28 results match your criteria: "Hospices Civils de Lyon and Lyon 1 University[Affiliation]"

The role of SEEG in the presurgical decision-making process in MRI-normal mesial temporal lobe epilepsy.

Rev Neurol (Paris)

December 2024

Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and Lyon 1 University, Lyon, France; Lyon Neuroscience Research Center, Inserm U1028, CNRS UMR5292, Lyon 1 University, Lyon, France.

Article Synopsis
  • In patients with mesial temporal lobe epilepsy (mTLE) who have normal MRI results, there is debate about whether to perform anterior temporal lobectomy while sparing the hippocampus due to potential memory loss risks.
  • A study examined 17 patients with normal MRIs and EEG data that indicated unilateral seizure activity, categorizing them into two groups based on the timing of hippocampal involvement during seizures.
  • The results showed no significant difference in post-operative seizure and neuropsychological outcomes regardless of whether the hippocampus was removed during surgery, suggesting that SEEG should be part of the surgical planning for these patients.
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Because of its involvement in breathing control and neuronal excitability, dysregulation of the serotonin (5-HT) 2C receptor (5-HT2C) might play a key role in sudden unexpected death in epilepsy. Seizure-induced respiratory arrest is thus prevented by a 5-HT2B/C agonist in different seizure model. However, the specific contribution of 5-HT2C in chronic epilepsy-related respiratory dysfunction remains unknown.

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Objective: This study was undertaken to develop a standardized grading system based on expert consensus for evaluating the level of confidence in the localization of the epileptogenic zone (EZ) as reported in published studies, to harmonize and facilitate systematic reviews in the field of epilepsy surgery.

Methods: We conducted a Delphi study involving 22 experts from 18 countries, who were asked to rate their level of confidence in the localization of the EZ for various theoretical clinical scenarios, using different scales. Information provided in these scenarios included one or several of the following data: magnetic resonance imaging (MRI) findings, invasive electroencephalography summary, and postoperative seizure outcome.

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Combining general and personal models for epilepsy detection with hyperdimensional computing.

Artif Intell Med

February 2024

Embedded Systems Laboratory (ESL), Ecole Polytechnique Federale de Lausanne (EPFL), Switzerland.

Article Synopsis
  • Epilepsy is a common neurological disorder that significantly affects patients' daily lives, yet current technological solutions for detection and monitoring are inadequate.
  • Hyperdimensional (HD) computing offers a more efficient approach for epilepsy detection through wearable devices, with advantages like simpler learning processes and lower memory needs compared to traditional methods.
  • The study explores innovative ways to build and enhance HD computing models for epilepsy detection, including the creation of hybrid models that improve detection accuracy and insights into individual epilepsy patterns.
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Background: Attention-deficit hyperactivity disorder (ADHD) is a frequent comorbidity in children with epilepsy, which management mostly relies on the usual treatments of ADHD, especially methylphenidate. Supplementation with polyunsaturated n-3 Fatty Acid (PUFA) has been proposed as an alternative therapeutic approach in ADHD without epilepsy but has never been evaluated in epilepsy-associated ADHD.

Methods: A multicenter double blind randomized placebo-controlled trial evaluating supplementation with PUFA, in eicosapentaenoic- and docosahexaenoic-acid form, conjugated to a phospholipid vector (PS-Omega3) in children aged >6 and <16-years old, and suffering from any type of epilepsy and ADHD (inattentive or combined type) according to DSM-V.

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Pituitary apoplexy (PA), a rare and life-threatening complication of pituitary adenomas, prompts urgent glucocorticoid administration. The optimal surgical approach is debated, and the Pituitary Apoplexy Score (PAS) aids decision-making. Our retrospective study (2003-2022) assesses variables in PA patient groups (surgical vs.

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Developmental epileptic encephalopathy in DLG4-related synaptopathy.

Epilepsia

April 2024

Department of Epilepsy Genetics and Precision Medicine, Danish Epilepsy Center Filadelfia, member of the European Reference Network EpiCARE, Dianalund, Denmark.

