Effect of late-onset epilepsy on cognitive functioning in patients with small vessel disease.

Rationale: Late-onset epilepsy (LOE) often has underlying cerebrovascular cause and has been associated with neurocognitive deficits and dementia. Nevertheless, the interplay between these factors has not been studied thus far. Hence, we conducted a retrospective cross-sectional study aimed to explore how unprovoked epileptic seizures along with vascular-related factors contribute to neurocognitive impairments in patients with cerebral small vessel disease.

Status epilepticus without impairment of consciousness: Long-term outcomes according to duration.

Objective: The point after which non-convulsive status epilepticus (NCSE) can cause permanent damage remains to be elucidated. The aim of this study was to analyze the association between time to resolution and long-term outcomes in NCSE.

Methods: We performed a retrospective study of all patients with focal NCSE without consciousness impairment at two tertiary care hospitals in Spain.

Etiology, seizure type, and prognosis of epileptic seizures in the emergency department.

Unlabelled: Epileptic seizures are a common reason for emergency department (ED) admittance. We aimed to describe the etiological distribution of epileptic seizures and the relationships between etiology and semiology in patients admitted to the emergency room, and to identify early prognostic factors for recurrence and mortality.

Methods: A retrospective observational study was conducted in adult patients consecutively attended in the emergency room with epileptic seizures over a 2-year period.

Accidental injuries in patients with generalized tonic-clonic seizures. A multicenter, observational, cross-sectional study (QUIN-GTC study).

Purpose: Patients with epilepsy have a higher risk of accidental injuries. The aim of this study was to determine the incidence of accidental injuries and quality of life in patients with epilepsy and generalized tonic-clonic seizures and their association with patient-related factors.

Methods: This is an observational, cross-sectional, multicenter study of patients with epilepsy and primary generalized tonic-clonic seizures and/or focal to bilateral tonic-clonic seizures in the routine clinical practice of epilepsy clinics.

The ADAN scale: a proposed scale for pre-hospital use to identify status epilepticus.

Background And Purpose: The prognosis of status epilepticus (SE) depends on the time between onset and the diagnosis and start of treatment. Our aim was to design a scale with predictive value for pre-hospital diagnosis of SE.

Methods: This was a retrospective study of 292 patients who attended the emergency department for an epileptic seizure.

Cost of status epilepticus (SE): Effects of delayed treatment and SE duration.

Background: The health expenditure related to status epilepticus (SE) is high because of lengthy hospitalization requirements and possible sequelae. We aimed to study the factors associated with this cost including the different timings of the treatment and SE duration.

Methods: We evaluated retrospectively all SE recorded in 2 hospitals.

Reliability of the early syndromic diagnosis in adults with new-onset epileptic seizures: A retrospective study of 116 patients attended in the emergency room.

Purpose: New-onset seizures (NOS) are a common reason for emergency department (ED) consultations. Decisions regarding treatment and further examinations are made based on the initial evaluation. We aimed to evaluate the reliability of the early syndromic diagnosis in NOS and find predictive factors to establish a consistent early diagnosis based on the semiology and prompt supplementary examinations.

Long-term retention rates of antiepileptic drugs used in acute seizures.

Purpose: A number of antiepileptic drugs (AEDs) are currently available for treating acute seizures. It is recommended to select the initial treatment option according to the type of epileptic syndrome and the patient's clinical characteristics, but little is known about the long-term retention rates of AEDs started in the emergency department.

Methods: We recruited patients admitted with seizures over a two-year period.

A novel EPM2A mutation yields a slow progression form of Lafora disease.

Lafora disease (LD, OMIM 254780) is a rare disorder characterized by epilepsy and neurodegeneration leading patients to a vegetative state and death, usually within the first decade from the onset of the first symptoms. In the vast majority of cases LD is related to mutations in either the EPM2A gene (encoding the glucan phosphatase laforin) or the EPM2B gene (encoding the E3-ubiquitin ligase malin). In this work, we characterize the mutations present in the EPM2A gene in a patient displaying a slow progression form of the disease.

Anger Assessment in Patients Treated With Brivaracetam.

Objectives: To assess state and trait anger, adjusted by epilepsy type, seizure control, anxiety-depression status and quality of life, in patients treated with brivaracetam (BRV) from an open study.

Methods: We evaluated prospectively consecutive patients with partial onset seizures in an open-label study. Patients had 5 years or longer of epilepsy and were taking between 1 and 3 antiepileptic drugs.

Effect of adjunctive perampanel on the quality of sleep and daytime somnolence in patients with epilepsy.

This prospective uncontrolled study evaluated the effect of low-dose adjunctive perampanel therapy (4 mg/day for 3 months) on the sleep-wake cycle and daytime somnolence in adult patients (n = 10) with focal seizures. A > 50% reduction in the number of seizures was reported in 80% of the study patients; treatment had no significant effect on any sleep parameters as evident by the Maintenance of Wakefulness Test, Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale scores. Two patients reported dizziness with treatment.

