Effectiveness of transcranial direct current stimulation (tDCS) in treating drug-resistant focal epilepsy: A systematic review and meta-analysis.

Introduction Epilepsy is a prevalent neurological disorder globally, with about 30% of patients developing resistance despite optimal antiseizure drug therapies (ASD). Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation technique and offers a potential therapeutic alternative for drug-resistant focal epilepsy, aiming to reduce seizure frequency and improve patient quality of life. Methods Following PRISMA guidelines; a search was performed on MEDLINE, Web of Science, and Cochrane Library from inception to June 2024.

Central expression and peripheral levels of MMP-9 and TIMP-1 in patients with temporal lobe epilepsy.

Purpose: Thirty percent of epilepsy patients are drug-resistant (DR) and, in adults, temporal lobe epilepsy (TLE) is the most common form of DR- epilepsy. Patients with TLE exhibit a neuroinflammatory response associated with blood-brain barrier dysfunction. In this context, the main aim of our study was to evaluate peripheral levels and central expression of MMP-9 and TIMP-1 in TLE patients and assess their association with drug resistance and inflammatory markers.

Anxiety and depression in people with epilepsy during and one year after the COVID-19 pandemic.

Objective: Compare the prevalence and severity of anxiety and depression among people with epilepsy (PWE) evaluated by telemedicine during the initial stages of the COVID-19 pandemic and follow up on their status 15 months later.

Methods: We conducted a prospective, observational, and analytical study at the Epilepsy Clinic of the National Institute of Neurology and Neurosurgery (NINN) in Mexico City during the COVID-19 pandemic. HADS-A and HADS-D instruments were administered to adult patients diagnosed with epilepsy, initially through telemedicine and later through in-person visits or phone calls after one year.

Unmasking the Mimic: Radionecrotic Lesion Masquerading as Brain Neoplasia on Magnetic Resonance Imaging.

Corpus callosotomy is a therapeutic approach for drug-resistant epilepsy, with positive outcomes observed in managing atonic seizures. Despite a decline in its usage, radiosurgical callosotomy remains a viable option for drug-resistant epilepsy due to its low risks of post-radiation neoplasia, albeit not with exceptions. Brain radionecrosis is characterized by tissue death and vascular endothelial damage following the procedure.

Frequency and Focus of in Vitro Studies of Microglia-Expressed Cytokines in Response to Viral Infection: A Systematic Review.

It is well known that as part of their response to infectious agents such as viruses, microglia transition from a quiescent state to an activated state that includes proinflammatory and anti-inflammatory phases; this behavior has been described through in vitro studies. However, recent in vivo studies on the function of microglia have questioned the two-phase paradigm; therefore, a change in the frequency of in vitro studies is expected. A systematic review was carried out to identify the microglial cytokine profile against viral infection that has been further evaluated through in vitro studies (pro-inflammatory or anti-inflammatory), along with analysis of its publication frequency over the years.

Association of variants in the ABCB1, CYP2C19 and CYP2C9 genes for Juvenile Myoclonic Epilepsy.

Juvenile myoclonic epilepsy (JME) is the most common of the generalized genetic epilepsies, with multiple causal and susceptibility genes; however, its etiopathogenesis is mainly unknown. The toxic effects caused by xenobiotics in cells occur during their metabolic transformation, mainly by enzymes belonging to cytochrome P450. The elimination of these compounds by transporters of the ABC type protects the central nervous system, but their accumulation causes neuronal damage, resulting in neurological diseases.

An international consortium in epilepsy surgery education: Clinical case-based discussions between Latin-American and Canadian Epilepsy Centers.

An international consortium with a focus on Epilepsy Surgery Education was established with members from different centers in Latin America and Canada. All members of the consortium and attendees from different centers in Latin America and Canada have been meeting to discuss epilepsy surgery cases in a virtual manner. We surveyed all to assess the value of the meetings.

Protein expression of P-glycoprotein in neocortex from patients with frontal lobe epilepsy.

Frontal lobe epilepsy (FLE) is the second most frequent type of epilepsy and the surgical outcome depends on the etiology. For instance, patients with posttraumatic FLE (PTE) have a worse surgical outcome compared to patients with FLE related to a tumoral lesion (TL). The present study focuses to determine if the FLE etiology is associated with the P-glycoprotein (P-gp) expression, a condition associated with drug resistance.

Electroencephalographic findings in asymptomatic relatives of patients with juvenile myoclonic epilepsy: relationship with the degree of kinship.