Objective: The postsynaptic density protein of excitatory neurons PSD-95 is encoded by discs large MAGUK scaffold protein 4 (DLG4), de novo pathogenic variants of which lead to DLG4-related synaptopathy. The major clinical features are developmental delay, intellectual disability (ID), hypotonia, sleep disturbances, movement disorders, and epilepsy. Even though epilepsy is present in 50% of the individuals, it has not been investigated in detail.

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Article Synopsis
  • Animal models have contributed valuable insights into sudden unexpected death in epilepsy (SUDEP), but effective prevention strategies remain elusive, highlighting the challenges in accurately modeling this condition.
  • The diversity of preclinical models, which include various rodent and non-rodent species, presents both advantages and limitations, especially regarding the relevance of their findings to human cases of SUDEP.
  • Most models typically lead to cardiorespiratory arrest during seizures, raising questions about whether they realistically represent SUDEP or simply periseizure deaths, emphasizing the complexity of studying this phenomenon.
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High-purified cannabidiol efficacy and safety in a cohort of adult patients with various types of drug-resistant epilepsies.

Rev Neurol (Paris)

March 2024

Aix-Marseille University, Marseille, France; Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; Epilepsy and Clinical Neurophysiology Department, Timone Hospital, Assistance publique-Hôpitaux de Marseille, Marseille, France. Electronic address:

About 30% of patients with epilepsy are drug resistant. Lennox-Gastaut syndrome (LGS), Dravet syndrome (DS) and tuberous sclerosis complex (TSC) are diseases for which high-purified-cannabidiol (CBD) known as Epidiolex® (GW pharma) can be prescribed in add-on of other medications in case of drug-resistance. Currently, there are only a few recent data in the literature about the efficacy and safety of CBD in other forms of refractory epilepsies especially focal epilepsies in adults.

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Objective: Cortical stimulation is an important component of stereoelectroencephalography (SEEG). Despite this, there is currently no standardized approach and significant heterogeneity in the literature regarding cortical stimulation practices. Via an international survey of SEEG clinicians, we sought to examine the spectrum of cortical stimulation practices to reveal areas of consensus and variability.

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Objective: Visceral sensations are bodily symptoms which are component manifestations of emotions frequently reported during epileptic seizures. Nowadays, the underlying mechanism and location of brain areas involved in the processing of these sensations remain unclear. Our objectives were to characterize the type and frequency of visceral and emotional responses evoked by electrical stimulations, to produce a mapping of brain structures involved in their processing, and to assess the link between visceral sensations and emotional feelings.

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Article Synopsis
  • The study aimed to analyze how epilepsy develops in patients with LGI1 antibody-associated limbic encephalitis and to identify factors linked to drug-resistant epilepsy (DRE).
  • Researchers conducted a retrospective review of 39 patients' medical data from two epilepsy centers over a 14-year period, focusing on seizure history and responses to anti-seizure medications.
  • Results showed that 28% of patients achieved epilepsy remission, with longer delays in starting treatment linked to persistent epilepsy, while MRI changes, especially hippocampal atrophy, were main predictors of developing DRE.
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All endocrine glands are susceptible to neoplastic growth, yet the health consequences of these neoplasms differ between endocrine tissues. Pituitary neoplasms are highly prevalent and overwhelmingly benign, exhibiting a spectrum of diverse behaviors and impact on health. To understand the clinical biology of these common yet often innocuous neoplasms, we review pituitary physiology and adenoma epidemiology, pathophysiology, behavior, and clinical consequences.

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How to monitor thiopental administration in the intensive care unit for refectory status epilepticus or intracranial hypertension?

Crit Care

December 2021

Department of Neurological Anesthesiology and Intensive Care, Hospices Civils de Lyon, Hôpital Pierre Wertheimer, Groupement Hospitalier Est, 59 Boulevard Pinel, 69500, Bron, Lyon, France.

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Design of a prospective, longitudinal cohort of people living with type 1 diabetes exploring factors associated with the residual cardiovascular risk and other diabetes-related complications: The SFDT1 study.

Diabetes Metab

May 2022

Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Avicenne Hospital, Paris 13 University, Bobigny, France; UMR 557 INSERM/U11125 INRAE/CNAM / Université Paris 13, Unité de Recherche Epidémiologique Nutritionnelle, Paris 13 University Sorbonne Paris Cité, Bobigny, France.

