Epilepsy and Behavior Reports最新文献_第6页

Before diagnosing stroke-like episodes in OPA1-related mitochondrial disorder, its imaging criteria must be met 在诊断与opa1相关的线粒体疾病的卒中样发作之前，必须满足其影像学标准

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Epilepsy and Behavior Reports Pub Date : 2025-09-01 Epub Date: 2025-04-12 DOI: 10.1016/j.ebr.2025.100772

Josef Finsterer

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A french real-world experience with cenobamate in patients with drug-resistant focal epilepsy: A retrospective observational study 法国对耐药局灶性癫痫患者使用cenobamate的实际经验：一项回顾性观察研究

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Epilepsy and Behavior Reports Pub Date : 2025-09-01 Epub Date: 2025-06-02 DOI: 10.1016/j.ebr.2025.100782

Antoine Plaquevent , Floriane Le Goff , Nathalie Chastan

{"title":"A french real-world experience with cenobamate in patients with drug-resistant focal epilepsy: A retrospective observational study","authors":"Antoine Plaquevent , Floriane Le Goff , Nathalie Chastan","doi":"10.1016/j.ebr.2025.100782","DOIUrl":"10.1016/j.ebr.2025.100782","url":null,"abstract":"<div><div>Epilepsy is a common and disabling neurological disorder. To significantly improve the quality of life of patients, the primary goal is to achieve seizure freedom. Unfortunately, 30 % of epilepsies are drug-resistant and seizure freedom is not acheived. Cenobamate is a new anti-seizure medication (ASM) used as a treatment for focal epilepsy in adults whose seizures have not been able to be controlled by two prior ASM. Two previous pivotal studies have showed an unusual seizure-free rate at 21 % and 28 %. A retrospective observational study was conducted to determine the effectiveness, safety and retention of cenobamate in 87 patients with highly focal drug-resistant epilepsy. The responder rate was 48 % with a seizure-free rate of 18 % at the last follow-up, with a mean dose of cenobamate at 216 mg. Adverse events were reported in 74 % patients, the most frequent being somnolence/fatigue and dizziness. No cases of DRESS or death were reported during the study. Cenobamate was discontinued in 34 % of patients, for a lack of efficacy despite an adequate dosage (≥ 200 mg) in 30 %, a poor tolerance in 27 %, for both insufficient efficacy and poor tolerance in 40 %, or for pregnancy plans in 3 %. Cenobamate is an effective and well-tolerated ASM in drug-resistant focal epilepsy and should be tried for highly drug-resistant epilepsy, even if many previous ASM have failed. Moreover, the impressive seizure-free rate leads to introducing cenobamate to all patients before or during the evaluation for surgical candidacy, and in any case before any resective surgery.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"31 ","pages":"Article 100782"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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The challenges in establishing and Upholding an adult Level III epilepsy center in an underserved area in the United states 在美国服务不足的地区建立和维护成人III级癫痫中心的挑战

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Epilepsy and Behavior Reports Pub Date : 2025-09-01 Epub Date: 2025-05-13 DOI: 10.1016/j.ebr.2025.100779

Kevin T. Dao , Clins Chacko , Shaan Braich , Lauren Liu , Neela Zalmay , Chrystal Nguyen , Kurupath Radhakrishnan , Charles Y. Liu , Hari Prasad Kunhi-Veedu

