Home-video EEG monitoring in a pediatric setting.

Introduction: Pediatric video-EEG monitoring is a standard procedure in epilepsy clinics, typically conducted in in-hospital settings.However, hospitalizationis sometimesunnecessary and imposes a burden on children and their families. In response to the rise of telehealth, home video-EEG monitoring has emerged, utilizing portable EEG equipment and video-cameras.

Economic aspects of prolonged home video-EEG monitoring: a simulation study.

Introduction: Video EEG monitoring (VEM) is an important tool for characterizing clinical events suspected as seizures. It is also used for pre-surgical workups in patients with drug-resistant epilepsy (DRE). In-hospital VEM high cost, long admission waiting periods and some other inconveniences led to an interest in home VEM (HVEM).

Source localization using virtual magnetoencephalography helmets: A simulation study toward a prior-based tailored scheme.

Magnetoencephalography (MEG) source estimation of brain electromagnetic fields is an ill-posed problem. A virtual MEG helmet (VMH), can be constructed by recording in different head positions and then transforming the multiple head-MEG coordinates into one head frame (i.e.

What is the optimal duration of home-video-EEG monitoring for patients with <1 seizure per day? A simulation study.

Ambulatory "at home" video-EEG monitoring (HVEM) may offer a more cost-effective and accessible option as compared to traditional inpatient admissions to epilepsy monitoring units. However, home monitoring may not allow for safe tapering of anti-seizure medications (ASM). As a result, longer periods of monitoring may be necessary to capture a sufficient number of the patients' stereotypic seizures.

Antiseizure Medications Withdrawal Seizures in Patients with Juvenile Myoclonic Epilepsy.

Background: Patients with juvenile myoclonic epilepsy (JME) are especially prone to having antiseizure medications (ASMs) withdrawal seizures (WS).

Objectives: To clarify whether WS in JME patients are caused by a high tendency of non-adherence from seizure-free patients or by a constitutive increased sensitivity to drug withdrawal.

Methods: Epilepsy patients followed in a tertiary epilepsy clinic between 2010 and 2013 were included in the study.

Not your usual drug-drug interactions: Monoclonal antibody-based therapeutics may interact with antiseizure medications.

Therapeutic monoclonal antibodies (mAbs) have emerged as the fastest growing drug class. As such, mAbs are increasingly being co-prescribed with other drugs, including antiseizure medications (ASMs). Although mAbs do not share direct targets or mechanisms of disposition with small-molecule drugs (SMDs), combining therapeutics of both types can increase the risk of adverse effects and treatment failure.

Digital Semiology: A Prototype for Standardized, Computer-Based Semiologic Encoding of Seizures.

Video-EEG monitoring (VEM) is imperative in seizure classification and presurgical assessment of epilepsy patients. Analysis of VEM is currently performed in most institutions using a freeform report, a time-consuming process resulting in a non-standardized report, limiting the use of this essential diagnostic tool. Herein we present a pilot feasibility study of our experience with "Digital Semiology" (DS), a novel seizure encoding software.

A functional magnetic resonance imaging investigation of prefrontal cortex deep transcranial magnetic stimulation efficacy in adults with attention deficit/hyperactive disorder: A double blind, randomized clinical trial.

ADHD is one of the most prevalent neurocognitive disorders. Deep Transcranial Magnetic Stimulation (dTMS) is a non-invasive neuromodulation tool that holds promise in treatment of neurocognitive disorders. Hypoactivity of the prefrontal cortex (PFC) has been observed in ADHD.

Interictal Epileptiform Discharge Dynamics in Peri-sylvian Polymicrogyria Using EEG-fMRI.

Polymicrogyria (PMG) is a common malformation of cortical development associated with a higher susceptibility to epileptic seizures. Seizures secondary to PMG are characterized by difficult-to-localize cerebral sources due to the complex and widespread lesion structure. Tracing the dynamics of interictal epileptiform discharges (IEDs) in patients with epilepsy has been shown to reveal the location of epileptic activity sources, crucial for successful treatment in cases of focal drug-resistant epilepsy.

Bilateral epileptic networks in congenital and acquired corpus callosum defects: EEG-fMRI study.

Objectives: Electroencephalography-correlated functional magnetic resonance imaging (EEG-fMRI) allows imaging of brain-wide epileptic networks, and demonstrates that focal interictal epileptic activity is sometimes accompanied by bilateral functional activations. The corpus callosum (CC) facilitates bilateral spread of epileptic activity and at times targeted surgically for drug-resistant epilepsy (DRE). We hypothesized that focal epileptic networks are more unilateral in patients lacking intact CC.

Preoperative localization of seizure onset zones by magnetic source imaging, EEG-correlated functional MRI, and their combination.

Objective: Preoperative localization of seizure onset zones (SOZs) is an evolving field in the treatment of refractory epilepsy. Both magnetic source imaging (MSI), and the more recent EEG-correlated functional MRI (EEG-fMRI), have shown applicability in assisting surgical planning. The purpose of this study was to evaluate the capability of each method and their combination in localizing the seizure onset lobe (SL).

Conductive gel bridge sensor for motion tracking in simultaneous EEG-fMRI recordings.

EEG-fMRI allows the localization of the hemodynamic correlates of neural activity and has been shown to be useful as a diagnostic tool in pre-surgical evaluation of refractory epilepsy. However, EEG recordings may be highly contaminated by artifacts induced by movements inside the magnetic field thus rendering the scan difficult for interpretation. Existing methods for motion correction require additional equipment or hardware modification.

