Seizure Detection and Lateralization Using Thalamic Deep Brain Stimulator Recordings.

The lack of reliable seizure detection remains a significant challenge for epilepsy care. A clinical deep brain stimulation (DBS) system provides constrained ambulatory brain recordings; however, limited data exist on the use of DBS recordings for seizure detection and lateralization. We present the case of an 18-year-old patient with drug-resistant focal epilepsy, who had seizure detection and lateralization by DBS recordings.

Favorable outcomes and FDG-PET changes following tocilizumab treatment for febrile infection-related epilepsy syndrome in a child.

Febrile Infection-Related Epilepsy Syndrome (FIRES) is an infrequent yet severe form of epilepsy that rapidly evolves into status epilepticus following a febrile episode. Prompt diagnosis coupled with effective treatment strategies is critical for improving patient outcomes. Herein, we describe the case of an 11-year-old male with FIRES who was successfully treated with tocilizumab, resulting in no further seizures or residual disability.

Understanding teachers' perspectives on students with epilepsy in Germany: A survey examining knowledge, experience, and affective, cognitive, and behavioral attitudes to inform teacher training.

The comprehensive teacher survey (N = 210 teachers), conducted in Germany, focused on a broad range of student needs (medical, instructional, and emotional), and captured teachers' knowledge about epilepsy and experiences with students with epilepsy (SWE), alongside multiple attitudes towards SWE. Results reveal gaps in teachers' understanding of appropriate responses to seizures, exemplified by 33 % believing an object should be put into the mouth during a seizure. Misconceptions about the risks of physical activity for SWE are prevalent among teachers (6.

Communication About Sudden Unexpected Death in Epilepsy: An Adaptation of the SPIKES Protocol.

Background: Sudden unexpected death in epilepsy (SUDEP) is a common cause of premature death in children and adults with epilepsy. People with epilepsy and their caregivers prefer the risk of SUDEP to be disclosed by their clinicians; however, few tools exist to support these conversations.

Methods: We aimed to (1) characterize SUDEP communication preferences of clinicians and caregivers of children with epilepsy, and (2) leverage these preferences to develop a conversation guide to support the discussion of SUDEP risk.

CASPR2-related epilepsy: A distinctive and unrecognized form of epilepsy in adult and elderly males.

Objective: The aim of this study was to describe the clinical features of contactin-associated protein-like 2 (CASPR2)-IgG-associated seizures.

Methods: Nine patients were retrospectively collected from two epilepsy centers. For each patient we obtained a full clinical, neurophysiological, and MRI study along with detection of antineuronal autoantibodies from serum and CSF.

A rare case of dedifferentiated intracranial solitary fibrous tumor with chondrosarcomatous differentiation.

This report details a rare case of a 30-year-old female presenting with neurological symptoms, including headaches, seizures, and left-sided weakness. Imaging revealed a mass in the right parafalcine region of her brain. Surgical resection identified a tumor with two distinct components.

Does the time between doses in an unintentional double dose bupropion exposure affect the incidence of adverse effects? A retrospective cohort study.

Introduction: Unintentional therapeutic errors with bupropion are common. The impact of the timing of the second dose in a double dose exposure on adverse effects is not well studied. This study aims to compare adverse effects between double doses separated by <720 min and ≥720 min.

Monitoring Addiction to Pregabalin in Northern Algeria by Using Hair Testing.

Pregabalin (PGB) is a novel gamma-aminobutyric acid analog that has been recently approved for the treatment of partial-onset seizures, neuropathic pain, and fibromyalgia. Although PGB presents a low potential for abuse in comparison to other scheduled drugs, the literature reports its potential misuse, especially among individuals with former or current drug addiction. The present study aimed to develop and validate a novel method for the determination of PGB in hair to perform a retrospective observational study on the misuse of this drug in a population of addicted subjects from Northern Algeria.

Budget impact analysis of cenobamate for epilepsy patients with drug-resistant focal onset seizures in the Netherlands.

Objective: The objective of this study was to explore the financial consequences of adopting cenobamate as a treatment alternative in epilepsy patients with drug-resistant focal onset seizures (FOS) from a societal perspective in the Netherlands.

