Article
Clinical Neurology
Marina Gainza-Lein, Cristina Barcia Aguilar, Juan Piantino, Kevin E. Chapman, Ivan Sanchez Fernandez, Marta Amengual-Gual, Anne Anderson, Brian Appavu, Ravindra Arya, James Nicholas Brenton, Jessica L. Carpenter, Justice Clark, Raquel Farias-Moeller, William D. Gaillard, Tracy A. Glauser, Joshua L. Goldstein, Howard P. Goodkin, Linda Huh, Robert Kahoud, Kush Kapur, Yi-Chen Lai, Tiffani L. McDonough, Mohamad A. Mikati, Lindsey A. Morgan, Anuranjita Nayak, Edward Novotny, Adam P. Ostendorf, Eric T. Payne, Katrina Peariso, Latania Reece, James Riviello, Kumar Sannagowdara, Tristan T. Sands, Theodore Sheehan, Robert C. Tasker, Dmitry Tchapyjnikov, Alejandra Vasquez, Mark S. Wainwright, Angus Wilfong, Korwyn Williams, Bo Zhang, Tobias Loddenkemper
Summary: This study aimed to describe long-term clinical and developmental outcomes in pediatric refractory status epilepticus (RSE) and identify factors related to new neurological deficits after RSE. The results showed that about one third of patients without prior epilepsy developed recurrent unprovoked seizures after the RSE episode, while in previously normally developing patients, 39% presented with new deficits during follow-up, with longer electroclinical RSE duration as a predictor.
Review
Clinical Neurology
Odile Feys, Serge Goldman, Valentina Lolli, Chantal Depondt, Benjamin Legros, Nicolas Gaspard, Sophie Schuind, Xavier De Tiege, Estelle Rikir
Summary: Insular epilepsy requires appropriate diagnostic tools due to its heterogeneous seizure semiology and limited contribution of scalp EEG signals. The deep and highly connected location of the insula presents surgical challenges. Advances in diagnostic and therapeutic tools, such as functional MRI and SEEG, have improved the management of insular epilepsy. Tailored resection based on SEEG or alternative curative treatments have shown promising results.
Article
Clinical Neurology
Cristina Barcia Aguilar, Marta Amengual-Gual, Ivan Sanchez Fernandez, Nicholas S. Abend, Anne Anderson, Brian Appavu, Ravindra Arya, J. Nicholas Brenton, Jessica L. Carpenter, Kevin E. Chapman, Justice Clark, Raquel Farias-Moeller, William D. Gaillard, Marina Gainza-Lein, Tracy Glauser, Joshua L. Goldstein, Howard P. Goodkin, Rejean M. Guerriero, Linda Huh, Yi-Chen Lai, Tiffani L. McDonough, Mohamad A. Mikati, Lyndsey A. Morgan, Edward J. Novotny, Adam Ostendorf, Eric T. Payne, Katrina Peariso, Juan Piantino, James Riviello, Kumar Sannagowdara, Theodore Sheehan, Tristan T. Sands, Robert C. Tasker, Dmitry Tchapyjnikov, Alexis A. Topjian, Alejandra Vasquez, Mark S. Wainwright, Angus A. Wilfong, Korwyn Williams, Tobias Loddenkemper
Summary: In pediatric refractory status epilepticus patients, the time to first non-BZD ASM is shorter on weekends and holidays compared to weekdays, mainly driven by in-hospital onset status epilepticus.
