Epilepsy

PURPOSE: Proinflammatory cytokines seems to play a role in epileptogenesis independent of the underlying cause. The purpose of this study was to assess if IL-18 and its binding protein IL-18BP are related to epilepsy and could act as a predictive biomarker for epileptogenesis. METHODS: In this cross-sectional study, circulating levels of IL-18 and IL-18BP were analysed in 119 epilepsy patients, and 80 healthy controls. Participants completed a questionnaire regarding epilepsy, use of drug(-s) and comorbidity...

INTRODUCTION: As a dynamical system, the brain constantly modulates its state and epileptic seizures have been hypothesized to be low dimensional periodic states of the brain. With this assumption, seizures have previously been investigated to identify patterns of these recurrent states; however, these attempts have generated conflicting results. These discrepant observations led us to reconsider the dynamic of state transitions during seizures. METHODS: Using intracerebral recordings of 17 refractory epilepsy patients assessed prior to surgery, we studied ictal states with several state-of-the-art methods in order to investigate their dynamics...

BACKGROUND: Mir-9 was recognized as a potential tumor suppressor gene or oncogene in varies of diseases; however, its roles in glioma have not been investigated. Our study was to identify the mRNA expression of mir-9 gene in glioma and correlate abnormal versions of microRNAs with clinicopathological features and investigate the impact of mir-9 in glioma prognosis. METHODS: Seventy-one glioma samples, which included 22 grade II, 24 grade III, and 25 glioblastoma tumors of previously untreated patients who underwent surgical excision at Qing Hai Province People's Hospital from 2011 to 2014, were included...

No abstract text is available yet for this article.

OBJECTIVE: Compared to other seizure types, generalized tonic-clonic (GTC) seizures may be disproportionately related to increased morbidity, and reducing seizure frequency could translate into improvements across measures of morbidity in medically treated patients with drug-resistant epilepsy (DRE). The primary objective of this analysis was to quantify the burden of patients with DRE who experience GTC seizures (GTC+) compared to patients with DRE who do not experience GTC seizures (GTC-)...

OBJECTIVE: Previous research suggests that natural fluctuations in seizure rates within individuals have a quantifiable impact on therapeutic clinical trial outcomes. METHODS: A trial simulator estimated the statistical power of clinical trials with a typical trial design with and without patients included who exhibited a range of means (1-15 seizures/mo) and standard deviations (1-15 seizures/mo) in their baseline seizure rates. Trial outcomes were evaluated using 50% responder rates, median percentage change, and time to prerandomization...

OBJECTIVE: The RNS System is a direct brain-responsive neurostimulation system that is US Food and Drug Administration-approved for adults with medically intractable focal onset seizures based on safety and effectiveness data from controlled clinical trials. The purpose of this study was to retrospectively evaluate the real-world safety and effectiveness of the RNS System. METHODS: Eight comprehensive epilepsy centers conducted a chart review of patients treated with the RNS System for at least 1 year, in accordance with the indication for use...

PURPOSE OF REVIEW: The discovery of new disease-causing genes and availability of next-generation sequencing platforms have both progressed rapidly over the last few years. For the practicing neurologist, this presents an increasingly bewildering array both of potential diagnoses and of means to investigate them. We review the latest newly described genetic conditions associated with dystonia, and also address how the changing landscape of gene discovery and genetic testing can best be approached, from both a research and a clinical perspective...

PURPOSE OF REVIEW: Hybrid PET- MRI is a technique that has the ability to improve diagnostic accuracy in many applications, whereas PET and MRI performed separately often fail to provide accurate responses to clinical questions. Here, we review recent studies and current developments in PET-MRI, focusing on clinical applications. RECENT FINDINGS: The combination of PET and MRI imaging methods aims at increasing the potential of each individual modality. Combined methods of image reconstruction and correction of PET-MRI attenuation are being developed, and a number of applications are being introduced into clinical practice...

The South African (SA) Constitutional Court recently decriminalised the private cultivation, possession and use of cannabis by adults. Cannabis contains varying amounts of the cannabinoids delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), depending on various cultivation factors. No commercial plant-derived cannabis products are currently registered by the SA Health Products Regulatory Authority (SAHPRA) for medical use. Such products are therefore unregulated, but are freely available in SA, and may be of inadequate quality and unverified composition, and not guaranteed to be safe or effective...

The compounds present in cannabis have been in use for both recreational and medicinal purposes for many centuries. Changes in the legislation in South Africa have led to an increase in the number of people interested in using these compounds for self-medication. Many of them may approach their general practitioner as the first source of information about possible therapeutic effects. It is important that medical professionals are able to give patients the correct information. Cannabidiol (CBD) is one of the main compounds in cannabis plants, and there is evidence that it can successfully treat certain patients with epilepsy...

