Epilepsy and Behavior Reports最新文献

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Major depression, anxiety disorder and suicidality in epilepsy: What should neurologists do? 癫痫患者的重度抑郁、焦虑障碍和自杀倾向:神经科医生应该怎么做?
IF 1.8
Epilepsy and Behavior Reports Pub Date : 2025-02-27 DOI: 10.1016/j.ebr.2025.100758
Andres M. Kanner
{"title":"Major depression, anxiety disorder and suicidality in epilepsy: What should neurologists do?","authors":"Andres M. Kanner","doi":"10.1016/j.ebr.2025.100758","DOIUrl":"10.1016/j.ebr.2025.100758","url":null,"abstract":"<div><div>Four to five patients with epilepsy (PWE) can suffer from Major Depressive episodes (MDE). Comorbid anxiety disorders (AD) frequently occur together with MDE. Failure to treat MDE can negatively affect several aspects of their life as well as the management of the epilepsy. Often, suicidal ideation is among its symptoms, which need to be addressed without delay to prevent suicidal attempts or a completed suicide. Unfortunately, access to health care professionals is very limited and, in many communities, non-existent. Accordingly, it falls upon the treating neurologist to begin a pharmacologic trial with psychotropic drugs. The purpose of this manuscript is to provide neurologists with very useful strategies on how to screen and identify MDEs with and without AD in the outpatient clinic and how to select the appropiate psychotropic drugs. Using an illustrative case, we discuss its differential diagnosis, particularly the recognition of iatrogenic episodes, and demonstrate the selection and mode of use of commonly used antidepressant in PWE. Finally, we provide a guide on how the neurologist can assess the suicidal risk of a patient that endorses suicidal ideation and the steps that need to be taken to minimize the risk of suicidal behavior.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"30 ","pages":"Article 100758"},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhancing seizure control in ultra-refractory postencephalitic epilepsies using multinodal network neuromodulation 多节神经网络调节增强超难治性脑后癫痫发作控制
IF 1.8
Epilepsy and Behavior Reports Pub Date : 2025-02-17 DOI: 10.1016/j.ebr.2025.100755
Subhiksha Srinivasan , Surya Suresh , Ganne Chaitanya , Manoj Saranathan , Nitin Tandon , Sandipan Pati
{"title":"Enhancing seizure control in ultra-refractory postencephalitic epilepsies using multinodal network neuromodulation","authors":"Subhiksha Srinivasan ,&nbsp;Surya Suresh ,&nbsp;Ganne Chaitanya ,&nbsp;Manoj Saranathan ,&nbsp;Nitin Tandon ,&nbsp;Sandipan Pati","doi":"10.1016/j.ebr.2025.100755","DOIUrl":"10.1016/j.ebr.2025.100755","url":null,"abstract":"<div><div>This case series reports the formidable challenge posed by postencephalitic epilepsies, characterized by frequent drug-resistant seizures and neuropsychiatric and cognitive comorbidities. Polypharmacy is frequently required, and surgical resection may not be feasible due to multifocality. Neuromodulation therapies, including Deep Brain Stimulation (DBS) and Responsive Neurostimulation (RNS), offer a potential lifeline. In this case series, we shed light on the intricate landscape of seizure management and neuropsychiatric comorbidities in five individuals with frequent seizures (often weekly) and ultra-refractory epilepsy (defined as resistance to more than six different antiseizure medications, including failed epilepsy surgery) following catastrophic encephalitis. Four out of five patients achieved at least 50% reduction in seizure frequency following multimodal neuromodulation interventions. Moreover, we underscore the pivotal role of RNS electrocorticography (ECoG) in monitoring the epileptiform burden to guide therapy. Postencephalitic patients often present with a complex interplay of epileptic and nonepileptic (including neuropsychiatric) events, necessitating distinct therapeutic approaches. RNS ECoG emerges as a critical tool for differentiation and tailored therapy. While our findings highlight the potential effectiveness of neuromodulation in managing postencephalitic epilepsy, further research is needed to identify predictors of treatment response and explore the application of these therapies in chronic epilepsy caused by encephalitis. Overall, neuromodulation offers hope for improving these patients’ quality of life.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"30 ","pages":"Article 100755"},"PeriodicalIF":1.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Examining the role of physical activity in older adults with epilepsy 检查身体活动在老年癫痫患者中的作用