PEDIATRIC NEUROLOGY
(2021)
Article
Clinical Neurology
Valeri Borger, Motaz Hamed, Julia Taube, Gulsah Aydin, Inja Ilic, Matthias Schneider, Patrick Schuss, Erdem Guresir, Albert Becker, Christoph Helmstaedter, Christian E. Elger, Hartmut Vatter
Summary: Temporal lobe epilepsy (TLE) is a common form of epilepsy, and about 30% of patients have drug-resistant seizures. This study evaluated the seizure outcomes of patients with drug-refractory TLE who underwent resective temporal lobe surgery (rTLS), finding that the lack of MRI lesions and placement of depth electrodes before surgery were associated with unfavorable postsurgical seizure outcomes.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Fiona M. Baumer, John R. Mytinger, Kerri Neville, Christina Briscoe Abath, Camilo A. Gutierrez, Adam L. Numis, Chellamani Harini, Zihuai He, Shaun A. Hussain, Anne T. Berg, Catherine J. Chu, William D. Gaillard, Tobias Loddenkemper, Archana Pasupuleti, Debopam Samanta, Rani K. Singh, Nilika S. Singhal, Courtney J. Wusthoff, Elaine C. Wirrell, Elissa Yozawitz, Kelly G. Knupp, Renee A. Shellhaas, Zachary M. Grinspan
Summary: This study aimed to investigate whether the treatment selection for children with infantile spasms (IS) varies by race/ethnicity. The results showed that non-Hispanic Black children were more often treated with non-standard therapies, and children with public insurance were less likely to receive standard therapies. Further research on the drivers of inequities and the impact of racism on treatment decisions is crucial for improving care for IS patients.
ANNALS OF NEUROLOGY
(2022)
Article
Medicine, General & Internal
Michael Jackson, Marta Szczepaniak, Jasmine Wall, Mark Maskery, Catherine Mummery, Paul Morrish, Adrian Williams, Joanne Knight, Hedley C. A. Emsley
Summary: This study provides a large-scale analysis of neurological emergency admissions in England, identifying the number and types of admissions, the involvement of neurologists or neurosurgeons, and the variations based on levels of deprivation. The findings highlight epilepsy as the most common reason for adult admissions and significant associations between deprivation and epilepsy and functional neurological disorders.
Review
Clinical Neurology
Aurelie Hanin, Jorge Cespedes, Anita Huttner, David Strelnikov, Margaret Gopaul, Marcello DiStasio, Annamaria Vezzani, Lawrence J. Hirsch, Eleonora Aronica
Summary: New-Onset Refractory Status Epilepticus (NORSE) is a severe form of status epilepticus and its subtype with a preceding febrile illness, known as FIRES, remains largely unexplained. Understanding the pathophysiological mechanisms and long-term consequences of cryptogenic NORSE is crucial for improving patient management and preventing secondary neuronal injury and drug-resistant post-NORSE epilepsy. Neuropathological evaluations have been helpful in identifying the etiologies of some previously unknown cases. This study summarizes the findings of neuropathology studies in NORSE patients, highlighting cases where neuropathology findings aided in diagnosis or treatment selection.
JOURNAL OF NEUROLOGY
(2023)
Review
Clinical Neurology
Elena Iurina, Eva Bailles, Luis Pintor
Summary: Most of the studies found adaptive personality changes in adult patients with drug-resistant epilepsy after surgical treatment, such as decreased neuroticism and impulsivity, while one study showed increased emotional lability. The extent of personality changes depended on the epileptogenic area, seizure status after treatment, and duration of follow-up.
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
(2021)
Article
Clinical Neurology
Claudine Sculier, Cristina Barcia Aguilar, Nicolas Gaspard, Marina Gainza-Lein, Ivan Sanchez Fernandez, Marta Amengual-Gual, Anne Anderson, Ravindra Arya, Brian T. Burrows, James N. Brenton, Jessica L. Carpenter, Kevin E. Chapman, Justice Clark, William D. Gaillard, Tracy A. Glauser, Joshua L. Goldstein, Howard P. Goodkin, Mark Gorman, Yi-Chen Lai, Tiffani L. McDonough, Mohamad A. Mikati, Anuranjita Nayak, Katrina Peariso, James Riviello, Allison Rusie, Katherine Sperberg, Coral M. Stredny, Robert C. Tasker, Dmitry Tchapyjnikov, Alejandra Vasquez, Mark S. Wainwright, Angus A. Wilfong, Korwyn Williams, Tobias Loddenkemper
Summary: This study characterized the clinical profile and outcomes of new onset refractory status epilepticus (NORSE) in children, and found a relationship between fever onset and status epilepticus (SE). It showed that patients with fever at onset were younger and had shorter SE episodes with better outcomes, while patients with preceding fever had more prolonged SE and worse outcomes. This highlights the importance of fever timing in predicting clinical characteristics and outcomes of NORSE in pediatric patients.
