Development of an Equity, Diversity, Inclusion, and Anti-racism Pledge as the Foundation for Action in an Academic Department of Neurology.

Recent racial inequities as illustrated by the health disparities in COVID-19 infections and deaths, the recent killings of Black men and women by law enforcement, and the widening socioeconomic inequality and have brought systemic racism into a national conversation. These unprecedented times may have deleterious consequences, increasing stress, and trauma for many members of the neurology workforce. The Equity, Diversity, Inclusion and Anti-Racism Committee within our Department of Neurology provides infrastructure and guidance to foster a culture of belonging and addresses the well-being of faculty, staff, and trainees.

Characteristics of patients with confirmed epilepsy and psychogenic nonepileptic seizures in Qatar.

Objective: The Middle Eastern country of Qatar opened its first epilepsy monitoring unit (EMU) in late 2015. This study compared demographic and clinical characteristics of patients with confirmed epilepsy to those of patients with confirmed psychogenic nonepileptic seizures (PNES).

Methods: Data were collected via retrospective chart review on 113 patients admitted for evaluation to the Qatar national health system EMU between November 2015 and May 2017.

Clinical presentation, epidemiology, neurophysiological findings, treatment and outcome of nonconvulsive status epilepticus: a 3-year prospective, hospital-based study.

This study reports the prevalence of Nonconvulsive Status Epilepticus (NCSE) in patients with altered mental status (AMS), and describes the clinical presentation, etiology, neurophysiological findings, neuroimaging, treatment, and outcome of NCSE in Qatar. Recording duration of continuous EEG monitoring was also discussed. This was a 3-year, prospective, hospital-based study involving patients with AMS and continuous EEG monitoring admitted to the Emergency and ICUs of Hamad Hospital, Qatar.

Building Bridges through Science.

Science is ideally suited to connect people from different cultures and thereby foster mutual understanding. To promote international life science collaboration, we have launched "The Science Bridge" initiative. Our current project focuses on partnership between Western and Middle Eastern neuroscience communities.

Using Time-Driven Activity-Based Costing to Implement Change.

Academic medical libraries have responded to changes in technology, evolving professional roles, reduced budgets, and declining traditional services. Libraries that have taken a proactive role to change have seen their librarians emerge as collaborators and partners with faculty and researchers, while para-professional staff is increasingly overseeing traditional services. This article addresses shifting staff and schedules at a single-service-point information desk by using time-driven activity-based costing to determine the utilization of resources available to provide traditional library services.

Validation and cultural adaptation of the Arabic versions of the Mini-Mental Status Examination - 2 and Mini-Cog test.

Introduction: The elderly population is increasing around the world, and the prevalence of dementia increases with age. Hence, it is expected that the number of people with dementia will increase significantly in the coming years. The Mini-Mental Status Examination - 2 (MMSE-2) and Mini-Cog are widely used tests to screen for dementia.

Epilepsy in Qatar: Causes, treatment, and outcome.

Objective: Qatar is a small country on the Eastern coast of the Arabian Peninsula. Its population is a unique mixture of native citizens and immigrants. We aimed to describe the features of epilepsy in Qatar as such information is virtually lacking from the current literature.

A prototype worldwide survey of diagnostic and treatment modalities for stroke.

Stroke is a global health problem. However, very little is known about stroke care in low- to middle-income countries. Obtaining country-specific information could enable us to develop targeted programs to improve stroke care.

Isolated brainstem involvement in a patient with hypertensive encephalopathy.

Hypertensive encephalopathy typically presents with headache, confusion, and bilateral parietooccipital vasogenic edema. Brainstem edema in hypertensive encephalopathy usually occurs in association with typical supratentorial parieto-occipital changes and is usually asymptomatic. We report here a patient with hypertensive encephalopathy, with isolated brain stem involvement on magnetic resonance imaging (MRI).

Pregabalin or placebo used adjunctively with levetiracetam in refractory partial-onset epilepsy: a post hoc efficacy and safety analysis in combined clinical trials.

