Article
Clinical Neurology
William O. Tatum, Jayanti Mani, Kazutaka Jin, Jonathan J. Halford, David Gloss, Firas Fahoum, Louis Maillard, Ian Mothersill, Sandor Beniczky
Summary: The objective of this clinical practice guideline is to provide recommendations on the indications and minimum standards for inpatient long-term video-electroencephalographic monitoring (LTVEM). The review of published evidence using The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement found limited high-level evidence. Recommendations were formulated for the indications, technical requirements, and essential practice elements of LTVEM. Further research is needed to obtain evidence about long-term outcome effects of LTVEM and establish its clinical utility.
CLINICAL NEUROPHYSIOLOGY
(2022)
Article
Clinical Neurology
William O. Tatum, Jayanti Mani, Kazutaka Jin, Jonathan J. Halford, David Gloss, Firas Fahoum, Louis Maillard, Ian Mothersill, Sandor Beniczky
Summary: The clinical practice guideline aims to provide recommendations on the indications and minimum standards for inpatient long-term video-electroencephalographic monitoring (LTVEM). Limited high-level evidence exists for specific aspects of diagnosis for LTVEM in patients with seizures and nonepileptic events, indicating a need for further research.
Article
Computer Science, Artificial Intelligence
Ozlem Karabiber Cura, Aydin Akan, Hatice Sabiha Ture
Summary: The majority of psychogenic nonepileptic seizures (PNESs) are often misdiagnosed due to their symptom similarity with epilepsy. EEG recordings alone are not enough for accurate diagnosis, and video EEG data and patient history are necessary. This study proposes a technique using short-term EEG data and time-frequency methods to classify different seizure segments.
INTERNATIONAL JOURNAL OF NEURAL SYSTEMS
(2023)
Article
Behavioral Sciences
Caitlynn Pham, Cayla Roy, Christine Tang, Atul Maheshwari
Summary: This study suggests that ADHD is underrecognized and underdiagnosed in patients presenting to the Epilepsy Monitoring Unit, and screening tools may be useful to help clinicians address seizure comorbidities such as ADHD.
BRAIN AND BEHAVIOR
(2022)
Review
Clinical Neurology
M. Raquel Lopez, W. Curt LaFrance
Summary: This review summarizes the recent advances in the diagnosis and treatment of psychogenic nonepileptic seizures (PNES). It emphasizes the effectiveness of psychotherapeutic modalities in empowering patients and reducing seizures, and highlights the importance of a multidisciplinary and holistic approach. The review also suggests the need for additional treatment modalities and further research for patients who are refractory to current treatment.
CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS
(2022)
Review
Health Care Sciences & Services
Soultana Papadopoulou, Efterpi Pavlidou, Georgios Argyris, Thaleia Flouda, Panagiota Koukoutsidi, Konstantinos Krikonis, Sidrah Shah, Dana Chirosca-Vasileiou, Stergios Boussios
Summary: This study explores the relationship between speech disorder-stuttering and epileptic seizures, and raises awareness of the diagnostic dilemmas and potential misdiagnosis. It emphasizes the complexity and importance of accurately detecting stuttering-induced epilepsy.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Article
Clinical Neurology
Wesley T. Kerr, Xingruo Zhang, Chloe E. Hill, Emily A. Janio, Andrea M. Chau, Chelsea T. Braesch, Justine M. Le, Jessica M. Hori, Akash B. Patel, Corinne H. Allas, Amir H. Karimi, Ishita Dubey, Siddhika S. Sreenivasan, Norma L. Gallardo, Janar Bauirjan, Eric S. Hwang, Emily C. Davis, Shannon R. D'Ambrosio, Mona Al Banna, Andrew Y. Cho, Sandra R. Dewar, Jerome Engel, Jamie D. Feusner, John M. Stern
Summary: The study found that in all patients, factors such as unemployment, more antiseizure medications, and concussion were associated with longer time from first seizure to VEM. Average time to VEM was shorter for patients with depression, anxiety, migraines, and eye closure in DS, highlighting a disconnect between International League Against Epilepsy practice parameters and referral patterns.
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
(2021)
Article
Psychology, Developmental
Corrinne Dunbar, Maxwell Lee, Atul Maheshwari
Summary: ADHD is common in patients with epilepsy, with a higher proportion in patients with psychogenic nonepileptic seizures compared to epileptic seizures. Positive ASRS screens did not show a significant association with positive CPT screens in this population. Adult patients admitted to the EMU are at a high risk of comorbid attention deficits.