{"title":"The challenges in establishing and Upholding an adult Level III epilepsy center in an underserved area in the United states","authors":"Kevin T. Dao , Clins Chacko , Shaan Braich , Lauren Liu , Neela Zalmay , Chrystal Nguyen , Kurupath Radhakrishnan , Charles Y. Liu , Hari Prasad Kunhi-Veedu","doi":"10.1016/j.ebr.2025.100779","DOIUrl":"10.1016/j.ebr.2025.100779","url":null,"abstract":"<div><div>Despite vast improvement, even today, care of people with epilepsy (PWE) in many parts of the USA remains unevenly distributed and disjointed. We reviewed the experience of the Kern Medical Epilepsy Center (KMEC) to highlight the challenges in establishing and maintaining an epilepsy center in an underserved region of Southern California. We analyzed the prospectively collected data from 2018 through 2021 of KMEC, a National Association of Epilepsy Centers Level III accredited facility that serves PWE people residing in Central Valley, California. During the study period, there were 246 admissions to the Epilepsy Monitoring Unit, KMEC for detailed evaluation of difficult to treat epilepsy. Most patients were either of Hispanic descent or Caucasian. Thirty-seven patients underwent surgical interventions (8 resective surgery, and 23 vagus nerve stimulators and 6 responsive neurostimulators) with favorable outcomes in the majority. Many of them required referrals to the Level IV center at University of Southern California, Los Angeles, which were hindered by difficulties with getting appointments, transportation, insurance coverage, payment for treatment, and sluggish treatment processes. Our experience demonstrates that, despite considerable challenges, epilepsy care can be coordinated across complex and competing health systems separated by large geographic distances through creative, physician-driven strategies of resource sharing and goal alignment across the health care ecosystem. We hope that our experience will facilitate future efforts to integrate epilepsy care beyond this region in the USA, and elsewhere in the world. sluggish treatment processes. and elsewhere in the world.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"31 ","pages":"Article 100779"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Seizure control in glycine encephalopathy using the Ketamine-Dextromethorphan-Sodium benzoate triple therapy 氯胺酮-右美沙芬-苯甲酸钠三联疗法控制甘氨酸脑病的癫痫发作

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Epilepsy and Behavior Reports Pub Date : 2025-09-01 Epub Date: 2025-06-19 DOI: 10.1016/j.ebr.2025.100797

Laith Haddad , Samah Trad , Lama Charafeddine , Pascale E. Karam

{"title":"Seizure control in glycine encephalopathy using the Ketamine-Dextromethorphan-Sodium benzoate triple therapy","authors":"Laith Haddad , Samah Trad , Lama Charafeddine , Pascale E. Karam","doi":"10.1016/j.ebr.2025.100797","DOIUrl":"10.1016/j.ebr.2025.100797","url":null,"abstract":"<div><div>Neonatal glycine encephalopathy is a rare genetic neurometabolic disorder secondary to glycine cleavage system deficiency. Patients typically present with early-onset intractable seizures, status epilepticus and encephalopathy. Seizures control remains challenging in view of their refractoriness to standard anti-seizure medications. Sodium benzoate is commonly used to control the elevated glycine level. Oral anti-NMDA receptor antagonists, ketamine and dextromethorphan, have been used in various combinations in the treatment of this complex disorder. In this report, we present a neonatal case of classical glycine encephalopathy with hypotonia and refractory myoclonic seizures. The status epilepticus was successfully treated using a combination of intravenous ketamine, oral dextromethorphan and sodium benzoate. Seizures resolved and the patient’s development showed improvement on follow-up. The intravenous form of ketamine in the neonatal period is rarely used, and it has been reported in only two glycine encephalopathy patients in the literature. This is the first report in the literature of the efficacy of intravenous ketamine using the above triple therapy. This intervention might have implications on the management of neonatal intractable seizures in glycine encephalopathy, which might improve the outcome of this devastating disorder.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"31 ","pages":"Article 100797"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Ultra-long-term subcutaneous EEG recordings in ten epilepsy patients: Experiences and circadian rhythms in epileptiform discharges 10例癫痫患者的超长期皮下脑电图记录：癫痫样放电的经历和昼夜节律

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Epilepsy and Behavior Reports Pub Date : 2025-09-01 Epub Date: 2025-05-20 DOI: 10.1016/j.ebr.2025.100781

S.J. van Norden , K.H. Kho , A.M. Meppelink , J.J. Ardesch , M.C. Tjepkema-Cloostermans , M.J.A.M. van Putten

