The yield of long-term electrocardiographic recordings in refractory focal epilepsy.

Objective: To determine the incidence of clinically relevant arrhythmias in refractory focal epilepsy and to assess the potential of postictal arrhythmias as risk markers for sudden unexpected death in epilepsy (SUDEP).

Methods: We recruited people with refractory focal epilepsy without signs of ictal asystole and who had at least one focal seizure per month and implanted a loop recorder with 2-year follow-up. The devices automatically record arrhythmias.

Automated video-based detection of nocturnal convulsive seizures in a residential care setting.

People with epilepsy need assistance and are at risk of sudden death when having convulsive seizures (CS). Automated real-time seizure detection systems can help alert caregivers, but wearable sensors are not always tolerated. We determined algorithm settings and investigated detection performance of a video algorithm to detect CS in a residential care setting.

Seizure detection using dynamic warping for patients with intellectual disability.

Electroencephalography (EEG) is paramount for both retrospective analysis and real-time monitoring of epileptic seizures. Studies have shown that EEG-based seizure detection is very difficult for a specific epileptic population with intellectual disability due to the cerebral development disorders. In this work, a seizure detection method based on dynamic warping (DW) is proposed for patients with intellectual disability.

Value of re-interpretation of controversial EEGs in a tertiary epilepsy clinic.

Objective: Diagnostic value and efficacy of re-interpretation of previous EEGs in 100 patients admitted to a tertiary epilepsy center with EEG results conflicting with the clinical diagnosis after the first visit.

Methods: EEGs were reclassified. A matched control group was included to assess the efficiency of the re-interpretation process.

Diagnostic accuracy of audio-based seizure detection in patients with severe epilepsy and an intellectual disability.

Unlabelled: We evaluated the performance of audio-based detection of major seizures (tonic-clonic and long generalized tonic) in adult patients with intellectual disability living in an institute for residential care.

Methods: First, we checked in a random sample (n=17, 102 major seizures) how many patients have recognizable sounds during these seizures. In the second part of this trial, we followed 10 patients (who had major seizures with recognizable sounds) during four weeks with an acoustic monitoring system developed by CLB ('CLB-monitor') and video camera.

Epileptic seizure detection on patients with mental retardation based on EEG features: A pilot study.

Mental retardation (MR) is one of the most common secondary disabilities in people with Epilepsy. However, to our knowledge there are no reliable seizure detection methods specified for MR-patients. In this paper we performed a pilot study on a group of six patients with mental retardation to assess what EEG features potentially work well on this group.

Accelerometer-based quantitative analysis of axial nocturnal movements differentiates patients with Parkinson's disease, but not high-risk individuals, from controls.

Introduction: There is a need for prodromal markers to diagnose Parkinson's disease (PD) as early as possible. Knowing that most patients with overt PD have abnormal nocturnal movement patterns, we hypothesised that such changes might occur already in non-PD individuals with a potentially high risk for future development of the disease.

Methods: Eleven patients with early PD (Hoehn & Yahr stage ≤2.

Can an early 24-hour EEG predict the response to the ketogenic diet? A prospective study in 34 children and adults with refractory epilepsy treated with the ketogenic diet.

Purpose: We examined whether early EEG changes in a 24-h EEG at 6 weeks of treatment were related to the later clinical response to the ketogenic diet (KD) in a 6-month period of treatment.

Methods: We examined 34 patients with heterogeneous epilepsy syndromes (21 children, 13 adults) and found 9 clinical responders (≥50% seizure reduction); this is a responder rate of 26%. We visually counted the interictal epileptic discharge index (IED index) in % during 2h of wakefulness and in the first hour of sleep (method 1), and also globally reviewed EEG changes (method 2), while blinded to the effect of the KD.

Actigraphy as a diagnostic aid for REM sleep behavior disorder in Parkinson's disease.

Background: Rapid eye movement (REM) sleep behavior disorder (RBD) is a common parasomnia in Parkinson's disease (PD) patients. The current International Classification of Sleep Disorders (ICSD-II) requires a clinical interview combined with video polysomnography (video-PSG) to diagnose. The latter is time consuming and expensive and not always feasible in clinical practice.

Subjectively impaired bed mobility in Parkinson disease affects sleep efficiency.

Background: Impaired bed mobility (IBM) may be an important reason for the high prevalence of sleep insomnia in Parkinson disease (PD). Here we assessed the influence of subjectively IBM on both subjective and objective sleep parameters in insomnia PD patients with (PD+IBM) and without (PD-IBM) concerns of IBM and controls with primary insomnia.

Methods: We included 44 PD patients with sleep initiation or maintenance concerns and 44 control subjects with primary insomnia.

Motor function in children with cryptogenic localization related epilepsy.

Introduction: In CLRE specific learning difficulties and motor problems may occur. The aim of this study is to examine whether CLRE or the accompanying specific learning difficulties are associated with the occurring problems in motor function.

Methods: Motor functioning in 140 children with CLRE and without epilepsy, as well as with and without specific learning difficulties is compared using Chi-square.

An investigation of the phase locking index for measuring of interdependency of cortical source signals recorded in the EEG.

The phase locking index (PLI) was introduced to quantify in a statistical sense the phase synchronization of two signals. It has been commonly used to process biosignals. In this article, we investigate the PLI for measuring the interdependency of cortical source signals (CSSs) recorded in the Electroencephalogram (EEG).

Prognosis after temporal lobe epilepsy surgery: the value of combining predictors.