Objective: Some patients with epilepsy require treatment with >1 adjunctive antiepileptic drug (AED) to achieve adequate seizure remission. The purpose of this analysis was to evaluate the efficacy and safety of adding adjunctive pregabalin to an AED regimen that included levetiracetam in patients with refractory partial-onset epilepsy.

Research Design And Methods: Data from the pregabalin and placebo arms of two placebo-controlled, double-blind, randomized studies of pregabalin in patients who received adjunctive treatment with levetiracetam in addition to ≥1 other AEDs were pooled for this post hoc analysis.

Long-term add-on pregabalin treatment in patients with partial-onset epilepsy: pooled analysis of open-label clinical trials.

Purpose: To evaluate the safety, tolerability, and efficacy of long-term pregabalin as add-on therapy for patients with poorly controlled partial seizures.

Methods: Analysis of data from six long-term clinical trials involving 2,061 patients receiving open-label pregabalin 75-600 mg/day adjunctive therapy for partial onset epilepsy refractory to multiple antiepileptic drugs.

Results: Total pregabalin exposure was 3,877 person-years.

A robust spike and wave algorithm for detecting seizures in a genetic absence seizure model.

Animal Models are used extensively in basic epilepsy research. In many studies, there is a need to accurately score and quantify all epileptic spike and wave discharges (SWDs) as captured by electroencephalographic (EEG) recordings. Manual scoring of long term EEG recordings is a time-consuming and tedious task that requires inordinate amount of time of laboratory personnel and an experienced electroencephalographer.

Cerebral hemodynamic compromise associated with limb shaking TIA and focal EEG slowing.

We report four cases of cerebral hemodynamic compromise identified over a five year period. Cerebral hemodynamic compromise is characterized by reversible attacks of regional cerebral ischemia affecting patients with occlusive disease of main arteries supplying blood to the brain. All four of our patients had occlusion of one internal carotid artery (ICA) often associated with high grade stenosis or occlusion of the contralateral internal carotid artery and/or major intracranial arteries.

Real-time differentiation of nonconvulsive status epilepticus from other encephalopathies using quantitative EEG analysis: a pilot study.

Purpose: Distinguishing nonconvulsive status epilepticus (NCSE) from some nonepileptic encephalopathies is a challenging problem. In many situations, NCSE and nonepileptic encephalopathies are indistinguishable by clinical symptoms and can produce very similar electroencephalography (EEG) patterns. Misdiagnosis or delay to diagnosis of NCSE may increase the rate of morbidity and mortality.

Antiepileptic drug intervention decouples electroencephalogram (EEG) signals: a case study in Unverricht-Lundborg Disease.

Change in severity of myoclonus as an outcome measure of antiepileptic drug (AED) treatment in patients with Unverricht-Lundborg Disease (ULD) has been estimated by utilizing the Unified Myoclonus Rating Scale (UMRS). In this study, we measure treatment effects through EEG analysis using mutual information approach to quantify interdependence/coupling strength among different electrode sites. Mutual information is known to have the ability to capture linear and non-linear dependencies between EEG time series with superior performance over the traditional linear measures.

Topiramate in older patients with partial-onset seizures: a pilot double-blind, dose-comparison study.

Purpose: Pharmacokinetics of antiepileptic drugs (AEDs) can be altered by age-related changes in physiology, thereby altering clinical effects, especially tolerability, in older adults. We compared two dosages of topiramate (TPM) in a pilot study of patients >or=60 years of age with partial-onset seizures.

Methods: In this 24-week, double-blind, randomized, parallel-group study, patients with one or more seizures in previous 6 months were randomized to treatment with 50 or 200 mg/day TPM.

Diagnosis of nonconvulsive status epilepticus (NCSE) in adults with altered mental status: clinico-electroencephalographic considerations.

The high incidence of nonconvulsive status epilepticus (NCSE) and difficulties encountered in rapid diagnosis have only recently become apparent and most neurophysiology textbooks have yet to fully address this topic. There is an immediate need to provide neurologists, neurology residents, and electroneurodiagnostic technologists with information to assist them in achieving early, accurate diagnosis of NCSE in patients they encounter on a daily basis. Instead of attempting to write a comprehensive review of the topic, we examined over 90 NCSE publications since 1972 and focused our efforts on extracting and summarizing those EEG and clinical considerations we found most useful for accurate diagnosis of NCSE in an adult population.