Epilepsia partialis continua: aetiology, semiology and prognosis in a Spanish adult cohort.

To describe the semiological features in patients suffering with Epilepsia Partialis Continua (EPC), also referred as Kozhevnikov syndrome and their relationship with aetiology, duration, and prognosis, as well as recurrence during follow-up. We analysed consecutive EPC patients diagnosed and followed in our centre over a seven-and-a half year period. We collected demographic and clinical data, along with neuroimaging and EEG recordings.

Levetiracetam and Valproate Retention Rate in Juvenile Myoclonic Epilepsy.

Background: Valproic acid (VPA) is an effective treatment in juvenile myoclonic epilepsy (JME), but concerns on its use during pregnancy are remarkable. Levetiracetam (LEV) is approved as second-line therapy, and used as monotherapy in clinical practice. Our objective was to analyze the outcome of LEV and VPA in JME.

Prognosis of status epilepticus (SE): Relationship between SE duration and subsequent development of epilepsy.

Unlabelled: In animal models, SE duration is related to epileptogenesis. Data in humans are scarce, mainly in NCSE; therefore, we aimed to study the prognosis of SE de novo and which factors may influence subsequent development of epilepsy.

Methods: We evaluated patients with SE without previous epilepsy at our hospital (February 2011-February 2014), including demographics, etiology, number of AEDs, duration of SE, mortality, and occurrence of seizures during follow-up.

Epilepsy in patients with malignant middle cerebral artery infarcts and decompressive craniectomies.

Unlabelled: Patients with malignant middle cerebral artery (MCA) infarctions who have undergone craniectomy are susceptible to the development of vascular epilepsy. Our objective was to study the factors that might influence the occurrence of seizures in this group of patients.

Materials And Methods: All patients who developed malignant MCA infarction and had undergone decompressive craniectomy in our center between November 2002 and January 2014 were evaluated.

Psychosocial factors and antiepileptic drug use related to delayed diagnosis of refractory psychogenic nonepileptic seizures.

Objective: We analyzed clinical and psychosocial factors in patients with refractory psychogenic nonepileptic seizures, seeking characteristics that could hasten diagnosis.

Background: Psychogenic nonepileptic seizures remain a diagnostic challenge. Prognosis is best if patients are treated within 2 years of symptom onset.

Prognosis in epilepsy: initiating long-term drug therapy.

Introduction: Prognosis in epilepsy refers to the probability of either achieving seizure remission (SR), whether spontaneously or using antiepileptic drugs (AED), or failing to achieve control of epileptic seizures (ES) despite appropriate treatment. Use of AED is recommended after a second unprovoked ES. For a first episode, the decision of whether or not to start drug treatment depends on the risk of recurrence and the advantages or disadvantages of the antiepileptic drug.

The Spanish Neurological Society official clinical practice guidelines in epilepsy.

Unlabelled: Previous Official Clinical Practice Guidelines (CPGs) in Epilepsy were based on expert opinions and developed by the Epilepsy Study Group of the Spanish Neurological Society (GE-SEN). The current CPG in epilepsy is based on the scientific method, which extracts recommendations from published scientific evidence. A reduction in the variability in clinical practice through standardization of medical practice has become its main function.

3 TESLA MR imaging in adults with focal onset epilepsy.

Objective: The finding of cerebral epileptogenic lesions in magnetic resonance (MR) has demonstrated to be a relevant prognostic factor for potential surgical candidates. In a series of consecutive adults with focal onset epilepsy, we investigated the yield of 3T MR imaging for detecting epileptogenic cerebral lesions.

Materials And Methods: We prospectively recruited 161 adult patients with a diagnosis of focal epilepsy, all of whom underwent standardized MR imaging study performed with a 3T magnet.

Causes of CNS inflammation and potential targets for anticonvulsants.

Inflammation is one of the most important endogenous defence mechanisms in an organism. It has been suggested that inflammation plays an important role in the pathophysiology of a number of human epilepsies and convulsive disorders, and there is clinical and experimental evidence to suggest that inflammatory processes within the CNS may either contribute to or be a consequence of epileptogenesis. This review discusses evidence from human studies on the role of inflammation in epilepsy and highlights potential new targets in the inflammatory cascade for antiepileptic drugs.

Localisation value of ictal arterial spin-labelled sequences in partial seizures.

Perfusion-based magnetic resonance imaging (MRI) using pulsed arterial spin-labelled (ASL) sequences is becoming a more commonly used tool for the diagnosis of patients with focal epilepsy. We report a patient with post-traumatic epilepsy and cortical haemorrhage who had a complex partial seizure characterised mainly by ictal speech (verbalisation) during MRI acquisition. Ictal ASL showed focal hyperperfusion over the right temporal region which had resolved on follow-up MRI, two weeks later.