{"title":"Ultra-long-term subcutaneous EEG recordings in ten epilepsy patients: Experiences and circadian rhythms in epileptiform discharges","authors":"S.J. van Norden , K.H. Kho , A.M. Meppelink , J.J. Ardesch , M.C. Tjepkema-Cloostermans , M.J.A.M. van Putten","doi":"10.1016/j.ebr.2025.100781","DOIUrl":"10.1016/j.ebr.2025.100781","url":null,"abstract":"<div><div>Recently, a subcutaneous electroencephalography (sqEEG) electrode became available, enabling ultra-long-term EEG recordings. In our PREDYct study, we aim to predict the efficacy of vagus nerve stimulation (VNS) in epilepsy patients. The study records sqEEG for up to fifteen months, including a 2–3 month period before VNS implantation. Here we report on initial patient experiences, compliance and recordings of epileptiform discharges (EDs). We included the first 10 participants from our ongoing PREDYct study. We calculated recording compliance for each patient. Patients rated their pain during electrode implantation, wearing and explantation using the visual analogue scale (VAS). Approximately two weeks of data from each patient were visually assessed and all EDs were annotated. We used these annotations to evaluate circadian rhythms in ED rate and duration and to compare seizure diaries with annotated ictal patterns. Electrode implantation and explantation were well-tolerated with a median VAS of 4 and 2, respectively. Wearing the electrode was also well-tolerated with median VAS scores of 0 and 0.5 at two and fifteen months, respectively. On average, patients wore the electrode for 441 days with an overall compliance of 27 %, resulting in 28,331 h of EEG. A circadian rhythm in ED rate was observed in three patients, while one patient exhibited a circadian rhythm in ED duration. A comparison of reported seizures and annotated ictal patterns revealed discrepancies. Ultra-long-term sqEEG is well-tolerated and has the potential to be a valuable tool for monitoring treatment. Nevertheless, it remains a challenge but crucial to attain high recording compliance.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"31 ","pages":"Article 100781"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

GAD65-positive autoimmune-associated epilepsy presenting with Ictal Hand Kissing; an uncommon presentation of a rare disease gad65阳性的自身免疫相关癫痫，表现为纵向吻手；罕见病的罕见表现

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Epilepsy and Behavior Reports Pub Date : 2025-09-01 Epub Date: 2025-07-01 DOI: 10.1016/j.ebr.2025.100801

Alia M.R. Fallatah, Hanan M. Abdulmutali, Majed H. Alhameed

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Temporopolar epilepsy stereoEEG: implant technique and outcomes 颞极癫痫立体脑电图：植入技术和结果

IF 1.5

Epilepsy and Behavior Reports Pub Date : 2025-09-01 Epub Date: 2025-07-29 DOI: 10.1016/j.ebr.2025.100813

Maya A. Jayaram , Andrew I. Yang , Ashley L.B. Raghu , Peter A. Rozman , Denise F. Chen , Jon T. Willie , Ammar Kheder , Robert E. Gross

{"title":"Temporopolar epilepsy stereoEEG: implant technique and outcomes","authors":"Maya A. Jayaram , Andrew I. Yang , Ashley L.B. Raghu , Peter A. Rozman , Denise F. Chen , Jon T. Willie , Ammar Kheder , Robert E. Gross","doi":"10.1016/j.ebr.2025.100813","DOIUrl":"10.1016/j.ebr.2025.100813","url":null,"abstract":"<div><div>The temporal pole (TP) is an under-investigated region in temporal lobe epilepsy, often overlooked during stereoEEG (sEEG) due to the lack of characteristic Phase 1 findings and technical limitations in implanting using traditional orthogonal trajectories. We retrospectively reviewed consecutive patients with TP-onset seizures confirmed on sEEG. Two non-orthogonal trajectories were utilized targeting the inferior (iTP) and superior (sTP) aspects of TP. TP was implanted in 43 hemispheres of 30 patients, in whom seizure onset in TP was identified in 32 hemispheres. Seizure foci were spatially limited to TP in 50 % of cases, whereas the remainder involved broader regions, most commonly mesial temporal structures (88 %). In a subset of cases (22 %), TP seizures emerged from either the sTP or iTP, in contrast to those emerging more diffusely across both sub-regions. Encephaloceles were found in 43 % of patients and were associated with ipsilateral TP-onset seizures in 93 % of those cases. In a heterogeneous cohort who underwent surgical intervention, 50 % achieved Engel class I outcomes at 2 years. Our series illustrates the considerable variability in the seizure onset zone across patients with TP epilepsy, both within TP as well as in its involvement of neighboring regions. Inclusion of TP during invasive monitoring can inform subsequent surgical interventions.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"31 ","pages":"Article 100813"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Changes in brain network dynamics during functional/dissociative seizures: An exploratory pilot study on EEG microstates 功能性/解离性癫痫发作期间脑网络动力学的变化：脑电图微观状态的探索性初步研究