IF 1.8
Epilepsy and Behavior Reports Pub Date : 2025-02-17 DOI: 10.1016/j.ebr.2025.100756
Stephen P. Klaus , Serdar Akkol , Smitha K. Achuthan , Annie He , Cynthia Zheng , Ed Faught , Halley B. Alexander
{"title":"Examining the role of physical activity in older adults with epilepsy","authors":"Stephen P. Klaus ,&nbsp;Serdar Akkol ,&nbsp;Smitha K. Achuthan ,&nbsp;Annie He ,&nbsp;Cynthia Zheng ,&nbsp;Ed Faught ,&nbsp;Halley B. Alexander","doi":"10.1016/j.ebr.2025.100756","DOIUrl":"10.1016/j.ebr.2025.100756","url":null,"abstract":"<div><div>Epilepsy disproportionately affects older adults due to acquired conditions including stroke, neurodegeneration and head trauma secondary to falls. Current literature lacks adequate representation of specific therapies and considerations for this cohort. Furthermore, older adults are more susceptible to the adverse effects of anti-seizure medications necessitating increased caution when treating. Non-pharmacological interventions, including physical activity (PA), are underrecognized, particularly in older adults where they may be of greatest benefit. The following narrative review describes how older adults are uniquely impacted by epilepsy and associated comorbidities. It examines the current literature with respect to PA in epilepsy and, where available, evidence for PA in older adults. This includes how PA can affect pathogenesis and reduce the incidence of epilepsy onset through the reduction of neuroinflammation. PA may also be utilized by older adults with epilepsy to improve cardiovascular function, seizure control, prevent falls and secondary head injury, as an adjunct treatment for mood disorders and cognitive decline, and to promote general well-being. PA has a large and underappreciated role to play in older adults with epilepsy and is increasingly being recognized by healthcare providers and incorporated into practice guidelines.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"30 ","pages":"Article 100756"},"PeriodicalIF":1.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) with high-frequency oscillations on scalp EEG: A case report 线粒体肌病、脑病、乳酸性酸中毒和脑卒中样发作(MELAS)伴头皮脑电图高频振荡1例报告
IF 1.8
Epilepsy and Behavior Reports Pub Date : 2025-02-13 DOI: 10.1016/j.ebr.2025.100754
Keisuke Maeda , Himari Tsuboi , Nami Hosoda , Junichi Fukumoto , Shiho Fujita , Naohiro Ichino , Keisuke Osakabe , Keiko Sugimoto , Gen Furukawa , Naoko Ishihara
{"title":"Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) with high-frequency oscillations on scalp EEG: A case report","authors":"Keisuke Maeda ,&nbsp;Himari Tsuboi ,&nbsp;Nami Hosoda ,&nbsp;Junichi Fukumoto ,&nbsp;Shiho Fujita ,&nbsp;Naohiro Ichino ,&nbsp;Keisuke Osakabe ,&nbsp;Keiko Sugimoto ,&nbsp;Gen Furukawa ,&nbsp;Naoko Ishihara","doi":"10.1016/j.ebr.2025.100754","DOIUrl":"10.1016/j.ebr.2025.100754","url":null,"abstract":"<div><div>Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is a rare mitochondrial disease with a prevalence of 16–18 per 100,000 persons. Most patients with MELAS develop epilepsy and require effective control of recurrent attacks. High-frequency oscillations (HFOs) on scalp EEG are transient bursts of EEG activity with frequencies beyond 80 Hz and are a promising biomarker for seizure control in epilepsy. However, reports on scalp HFOs are limited to some epilepsy syndromes. Herein, we report on the appearance of scalp HFOs in a pediatric patient with MELAS. The patient, a 13-year-old boy, presented with