Predictors and reasons for epilepsy patients to decline surgery: a prospective study.

Background: In patients with drug-resistant focal epilepsy, resective surgery is the most successful treatment option to achieve seizure freedom. However, a surprisingly high rate of patients declines their physicians' recommendation to undergo removal of the seizure focus or-if necessary-further video-EEG monitoring (VEM).

Methods: In this prospective study, consecutive patients in presurgical assessment with at least one scalp VEM between 2016 and 2018 were included.

Presurgical video-EEG monitoring with foramen ovale and epidural peg electrodes: a 25-year perspective.

Background: Epilepsy surgery cases are becoming more complex and increasingly require invasive video-EEG monitoring (VEM) with intracranial subdural or intracerebral electrodes, exposing patients to substantial risks. We assessed the utility and safety of using foramen ovale (FO) and epidural peg electrodes (FOP) as a next step diagnostic approach following scalp VEM.

Methods: We analyzed clinical, electrophysiological, and imaging characteristics of 180 consecutive patients that underwent FOP VEM between 1996 and 2021.

Surgery in intractable epilepsy-physicians' recommendations and patients' decisions.

Objectives: To identify demographic and clinical variables independently associated with patients' decisions against their physicians' recommendations for resective epilepsy surgery or further scalp video-EEG monitoring (sca-VEM), semi-invasive (sem-)VEM with foramen ovale and/or peg electrodes, and invasive (in-)VEM.

Methods: Consecutive patients, who underwent presurgical assessment with at least one sca-VEM between 2010 and 2014, were included into this retrospective analysis. Multivariate analysis was used to identify independent variables associated with patients' decisions.

Craniotomy Size for Subdural Grid Electrode Placement in Invasive Epilepsy Diagnostics.

Background: Traditionally, for subdural grid electrode placement, large craniotomies have been applied for optimal electrode placement. Nowadays, microneurosurgeons prefer patient-tailored minimally invasive approaches. Absolute figures on craniotomy size have never been reported.

The anticonvulsant lamotrigine enhances I in layer 2/3 neocortical pyramidal neurons of patients with pharmacoresistant epilepsy.

Alterations of the hyperpolarization activated nonselective cation current (I) are associated with epileptogenesis. Accordingly, the second-generation antiepileptic drug lamotrigine (LTG) enhances I in rodent hippocampus. We directly evaluated here whether LTG fails to enhance I in neocortical slices from patients with pharmacoresistant epilepsy.