Type 1 diabetes mellitus (T1DM) is associated with a high risk of cardiovascular (CV) complications, even after controlling for traditional CV risk factors. Therefore, determinants of the residual increased CV morbidity and mortality remain to be discovered. This prospective cohort of people living with T1DM in France (SFDT1) will include adults and children aged over six years living with T1DM, recruited throughout metropolitan France and overseas French departments and territories.

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Purpose: Intracranial electroencephalography (iEEG) offers a unique window on brain dynamics with excellent temporal and spatial resolution and is less prone to recording artefacts than surface EEG. This study used a within-subject design to explore the feasibility to compare iEEG data during mind wandering, mindfulness meditation and hypnosis.

Results: Three patients who had iEEG for clinical monitoring and who were new to mindfulness meditation and hypnosis were able to enter these states.

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Classification of complications of epilepsy surgery and invasive diagnostic procedures: A proposed protocol and feasibility study.

Epilepsia

November 2021

Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Objective: In epilepsy surgery, which aims to treat seizures and thereby to improve the lives of persons with drug-resistant epilepsy, the chances of attaining seizure relief must be carefully weighed against the risks of complications and expected adverse events. The interpretation of data regarding complications of epilepsy surgery and invasive diagnostic procedures is hampered by a lack of uniform definitions and method of data collection.

Methods: Based on a review of previous definitions and classifications of complications, we developed a proposal for a new classification.

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Relationships between migraine and epilepsy: Pathophysiological mechanisms and clinical implications.

Rev Neurol (Paris)

September 2021

Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and Lyon 1 University, Lyon, France; Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292 and Lyon 1 University, Lyon, France.

Migraine and epilepsy are distinct neurological diseases with specific clinical features and underlying pathophysiological mechanisms. However, numerous studies have highlighted the complex and multifaceted relationships between the two conditions. The relationships between headache and epilepsy manifest themselves in different ways.

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The designates pituitary neoplasms as adenomas. A proposed nomenclature change to pituitary neuroendocrine tumors (PitNETs) has been met with concern by some stakeholder groups. The Pituitary Society coordinated the Pituitary Neoplasm Nomenclature (PANOMEN) workshop to address the topic.

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Purpose: Patients with Graves' orbitopathy can present with asymmetric disease. The aim of this study was to identify clinical characteristics that distinguish asymmetric from unilateral and symmetric Graves' orbitopathy.

Methods: This was a multi-centre study of new referrals to 13 European Group on Graves' Orbitopathy (EUGOGO) tertiary centres.

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Objective: In the Phase III PAOLA study (clinicaltrials.gov: NCT01137682), enrolled patients had uncontrolled acromegaly despite ≥6 months of octreotide/lanreotide treatment before study start. More patients achieved biochemical control with long-acting pasireotide versus continued treatment with octreotide/lanreotide (active control) at month 6.

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Resective surgery in tuberous Sclerosis complex, from Penfield to 2018: A critical review.

Rev Neurol (Paris)

March 2019

Lyon's Neuroscience Research Center, Inserm U1028/CNRS UMR 5292, 69003 Lyon, France; Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and Lyon 1 University, 69003 Lyon, France.

Medically treated patients suffering from tuberous sclerosis complex (TSC) have less than 30% chance of achieving a sustained remission. Both the international TSC consensus conference in 2012, and the panel of European experts in 2012 and 2018 have concluded that surgery should be considered for medically refractory TSC patients. However, surgery remains currently underutilized in TSC.

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Article Synopsis
  • The study investigates the relationship between ADHD and epilepsy in children aged 6-16, focusing on how different factors may influence ADHD development and treatment responses.
  • Participants, diagnosed with both epilepsy and ADHD, were treated with methylphenidate over a 12-16 week follow-up period, with ADHD symptoms assessed using the ADHD Rating Scale-IV.
  • Results showed that while 75% of those treated with methylphenidate experienced significant improvement, no epilepsy-related factors were found to correlate with ADHD severity, indicating a need for deeper understanding of ADHD in children with epilepsy.
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