Purpose: Although several independent predictors of seizure freedom after temporal lobe epilepsy surgery have been identified, their combined predictive value is largely unknown. Using a large database of operated patients, we assessed the combined predictive value of previously reported predictors included in a single multivariable model.

Methods: The database comprised a cohort of 484 patients who underwent temporal lobe surgery for drug-resistant epilepsy.

Decision-making in temporal lobe epilepsy surgery: the contribution of basic non-invasive tests.

Purpose: We studied the extent to which the widely used diagnostic tests contribute to the decision whether or not to perform temporal lobe epilepsy (TLE) surgery in The Netherlands.

Methods: This nation-wide, retrospective study included 201 consecutive patients referred for TLE surgery screening. The individual and combined contribution of nine index tests to the consensus decision to perform surgery was investigated.

Detection of subtle nocturnal motor activity from 3-D accelerometry recordings in epilepsy patients.

This paper presents a first step towards reliable detection of nocturnal epileptic seizures based on 3-D accelerometry (ACM) recordings. The main goal is to distinguish between data with and without subtle nocturnal motor activity, thus reducing the amount of data that needs further (more complex) analysis for seizure detection. From 15 ACM signals (measured on five positions on the body), two features are computed, the variance and the jerk.

Analysis of the phase locking index for measuring of interdependency of cortical signals recorded in the EEG.

The phase locking index (PLI) was introduced to quantify in a statistical sense the phase synchronization of two signals. It has been commonly used to process biosignals. In this paper, we analyze the PLI for measuring the interdependency of cortical source signals (CSSs) recorded in the Electroencephalogram (EEG).

Model for arm movements during myoclonic seizures.

A model is formulated for arm movements during myoclonic (epileptic) seizures. The system described in the model, consists of a mechanical and an electrophysiological part. The model output is compared to real patient accelerometry (ACM)-data from six epilepsy patients.

Separation of spatially localized cortical activities in the EEG: model-based analysis and optimization.

The mapping of brain sources into the scalp electroencephalogram (EEG) depends on volume conduction properties of the head and on an electrode montage involving a reference. In this article, the source mapping (SM) is formalized mathematically in the form of an observation function (OF) matrix. The OF-matrix is used to analyze and optimize the SM for a generation model for the desynchronized spontaneous EEG.

The added value of [18F]-fluoro-D-deoxyglucose positron emission tomography in screening for temporal lobe epilepsy surgery.

Purpose: [18F]-Fluoro-d-deoxyglucose positron emission tomography (FDG-PET) is an expensive, invasive, and not widely available technique used in the presurgical evaluation of temporal lobe epilepsy. We assessed its added value to the decision-making process in relation to other commonly used tests.

Methods: In a retrospective study of a large series of consecutive patients referred to the national Dutch epilepsy surgery program between 1996 and 2002, the contribution of FDG-PET, magnetic resonance imaging (MRI), and video-electroencephalogram (video-EEG) monitoring findings, alone or in combination, to the decision whether to perform surgery was investigated.

EEG characteristics related to educational impairments in children with benign childhood epilepsy with centrotemporal spikes.

Purpose: Learning and behavioral difficulties often occur in benign childhood epilepsy with centrotemporal spikes (BCECTS). In recent years, several electroencephalogram (EEG) characteristics have been related to the occurrence of learning and behavioral problems.

Methods: From 28 children medical, school and psychological reports were present and children were rated according to a 4-point scale for educational and behavioral impairment (Part 1).

The validity of a separate classification of cryptogenic localization related epilepsy amongst childhood epilepsies.

Introduction: One-third of children with epilepsy are classified as having a cryptogenic localization related epilepsy (CLRE). In cohort studies CLRE is often grouped together with either symptomatic localization related epilepsy (SLRE) or idiopathic generalized epilepsy (IGE). Therefore, this categorization is not specific enough and will not lead to prognostic or treatment information.

Cryptogenic localization related epilepsy in children from a tertiary outpatient clinic: is neurological and neuropsychological outcome predictable?

Objectives: Up to one-third of the children with epilepsy are diagnosed with cryptogenic localization related epilepsy (CLRE). As yet, there is a lack of studies that specify the short- and long-term prognosis for this group. In this study, we systematically established neurological outcome (represented by seizure frequency) as well as neuropsychological outcome in a cohort of 68 children with CLRE who had been referred to our tertiary outpatient clinic.

A model of heart rate changes to detect seizures in severe epilepsy.

Aim Of The Study: An explorative study to assess the value of a model for the automatic detection and characterization of heart rate (HR) changes during seizures in severe epilepsy.

Methods: Heart rate changes were monitored in 10 patients with 104 seizures, mostly tonic and myoclonic, to assess the value of various modalities for the detection of seizures based on heart rate. EEG/video monitoring served as the golden standard.

Cryptogenic localization-related epilepsy with childhood onset: The problem of definition and prognosis.

Background: Up to one-third of children with epilepsy are diagnosed with cryptogenic localization-related epilepsy (CLRE). CLRE is a large nonspecific category within the ILAE classification. For this population no unequivocal prognosis exists.

What is the current evidence on decision-making after referral for temporal lobe epilepsy surgery? A review of the literature.

Objectives: Many patients thought to have temporal lobe epilepsy, are evaluated for surgical treatment. Decision-making in epilepsy surgery is a multidisciplinary, phased process involving complex diagnostic tests. This study reviews the literature on the value of different tests to decide on whether to operate.