Article
Clinical Neurology
Sami Barrit, Eun-Hyoung Park, Joseph R. Madsen
Summary: This article presents the surgical procedure and management considerations of posterior quadrant disconnection (PQD) for the treatment of intractable unilateral temporo-parieto-occipital epilepsy. PQD is a less invasive surgical option for selected cases, offering potential benefits over typical hemispherotomy and hemispherectomy.
ACTA NEUROCHIRURGICA
(2022)
Review
Neurosciences
Stanislas Lagarde, Christian-G Benar, Fabrice Wendling, Fabrice Bartolomei
Summary: This article reviews the concept of the epileptogenic network, explains the basic notions of functional connectivity, and reports the current body of published data using intracranial EEG. The data show that there are differential changes in functional connectivity between epileptic and non-epileptic areas even at temporal distance from seizures. These findings may help locate epileptic areas and predict surgical outcomes.
BRAIN CONNECTIVITY
(2022)
Review
Surgery
Arun Swaminathan
Summary: Epilepsy is a prevalent condition affecting a significant portion of the population, with refractory epilepsy requiring alternative interventions for patients who do not respond well to medication. Utilizing minimally invasive techniques and 3D reconstructions allows for precise localization and understanding of seizure networks, leading to optimal treatment outcomes.
FRONTIERS IN SURGERY
(2021)
Article
Clinical Neurology
Marie-Laure Girardin, Thomas Flamand, Ombeline Roignot, Marie-Therese Abi Warde, Veronique Mutschler, Paul Voulleminot, Max Guillot, Vera Dinkelacker, Anne De Saint-Martin
Summary: New onset refractory status epilepticus (NORSE) is a rare and devastating condition that affects previously healthy individuals. When preceded by a febrile infection, it is known as febrile infection-related epilepsy syndrome (FIRES). Treatment involves intensive care and the use of antiseizure drugs, anesthetic agents, and sometimes a ketogenic diet. Neuroinflammation plays a role in the condition, and intravenous immunoglobulin, corticosteroids, and immunomodulatory treatment can be added. Tocilizumab may have a positive response in treating status epilepticus but has varying neurological outcomes. Further research is needed to confirm the efficacy and safety of this treatment for FIRES/NORSE.
Article
Clinical Neurology
Elena Merli, Michele Romoli, Simone Galluzzo, Lorenzo Bevacqua, Emanuele Saverio Cece, Gabriele Ricci, Stefania Testoni, Anna Zaniboni, Maria Maddalena Viola, Luigi Simonetti, Francesca Bisulli, Sara Contardi, Paolo Tinuper, Andrea Zini
Summary: This study demonstrated the accuracy of CTP in identifying non-convulsive status epilepticus (NCSE), potentially serving as part of a pragmatic diagnostic workflow. CTP hyperperfusion showed a high negative predictive value for the diagnosis of NCSE, with further validation studies needed to evaluate its real-world application in NCSE cases.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Kun Guo, Bixiao Cui, Kun Shang, Yaqin Hou, Xiaotong Fan, Hongwei Yang, Guoguang Zhao, Jie Lu
Summary: This study evaluated the accuracy of [F-18]-FDG PET/MRI in preoperative localization and postsurgical prediction for refractory epilepsy patients. The results showed significant structural abnormalities in the MR portion and hypometabolism in the PET portion of the PET/MRI, suggesting a high sensitivity for detecting possible epileptic foci.
EUROPEAN RADIOLOGY
(2021)