Introduction: A prevalence of 1 to 71% of electroencephalogram (EEG) abnormalities has been reported in asymptomatic relatives of patients with juvenile myoclonic epilepsy (JME).

Objective: To determine the frequency of EEG abnormalities in asymptomatic relatives of patients with JME according to the degree of kinship.

Methods: Prospective, analytical study.

Relevance of variants on carbamazepine therapy in Mexican Mestizos with epilepsy at a tertiary-care hospital.

We evaluated the potential influence of genetic (, , , , , , , and ) and nongenetic factors on carbamazepine (CBZ) response, adverse drug reactions and CBZ plasma concentrations in 126 Mexican Mestizos (MM) with epilepsy. Patients were genotyped for 27 variants using TaqMan assays. CBZ response was associated with variants and lamotrigine cotreatment.

Temporal lobe epilepsy: Evaluation of central and systemic immune-inflammatory features associated with drug resistance.

Neuroinflammation is probably one of the factors involved in drug resistance in people with epilepsy. Finding peripheral markers reflecting the intensity of neuroinflammation could be of great help to decide for which patients anti-inflammatory treatment might be an option. In this context, peripheral cytokines levels and lymphocyte phenotypes were assessed by ELISA and flow cytometry in 3 groups of subjects: drug resistant patients with temporal lobe epilepsy (DR-TLE), non DR-TLE patients and healthy controls.

Increased non-attendance at epilepsy clinic in patients with neuropsychiatric comorbidities: A prospective study.

Background: In patients with epilepsy, regular follow-up is vital for adequate seizure control, antiseizure drugs' (ASDs) side effects, psychiatric comorbidities, and planning for epilepsy surgery. Non-attendance creates barriers to adequate patient care, inefficient allocation of resources, loss of income, and unnecessary emergency department visits due to lack of seizure control. This study aimed to determine the causes and sociodemographic characteristics of the non-attendant population at the Epilepsy Clinic.

[Clozapine in epilepsy and psychosis: effects on seizures and metabolic profile].

Background: Clozapine (CZP) is an antipsychotic used in resistant psychosis, but has adverse metabolic effects and is associated with new onset or worsening of epileptic seizures (ES). There is not enough information available regarding its effect on metabolic variables and on ES in patients with epilepsy.

Objective: To describe the effect of CZP on the metabolic and hematologic profiles, and on ES in patients with epilepsy and with psychosis and/or aggressive behavior.

Continuous Visual Focal Status Epilepticus as the Primary Presentation of NMDA-R and GAD65-R Autoimmune Epilepsy.

) has changed in its clinical and pathophysiological definition throughout time. Several etiologies have been described in addition to classic causes of EPC. The following case depicts a young woman who had a peculiar onset of epilepsy with a continuous visual aura becoming a form of chronic recurrent and non-progressive EPC.

Influence of genetic variants and antiepileptic drug co-treatment on lamotrigine plasma concentration in Mexican Mestizo patients with epilepsy.

Genetic and nongenetic factors may contribute to lamotrigine (LTG) plasma concentration variability among patients. We simultaneously investigated the association of UGT1A1, UGT1A4, UGT2B7, ABCB1, ABCG2, and SLC22A1 variants, as well as antiepileptic drug co-treatment, on LTG plasma concentration in 97 Mexican Mestizo (MM) patients with epilepsy. UGT1A4*1b was associated with lower LTG dose-corrected concentrations.

Source localization of high-frequency activity in tripolar electroencephalography of patients with epilepsy.

Objective: The objective of the study was to localize sources of interictal high-frequency activity (HFA), from tripolar electroencephalography (tEEG), in patient-specific, realistic head models.

Methods: Concurrent electroencephalogram (EEG) and tEEG were recorded from nine patients undergoing video-EEG, of which eight had seizures during the recordings and the other had epileptic activity. Patient-specific, realistic boundary element head models were generated from the patient's magnetic resonance images (MRIs).

Resolution of ictal bradycardia and asystole following temporal lobectomy: A case report, and review of available cases using pacemakers.

Ictal bradycardia (IB) and ictal asystole (IA) are uncommonly recognized phenomena that increase morbidity in patients with epilepsy by causing syncope and seizure-related falls. These arrhythmias are also suspected to be involved in the pathophysiology of sudden unexpected death in epilepsy (SUDEP). We report a case of a 57-year-old male with left temporal lobe epilepsy who experienced both IB and IA.

