Epilepsy Currents最新文献

{"title":"Brain on Fire: How Brain Infection and Neuroinflammation Drive Worldwide Epilepsy Burden","authors":"Melissa Barker-Haliski, Ana Beatriz DePaula-Silva, Julika Pitsch, Harald Sontheimer, Lawrence J. Hirsch, Aristea S. Galanopoulou, Jennifer A. Kearney","doi":"10.1177/15357597241242238","DOIUrl":"https://doi.org/10.1177/15357597241242238","url":null,"abstract":"Roughly 80% of the global burden of epilepsy resides in low- and middle-income countries (LMICs; WHO, 2022). Despite numerous new therapies for the treatment of epilepsy, the number of patients who remain resistant to available medications is unchanged. Additionally, no therapy has yet been clinically proven to prevent or attenuate the development of epilepsy in at-risk individuals. Unfortunately, access to next generation therapies in LMICs is low, the stigma associated with epilepsy remains high, and access to adequate resources is unchanged. Thus, the global epilepsy burden disproportionately falls on LMICs such that strategies to conscientiously integrate global epilepsy risk factors into preclinical research may meaningfully advance 21st century epilepsy therapies. Brain infections are one of the main risk factors for epilepsy in resource-poor settings. Further, both infection- and autoimmune-associated encephalitis contribute to worldwide epilepsy risk and remain relatively understudied. For example, clinical SARS CoV-2 infection can induce rare instances of encephalopathy and acute seizures. Among viruses known to cause acute brain infection, enteroviruses increase risk for encephalitis-induced epilepsy, but are not associated with risk for other neurodevelopmental disorders (eg, autism spectrum or attentional deficit hyperactivity disorders). Naturally occurring models of viral infection-induced epilepsy therefore provide an exquisite opportunity to uncover novel contributors to epileptogenesis. Moreover, the convergent neuroinflammatory pathways that are associated with viral infection-induced encephalitis and autoimmune encephalitis reflect an untapped therapeutic opportunity to meaningfully reduce the global burden of epilepsy. This review summarizes the latest advances in translational research integrating encephalitis-induced seizure and epilepsy models, in tandem with progress in clinical diagnosis of inflammation and virally mediated epilepsy. This improved awareness of the shared biological underpinnings of epileptogenesis following brain infection or autoimmune encephalitis is anticipated to beneficially impact the global burden of epilepsy.","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140840331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Testing in the Presurgical Evaluation of Drug-Resistant Epilepsy: Bells and Whistles or Nuts and Bolts?","authors":"Ioannis Karakis","doi":"10.1177/15357597241250161","DOIUrl":"https://doi.org/10.1177/15357597241250161","url":null,"abstract":"[Box: see text][Box: see text]","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":"1 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140840191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyclin-Dependent Kinase-Like 5 Deficiency Disorder: A Calcium Channelopathy?","authors":"Carl E. Stafstrom","doi":"10.1177/15357597241249045","DOIUrl":"https://doi.org/10.1177/15357597241249045","url":null,"abstract":"[Box: see text]","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140840396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common Ground: We Can Comprehensively Treat Pediatric Epilepsy and Psychiatric Comorbidities","authors":"Jay A. Salpekar, D. Dilara Ertenu","doi":"10.1177/15357597241250159","DOIUrl":"https://doi.org/10.1177/15357597241250159","url":null,"abstract":"Epilepsy and psychiatric illness have been long studied and today are better accepted as co-occurring than as discrete illnesses that are independent even if associated. Common pathophysiology may not be easily explained, but clearly exists given the significant overrepresentation of psychiatric illness among individuals with epilepsy. Conditions like autism spectrum disorder, anxiety, depression, and attention deficit hyperactivity disorder are prevalent in pediatric epilepsy much more than expected, even in the context of chronic neurologic disease. The interplay between pediatric epilepsy and neuropsychiatric symptoms represents a complex clinical circumstance that is not well subtended by the chasm-like division of labor between psychiatrists and neurologists. The unfortunate result is that children and families often experience care that is fractured and at worst, counterproductive for their quality of life. A neuropsychiatric paradigm is essential to address epilepsy and its intrinsic psychiatric symptoms. Practical strategies will be discussed to address this challenge.","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":"105 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140840506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizing the Future: Predicting Epilepsy After TBI","authors":"Jeanne T. Paz","doi":"10.1177/15357597241242241","DOIUrl":"https://doi.org/10.1177/15357597241242241","url":null,"abstract":"[Box: see text]","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":"26 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140617392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Any Way You Slice It: Corpus Callosotomy in Pediatric Drug-Resistant Epilepsy","authors":"Anthony Fine","doi":"10.1177/15357597241242243","DOIUrl":"https://doi.org/10.1177/15357597241242243","url":null,"abstract":"[Box: see text]","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":"2013 