Alterations in the hippocampal ‐thalamic pathway underlying secondarily generalized tonic–clonic seizures in mesial temporal lobe epilepsy: A diffusion tensor imaging study
SummaryObjectiveThe epileptogenic network underlying secondarily generalized tonic –clonic seizures (sGTCS) in mesial temporal lobe epilepsy (mTLE) is not well understood. Here, we investigated alterations in the probabilistic hippocampal‐thalamic pathway (pHTP) underlying sGTCS using diffusion tensor imaging and resting‐state functional magnetic resonance imaging in a cohor t of TLE patients with hippocampal sclerosis (HS).MethodsWe consecutively recruited 51 unilateral TLE ‐HS patients (26 with and 25 without sGTCS) and 22 healthy controls. Probabilistic tractography was used to track the pHTP. Raw fractional ani...
Source: Epilepsia - November 26, 2018 Category: Neurology Authors: Cong Chen, Hong Li, Fang Ding, Linglin Yang, Peiyu Huang, Shan Wang, Bo Jin, Cenglin Xu, Yi Wang, Meiping Ding, Zhong Chen, Shuang Wang Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research

Epidemiology of status epilepticus in adults: A population ‐based study on incidence, causes, and outcomes
We present the first population‐based incidence study applying the new 2015 ILAE definition and classification of SE and report the impact of the evolution of semiology and level of consciousness (LOC) on outcome.MethodsWe conducted a retrospective population ‐based incidence study of all adult patients with SE residing in the city of Salzburg between January 2011 and December 2015. Patients with hypoxic encephalopathy were excluded. SE was defined and classified according to the ILAE 2015.ResultsWe identified 221 patients with a median age of 69  years (range 20‐99 years). The age‐ and sex‐adjusted incidence of...
Source: Epilepsia - November 26, 2018 Category: Neurology Authors: Markus Leitinger, Eugen Trinka, Giada Giovannini, Georg Zimmermann, Cristina Florea, Alexandra Rohracher, Gudrun Kalss, Caroline Neuray, Rudolf Kreidenhuber, Julia H öfler, Giorgi Kuchukhidze, Claudia Granbichler, Judith Dobesberger, Helmut Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research

Homomeric Kv7.2 current suppression is a common feature in KCNQ2 epileptic encephalopathy
SummaryObjectiveTo gain insight into the mechanisms underlyingKCNQ2 encephalopathy by examining the electrophysiologic properties of mutant Kv7.2 channels in different multimeric configurations.MethodsWe analyzed the genotype ‐phenotype relationship in 4 patients withKCNQ2 encephalopathy and performed electrophysiologic analysis of M ‐currents mediated by homomeric Kv7.2 or heteromeric Kv7.2/Kv7.3 channels.ResultsNegligible or no current was recorded in cells expressing homomeric E130K, W270R, or G281R de novo mutants, and it was reduced by more than 90% for the L243F maternally inherited mutant. The E130K and G281R mu...
Source: Epilepsia - November 26, 2018 Category: Neurology Authors: Carolina Gomis ‐Pérez, Janire Urrutia, Anna Marcé‐Grau, Covadonga Malo, Eduardo López‐Laso, Ana Felipe‐Rucián, Miquel Raspall‐Chaure, Alfons Macaya, Alvaro Villarroel Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research

Temporal trends and patterns in carbamazepine use, related severe cutaneous adverse reactions, and HLA ‐B*15:02 screening: A nationwide study
SummaryObjectiveAfter discovering the association between the HLA ‐B*15:02 allele and carbamazepine‐related severe cutaneous adverse reactions (SCARs), particularly in Southeastern Asian populations, clinical strategies to prevent carbamazepine‐related SCARs have changed. We aimed to investigate 10‐year trends in carbamazepine use and carbamazepine‐relat ed SCARs and to examine the patterns and determinants of HLA‐B*15:02 screening in Taiwan.MethodsA nationwide study was performed using Taiwan ’s National Health Insurance Research Database. In the first part of the study, new users of carbamazepine were inclu...
Source: Epilepsia - November 26, 2018 Category: Neurology Authors: Chih ‐Wan Lin, Wei‐I Huang, Pi‐Hui Chao, Wen‐Wen Chen, Fei‐Yuan Hsiao Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research