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Epilepsy and Behavior Reports Pub Date : 2025-09-01 Epub Date: 2025-07-23 DOI: 10.1016/j.ebr.2025.100809

Domantė Kučikienė , Johannes Jungilligens , Stefan Wolking , Yvonne Weber , Jörg Wellmer , Stoyan Popkirov

{"title":"Changes in brain network dynamics during functional/dissociative seizures: An exploratory pilot study on EEG microstates","authors":"Domantė Kučikienė , Johannes Jungilligens , Stefan Wolking , Yvonne Weber , Jörg Wellmer , Stoyan Popkirov","doi":"10.1016/j.ebr.2025.100809","DOIUrl":"10.1016/j.ebr.2025.100809","url":null,"abstract":"<div><div>The pathophysiology of functional/dissociative seizures (FDS), also known as psychogenic nonepileptic seizures, remains incompletely understood. Current theories suggest that ictal changes in self-awareness and behavioural control are likely related to arousal-mediated disruptions of brain network dynamics, but direct electrophysiological evidence is scarce. In a proof-of-concept, the second of its kind pilot study, we explored ictal changes in EEG microstates – quasi-stable patterns of electrical activity of 50–70 ms duration that represent fundamental building blocks of large-scale brain network dynamics. Across a sample of 13 FDS patients, four microstates yielded a high mean global explained variance of 76.2 % and qualitatively resembled the well-established “canonical” microstate map topographies A-D. Repeated measure analysis of variance did not reveal any significant differences in contribution, occurrence or global field power of microstates between baseline and ictal recordings. Microstate duration, however, was significantly different between baseline and seizure recordings with shorter durations of microstates in FDS (p = 0.007). This was most pronounced for microstate D (Cohen’s <em>d</em> = 0.75) with the change being significant in an exploratory post hoc paired <em>t</em>-test (p = 0.044). Since microstate D is thought to reflect frontoparietal network activity, the findings of this pilot study can be interpreted as supportive of current theories of arousal-mediated disruptions of network activity that reduce cognitive and behavioural control during FDS.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"31 ","pages":"Article 100809"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Implementation of a digital health tool for seizure video transfer in a pediatric epilepsy center: A prospective pilot study 在儿童癫痫中心实施用于癫痫视频传输的数字健康工具：一项前瞻性试点研究

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Epilepsy and Behavior Reports Pub Date : 2025-09-01 Epub Date: 2025-07-30 DOI: 10.1016/j.ebr.2025.100811

Rahel M. Burger , Gadi Miron , Pascal Fenske , Cornelia Potratz , Angela M. Kaindl , Christian Meisel