JOURNAL OF ATTENTION DISORDERS
(2021)
Article
Clinical Neurology
Antonia Villagran, Guttorm Eldoen, Roderick Duncan, Kari Modalsli Aaberg, Dag Hofoss, Morten Ingvar Lossius
Summary: This study provided a population-based estimate of the prevalence of PNES for the first time. The findings suggest that the prevalence of PNES falls within the range of estimates from non-population-based data. A notably high prevalence of PNES was found in the 15-19-year age group.
Article
Emergency Medicine
Sanuri Gunawardena, Mahesh Chikkannaiah, Adrienne Stolfi, Gogi Kumar
Summary: EEG performed in the emergency department is a useful diagnostic tool that can aid in diagnosis and management, potentially avoiding hospital admission. Video EEGs can provide additional information for difficult cases.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Article
Behavioral Sciences
Wesley T. Kerr, Xingruo Zhang, Emily A. Janio, Amir H. Karimi, Corinne H. Allas, Ishita Dubey, Siddhika S. Sreenivasan, Janar Bauirjan, Shannon R. D'Ambrosio, Mona Al Banna, Andrew Y. Cho, Jerome Engel, Mark S. Cohen, Jamie D. Feusner, John M. Stern
Summary: Descriptions of seizure manifestations can aid in identifying patients with dissociative seizures, but no single manifestation is specific for either epileptic seizures or dissociative seizures. Patients with mixed epileptic seizures and dissociative seizures report factors divergent from those with isolated epileptic seizures or dissociative seizures.
EPILEPSY & BEHAVIOR
(2021)
Article
Behavioral Sciences
Michael Lloyd, Toby T. Winton-Brown, Anthony Hew, Genevieve Rayner, Emma Foster, Maria Rychkova, Rashida Ali, Dennis Velakoulis, Terence J. O'Brien, Patrick Kwan, Charles B. Malpas
Summary: This study aimed to compare the multidimensional psychopathological profiles of patients with PNES and ES. The results showed that PNES patients reported more overall psychopathology, particularly in childhood trauma, dissociation, and depression. These psychopathological profiles have limited usefulness as standalone screening tools for differentiating PNES and ES.
EPILEPSY & BEHAVIOR
(2022)
Article
Behavioral Sciences
Andrea L. Tanner, Jane R. von Gaudecker, Janice M. Buelow, Ukamaka M. Oruche, Wendy R. Miller
Summary: Adolescents with psychogenic nonepileptic seizures (PNES) face numerous challenges in school. This qualitative study explored the experience of attending school as an adolescent with PNES and identified several themes, including stress, bullying, accusations of faking seizure events, feeling left out, and school management of PNES. The study highlights the need for increased understanding and collaboration among peers, as well as from families, healthcare providers, and school personnel.
EPILEPSY & BEHAVIOR
(2022)
Article
Behavioral Sciences
Filiz Azman Iste, M. Ilker Yon, F. Irsel Tezer, Serap Saygi
Summary: This study investigated the frequency of ictal crying in epileptic seizures (ESs) and psychogenic nonepileptic seizures (PNESs), highlighting the differences between the two. The study also analyzed the etiology, symptoms, treatment options, and prognosis of ictal crying in ESs. Results showed that all patients in the ES group had refractory focal epilepsy, and some achieved good outcomes through surgical treatment.
EPILEPSY & BEHAVIOR
(2023)
Article
Clinical Neurology
Ruta Mameniskiene, Kristijonas Puteikis, Jaime Carrizosa-Moog
Summary: This study explored how neurology specialists perceive psychogenic nonepileptic seizures (PNES) through an art project, finding that they often see PNES as masking underlying psychological issues with limited understanding of its origin. Specialists used the symbol of a labyrinth to represent the challenges in diagnosing and providing multidisciplinary care for patients with PNES.
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
(2021)
Review
Clinical Neurology
Robert S. Fisher, Jayant N. Acharya, Fiona Mitchell Baumer, Jacqueline A. French, Pasquale Parisi, Jessica H. Solodar, Jerzy P. Szaflarski, Liu Lin Thio, Benjamin Tolchin, Arnold J. Wilkins, Dorothee Kasteleijn-Nolst Trenite
Summary: Light stimulation can trigger seizures in certain individuals, especially in young people and those with specific forms of epilepsy. Photosensitive seizures can coexist with spontaneous seizures and have a genetic component. The exact mechanisms of photosensitive seizures are still unclear, but specific triggers such as flashes or color changes can provoke seizures. Prevention strategies include avoiding triggers, covering one eye, keeping a safe distance from screens, reducing contrast, and taking certain antiseizure medications. Visually-induced seizures pose significant public health risks, requiring ongoing scientific research, regulation, and public education.
