HLA typing in anti-GAD antibody associated epilepsy.

Objective: Anti-GAD65 antibodies have been identified in people with epilepsy for many years, but their pathophysiological relevance is still debated. Susceptibility to autoimmune disease has been associated with Human Leukocyte Antigen (HLA) subtypes. Therefore, this study aimed to determine if there are common HLA types in anti-GAD65 antibody associated epilepsy cases compared to epilepsy controls.

RESILIENCE (Retrospective Linkage Study of Autoimmune Encephalitis): protocol for an Australian retrospective cohort study of outcomes in autoimmune encephalitis using data linkage techniques.

Introduction: The autoimmune encephalitides (AE) are a heterogeneous group of neurological disorders with significant morbidity and healthcare costs. Despite advancements in understanding their pathophysiology, uncertainties persist regarding long-term prognosis and optimal management. This study aims to address these gaps, focusing on immunotherapeutic strategies, neoplastic associations and functional outcomes.

Uncovering language deficits in focal epilepsy: Beyond the limits of noun naming and verbal fluency.

Background: A range of language impairments have been reported in people with epilepsy both pre- and post-surgically, however language is not routinely comprehensively assessed in epilepsy clinics. When language is assessed, this is typically as part of a broader neuropsychological battery of assessment, often limited to tests of noun naming and/or verbal fluency, despite evidence to suggest these tests are not sufficiently sensitive to detect the often-subtle deficits present in chronic focal epilepsy. Many areas of language function, including the production of connected speech, have also not been adequately explored in this population, and research relating to subjective report of language and communication difficulties is limited.

The network is more important than the node: stereo-EEG evidence of neurocognitive networks in epilepsy.

Introduction: Neuropsychological assessment forms an integral part of the presurgical evaluation for patients with medically refractory focal epilepsy. Our understanding of cognitive impairment in epilepsy is based on seminal lesional studies that have demonstrated important structure-function relationships within the brain. However, a growing body of literature demonstrating heterogeneity in the cognitive profiles of patients with focal epilepsy (e.

Stereoelectroencephalography: a review of complications and outcomes in a new Australian centre.

Background: Surgical management of refractory focal epilepsy requires preoperative localisation of the epileptogenic zone (EZ). To augment noninvasive studies, stereoelectroencephalography (SEEG) is being increasingly adopted as a form of intracranial monitoring.

Aims: This study aimed to determine the rate of complications for patients undergoing SEEG and to report the success of SEEG with regard to EZ detection and seizure outcome following definitive surgery.

Phase II randomised placebo-controlled trial of sodium selenate as a disease-modifying treatment in chronic drug-resistant temporal lobe epilepsy: the SeLECT study protocol.

Introduction: Epilepsy is one of the most common neurological conditions worldwide. Despite many antiseizure medications (ASMs) being available, up to one-third of patients do not achieve seizure control. Preclinical studies have shown treatment with sodium selenate to have a disease-modifying effect in a rat model of chronic temporal lobe epilepsy (TLE).

The efficacy and tolerability of adjunctive brivaracetam for the treatment of adult epilepsy: An Australian multi-center retrospective real-world observational cohort study.

Objective: Assess the efficacy and tolerability of add-on therapy brivaracetam (BRV) in adult patients with epilepsy in a real-world setting.

Methods: This multi-center retrospective observational cohort study examined all adult patients who commenced on BRV at 11 Australian epilepsy centers between 2017 and 2020. Primary outcomes were seizure response (≥50% reduction in frequency) and seizure freedom 12 months post BRV commencement, and tolerability.

High-fidelity dendritic sodium spike generation in human layer 2/3 neocortical pyramidal neurons.

Dendritic spikes function as cardinal components of rodent neocortical circuit computations. Recently, the biophysical properties of human pyramidal neurons (PNs) have been reported to be divergent, raising the question of whether dendritic spikes have homologous roles in the human neocortex. To directly address this, we made electrical recordings from the soma and apical dendrites of human and rat layer 2/3 PNs of the temporal cortex.

Effect of immunotherapy on intracranial EEG in patients with seronegative autoimmune-associated epilepsy.

Objective: Immunity is increasingly implicated in the aetiology of certain types of epilepsy, however, the clinical and EEG features in such cases remain poorly defined. We present stereo-electroencephalography (SEEG) findings in patients who were thought to have autoantibody-mediated epilepsy on the basis of clinical improvement after administration of immunotherapy (IT).

Methods: All patients undergoing SEEG implantation in our service were reviewed and those receiving immunotherapy, either before, during, or after SEEG evaluation, were identified.

Potential new roles for glycogen in epilepsy.

Seizures often originate in epileptogenic foci. Between seizures (interictally), these foci and some of the surrounding tissue often show low signals with fluorodeoxyglucose (FDG) positron emission tomography (PET) in many epileptic patients, even when there are no radiologically detectable structural abnormalities. Low FDG-PET signals are thought to reflect glucose hypometabolism.

Impact of the first wave of COVID-19 on stroke admissions across three tertiary hospitals in Brisbane.

Background: COVID-19 has caused a global shift in healthcare-seeking behaviour; however, presentation rates with serious conditions, such as stroke in low COVID-19-prevalence cities, has received less attention.