Rhythmic diffuse delta frequency activity presenting as an unusual EEG correlate of nonconvulsive status epilepticus: three case studies.

We report three cases of nonconvulsive status epilepticus (NCSE) in which electroencephalograms (EEGs) were dominated by rhythmic or semirhythmic, high-voltage, diffuse, delta activity. These recordings initially contained little or no clear epileptiform activity. Two of these patients had prolonged episodes of NCSE, which were recorded with continuous long-term EEGs.

Bioavailability of a Divalproex Extended-Release Formulation versus the Conventional Divalproex Formulation in Adult Patients Receiving Enzyme-Inducing Antiepileptic Drugs.

Objectives: To compare the bioavailability of divalproex extended release (divalproex-ER) given once daily relative to the conventional divalproex formulation given once every 8 hours, using various divalproex-ER doses that are 8-20% greater than the corresponding divalproex total daily doses.

Design And Subjects: This multiple-dose, fasting, randomised, two-period, crossover design study in 76 subjects with epilepsy taking a concomitant enzyme-inducing antiepileptic drug compared the bioavailability of divalproex once-every-8-hours regimens with 8-20% higher daily dose divalproex-ER once-daily regimens.

Results: The 8-20% higher divalproex-ER once-daily-dose regimens were equivalent, with respect to exposure (area under the concentration-time curve; 1551 vs 1539 mg .

The influence of vagus nerve stimulation on memory.

Background: Vagus nerve stimulation (VNS) has been shown to improve memory.

Objective: The purpose of this study was to learn at which stage of memory formation this influence occurs.

Methods: Ten subjects who had been implanted with vagus nerve stimulators for the treatment of intractable seizures performed tasks that assessed learning and retention (Hopkins Verbal Learning Test) during actual and sham VNS.

Effect of vagus nerve stimulation on creativity and cognitive flexibility.

Objective: The purpose of this study was to determine whether vagus nerve stimulation influences cognitive flexibility and creativity.

Methods: Ten subjects, in whom vagus nerve stimulators had been implanted for the treatment of intractable seizures, performed tasks that assessed cognitive flexibility (solving anagrams), creativity (Torrance Test), and memory (Hopkins Verbal Learning Test) during actual and sham vagus nerve stimulation.

Results: Vagus nerve stimulation impaired cognitive flexibility and creativity, but these results could not be explained by the induction of a general encephalopathy because VNS did not impair learning and improved retention.

New onset geriatric epilepsy: a randomized study of gabapentin, lamotrigine, and carbamazepine.

Objective: To determine the relative tolerability and efficacy of two newer antiepileptic drugs, lamotrigine (LTG) and gabapentin (GBP), as compared to carbamazepine (CBZ) in older patients with epilepsy.

Methods: This was an 18-center, randomized, double-blind, double dummy, parallel study of 593 elderly subjects with newly diagnosed seizures. Patients were randomly assigned to one of three treatment groups: GBP 1,500 mg/day, LTG 150 mg/day, CBZ 600 mg/day.

Safety and efficacy of two pregabalin regimens for add-on treatment of partial epilepsy.

Objective: To evaluate the efficacy, tolerability, and safety of two pregabalin regimens administered as adjunctive therapy to that of placebo in patients with medically refractory partial epilepsy.

Methods: A multicenter, double-blind, randomized, parallel-group, placebo-controlled trial was performed. Following a prospective 8-week baseline phase, patients were randomized to 12 weeks of double-blind treatment with placebo or pregabalin 600 mg/day administered twice daily (BID) or three times daily (TID).

Effectiveness of vagus nerve stimulation in epilepsy patients: a 12-year observation.

A retrospective review of the safety, tolerability, and efficacy of vagus nerve stimulation (VNS) in 48 patients with intractable partial epilepsy was performed. Side effects were few and mild to moderate. Mean seizure frequency decreased by 26% after 1 year, 30% after 5 years, and 52% after 12 years with VNS treatment.