{"title":"Implementation of a digital health tool for seizure video transfer in a pediatric epilepsy center: A prospective pilot study","authors":"Rahel M. Burger , Gadi Miron , Pascal Fenske , Cornelia Potratz , Angela M. Kaindl , Christian Meisel","doi":"10.1016/j.ebr.2025.100811","DOIUrl":"10.1016/j.ebr.2025.100811","url":null,"abstract":"<div><div>Home videos are increasingly presented in clinical practice, and secure digital tools for clinical video sharing are urgently needed. This study evaluated the feasibility of a secure video-sharing digital platform in pediatric epilepsy diagnostics. We conducted a prospective pilot study that included 60 children (median age 5.5 years) with suspected seizures and their caregivers at a tertiary pediatric center. Participants were invited to submit videos of suspected events through a secure smartphone application. Videos were reviewed by an epileptologist and in parallel participants underwent standard diagnostic evaluation. Outcome measures included video quality, concordance of video assessment with diagnostic workup, and user evaluation questionnaires. Of recruited participants, 16 (26.7 %) used the app to submit 81 videos (median 5.1 videos per patient), with 94 % (76/81 videos) having sufficient quality for meaningful clinical review. Among these participants, 11 (68.8 %) had confirmed epilepsy as their final diagnosis, while 5 (31.2 %) did not. Expert review classified 48.1 % of videos as likely epileptic events, with generalized tonic-clonic seizures being most common (24.7 %). Concordance between submitted videos and final clinical diagnosis was demonstrated in 68.8 % of cases, with higher concordance significantly related to the number of videos submitted (mean 6.4 vs. 2.2 videos per patient, p = 0.04). User evaluation showed favorable ratings for app usability (mean score 5.4/7). This study demonstrates the feasibility of secure digital video transfer in pediatric epilepsy diagnostics, emphasizing the importance of multiple video submissions for accurate diagnosis. Future implementation should address barriers to wider adoption and investigate clinical impact.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"31 ","pages":"Article 100811"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144748990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful treatment of super-refractory focal status epilepticus: Surgery, vagus nerve stimulation, and botox for epilepsia partialis continua 成功治疗超难治性局灶性癫痫持续状态：手术、迷走神经刺激和肉毒杆菌毒素治疗部分持续性癫痫

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Epilepsy and Behavior Reports Pub Date : 2025-09-01 Epub Date: 2025-05-02 DOI: 10.1016/j.ebr.2025.100775

N. Zalmay , G. Nune , C.N. Heck , K.T. Dao , B.T. Ly , J. Ipe , C.Y. Liu , H.P. Kunhi Veedu

{"title":"Successful treatment of super-refractory focal status epilepticus: Surgery, vagus nerve stimulation, and botox for epilepsia partialis continua","authors":"N. Zalmay , G. Nune , C.N. Heck , K.T. Dao , B.T. Ly , J. Ipe , C.Y. Liu , H.P. Kunhi Veedu","doi":"10.1016/j.ebr.2025.100775","DOIUrl":"10.1016/j.ebr.2025.100775","url":null,"abstract":"<div><div>Super-refractory status epilepticus (SRSE) is a life-threatening condition characterized by persistent seizures lasting beyond seven days despite anesthetic therapy. Managing SRSE is challenging, particularly in cases resistant to conventional treatments. This case report presents a 41-year-old female with prolonged SRSE secondary to focal epilepsy, successfully treated with surgical resection, vagus nerve stimulation (VNS), and botulinum toxin (BoNT) therapy. The patient initially presented with left focal motor status epilepticus and a right frontal intracerebral hematoma. Despite an emergency craniotomy, her seizures persisted, leading to prolonged SRSE. After multiple failed sedation weaning attempts, a stepwise intervention approach was implemented consisting of an Electrocorticography (ECoG)-guided surgical resection of the residual epileptic focus, VNS implantation for long-term seizure modulation, BoNT therapy for residual epilepsia partialis continua (EPC). The combined approach of surgical resection and VNS implantation successfully terminated the status epilepticus. Residual Epilepsia Partialis Continua (EPC) was effectively managed with botulinum toxin therapy (BoNT). This case underscores the potential efficacy of combining surgical resection and VNS implantation in treating SRSE and highlights the beneficial effects of BoNT in managing residual EPC, offering a potential treatment pathway for similar refractory cases.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"31 ","pages":"Article 100775"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0