a stroke-like episode at age 9 years and was diagnosed with MELAS. The main symptom was visual disturbances, but epilepsia partialis continua (EPC) was also observed. Scalp EEG recordings were made six times: 8 days before the stroke-like episode (day –8 EEG), the day of appearance (day 1 EEG), and 4, 8, 10, and 100 days after the episode. Analysis of scalp HFOs showed that no scalp HFOs were detected in the day –8 EEG, whereas 1.20 scalp HFOs per minute were detected in the day 1 EEG at the appearance of the stroke-like episode with EPC. The scalp HFO detection rate decreased with the loss of EPC, and no scalp HFOs appeared on EEG, although visual disturbances continued to be observed. By contrast, epileptic discharges remained on EEG after EPC disappearance. Scalp HFOs have the potential to be a useful biomarker for reflecting epileptic seizure in patients with MELAS.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"29 ","pages":"Article 100754"},"PeriodicalIF":1.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Frequently asked questions and answers on Visually-Provoked (Photosensitive) epilepsy 关于视觉诱发性(光敏性)癫痫的常见问题和答案
IF 1.8
Epilepsy and Behavior Reports Pub Date : 2025-02-10 DOI: 10.1016/j.ebr.2025.100753
Dorothée Kasteleijn-Nolst Trenité , Jayant Acharya , Fiona Mitchell Baumer , Roy Beran , Dana Craiu , Jaqueline French , Pasquale Parisi , Jessica Solodar , Jerzy P. Szaflarski , Yukitoshi Takahashi , Liu Lin Thio , Ben Tolchin , Arnold Wilkins , Robert S. Fisher
{"title":"Frequently asked questions and answers on Visually-Provoked (Photosensitive) epilepsy","authors":"Dorothée Kasteleijn-Nolst Trenité ,&nbsp;Jayant Acharya ,&nbsp;Fiona Mitchell Baumer ,&nbsp;Roy Beran ,&nbsp;Dana Craiu ,&nbsp;Jaqueline French ,&nbsp;Pasquale Parisi ,&nbsp;Jessica Solodar ,&nbsp;Jerzy P. Szaflarski ,&nbsp;Yukitoshi Takahashi ,&nbsp;Liu Lin Thio ,&nbsp;Ben Tolchin ,&nbsp;Arnold Wilkins ,&nbsp;Robert S. Fisher","doi":"10.1016/j.ebr.2025.100753","DOIUrl":"10.1016/j.ebr.2025.100753","url":null,"abstract":"<div><div>Clinical experts associated with national epilepsy-related societies, led by the Epilepsy Foundation, collected, collated and answered “Frequently asked questions (FAQ)” of broad interest pertaining to visually-provoked seizures. Questions emerged from people with epilepsy, caretakers and healthcare professionals from different countries around the world. Focus is on practical implications of visually-provoked seizures. The top 5 most frequently asked questions were.<ul><li><span>1.</span><span><div>How does a doctor make a diagnosis of visually-provoked seizures?</div></span></li><li><span>2.</span><span><div>What can I do in general to prevent visually-provoked seizures?</div></span></li><li><span>3.</span><span><div>Will I need antiseizure medications for my visually-provoked seizures?”</div></span></li><li><span>4.</span><span><div>Will I outgrow visually-provoked seizures? How will I know if I’ve outgrown them?</div></span></li><li><span>5.</span><span><div>How do I enable safety features to block content that could trigger seizures on social media, websites, phones, laptops and tablets?</div></span></li></ul>Answers were based on scientific evidence, where such information was available <span><span>[1]</span></span> and expert opinion when formal evidence was insufficient.<!--> <!-->Key answers included distinction of photoparoxysmal EEG findings versus light-provoked seizures. Typical provocation is by flashes at 10–25 per second or certain moving patterns. There is a genetic risk, which is outgrown in about half. Covering one or both eyes can prevent a light-provoked seizure. TV, videogames, virtual reality and 3D images are not in themselves provocative, but their content can be.</div><div>Topics covered included: 1. Photosensitive epilepsy diagnosis; 2. Preventing visually-provoked seizures; 3. Do treatments help; 4. Life and behavioral decisions; 5. School; 6. Multi-media; 7. Children and youth.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"30 ","pages":"Article 100753"},"PeriodicalIF":1.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Encephalocele-associated temporal lobe refractory epilepsy: Report of two cases 脑膨出性颞叶难治性癫痫2例报告