Catatonia in patients with anti-NMDA receptor encephalitis.

Aim: There is a lack of studies related to the frequency, phenomenology, and associated features of catatonic syndrome in patients with anti-NMDA receptor encephalitis (ANMDARE). This study aimed to measure the frequency of catatonia in this condition and to delineate its particular symptoms.

Methods: A prospective study was done with all inpatients who fulfilled the criteria of definite ANMDARE admitted to the National Institute of Neurology and Neurosurgery of Mexico from January 2014 to September 2018.

Neurosurgical Therapy for Status Epilepticus in Oligoastrocytoma Patients.

Background: Super-refractory status epilepticus (SRSE) is a life-threatening neurologic emergency defined as "status epilepticus (SE) that continues 24 hours or more after the onset of anesthesia, including those cases in which the SE recurs on the reduction or withdrawal of anesthesia," which occurs in 10% to 15% of patients with SE and rarely has been resolved surgically.

Case Descriptions: A 20-year-old man with SRSE and a long history of left parieto-occipital oligoastrocytoma was admitted for convulsive SE that became SRSE and underwent lesionectomy guided by electrocorticography and neuronavigation for local tumor recurrence. Histopathologic diagnosis was oligoastrocytoma.

A comparison of waiting times for assessment and epilepsy surgery between a Canadian and a Mexican referral center.

Objective: To provide a comprehensive transnational overview of wait times for epilepsy surgery in Canada and Mexico.

Methods: We reviewed all cases referred for epilepsy surgery between 2007 and 2015 at the Saskatchewan Epilepsy Program Royal University Hospital (SEP) (n = 70; Saskatoon, Canada) and the National Institute of Neurology and Neurosurgery (NINN) (n = 76; Mexico City, Mexico) and compared wait times, calculated as the time from diagnosis of epilepsy on assessment at an epilepsy center to epilepsy surgery.

Results: Mean wait times were similar across centers.

Variant Intestinal-Cell Kinase in Juvenile Myoclonic Epilepsy.

Background: In juvenile myoclonic epilepsy, data are limited on the genetic basis of networks promoting convulsions with diffuse polyspikes on electroencephalography (EEG) and the subtle microscopic brain dysplasia called microdysgenesis.

Methods: Using Sanger sequencing, we sequenced the exomes of six members of a large family affected with juvenile myoclonic epilepsy and confirmed cosegregation in all 37 family members. We screened an additional 310 patients with this disorder for variants on DNA melting-curve analysis and targeted real-time DNA sequencing of the gene encoding intestinal-cell kinase ( ICK).

Quality of life and level of burden in primary caregivers of patients with epilepsy: Effect of neuropsychiatric comorbidity.

Background: Few studies are focused on the quality of life (QOL) of primary caregivers and the effects of the clinical variables of epilepsy and patient psychiatric comorbidity on primary caregivers.

Purpose: Our main objective was to describe QOL and level of burden (LB) in caregivers of people with epilepsy (PWE) at a tertiary-care hospital in Mexico City. A secondary purpose was to determine if LB and QOL were different between caregivers of patients with neuropsychiatric comorbidity and caregivers of patients without neuropsychiatric comorbidity.

EFHC1 variants in juvenile myoclonic epilepsy: reanalysis according to NHGRI and ACMG guidelines for assigning disease causality.

Purpose: EFHC1 variants are the most common mutations in inherited myoclonic and grand mal clonic-tonic-clonic (CTC) convulsions of juvenile myoclonic epilepsy (JME). We reanalyzed 54 EFHC1 variants associated with epilepsy from 17 cohorts based on National Human Genome Research Institute (NHGRI) and American College of Medical Genetics and Genomics (ACMG) guidelines for interpretation of sequence variants.

Methods: We calculated Bayesian LOD scores for variants in coinheritance, unconditional exact tests and odds ratios (OR) in case-control associations, allele frequencies in genome databases, and predictions for conservation/pathogenicity.

High-dose versus low-dose valproate for the treatment of juvenile myoclonic epilepsy: Going from low to high.

Juvenile myoclonic epilepsy (JME) is a genetic generalized epilepsy accounting for 3-12% of adult cases of epilepsy. Valproate has proven to be the first-choice drug in JME for controlling the most common seizure types: myoclonic, absence, and generalized tonic-clonic (GTC). In this retrospective study, we analyzed seizure outcome in patients with JME using valproate monotherapy for a minimum period of one year.