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Objective
Epilepsy management employs self‐reported seizure diaries, despite evidence of seizure underreporting. Wearable and implantable seizure detection devices are now becoming more widely available. There are no clear guidelines about what levels of accuracy are sufficient. This study aimed to simulate clinical use cases and identify the necessary level of accuracy for each.
Methods
Using...
Objective
Pediatric status epilepticus is one of the most frequent pediatric emergencies, with high mortality and morbidity. Utilizing electronic health records (EHRs) permits analysis of care approaches and disease outcomes at a lower cost than prospective research. However, reviewing EHR manually is time intensive. We aimed to compare refractory status epilepticus (rSE) cases identified by human...
Objective
Wrist‐ or ankle‐worn devices are less intrusive than the widely used electroencephalographic (EEG) systems for monitoring epileptic seizures. Using custom‐developed deep‐learning seizure detection models, we demonstrate the detection of a broad range of seizure types by wearable signals.
Methods
Patients admitted to the epilepsy monitoring unit were enrolled and asked to wear wearable...
Objective
This study was undertaken to develop consensus‐based recommendations for the management of adult and pediatric patients with new onset refractory status epilepticus (NORSE)/febrile infection‐related epilepsy syndrome (FIRES) based on best evidence and experience.
Methods
The Delphi methodology was followed. A facilitator group of nine experts was established, who defined the scope, users,...
Objective
To develop consensus‐based recommendations for the management of adult and pediatric patients with new‐onset refractory status epilepticus (NORSE)/febrile infection‐related epilepsy syndrome (FIRES) based on best available evidence and expert opinion.
Methods
The Delphi methodology was followed. A facilitator group of nine experts was established who defined the scope, users, and suggestions...
Objective
The aim of this study was to determine whether selection of treatment for children with infantile spasms (IS) varies by race/ethnicity.
Methods
The prospective US National Infantile Spasms Consortium database includes children with IS treated from 2012 to 2018. We examined the relationship between race/ethnicity and receipt of standard IS therapy (prednisolone, adrenocorticotropic hormone,...
Objective
This study was undertaken to evaluate benzodiazepine (BZD) administration patterns before transitioning to non‐BZD antiseizure medication (ASM) in pediatric patients with refractory convulsive status epilepticus (rSE).
Methods
This retrospective multicenter study in the United States and Canada used prospectively collected observational data from children admitted with rSE between 2011...
The Wearables for Epilepsy And Research (WEAR) International Study Group identified a set of methodology standards to guide research on wearable devices for seizure detection. We formed an international consortium of experts from clinical research, engineering, computer science, and data analytics at the beginning of 2020. The study protocols and practical experience acquired during the development...
Objective
This study was undertaken to describe long‐term clinical and developmental outcomes in pediatric refractory status epilepticus (RSE) and identify factors associated with new neurological deficits after RSE.
Methods
We performed retrospective analyses of prospectively collected observational data from June 2011 to March 2020 on pediatric patients with RSE. We analyzed clinical outcomes...
Objective
Tracking seizures is crucial for epilepsy monitoring and treatment evaluation. Current epilepsy care relies on caretaker seizure diaries, but clinical seizure monitoring may miss seizures. Wearable devices may be better tolerated and more suitable for long‐term ambulatory monitoring. This study evaluates the seizure detection performance of custom‐developed machine learning (ML) algorithms...
Objective
We aimed to characterize the clinical profile and outcomes of new onset refractory status epilepticus (NORSE) in children, and investigated the relationship between fever onset and status epilepticus (SE).
Methods
Patients with refractory SE (RSE) between June 1, 2011 and October 1, 2016 were prospectively enrolled in the pSERG (Pediatric Status Epilepticus Research Group) cohort. Cases...
Objective
Daytime and nighttime patterns affect the dynamic modulation of brain and body functions and influence the autonomic nervous system response to seizures. Therefore, we aimed to evaluate 24‐hour patterns of electrodermal activity (EDA) in patients with and without seizures.
Methods
We included pediatric patients with (a) seizures (SZ), including focal impaired awareness seizures (FIAS)...
Objective
Seizure forecasting may provide patients with timely warnings to adapt their daily activities and help clinicians deliver more objective, personalized treatments. Although recent work has convincingly demonstrated that seizure risk assessment is in principle possible, these early approaches relied largely on complex, often invasive setups including intracranial electrocorticography, implanted...
Objective
Treatments for convulsive status epilepticus (SE) have a wide range of effectiveness. The estimated effectiveness of non‐intravenous benzodiazepines (non‐IV BZDs) ranges from approximately 70% to 90% and the estimated effectiveness of non‐benzodiazepine antiseizure medications (non‐BZD ASMs) ranges from approximately 50% to 80%. This study aimed to quantify the clinical and economic burden...
Objectives
Photoplethysmography (PPG) reflects variations of blood perfusion in tissues, which may signify seizure‐related autonomic changes. The aim of this study is to assess the variability of PPG signals and their value in detecting peri‐ictal changes in patients with focal impaired awareness seizures (FIASs).
Methods
PPG data were recorded using a wearable sensor placed on the wrist or ankle...
Objective
Photoplethysmography (PPG) is an optical technique measuring variations of blood perfusion in peripheral tissues. We evaluated alterations in PPG signals in relationship to the occurrence of generalized tonic‐clonic seizures (GTCSs) in patients with epilepsy to evaluate the feasibility of seizure detection.
Methods
During electroencephalographic (EEG) long‐term monitoring, patients wore...
Objective
Describe hospital readmission for status epilepticus (SE) in the United States, and study potential risk factors for readmission.
Methods
This is a retrospective observational study using the Healthcare Cost and Utilization Project's 2016 Nationwide Readmissions Database. We studied patients of all ages admitted to the hospital due to SE.
Results
We included 32 327 patients admitted...
Objective
To determine risk factors and causes for mortality during childhood in patients with infantile spasms (IS). We describe the overall goals of care for those who died.
Methods
This is a retrospective chart review of IS patients born between 2000 and 2011. We examined potential risk factors for mortality, including etiology, neurologic impairment, medication use, persistence of epileptic...
Objective
Sudden unexpected death in epilepsy (SUDEP) is an important cause of mortality in epilepsy. However, there is a gap in how often providers counsel patients about SUDEP. One potential solution is to electronically prompt clinicians to provide counseling via automated detection of risk factors in electronic medical records (EMRs). We evaluated (1) the feasibility and generalizability of using...
Objective
Several small case series identified KCTD7 mutations in patients with a rare autosomal recessive disorder designated progressive myoclonic epilepsy (EPM3) and neuronal ceroid lipofuscinosis (CLN14). Despite the name KCTD (potassium channel tetramerization domain), KCTD protein family members lack predicted channel domains. We sought to translate insight gained from yeast studies to uncover...
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