IF 1.8
Epilepsy and Behavior Reports Pub Date : 2025-02-08 DOI: 10.1016/j.ebr.2025.100752
María Zuluaga , Valeria Valencia-Cifuentes , María Alejandra Recio , Juan Camilo Márquez , Juan P. Fernández-Cubillos , Yuri Takeuchi
{"title":"Encephalocele-associated temporal lobe refractory epilepsy: Report of two cases","authors":"María Zuluaga ,&nbsp;Valeria Valencia-Cifuentes ,&nbsp;María Alejandra Recio ,&nbsp;Juan Camilo Márquez ,&nbsp;Juan P. Fernández-Cubillos ,&nbsp;Yuri Takeuchi","doi":"10.1016/j.ebr.2025.100752","DOIUrl":"10.1016/j.ebr.2025.100752","url":null,"abstract":"<div><div>Encephaloceles are abnormal protrusions of brain tissue, meninges, and cerebrospinal fluid that result from defects in the skull base or cranial vault. These abnormalities can lead to seizure disorders and focal pharmacoresistant epilepsies. However, clinical suspicion and diagnosis are frequently delayed due to the significant challenges in interpreting initial imaging. Interpretation omissions can contribute to false diagnosis as non-lesional epilepsy in patients with encephalocele. This warrants appropriate imaging paradigms and careful interpretation. When clinical suspicion remains, further surgical exploration should be considered. Different treatment approaches, such as lesionectomy, temporal lobectomy, or invasive studies such as stereoelectroencephalography, may be employed. We describe two cases of adult-onset epilepsy associated with encephaloceles: a 28-year-old woman with drug-resistant epilepsy secondary to a right temporal encephalocele that was not initially diagnosed through neuroimaging, and a 43-year-old woman who presented with de novo focal status epilepticus attributed to a left temporal encephalocele, diagnosed during surgical exploration for a misdiagnosed neoplasm. Both cases were successfully treated surgically, with one-year follow-up free of new seizures.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"29 ","pages":"Article 100752"},"PeriodicalIF":1.8,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gelastic spells in Angelman Syndrome, when laughter isn’t funny 天使综合症的弹性法术,当笑声不有趣时
IF 1.8
Epilepsy and Behavior Reports Pub Date : 2025-02-08 DOI: 10.1016/j.ebr.2025.100751
Natasha Varughese , Femke Horn , Robert P. Carson
{"title":"Gelastic spells in Angelman Syndrome, when laughter isn’t funny","authors":"Natasha Varughese ,&nbsp;Femke Horn ,&nbsp;Robert P. Carson","doi":"10.1016/j.ebr.2025.100751","DOIUrl":"10.1016/j.ebr.2025.100751","url":null,"abstract":"<div><div>Angelman syndrome (AS) is a neurodevelopmental syndrome characterized by people with a characteristic happy demeanor, impaired expressive communication, sleep disruptions, and a variety of paroxysmal events, including seizures and movement disorders. Herein, we report three cases, one child and two adults with AS, of gelastic (laugh-related) spells. The phenomenology in all three is most consistent with gelastic syncope. A fourth example demonstrating transient breath-holding while laughing is included for reference. We subsequently review the differential for gelastic spells in AS, including seizures and cataplexy, and expound on the importance of their identification in the context of risk factors for cardiac arrhythmia. This work adds gelastic syncope to the list of paroxysmal events in AS and may serve to inform providers and parents of this phenotype and provide guidance for subsequent evaluation and treatment if indicated.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"29 ","pages":"Article 100751"},"PeriodicalIF":1.8,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ultrahigh-field imaging (7 Tesla) in DNET: Unmasking microstructural imaging characteristics – A case report DNET中的超高场成像(7特斯拉):揭示微结构成像特征- 1例报告
IF 1.8