Postictal electroencephalographic (EEG) suppression: A stereo ‐EEG study of 100 focal to bilateral tonic–clonic seizures
SummaryObjectivesWe aimed to describe intracerebral aspects of postictal generalized electroencephalography suppression (PGES) following focal to bilateral tonic –clonic (“secondarily generalized tonic–clonic”) seizures (GTCS) recorded using stereoelectroencephalographic (SEEG), and to correlate these with electroclinical features.MethodsThree independent observers scored semiologic and SEEG features. Patient and epilepsy characteristics were collected. Descriptive statistics and multivariate analysis were performed. The operational definition of PGES on SEEG used strict criteria (absence of visible signal at 20  ...
Source: Epilepsia - November 22, 2018 Category: Neurology Authors: Angela Marchi, Bernard Giusiano, Mark King, Stanislas Lagarde, Agn ès Trébuchon‐Dafonseca, Christophe Bernard, Sylvain Rheims, Fabrice Bartolomei, Aileen McGonigal Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research

Prolonged status epilepticus: Early recognition and prediction of full recovery in a 12 ‐year cohort
SummaryObjectivesEarly identification of patients who are at risk of prolonged status epilepticus (SE) and patients with high chances of full recovery despite prolonged SE may urge clinicians to intensify treatment rather than to withdraw care. We aimed to develop prediction models based on readily available clinical parameters to predict prolonged SE at seizure onset and to identify patients with high chances for full recovery.MethodsFrom 2005 to 2016, all adult SE patients treated at the University Hospital Basel, a Swiss medical care center, were included. Multivariable Poisson regression was performed to identify predi...
Source: Epilepsia - November 22, 2018 Category: Neurology Authors: Raoul Sutter, Saskia Semmlack, Peter W. Kaplan, Petra Opi ć, Stephan Marsch, Stephan Rüegg Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research

Neurocognition in childhood epilepsy: Impact on mortality and complete seizure remission 50 years later
SummaryObjectiveTo study associations of the severity of impairment in childhood neurocognition (NC) with long ‐term mortality and complete seizure remission.MethodsA population ‐based cohort of 245 subjects with childhood onset epilepsy was followed up for 50 years (median = 45, range = 2‐50). Childhood NC before age 18 years was assessed as a combination of formal intelligence quotient scores and functional criteria (school achievement, working history, and psychoneur ological development). Impaired NC was categorized with respect to definitions of intellectual functioning in International Classification of Disease...
Source: Epilepsia - November 22, 2018 Category: Neurology Authors: Matti Sillanp ää, Maiju M. Saarinen, Mira Karrasch, Dieter Schmidt, Bruce P. Hermann Tags: FULL ‐LENGTH ORIGINAL RESEARCH PAPER Source Type: research

Diagnostic and prognostic value of noninvasive long ‐term video‐electroencephalographic monitoring in epilepsy surgery: A systematic review and meta‐analysis from the E‐PILEPSY consortium
SummaryObjectiveThe European Union –funded E‐PILEPSY network (now continuing within the European Reference Network for rare and complex epilepsies [EpiCARE]) aims to harmonize and optimize presurgical diagnostic procedures by creating and implementing evidence‐based guidelines across Europe. The present study evaluates the curr ent evidence on the diagnostic accuracy of long‐term video‐electroencephalographic monitoring (LTM) in identifying the epileptogenic zone in epilepsy surgery candidates.MethodsMEDLINE, Embase, CENTRAL, and ClinicalTrials.gov were searched for relevant articles. First, we used random ‐eff...
Source: Epilepsia - November 22, 2018 Category: Neurology Authors: Teia Kobulashvili, Giorgi Kuchukhidze, Francesco Brigo, Georg Zimmermann, Julia H öfler, Markus Leitinger, Judith Dobesberger, Gudrun Kalss, Alexandra Rohracher, Caroline Neuray, Antonia Wakonig, Florian Ernst, Kees P. J. Braun, Brian E. Mou Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research

Two main focal seizure patterns revealed by intracerebral electroencephalographic biomarker analysis
SummaryObjectiveLong ‐term recording with intracerebral electrodes is commonly utilized to identify brain areas responsible for seizure generation (epileptogenic zone) and to tailor therapeutic surgical resections in patients with focal drug‐resistant epilepsy. This invasive diagnostic procedure generates a wealth o f data that contribute to understanding human epilepsy. We analyze intracerebral signals to identify and classify focal ictal patterns.MethodsWe retrospectively analyzed stereo ‐electroencephalographic (EEG) data in a cohort of patients either cryptogenic (magnetic resonance imaging negative) or presentin...
Source: Epilepsia - November 22, 2018 Category: Neurology Authors: Vadym Gnatkovsky, Veronica Pelliccia, Marco Curtis, Laura Tassi Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research