Methods: A previous budget impact model with a 5-year time horizon was adapted to the Dutch setting accounting for the eligible population, real-world market shares, treatment effectiveness and resource use in two scenarios: cenobamate with constant market share versus cenobamate with linearly increased market share up to 20%. Clinical inputs included treatment response, seizure reduction and adverse events.

Cenobamate, a New Promising Antiseizure Medication: Experimental and Clinical Aspects.

About 40-50% of patients with drug-resistant epilepsy do not properly respond to pharmacological therapy with antiseizure medications (ASMs). Recently approved by the US Food and Drug Administration and European Medicines Agency as an add-on drug for focal seizures, cenobamate is an ASM sharing two basic mechanisms of action and exhibiting a promising profile of clinical efficacy. The drug preferably inhibits persistent sodium current and activates GABA-mediated events via extrasynaptic, non-benzodiazepine receptors.

The Oxidative Stress in Epilepsy-Focus on Melatonin.

Oxidative stress develops when there is an excess of oxidants leading to molecular and cellular damage. Seizure activity leads to oxidative stress and the resulting increased lipid peroxidation. Generally, antiseizure medications reduce oxidative stress, although the data on levetiracetam are ambiguous.

Seizures Triggered by Systemic Administration of 4-Aminopyridine in Rats Lead to Acute Brain Glucose Hypometabolism, as Assessed by [F]FDG PET Neuroimaging.

4-aminopyridine (4-AP) is a non-selective blocker of voltage-dependent K channels used to improve walking in multiple sclerosis patients, and it may be useful in the treatment of cerebellar diseases. In animal models, 4-AP is used as a convulsant agent. When administered intrahippocampally, 4-AP induces acute local glucose hypermetabolism and significant brain damage, while i.

Microglia-Impaired Phagocytosis Contributes to the Epileptogenesis in a Mouse Model of Dravet Syndrome.

Dravet syndrome (DS) is a genetic disorder caused by a deficit in the Nav1.1 channel, leading to drug-resistant epilepsy. The Nav1.

Structure-Activity Relationship Studies in a Series of 2-Aryloxy--(pyrimidin-5-yl)acetamide Inhibitors of SLACK Potassium Channels.

Epilepsy of infancy with migrating focal seizures (EIMFS) is a rare, serious, and pharmacoresistant epileptic disorder often linked to gain-of-function mutations in the gene. encodes the sodium-activated potassium channel known as SLACK, making small molecule inhibitors of SLACK channels a compelling approach to the treatment of EIMFS and other epilepsies associated with mutations. In this manuscript, we describe a hit optimization effort executed within a series of 2-aryloxy--(pyrimidin-5-yl)acetamides that were identified via a high-throughput screen.

Ketogenic Diet and Neuroinflammation: Implications for Neuroimmunometabolism and Therapeutic Approaches to Refractory Epilepsy.

Refractory epilepsy, characterized by seizures that do not respond to standard antiseizure medications, remains a significant clinical challenge. The central role of the immune system on the occurrence of epileptic disorders has been long studied, but recent perspectives on immunometabolism and neuroinflammation are reshaping scientific knowledge. The ketogenic diet and its variants have been considered an important medical nutrition therapy for refractory epilepsy and may have a potential modulation effect on the immune system, specifically, on the metabolism of immune cells.

The Microsurgical Resection of an Arteriovenous Malformation in a Patient with Thrombophilia: A Case Report and Literature Review.

Arteriovenous malformations (AVMs) are complex vascular anomalies that can present with significant complications, including intracranial hemorrhage. This report presents the case of a 36-year-old female with Prothrombin G20210A mutation-associated thrombophilia, highlighting its potential impact on AVM pathophysiology and management. The patient presented with a right paramedian intraparenchymal frontal hematoma, left hemiparesis, and seizures.

Computed tomography-guided drainage of a canine intracerebral abscess.

