Increasing Blurriness of the Borders Between Focal and Generalized as Well as Cryptogenic and Idiopathic Epilepsies in Defining the Role for Focal Epilepsy Surgery

This case studies issue includes 2 excellent, intriguing case reports. The title of the case report by Wirrell is a little confusing, as following the surgical workup, no surgery ensued once the diagnosis of the syntaxin binding protein 1 gene c901delC mutation had been made. Thorough workup to that point had localized fairly well the seizures to be arising from the left temporoparietal region. In view of the genetic diagnosis and good response to vigabatrin, he was not considered to be a surgical candidate. However with recent, rapid advances in diagnosing genetic diseases in not just epilepsy but numerous disorders, many previously cryptogenic (or unknown cause) cases now have a genetic etiology. Indeed, successful temporal lobectomies have been performed in 2 patients (one with hippocampal sclerosis and one without) with SCN1B mutations and temporal lobe epilepsy phenotypes, with them both becoming seizure free. Certainly a genetic diagnosis of an idiopathic (or genetic) epilepsy currently would make one think twice about performing focal epilepsy surgery; however, it should not be a complete contraindication, and I believe many more focal epilepsy surgeries will be performed successfully in these patients as increasingly more genetic mutations are discovered. We all certainly hope this reported case of the young boy׳s seizures remain controlled; however, should they become refractory, he may still be cured of epilepsy by a tailored left temporoparietal focal resection.
Source: Seminars in Pediatric Neurology - Category: Neurology Authors: Source Type: research

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Publication date: Available online 22 February 2020Source: SeizureAuthor(s): Pornchai Sathirapanya, Amika Praipanapong, Chanon Kongkamol, Pensri ChongphattararotAbstractPurposeTo identify the predictors of seizure recurrence after a first seizure (FS) presentation to an emergency service.MethodsThe clinical characteristics of FS patients presenting to the emergency department (ED) of our university hospital from January 2001 to December 2014 were retrospectively reviewed. Recurrence of seizures following the FS was classified as: early recurrence (0-1 month), intermediate recurrence (>1-3 months), and late recurrence (&...
Source: Seizure - Category: Neurology Source Type: research
ConclusionsSeizure semiology is heterogeneous in pure insular-onset epilepsy. Differences between the anterior and posterior insular seizures reflect the functional organization of the insula. Particularly, the different types of motor symptoms may help to distinguish anterior from posterior insular seizure onset.
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
In this study, we determined the efficacy of ACTON PROLONGATUM® (AP; Ferring Pharmaceuticals) in comparison with Acthar® Gel (Mallinckrodt) and full 39 amino-acid rat ACTH molecule (Genscript) in the rodent model of IS consisting of prenatal priming with betamethasone and repeated postnatal trigger of spasms with N-methyl-d-aspartate. Treatment with these ACTH varieties was given on postnatal days (P)12, P13, and P14 in a prospective test (treatment onset on P12 AFTER induction of spasms). Two independent arms were investigated: subcutaneous (SC) and intramuscular (IM) deliveries that were evaluated separately. In ...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
Publication date: April 2020Source: Epilepsy &Behavior, Volume 105Author(s): Vivek Sabharwal, Mugilan Poongkunran, Murad Talahma, Ifeanyi O. Iwuchukwu, Eugene Ramsay, Fawad Khan, Uma Menon, Giuseppe Ciccotto, Namir Khandker, Harold McGradeAbstractBackgroundTherapeutic hypothermia as a potent nonpharmacologic antiseizure therapy has been investigated experimentally in animal models and humans. Although induced hypothermia has been shown to be neuroprotective in acute convulsive status epilepticus, whether its use will translate into improved outcomes for patients with super-refractory nonconvulsive status epilepticus (S...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
This study aimed to investigate the prevalence of psychogenic nonepileptic seizures (PNES) and PNES-epilepsy coexistence within all video-electroencephalography (EEG) monitoring unit (VEMU) referrals and to identify semiological and electrophysiological features to differentiate patients with PNES-epilepsy coexistence from PNES-only.MethodsWe retrospectively reviewed medical files, VEMU reports, and videos of 1983 adult patients. Demographical, historical, clinical, neuroimaging, and electrophysiological parameters of all patients were recorded. We classified patients into five groups as definite PNES-only, definite PNES-e...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
ConclusionsSeizure detection devices provide moderate or greater anxiety reduction among the majority of people with epilepsy and their caregivers, but current translatability into improvements in overall HR-QOL may be limited. Affordability and technological support are potential barriers to maximizing benefit equally among the epilepsy community. These considerations may be useful to help guide future device development and inform patient–clinician discussions on device usage and HR-QOL.
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
Publication date: April 2020Source: Epilepsy &Behavior, Volume 105Author(s): Kristine Lossius, Anne de Saint Martin, Sverre Myren-Svelstad, Marit Bjørnvold, Guro Minken, Caroline Seegmuller, Maria Paola Valenti Hirsch, Jamel Chelly, Ortrud Steinlein, Fabienne Picard, Eylert BrodtkorbAbstractObjectiveAutosomal dominant sleep-related hypermotor epilepsy (ADSHE) is characterized by hypermotor seizures and may be caused by gain-of-function mutations affecting the nicotinic acetylcholine receptor (nAChR). Benefit from nicotine consumption has been reported in adult patients with this disorder. For the first time, the...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
ConclusionsTaking lamotrigine IR tablets was associated with a greater probability of being GB and tended to cause more frequent switch problems than other AEDs in this cohort of patients. Six AEDs were associated with a reduced probability of being GB. The lower number of different generics for these six drugs may result in greater patient certainty in medication identity, due to greater consistency in medication color, shape, and size, and hence less generic skepticism or generic brittleness. Also, patients taking more AEDs showed increased odds of a switch problem.Graphical abstract
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
Publication date: Available online 21 February 2020Source: Biocybernetics and Biomedical EngineeringAuthor(s): Ashima Khosla, Padmavati Khandnor, Trilok ChandAbstractElectroencephalogram (EEG) measures the neuronal activities in the form of electric currents that are generated due to the synchronized activity by a group of specialized pyramidal cells inside the brain. The study presents a brief comparison of various functional neuroimaging techniques, revealing the excellent neuroimaging capabilities of EEG signals such as high temporal resolution, inexpensiveness, portability and non-invasiveness as compared to the other ...
Source: Biocybernetics and Biomedical Engineering - Category: Biomedical Engineering Source Type: research
The objective of this study is to determine prevalence and factors leading to verbal learning and memory dysfunction among patients with epilepsy.A total of 211 subjects were recruited. Their verbal memory was assessed by Rey’s Auditory Verbal Learning Test (RAVLT). This test was further subdivided into four major spheres for analysis, namely the verbal learning, interference list, immediate memory and delayed memory. All data collected were analyzed using Statistical Package for Social Sciences.Among the 211 patients, 55% (n = 116) had focal seizures and the remaining 45% (n = 95) had generalized...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
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