Ictal and interictal MEG in pediatric patients with tuberous sclerosis and drug resistant epilepsy.

Purpose: Drug resistant epilepsy (DRE) is common in patients with tuberous sclerosis (TS). Interictal MEG has been shown as a valuable instrument in the presurgical workup. The goal of our study was to evaluate the role of ictal MEG in epileptogenic tuber selection, especially in patients with multiple irritative zones.

Deviations from Critical Dynamics in Interictal Epileptiform Activity.

Unlabelled: The framework of criticality provides a unifying perspective on neuronal dynamics from in vitro cortical cultures to functioning human brains. Recent findings suggest that a healthy cortex displays critical dynamics, giving rise to scale-free spatiotemporal cascades of activity, termed neuronal avalanches. Pharmacological manipulations of the excitation-inhibition balance (EIB) in cortical cultures were previously shown to result in deviations from criticality and from the power law scaling of avalanche size distribution.

Dual array EEG-fMRI: An approach for motion artifact suppression in EEG recorded simultaneously with fMRI.

Objective: Although simultaneous recording of EEG and MRI has gained increasing popularity in recent years, the extent of its clinical use remains limited by various technical challenges. Motion interference is one of the major challenges in EEG-fMRI. Here we present an approach which reduces its impact with the aid of an MR compatible dual-array EEG (daEEG) in which the EEG itself is used both as a brain signal recorder and a motion sensor.

Virtual MEG Helmet: Computer Simulation of an Approach to Neuromagnetic Field Sampling.

Head movements during an MEG recording are commonly considered an obstacle. In this computer simulation study, we introduce an approach, the virtual MEG helmet (VMH), which employs the head movements for data quality improvement. With a VMH, a denser MEG helmet is constructed by adding new sensors corresponding to different head positions.

Improving the excess kurtosis (g2) method for localizing epileptic sources in magnetoencephalographic recordings.

Objective: To suggest ways to apply the excess kurtosis estimator g2, in the detection of epileptic activity with magnetoencephalography, while avoiding its bias towards detecting high-amplitude, infrequent events.

Methods: Synthetic aperture magnetometry (SAM), combined with g2, was applied using window lengths ranging from 0.125 s to 32 s and with sum and maximum metrics on simulated data and recordings of two focal epilepsy patients.

Defective auditory processing in a child with temporal epileptic focus.

A 9-year-old boy presented with intolerance to noise that was a trigger for violent temper tantrums that occasionally resembled complex partial seizures. The condition was also a cause for withdrawal from all activities and settings that could potentially be associated with noise. Both electroencephalography and magnetoencephalography clearly demonstrated a left temporal (T5) epileptic focus, although the child never had convulsive seizures.

Interictal MEG reveals focal cortical dysplasias: special focus on patients with no visible MRI lesions.

Purpose: To investigate the value of interictal magnetoencephalography (MEG) in localizing epileptogenic cortex in epilepsy surgery patients with focal cortical dysplasias (FCD), particularly in patients having no visible MRI lesions.

Methods: Thirty-four patients with FCD and preoperative MEG were retrospectively evaluated. Interictal MEG spike source localizations in respect to the resected area were studied using postoperative MR imaging.

Sensitivity and specificity of seizure-onset zone estimation by ictal magnetoencephalography.

Purpose: Ictal video-electroencephalography (EEG) is commonly used to establish ictal onset-zone location. Recently software development has enabled systematic studies of ictal magnetoencephalography (MEG). In this article, we evaluate the ability of ictal MEG signals to localize the seizure-onset zone.

Correction of steroidopenia as a new method of hypercholesterolemia treatment.

Objective: In 2002 we proposed a new hypothesis of the etiology and pathogenesis of hypercholesterolemia. There is paucity of information in the literature regarding the association of steroidopenia and hypercholesterolemia. Our goal is to determine if the treatment of steroidopenia with hormonorestorative therapy (HT) to youthful levels will normalize total cholesterol (TC) levels.

Fine tuning the correlation limit of spatio-temporal signal space separation for magnetoencephalography.

Head, jaw and tongue movements contribute to speech artifacts in magnetoencephalography (MEG). Their sources lay close to MEG sensors, therefore, the spatio-temporal signal space separation method (tSSS), specifically suppressing nearby artifacts, can be used for speech artifact suppression. After data reconstruction by signal space separation (referred as SSS), tSSS identifies artifacts by their correlated temporal behavior inside and outside the sensor helmet.

Artifact and head movement compensation in MEG.

Purpose: Magnetoencephalography (MEG) is traditionally considered impractical if the subject's head moves during measurements. A novel approach to correct the head position and the associated movement-related artifacts does, however, exist: continuous head position monitoring and movement compensation (MC) realized by the signal space separation (SSS) or its temporal extension (tSSS). The latter is especially important for rejection of close-to-sensor artifacts.

Postmenopausal HRT is not independent risk factor for dural sinus thrombosis.

While a dural sinus thrombosis (DST), is a well-known consequence of the use of oral contraceptives, the role of hormone replacement therapy (HRT) in DST was not previously evaluated. We report two postmenopausal women, presenting with DST under HRT. Antiphospholipid antibodies in one case and borderline protein S deficiency in another were diagnosed.

Epilepsia partialis continua possibly caused by cerebellar lesion.

The cerebellum is known to have inhibitory effects on seizures. Nevertheless, cerebellar dysplastic lesions can be epileptogenic. We report a patient presenting with epilepsia partialis continua (EPC) following a hemorrhagic cerebellar lesion.