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This review summarizes the findings obtained over the past 70 years on the fundamental mechanisms underlying generalized spike‐wave (SW) discharges associated with absence seizures. Thalamus and cerebral cortex are the brain areas that have attracted most of the attention from both clinical and experimental researchers. However, these studies have often favored either one or the other structure in...
Purpose: The metabolic and biochemical changes that occur during epileptogenesis remain to be determined. 18F‐Fluorodeoxyglucose positron emission tomography (FDG‐PET) and proton magnetic resonance spectroscopy (1H MRS) are noninvasive techniques that provide indirect information on ongoing pathologic changes. We, therefore, utilized these methods to assess changes in glucose metabolism and metabolites...
The role of N‐methyl‐d‐aspartate receptors (NMDARs) in the generation and maintenance of epileptic seizures has been widely investigated, however, little is known of possible separate roles played by NMDARs that contain different NR2 subunits. A better comprehension of how distinct NMDARs subtypes participate in seizure generation and/or diffusion may lead to the development of more targeted pharmacologic...
Purpose: Focal seizures are thought to reflect simultaneous activation of a large population of neurons within a discrete region of pathologic brain. Resective surgery targeting this focus is an effective treatment in carefully selected patients, but not all. Although in vivo recordings of single‐neuron (i.e., “unit”) activity in patients with epilepsy have a long history, no studies have examined...
Purpose: Secondarily generalized tonic–clonic seizure (SGTCS) may occur rarely in temporal lobe epilepsy (TLE), but SGTCS is the major risk factor for sudden death and for seizure‐related fatal injuries. Our aim was to investigate clinical factors associated with the occurrence of SGTCS in TLE by addressing two questions: (1) What clinical features differentiate patients with TLE who regularly had...
Purpose: Memory impairment is a common comorbidity in people with epilepsy‐associated malformations of cortical development. We studied spatial memory performance and hippocampal synaptic plasticity in an animal model of cortical dysplasia.
Methods: Embryonic day 17 rats were exposed to 2.25 Gy external radiation. One‐month‐old rats were tested for spatial recognition memory. After behavioral testing,...
Purpose: Many recent studies have reported the importance of high‐frequency oscillations (HFOs) in the intracerebral electroencephalography (EEG) of patients with epilepsy. These HFOs have been defined as events that stand out from the background. We have noticed that this background often consists itself of high‐frequency rhythmic activity. The purpose of this study is to perform a first evaluation...
The number of times that a published article is cited is one indicator of its scientific impact. An article is termed a “Citation Classic” once it has accumulated more than 400 citations. Trends in these highly cited works allow projection of future directions of high‐impact research within a field. Herein, we identified 89 articles in the field of epilepsy published in 35 different journals that...
Purpose: To better understand the nature of the focal spike‐wave discharges (FSWDs) and focally led generalized spike‐wave discharges (GSWDs) in typical childhood absence epilepsy (CAE) and by implication their nosologic and taxonomic significance.
Methods: Twenty‐four abnormal video‐electroencephalography (EEG) studies from 13 consecutive children with CAE and good response to appropriate antiepileptic...
The special requirements for a seizure detector suitable for everyday use in terms of cost, comfort, and social acceptance call for alternatives to electroencephalography (EEG)–based methods. Therefore, we developed an algorithm for automatic detection of generalized tonic–clonic (GTC) seizures based on sympathetically mediated electrodermal activity (EDA) and accelerometry measured using a novel...
Status epilepticus (SE) is associated with significant mortality and morbidity. A reliable prognosis may help better manage medical resources and treatment strategies. We examined the role of preexisting comorbidities on the outcome of patients with SE, an aspect that has received little attention to date. We prospectively studied incident SE episodes in 280 adults occurring over 55 months in our...
Purpose: C‐reactive protein (CRP) has been studied extensively in many noninflammatory neurologic conditions, but there has been little study of CRP in the context of seizures or epilepsy. The purpose of this study was to examine CRP concentrations in patients with refractory focal epilepsy who were undergoing video‐electroencephalography (EEG) monitoring compared with healthy controls, and CRP change...
Purpose: For a long time, antidepressants have been thought to possess proconvulsant properties. This assumption, however, remains controversial, since anticonvulsant effects have been attributed to certain antidepressants. To date, it remains unclear which antidepressants can be used for the treatment of depression in patients with epilepsy. In this respect, studies investigating the convulsant...
Purpose: Despite the consistent observation that γ‐aminobutyric acid A (GABAA) receptors mediate excitatory responses at perinatal stages, the role of the GABAergic system in the generation of neonatal epileptiform activity remains controversial. Therefore, we analyzed whether tonic and phasic GABAergic transmission had differential effects on neuronal excitability during early development.
Methods: ...
Purpose: Previous studies have suggested that cognitive tasks modulate (provoke or inhibit) the epileptiform electroencephalography (EEG) discharges (EDs) in patients with juvenile myoclonic epilepsy (JME). Their inhibitory effect was found to be especially frequent (64–90%). These studies arbitrarily defined modulation as a >100% increase or >50% decrease of the EDs compared with baseline,...
We aimed to characterize the seizure pattern during pregnancy in a large cohort of women with epilepsy (WWE) and identify possible predictors of seizure relapse during pregnancy. We recorded the antiepileptic drug (AED) use and seizure frequency for WWE during the prepregnancy month and pregnancy. The seizure profile was correlated with the clinical details and seizure type as abstracted from the...
We postulate that “system epilepsies” (SystE) are due to an enduring propensity to generate seizures of functionally characterized brain systems. Data supporting this hypothesis—that some types of epilepsy depend on the dysfunction of specific neural systems—are reviewed. The SystE hypothesis may drive pathophysiologic and clinical studies that can advance our understanding of epilepsies and can open...
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