Aims: To determine if there was a significant reduction in stroke admissions, delivery of acute reperfusion therapies, or increased delays to presentation during the first wave of the COVID-19 pandemic.

Methods: A multicentre, retrospective, observational cohort study was performed across three tertiary hospitals in Brisbane, Australia.

Autoimmune-Associated Seizures.

Purpose Of Review: This article focuses on the seizure manifestations and presentations of autoimmune-associated epilepsy and acute symptomatic seizures in autoimmune encephalitis. It discusses the specificity of the various central nervous system autoantibodies and clarifies when their presence can be considered indicative of an immune etiology. Finally, current recommendations regarding patient selection for autoimmune antibody evaluation are reviewed, and an approach to immunotherapy is provided.

What déjà vu and the "dreamy state" tell us about episodic memory networks.

Illusions of inappropriate familiarity with the current experience or hallucinatory recall of memories are reported in temporal lobe seizures. Pathophysiological hypotheses have been proposed, involving temporal limbic regions (Hughlings-Jackson), temporal neocortex ("interpretive cortex", Penfield), or both (Bancaud). Recent data acquired from presurgical investigations using intracerebral electrode recordings, demonstrate a critical role for the sub- and para-hippocampal cortices.

Discerning the Role of Autoimmunity and Autoantibodies in Epilepsy: A Review.

Importance: The literature on neural autoantibody positivity in epilepsy has expanded over the last decade, with an increased interest among clinicians in identifying potentially treatable causes of otherwise refractory seizures.

Observations: Prior studies have reported a wide range of neural autoantibody positivity rates among various epilepsy populations, with the highest frequency reported in individuals with focal epilepsy of unknown cause and new-onset seizures. The antibodies in some cases are of uncertain significance, and their presence can cause conundrums regarding therapy.

Cytokines as a marker of central nervous system autoantibody associated epilepsy.

Objective: Autoantibodies to central nervous system (CNS) antigens are increasingly identified in patients with epilepsy. Alterations in cytokines and chemokines have also been demonstrated in epilepsy, but this has not been explored in subjects with autoantibodies. If antibody positive and antibody negative subjects show a difference in immune activation, as measured by cytokine levels, this could improve diagnostic and therapeutic approaches, and provide insights into the underlying pathophysiology.

Intracranial EEG recording in autoimmune epilepsy dataset.

The appearance of seizures in autoimmune epilepsy on intracranial recordings has not been previously demonstrated. The following data shows a multifocal epilepsy in a patient with seronegative autoimmune epilepsy (reported here; "Electroclinical Insights into Autoimmune Epilepsy", Gillinder, 2019). Independent seizures were seen to arise from 5 separate foci.

Automatic detection of the epileptogenic zone: An application of the fingerprint of epilepsy.

Background: The successful delineation of the epileptogenic zone in epilepsy monitoring is crucial for achieving seizure freedom after epilepsy surgery.

New Method: We aim to improve epileptogenic zone localization by utilizing a computer-assisted tool for the automated grading of the seizure activity recorded in various locations for 20 patients undergoing stereo electroencephalography. Their epileptic seizures were processed to extract two potential biomarkers.

Short burst Clobazam dosing at discharge from VEEG evaluation reduces re-presentation with seizures.

Purpose: Recurrent seizures and status epilepticus after medication reduction for inpatient Video Electroencephalograph (VEEG) monitoring is a well-known complication of this investigation. In the literature this is reported to occur at a rate of approximately 3-7%. We review the use of short burst Clobazam dosing on discharge from the Epilepsy monitoring unit (EMU) to determine if this might reduce rates of representation with seizures.

Electroclinical insights into autoimmune epilepsy.

Purpose: Chronic autoimmune epilepsy is an increasingly recognised entity however its clinical and electrographic features remain poorly understood. We present a case undergoing diagnostic Stereo-electroencephalography implantation that was found to have a multifocal perisylvian epilepsy with unique electrographic features and is now seizure free with immunotherapy.

Methods: The patient had antibody negative refractory perisylvian epilepsy and underwent implantation of the perisylvian-temporal networks.

EEG findings in NMDA encephalitis - A systematic review.

Purpose: The clinical utility of EEG in cases of NMDA encephalitis is broad with many findings indicating not just epileptiform activity but also encephalopathy and potentially providing insights into pathophysiologic mechanisms of disease. We aimed to determine the frequency of different abnormalities described on EEG and their association with outcome in patients affected by NMDARE through a systematic review of all cases published.

Method: A systematic literature review of PubMed and Embase of all published cases of anti-NMDA receptor encephalitis with EEG results, was performed from inception to January 2018.

Refractory epilepsy secondary to anti-GAD encephalitis treated with DBS post SEEG evaluation: a novel case report based on stimulation findings.

We report a case of medically refractory anti-GAD encephalitis which was treated with deep brain stimulation (DBS) after seizure termination was achieved using cortical stimulation during stereo-electroencephalography (SEEG) evaluation. The patient underwent bilateral SEEG implantation and cortical stimulation. Upon stimulation, mimicking the intrinsic seizures (at 1 Hz), it was possible to induce seizures with typical semiology, on multiple attempts.