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The identification of the epileptogenic zone (EZ) boundaries is crucial for effective focal epilepsy surgery. We verify the value of a neurophysiological biomarker of focal ictogenesis, characterized by a low‐voltage fast‐activity ictal pattern (chirp) recorded with intracerebral electrodes during invasive presurgical monitoring (stereoelectroencephalography [SEEG]). The frequency content of SEEG...
Objective
Determination of the real‐world performance of a health care system in the treatment of status epilepticus (SE).
Methods
Prospective, multicenter population‐based study of SE in Auckland, New Zealand (NZ) over 1 year, with data recorded in the EpiNet database. Focus on treatment patterns and determinants of SE duration and 30‐day mortality. The incidence, etiology, ethnic discrepancies,...
Objective
Recently, a deep learning artificial intelligence (AI) model forecasted seizure risk using retrospective seizure diaries with higher accuracy than random forecasts. The present study sought to prospectively evaluate the same algorithm.
Methods
We recruited a prospective cohort of 46 people with epilepsy; 25 completed sufficient data entry for analysis (median = 5 months). We used the...
Objective
Recent studies have identified brain somatic variants as a cause of focal epilepsy. These studies relied on resected tissue from epilepsy surgery, which is not available in most patients. The use of trace tissue adherent to depth electrodes used for stereo electroencephalography (EEG) has been proposed as an alternative but is hampered by the low cell quality and contamination by nonbrain...
Objective
This study was undertaken to determine whether hippocampal T2 hyperintensity predicts sequelae of febrile status epilepticus, including hippocampal atrophy, sclerosis, and mesial temporal lobe epilepsy.
Methods
Acute magnetic resonance imaging (MRI) was obtained within a mean of 4.4 (SD = 5.5, median = 2.0) days after febrile status on >200 infants with follow‐up MRI at approximately...
Febrile infection‐related epilepsy syndrome (FIRES) is a subset of new onset refractory status epilepticus (NORSE) that involves a febrile infection prior to the onset of the refractory status epilepticus. It is unclear whether FIRES and non‐FIRES NORSE are distinct conditions. Here, we compare 34 patients with FIRES to 30 patients with non‐FIRES NORSE for demographics, clinical features, neuroimaging,...
In patients with drug‐resistant epilepsy (DRE) who are not candidates for resective surgery, various thalamic nuclei, including the anterior, centromedian, and pulvinar nuclei, have been extensively investigated as targets for neuromodulation. However, the therapeutic effects of different targets for thalamic neuromodulation on various types of epilepsy are not well understood. Here, we present a...
Objective
Despite the general safety and efficacy of epilepsy surgery, there is evidence that epilepsy surgery remains underutilized. Although there are an increasing number of studies reporting epilepsy surgery in older adults, there is no consensus on whether epilepsy surgery is efficacious or safe for this population. Our objective was to systematically assess the efficacy as well as safety of...
Objective
Status epilepticus (SE) is the second most common neurological emergency in adults. Despite improvements in the management of acute neurological conditions over the last decade, mortality is still durably high. Because a gap has emerged between SE management based on clinical practice guidelines (CPGs) and actual clinical practice, we conducted a systematic review of CPGs, assessing their...
Objective
Although disparities have been described in epilepsy care, their contribution to status epilepticus (SE) and associated outcomes remains understudied.
Methods
We used the 2010–2019 National Inpatient Sample to identify SE hospitalizations using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM)/ICD‐10‐CM codes. SE prevalence was stratified by demographics...
Objective
Due to the high clinical heterogeneity of epilepsy, there is a critical need for novel metrics aimed at capturing its biological and phenotypic complexity. Frailty is increasingly recognized in various medical disciplines as a useful construct to understand differences in susceptibility to adverse outcomes. Here, we develop a frailty index (FI) for patients with epilepsy (PwE) and explore...
Objective
Infantile epileptic spasms syndrome (IESS) is a common and urgent diagnosis with seizure and nonseizure mimics. Evaluation with prolonged video–electroencephalography (EEG) can be time‐consuming and costly. This study investigated the use of EEG review of a single sleep–wake cycle to exclude IESS.
Methods
We retrospectively reviewed video‐EEG studies to rule out IESS in children between...
Objectives
Amygdala enlargement is detected on magnetic resonance imaging (MRI) in some patients with drug‐resistant temporal lobe epilepsy (TLE), but its clinical significance remains uncertain We aimed to assess if the presence of amygdala enlargement (1) predicted seizure outcome following anterior temporal lobectomy with amygdalohippocampectomy (ATL‐AH) and (2) was associated with specific histopathological...
Objective
Focal to bilateral tonic–clonic seizures (FBTCS) represent a challenging subtype of focal temporal lobe epilepsy (TLE) in terms of both severity and treatment response. Most studies have focused on regional brain analysis that is agnostic to the distribution of white matter (WM) pathways associated with a node. We implemented a more selective, edge‐wise approach that allowed for identification...
Objective
We have developed a novel method for estimating brain tissue electrical conductivity using low‐intensity pulse stereoelectroencephalography (SEEG) stimulation coupled with biophysical modeling. We evaluated the hypothesis that brain conductivity is correlated with the degree of epileptogenicity in patients with drug‐resistant focal epilepsy.
Methods
We used bipolar low‐intensity biphasic...
Objective
Cortical intracerebral electrical stimulation is an important tool for language mapping in the presurgical work‐up of patients with drug‐resistant focal epilepsy. Language mapping with stereo–electroencephalography (EEG) is usually performed by high‐frequency stimulations (HFS: 50 Hz), whereas low‐frequency stimulations (LFS: 1 Hz) are usually considered useful for primary cortices mapping...