilepsy Guidelines Task Force. We reviewed published...
Background and purpose
Antiseizure medications (ASMs) should be tailored to individual characteristics, including seizure type, age, sex, comorbidities, comedications, drug allergies, and childbearing potential. We previously developed a web‐based algorithm for patient‐tailored ASM selection to assist health care professionals in prescribing medication using a decision support application (https://epipick...
Objective
Imaging activated glutamate N‐methyl‐D‐aspartate receptor ion channels (NMDAR‐ICs) using positron emission tomography (PET) has proved challenging due to low brain uptake, poor affinity and selectivity, and high metabolism and dissociation rates of candidate radioligands. The radioligand [18F]GE‐179 is a known use‐dependent marker of NMDAR‐ICs. We studied whether interictal [18F]GE‐179...
Objective
To develop and validate a pragmatic algorithm that classifies seizure types, to facilitate therapeutic decision‐making.
Methods
Using a modified Delphi method, five experts developed a pragmatic classification of nine types of epileptic seizures or combinations of seizures that influence choice of medication, and constructed a simple algorithm, freely available on the internet. The algorithm...
The objective of this clinical practice guideline (CPG) is to provide recommendations for healthcare personnel working with patients with epilepsy on the use of wearable devices for automated seizure detection in patients with epilepsy, in outpatient, ambulatory settings. The Working Group of the International League Against Epilepsy (ILAE) and the International Federation of Clinical Neurophysiology...
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