Epilepsy and Behavior Reports Pub Date : 2025-02-05 DOI: 10.1016/j.ebr.2025.100749
Marta Calvo-Imirizaldu , Daniele Botta , Margitta Seeck , Jan Novy , Jose Federico Ojeda Esparza , Aikaterini Fitsiori , Corrado Santarosa , Kevin Battistini , Karl-Olof Lövblad , Felix T. Kurz
{"title":"Ultrahigh-field imaging (7 Tesla) in DNET: Unmasking microstructural imaging characteristics – A case report","authors":"Marta Calvo-Imirizaldu ,&nbsp;Daniele Botta ,&nbsp;Margitta Seeck ,&nbsp;Jan Novy ,&nbsp;Jose Federico Ojeda Esparza ,&nbsp;Aikaterini Fitsiori ,&nbsp;Corrado Santarosa ,&nbsp;Kevin Battistini ,&nbsp;Karl-Olof Lövblad ,&nbsp;Felix T. Kurz","doi":"10.1016/j.ebr.2025.100749","DOIUrl":"10.1016/j.ebr.2025.100749","url":null,"abstract":"<div><div>Commercial ultrahigh-field 7 Tesla (T) MRI has been approved for clinical brain imaging, including applications in epilepsy and brain tumors. Increasing magnetic field strength offers significant advantages over lower-field MRI due to improved spatial resolution, signal-to-noise ratio, and contrast-to-noise ratio. These improvements provide better anatomical delineation and gray-white matter tissue-contrast differentiation.</div><div>We present a case of a presumed dysembryoplastic neuroepithelial tumor (DNET) imaged at 7 T MRI of the second generation, which revealed an unprecedented level of detail of the complex and intricate tumor architecture. Insights of its different components correlate closely with its known histopathological features. These tumors are unique among low-grade neoplasms due to their distinct clinical presentation, imaging features, and histopathological architecture. DNETs are rare, typically occurring in young patients with refractory epilepsy, and are classified by their well-defined histological subtypes. We review the various MRI patterns of DNET, which have been shown to correlate with histological subtypes and the extent of the epileptogenic zone.</div><div>Complete tumor resection is essential for long-term control and recurrence prevention, emphasizing the importance of precise preoperative visualization of the tumor and its surrounding tissue. In this case, 7 T images demonstrated superior lesion conspicuity and clearer boundaries, highlighting the advantages of ultrahigh-field MRI in defining the full extent of the lesion. Although 7 T MRI is not yet widely available, it has started to gain an important role in the management of epilepsy, particularly for cases requiring detailed structural analysis.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"29 ","pages":"Article 100749"},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Myoclonic status epilepticus with dystonia-like symptoms in patients with dementia: Report of two cases 痴呆患者伴张力障碍样症状的肌阵挛性癫痫持续状态:两例报告
IF 1.8
Epilepsy and Behavior Reports Pub Date : 2025-02-04 DOI: 10.1016/j.ebr.2025.100750
Rosario V. Rossi, Rosanna Melis, Noemi Murdeu, Sara Lizzos, Maria Luigia Piras, Loretta Racis, Silvia Serusi, Maria Valeria Saddi
{"title":"Myoclonic status epilepticus with dystonia-like symptoms in patients with dementia: Report of two cases","authors":"Rosario V. Rossi,&nbsp;Rosanna Melis,&nbsp;Noemi Murdeu,&nbsp;Sara Lizzos,&nbsp;Maria Luigia Piras,&nbsp;Loretta Racis,&nbsp;Silvia Serusi,&nbsp;Maria Valeria Saddi","doi":"10.1016/j.ebr.2025.100750","DOIUrl":"10.1016/j.ebr.2025.100750","url":null,"abstract":"<div><div>We report cases of two elderly women with dementia who presented with a new-onset seizure disorder characterized by subtle, rhythmic muscular contractions involving the buccolingual region and the four limbs, persistent jaw opening, and abnormal cervical posture that mimicked myoclonus-dystonia syndrome and oromandibular dystonia. The symptoms lasted several minutes to a few hours. Video-polygraphic recordings revealed an electromyographic (EMG) pattern of brief, shock-like muscular contractions consistent with myoclonus that correlated with a high-amplitude (70–90 µV), 11–14 Hertz, bilaterally symmetric electroencephalographic (EEG) rhythm