Article
Clinical Neurology
Josef Parvizi, Michael J. Veit, Daniel A. N. Barbosa, Aaron Kucyi, Claire Perry, Jonathon J. Parker, Rajat S. Shivacharan, Fengyixuan Chen, Jennifer Yih, James J. Gross, Robert Fisher, Jennifer A. McNab, Jessica Falco-Walter, Casey H. Halpern
Summary: This study investigates the causal effect of electrical stimulation near the ventromedial region of the human hypothalamus on subjective experience. The findings suggest that stimulation in this area induces feelings of shame, sadness, and fear, but not rage or anger. The study also reveals the electrophysiological connectivity between the hypothalamus and other brain regions associated with emotional responses.
Article
Behavioral Sciences
Gabriel Martz, Robert S. Fisher, Bradley Folley, Gregory A. Panza, Fumika Ando, Corey McEachern, Alma Blinn, Joyce A. Cramer
Summary: This study aims to determine the Minimal Clinically Important Change (MCID) in the Personal Impact of Epilepsy Scale (PIES) to assess the improvement in patient clinical status and quality of life. The results show that a reduction of 8% in PIES scores is considered meaningful improvement. The PIES scale can be useful in clinical care and research.
EPILEPSY & BEHAVIOR
(2022)
Article
Clinical Neurology
Po-Chun Chu, Hsiang-Yu Yu, Cheng-Chia Lee, Robert Fisher, Hao-Li Liu
Summary: This study explores the efficacy and time course of pulsed ultrasound in suppressing epileptiform activity. The results show that pulsed ultrasound can modulate epileptiform activity for up to 7 weeks, reducing the number of spikes and bursts as well as the duration of bursts.
Article
Chemistry, Analytical
Jing Zhou, Adam Fogarty, Kristina Pfeifer, Jordan Seliger, Robert S. Fisher
Summary: This study examined the effects of 1 Hz motor cortex stimulation using repetitive magnetic stimulation (rTMS) on cortical activity. The findings showed a reduction in the P60 peak and an increase in the N100 peak after 1 Hz rTMS, suggesting enhanced slow inhibition. TMS-EEG may serve as a useful biomarker for evaluating brain excitability, but individual responses are highly variable and distinguishing merged peaks can be challenging.
Article
Clinical Neurology
Yi Li, Adam Fogarty, Babak Razavi, Pooneh Memar Ardestani, Jessica Falco-Walter, Katherine Werbaneth, Kevin Graber, Kimford Meador, Robert S. Fisher
Summary: High-density EEG (HD-EEG) assists in presurgical planning for refractory epilepsy patients, with a higher yield in patients with non-lesional MRIs. The concordance of HD-EEG dipole analysis localization and resection site is a favorable outcome indicator.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2022)
Review
Clinical Neurology
Michel Saenz-Farret, Marina A. J. Tijssen, Dawn Eliashiv, Robert S. Fisher, Kapil Sethi, Alfonso Fasano
Summary: The relationship between antiseizure drugs and movement disorders is complex and not adequately reviewed so far. Antiseizure drugs can both treat and induce movement disorders, and this review aims to describe the different effects and proposed mechanisms between 15 movement disorders and 24 antiseizure drugs.
Review
Clinical Neurology
Hugh D. Simpson, Andreas Schulze-Bonhage, Gregory D. Cascino, Robert S. Fisher, Barbara C. Jobst, Michael R. Sperling, Brian N. Lundstrom
Summary: Neuromodulation is a key therapeutic tool for drug-resistant epilepsy patients. This review summarizes available neuromodulation techniques, focusing on patient selection, programming initiation, and outpatient management. Vagus nerve stimulation, deep brain stimulation of the anterior nucleus of the thalamus, and responsive neurostimulation have all shown safety and significant seizure reduction in randomized controlled trials. The choice of neuromodulation technique can be tailored to individual patients based on their epilepsy characteristics, risk tolerance, and preferences.
Correction
Clinical Neurology
Michel Saenz-Farret, Marina A. J. Tijssen, Dawn Eliashiv, Robert S. Fisher, Kapil Sethi, Alfonso Fasano
Article
Clinical Neurology
Robert S. Fisher, Ryan J. McGinn, Erica L. Von Stein, Teresa Q. Wu, Kurt Y. Qing, Adam Fogarty, Babak Razavi, Chitra Venkatasubramanian
Summary: This article demonstrates the benefit of transcranial direct current stimulation (tDCS) in focal status epilepticus in the critical care setting. When conventional antiseizure medications and anesthetics are not effective, tDCS treatment can reduce seizures and spikes. The results showed significant improvement in interictal spikes and electrographic seizure frequency after tDCS treatment.