Epilepsy is one of the most occurring neurological disease globally emerged back in 4000 BC. It is affecting around 50 million people of all ages these days. The trait of this disease is recurrent seizures. In the past few decades, the treatments available for seizure control have improved a lot with the advancements in the field of medical science and technology. Electroencephalogram (EEG) is a widely used technique for monitoring the brain activity and widely popular for seizure region detection. It is performed before surgery and also to predict seizure at the time operation which is useful in neuro stimulation device...

Sleep is pivotal for memory consolidation. According to two-stage accounts, memory traces are gradually translocated from hippocampus to neocortex during non-rapid-eye-movement (NREM) sleep. Mechanistically, this information transfer is thought to rely on interactions between thalamocortical spindles and hippocampal ripples. To test this hypothesis, we analyzed intracranial and scalp Electroencephalography sleep recordings from pre-surgical epilepsy patients. We first observed a concurrent spindle power increase in hippocampus (HIPP) and neocortex (NC) time-locked to individual hippocampal ripple events...

Reports on social cognition in patients with developmental amnesia resulting from bilateral hippocampal lesions are rare, although the link between social cognition and temporal lobe structures is well established. We present the case of a 23-year-old male epilepsy patient, BM, with developmental amnesia due to perinatal cerebral hypoxia. The patient was examined with neuroimaging and neuropsychological methods and compared to IQ-matched patients with epilepsy to control for effects of epilepsy. In addition, we used a test battery that evaluates emotion recognition and theory of mind to study his social cognition abilities...

BACKGROUND AND PURPOSE: Epilepsy is often associated with substantial stigma. This study evaluated clinical correlates of stigma in a sample of people living with epilepsy (PLWE) considered high risk due to frequent seizures or other negative health events. METHODS: Data were derived from an epilepsy self-management clinical trial. Standardized measures assessed socio-demographics, epilepsy stigma, epilepsy severity, self-efficacy, self-management competency, health literacy, depressive symptoms severity, functional status, social support and quality of life...

Antiepileptic drugs (AEDs) are the primary treatment strategy for epilepsy. As the use of AEDs has become more widespread and diverse over the past century, it has become necessary to refine the associated prescription strategies. This prompted the Drug Committee of the Korean Epilepsy Society to perform a systemic review of both international and domestic guidelines as well as literature related to medical treatment of epilepsy, and prepared a series of reviews to provide practical guidelines for clinicians to follow...

Introduction: Lafora disease (LD) is a rare form of progressive infantile epilepsy in which rapid neurological deterioration occurs as the disease advances, leading the patients to a vegetative state and then death, usually within the first decade of disease onset. Based on the capacity of the endogenous cannabinoid system (ECS) to modulate several cellular processes commonly altered in many neurodegenerative processes, as well as the antiepileptic properties of certain natural cannabinoids, the aim of this study was to evaluate the role of the ECS in LD progression...

Introduction: Highly purified cannabidiol (CBD) (approved as Epidiolex® in the United States) has demonstrated efficacy with an acceptable safety profile in patients with Lennox-Gastaut or Dravet syndrome in four randomized controlled trials. CBD possesses affinity for many target classes with functional effects relevant to the pathophysiology of many disease types, including epilepsy. Although the mechanism of action of CBD underlying the reduction of seizures in humans is unknown, transient receptor potential vanilloid 1 (TRPV1) represents a plausible target because (1) CBD activates and then desensitizes TRPV1, (2) TRPV1 is overexpressed in models of temporal lobe epilepsy and patients with epilepsy, (3) and TRPV1 modulates neuronal excitability...

This report describes a unique case of recurrent transient hyperammonemia (THA) following a first-time occurrence of generalized tonic-clonic seizure in a young adult, who went on to develop post-stroke epilepsy. Although this phenomenon has been described in recent literature, we report not only the highest initial ammonia level to date, 549 µmol/L, but we also document serial trends of the ammonia levels at multiple admissions for the same patient for the management of breakthrough seizures. Interestingly enough, persistence of the elevation of the ammonia levels was accompanied by no other significant metabolic derangements, unlike reported in similar cases...

Intractable epilepsy remains a significant medical challenge, resulting in recurrent and prolonged intensive care unit (ICU) admissions. Autoimmune encephalitis is emerging as a treatable cause of intractable epilepsy. It is characterized by antibodies against cerebral antigens, such as potassium channels such as leucine-rich, glioma inactivated 1 (LGI1) and contactin-associated protein 2 (CASPR2), calcium channels such as the voltage-gated calcium channel (VGCC), or neurotransmitter receptors such as the α -amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), gamma aminobutyric acid receptor (GABAR), and N -methyl-D-aspartate receptor (NMDAR)...