over the frontocentral regions. A time-locked relationship between the frontocentral EEG activity and the EMG myoclonic potentials demonstrated the cortical origin of myoclonus and therefore the epileptic nature of the disorder, whereas the oromandibular and cervical dystonic-like postures suggested the pathogenic involvement of subcortical structures. The intravenous administration of diazepam suppressed the clinical symptoms and the EEG–EMG correlate of myoclonus. The clinical and neurophysiological findings illustrate a form of myoclonic status epilepticus (SE) with dystonia-like symptoms resulting from the functional involvement of cortical and subcortical structures. The manifestation of subtle, rhythmic myoclonus and dystonic-like postures in patients with atypical EEG patterns of SE may require challenging differential diagnoses with myoclonus-dystonia syndrome and oromandibular dystonia.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"29 ","pages":"Article 100750"},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
First experiences with multiple bilateral insertions of a newly developed microcatheter-compatible endovascular electroencephalogram electrode for humans with epilepsy 首次为癫痫患者多次双侧插入新开发的微导管兼容血管内脑电图电极
IF 1.8
Epilepsy and Behavior Reports Pub Date : 2025-02-04 DOI: 10.1016/j.ebr.2025.100748
Yosuke Masuda , Ayataka Fujimoto , Hisayuki Hosoo , Kota Araki , Hiroki Ishida , Mitsuyo Nishimura , Aiki Marushima , Eiichi Ishikawa , Yuji Matsumaru
{"title":"First experiences with multiple bilateral insertions of a newly developed microcatheter-compatible endovascular electroencephalogram electrode for humans with epilepsy","authors":"Yosuke Masuda ,&nbsp;Ayataka Fujimoto ,&nbsp;Hisayuki Hosoo ,&nbsp;Kota Araki ,&nbsp;Hiroki Ishida ,&nbsp;Mitsuyo Nishimura ,&nbsp;Aiki Marushima ,&nbsp;Eiichi Ishikawa ,&nbsp;Yuji Matsumaru","doi":"10.1016/j.ebr.2025.100748","DOIUrl":"10.1016/j.ebr.2025.100748","url":null,"abstract":"<div><div>Identifying epileptogenic zones non-invasively is challenging due to signal interference by the scalp and skull, necessitating invasive methods like subdural recordings and stereoelectroencephalography. Recent microcatheter advancements suggest that a microcatheter-compatible endovascular EEG (eEEG) device could overcome these barriers. We developed a thin, flexible eEEG electrode, the EP-01, for use with current microcatheters. The EP-01, comprising a platinum electrode and alloy wire coated with an electrically non-conductive polymer, was inserted via the jugular veins under local anesthesia. The EP-01 electrodes were planned to be placed in six locations: bilateral transverse sinuses, bilateral cavernous sinuses, and the anterior and posterior superior sagittal sinuses. We conducted a first-in-human study demonstrating the feasibility and efficacy of the EP-01electrodes in simultaneously recording intracranial EEG signals from multiple brain locations. The EP-01 electrodes were successfully placed as planned, except for one, without complications. Simultaneous eEEG and scalp EEG recordings were performed during a Wada test to evaluate efficacy and safety. The eEEG recorded alpha waves and slow-wave activity during propofol administration, corresponding to scalp EEG findings, with amplitudes 3–4 times higher. Post-procedural assessments confirmed cranial vessels’ patency and absence of complications. The EP-01 successfully recorded EEG signals at multiple locations in the human brain using an endovascular approach. Compared to scalp EEG, the present approach seems to have the potential to record higher-amplitude EEG. However, the study was limited to short-term recordings without epileptic discharges. Further investigations, including long-term placement, are thus needed for seizure recordings and safety evaluations.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"29 ","pages":"Article 100748"},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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