Article
Clinical Neurology
Teresa Q. Wu, Neda Kaboodvand, Ryan J. McGinn, Mike Veit, Zachary Davey, Anjali Datta, Kevin D. Graber, Kimford J. Meador, Robert Fisher, Vivek Buch, Josef Parvizi
Summary: In patients with presumed temporal lobe epilepsy, the pulvinar subregion of the thalamus is found to be involved earlier and more prominently than the ANT in the propagation of seizures, according to a study. This research provides evidence for the feasibility and safety of personalized thalamic neuromodulation.
Article
Clinical Neurology
Vibhor Krishna, Jesse Mindel, Francesco Sammartino, Cady Block, Alok Kumar Dwivedi, Jamie J. Van Gomple, Nathan Fountain, Robert Fisher
Summary: This article describes the initial experience of using unilateral anterior nucleus of the thalamus (ANT) focused ultrasound ablation (FUSA) in patients with treatment-refractory epilepsy. The results show that ANT FUSA is safe, feasible, and can significantly reduce seizure frequency.
Article
Engineering, Biomedical
Amin Noroozi, Maryam Ravan, Babak Razavi, Robert. S. S. Fisher, Ying-Ying Law, Mohammad. S. S. Hasan
Summary: In this paper, a more robust version of electromagnetic tomography technique, ReLORETA, is presented to localize brain sources in the presence of different forward model uncertainties. The proposed method accurately estimates the transformation of the lead field matrix distorted by uncertainties. Testing the method with simulated uncertainties and real data shows that ReLORETA is considerably more robust and accurate than eLORETA. Therefore, ReLORETA is a promising method for real-world clinical applications.
IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING
(2023)
Article
Clinical Neurology
Po-Chun Chu, Chen-Syuan Huang, Shan-Zhi Ing, Hsiang-Yu Yu, Robert S. S. Fisher, Hao-Li Liu
Summary: This study explores the behavioral effects and hippocampal restoration induced by pulsed ultrasound in an animal model of epilepsy. The results show that ultrasound protected the hippocampus and improved anxiety, limb usage, sociability, and learning in the animals. This study supports the existence of both neuroprotective and beneficial behavioral effects of low-intensity pulsed ultrasound in epilepsy.
Article
Clinical Neurology
Cuiping Xu, Lei Qi, Xueyuan Wang, Frederic L. W. V. J. Schaper, Di Wu, Tao Yu, Xiaoming Yan, Guangyuan Jin, Qiao Wang, Xiaopeng Wang, Xinqi Huang, Yuke Wang, Yuanhong Chen, Jinghui Liu, Yuping Wang, Andreas Horn, Robert S. Fisher, Liankun Ren
Summary: This study aimed to investigate whether the functional connectivity between the ANT-DBS sites and the seizure foci is associated with effective seizure control in refractory epilepsy.
Article
Behavioral Sciences
Thomas Johnstone, Maria Isabel Barros Guinle, Gerald A. Grant, Brenda E. Porter
Summary: The study aimed to evaluate the safety and impact of Dexmedetomidine Hydrochloride (DH) administration during pediatric invasive intracranial electroencephalography (IEEG). The results showed that DH administration was not associated with adverse events and did not significantly affect the frequency of seizures captured on the IEEG and the duration of hospitalization.
EPILEPSY & BEHAVIOR
(2024)
Article
Behavioral Sciences
Sabra Zaraa, H. Steve White, Andy Stergachis, Edward Novotny Jr, Chris Protos, Grant Simic, Jennifer L. Bacci
Summary: This study used design thinking to develop a community pharmacist-led intervention for people living with epilepsy. Four features - pharmacist-patient consultations, care plan development, regular check-ins, and care coordination with other health care providers - were identified as desirable, feasible, and viable for the intervention. The study highlights the importance of involving pharmacists in epilepsy care and provides evidence-based features for such interventions.
EPILEPSY & BEHAVIOR
(2024)
Article
Behavioral Sciences
Bofei Tan, Qiang Liu, Yameng Qin, Qiuyan Chen, Rong Chen, Yanzi Jin, Mengyun Li, Xiaodan Jia, Xianrui Xu, Qing Zhang
Summary: The purpose of this study was to identify factors associated with insomnia in patients with epilepsy. The results showed that nocturnal seizures and anxiety were independently associated with insomnia in these patients. Patients with epilepsy and insomnia were more likely to experience depression and excessive daytime sleepiness.
EPILEPSY & BEHAVIOR
(2024)