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140617540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It Matters Who Starts the Fire in Mesial Temporal Lobe Epilepsy","authors":"Jeffrey H. Goodman","doi":"10.1177/15357597241238901","DOIUrl":"https://doi.org/10.1177/15357597241238901","url":null,"abstract":"[Box: see text]","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":"200 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140617315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It’s About Time! Timing in Epilepsy Evaluation and Treatment","authors":"Heather Ravvin McKee, Jorge Vidaurre, Dave Clarke, Janelle Wagner, Jeffrey W. Britton, Linda Laux, Eugen Trinka, Clio Rubinos, Tanya J. W. McDonald, Fred A. Lado, Martina Bebin, Christos Papadelis, Aaron F. Struck, Carolina B. Maciel, Ana L. Velasco, Arjun Chandran, Sandipan Pati, Nitin Tandon, Guadalupe Fernandez-Baca Vaca, Madison M. Berl, Ahsan N. Moosa","doi":"10.1177/15357597241238072","DOIUrl":"https://doi.org/10.1177/15357597241238072","url":null,"abstract":"The 2023 American Epilepsy Society Annual Course “It’s About Time” addressed timing in epilepsy evaluation and treatment with respect to health disparity and vulnerable populations and diagnostic, clinical, and epilepsy surgery evaluation. This comprehensive course included topics on gaps in epilepsy care and optimization of behavioral health for patients with epilepsy. The summary details current knowledge in areas of seizure forecasting and epileptogenesis. Intricacies and controversies over timing were discussed for treatment of nonconvulsive seizures and ictal-interictal patterns, acute symptomatic seizures, neuromodulation versus surgery, and epilepsy surgery in status epilepticus. Timing regarding clinical care in autoimmune-associated epilepsy, developmental and epileptic encephalopathy, and dietary therapy were examined. Additionally, salient topics on using novel biomarkers and collaboration with neuropsychological outcomes were also tackled in this all-encompassing lecture series.","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140603053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence: Fundamentals and Breakthrough Applications in Epilepsy","authors":"Wesley Kerr, Sandra Acosta, Patrick Kwan, Gregory Worrell, Mohamad A. Mikati","doi":"10.1177/15357597241238526","DOIUrl":"https://doi.org/10.1177/15357597241238526","url":null,"abstract":"Artificial intelligence, machine learning, and deep learning are increasingly being used in all medical fields including for epilepsy research and clinical care. Already there have been resultant cutting-edge applications in both the clinical and research arenas of epileptology. Because there is a need to disseminate knowledge about these approaches, how to use them, their advantages, and their potential limitations, the goal of the 2023 Merritt-Putnam Symposium and of this synopsis review of that symposium has been to present the background and state of the art and then to draw conclusions on current and future applications of these approaches through the following: (1) Initially provide an explanation of the fundamental principles of artificial intelligence, machine learning, and deep learning. These are presented in the first section of this review by Dr Wesley Kerr. (2) Provide insights into their cutting-edge applications in screening for medications in neural organoids, in general, and for epilepsy in particular. These are presented by Dr Sandra Acosta. (3) Provide insights into how artificial intelligence approaches can predict clinical response to medication treatments. These are presented by Dr Patrick Kwan. (4) Finally, provide insights into the expanding applications to the detection and analysis of EEG signals in intensive care, epilepsy monitoring unit, and intracranial monitoring situations, as presented below by Dr Gregory Worrell. The expectation is that, in the coming decade and beyond, the increasing use of the above approaches will transform epilepsy research and care and supplement, but not replace, the diligent work of epilepsy clinicians and researchers.","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":"37 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140573463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exit Strategy: Balancing the Risks and Rewards of Antiseizure Medication Withdrawal","authors":"Marian Galovic, Carolina Ferreira-Atuesta, Lara E. Jehi, Kees P. J. Braun, Samuel W. Terman","doi":"10.1177/15357597241238898","DOIUrl":"https://doi.org/10.1177/15357597241238898","url":null,"abstract":"The majority of people with epilepsy achieves long-term seizure-freedom and may consider withdrawal of their anti-seizure medications (ASMs). Withdrawal of ASMs can yield substantial benefits but may be associated with potential risks. This review critically examines the existing literature on ASM withdrawal, emphasizing evidence-based recommendations, where available. Our focus encompasses deprescribing strategies for individuals who have attained seizure freedom through medical treatment, those who have undergone successful epilepsy surgery, and individuals initiated on ASMs following acute symptomatic seizures. We explore state-of-the-art prognostic models in these scenarios that could guide the decision-making process. The review underscores the importance of a collaborative shared-decision approach between patients, caregivers, and physicians. We describe the subjective and objective factors influencing these decisions and illustrate how trade-offs may be effectively managed in practice.","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":"279 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140300649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}