An approximately 7-week-old female American Bulldog was presented for head injury and seizures. The dog was obtunded with absent left-sided postural reactions, absent left palpebral reflex, delayed vestibulo-ocular reflex bilaterally, and calvarial hyperesthesia. CT revealed a fragmented, depressed fracture of the right frontal bone, with an associated abscess and evidence of raised intracranial pressure.

Evaluation of dendrite morphology in Wistar and genetic absence epileptic rats.

Objective: Genetic Absence Epilepsy Rat from Strasbourg (GAERS), a rodent model genetically predisposed to absence epilepsy, serves as an experimental tool to elucidate the neuronal mechanisms underlying human absence epilepsy. This study aimed to investigate the morphological features of dendrites and dendritic spines of pyramidal neurons in somatosensory cortex and hippocampus of Wistar and GAERS rats.

Material And Method: Adult male GAERS (n = 5) and control Wistar (n = 5) rats were sacrificed by transcardial perfusion and brains were removed.

Vestibular epilepsy: clinical and electroencephalographic characteristics with the proposed diagnostic criteria.

Background: Focal seizures may encompass vestibular sensations in their symptomatology. When these manifestations occur in isolation or constitute the predominant symptom, they prompt consideration for diagnosing recurrent paroxysmal vertigo. However, the characterization of "vestibular epilepsy" remains debated and underexplored.

Evidence-based recommendations for the prophylactic use of antiseizure medications (ASMs) in neurosurgery: a systematic review of guidelines.

Objective: This study aims to evaluate the methodological quality of guidelines concerning the prophylactic use of antiseizure medications (ASMs) in neurosurgery and to summarize relevant recommendations.

Methods: PubMed, Embase, MEDLINE, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (VIP), National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), and other guideline repositories and official organizations were searched from 2004 to 2023 (20 years). The extracted information consisted of the guideline characteristics, relevant recommendations, levels of evidence, and strength of recommendations.

Bedside transfontanelle drain placement reduces the need for operative intervention in infants with subdural fluid collections.

Objective: Subdural fluid collection is a common neurosurgical condition in the pediatric population. Patients requiring surgical intervention have historically been managed with subdural drains, subdural-subgaleal shunting, subdural-peritoneal shunting, and mini-craniotomies. An alternative procedure for patients with an open anterior fontanelle is bedside transfontanelle drainage.

Golgi pH elevation due to loss of V-ATPase subunit V0a2 function correlates with tissue-specific glycosylation changes and globozoospermia.

Loss-of-function variants in ATP6V0A2, encoding the trans Golgi V-ATPase subunit V0a2, cause wrinkly skin syndrome (WSS), a connective tissue disorder with glycosylation defects and aberrant cortical neuron migration. We used knock-out (Atp6v0a2) and knock-in (Atp6v0a2) mice harboring the R755Q missense mutation selectively abolishing V0a2-mediated proton transport to investigate the WSS pathomechanism. Homozygous mutants from both strains displayed a reduction of growth, dermis thickness, and elastic fiber formation compatible with WSS.

Development of a model to predict electroencephalographic seizures in neonates with hypoxic ischemic encephalopathy treated with therapeutic hypothermia.

Objective: Electroencephalographic seizures (ES) are common in neonates with hypoxic-ischemic encephalopathy (HIE), but identification with continuous electroencephalographic (EEG) monitoring (CEEG) is resource-intensive. We aimed to develop an ES prediction model.

Methods: Using a prospective observational study of 260 neonates with HIE undergoing CEEG, we identified clinical and EEG risk factors for ES, evaluated model performance with area under the receiver operating characteristic curve (AUROC), and calculated test characteristics emphasizing high sensitivity.

Diffusion imaging shows microstructural alterations in untreated, non-lesional patients already after a first unprovoked seizure.

Objective: Patients with newly diagnosed epilepsy exhibit brain white matter (WM) abnormalities, but the temporal dynamics of these are unknown. The literature suggests these alterations might be present before diagnosis. This study investigates WM microstructural integrity using diffusion imaging in non-lesional (NL), interictal epileptiform discharge (IED)-free, unmedicated patients who experienced a first unprovoked seizure compared to healthy controls.