Defining the electroclinical phenotype and outcome of PCDH19 ‐related epilepsy: A multicenter study
SummaryObjectivePCDH19 ‐related epilepsy is an epileptic syndrome with infantile onset, characterized by clustered and fever‐induced seizures, often associated with intellectual disability (ID) and autistic features. The aim of this study was to analyze a large cohort of patients with PCDH19‐related epilepsy and bet ter define the epileptic phenotype, genotype‐phenotype correlations, and related outcome‐predicting factors.MethodsWe retrospectively collected genetic, clinical, and electroencephalogram (EEG) data of 61 patients with PCDH19 ‐related epilepsy followed at 15 epilepsy centers. All consecutively perfo...
Source: Epilepsia - November 19, 2018 Category: Neurology Authors: Marina Trivisano, Nicola Pietrafusa, Alessandra Terracciano, Carla Marini, Davide Mei, Francesca Darra, Patrizia Accorsi, Domenica Battaglia, Lorella Caffi, Maria P. Canevini, Simona Cappelletti, Elisabetta Cesaroni, Luca Palma, Paola Costa, Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research

Erratum
Epilepsia, EarlyView. (Source: Epilepsia)
Source: Epilepsia - November 19, 2018 Category: Neurology Tags: ERRATUM Source Type: research

Commentary on N óbrega‐Jr et al. “Mesial temporal lobe epilepsy with hippocampal sclerosis is infrequently associated with neuronal antibodies”
Epilepsia, EarlyView. (Source: Epilepsia)
Source: Epilepsia - November 19, 2018 Category: Neurology Authors: Niels Hansen Tags: COMMENTARY Source Type: research

The repertoire of seizure onset patterns in human focal epilepsies: Determinants and prognostic values
This study demonstrates that the main determinants of the SOP are the underlying etiology and the spatial organization of the EZ. Concerning the postsurgical seizure outcome, the main determinant factor is the spatial organization of the EZ, but the SOP plays also a role, conferring better prognosis when LVFA is present. (Source: Epilepsia)
Source: Epilepsia - November 13, 2018 Category: Neurology Authors: Stanislas Lagarde, Sinziana Buzori, Agn ès Trebuchon, Romain Carron, Didier Scavarda, Mathieu Milh, Aileen McGonigal, Fabrice Bartolomei Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research

Corpus callosum low ‐frequency stimulation suppresses seizures in an acute rat model of focal cortical seizures
The objective is to determine the efficacy of corpus callosum stimulation at low frequencies to suppress cortical seizures.Methods4 ‐Aminopyridine was injected in the primary motor cortex of 24 rats under anesthesia. Recording electrodes were placed in the contralateral motor cortex and hippocampus. Three pairs of stimulating electrodes were inserted into the corpus callosum along its longitudinal axis. Local field potentials were recorded 1 hour before, during, and after stimulation to determine the effect of stimulation on seizure duration. Stimulation was delivered from each pair of electrodes independently in separa...
Source: Epilepsia - November 13, 2018 Category: Neurology Authors: Nicholas H. Couturier, Dominique M. Durand Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research

High long ‐term mortality after incident status epilepticus in adults: Results from a population‐based study
SummaryObjectiveTo determine annual incidence, etiology, severity, and short ‐ and long‐term mortality of first‐time, nonanoxic status epilepticus (SE) in adults in a population‐based retrospective cohort study.MethodsWe systematically identified all episodes of SE in the year 2014 on the island of Funen. Patients with SE due to anoxia, patients with recurrent SE, and patients<18  years old were excluded. Nonconvulsive SE in coma was diagnosed according to the Salzburg criteria. Etiology, semiology, modified Rankin Scale (mRS) at discharge, survival, and the Status Epilepticus Severity Score were retrospectivel...
Source: Epilepsia - November 13, 2018 Category: Neurology Authors: Emmely Rodin, Martin H. Krogstad, Preben Aukland, Martin Lando, Harald S. M øller, Joanna Gesche, Thomas Krøigård, Christoph P. Beier Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research