Epileptic Disorders最新文献

{"title":"Ictal unilateral blinking in temporal focal cortical dysplasia a clinical vignette.","authors":"Kattia J Alfaro Vásquez, Celia K Jara Velásquez, Walter F De la Cruz Ramírez","doi":"10.1002/epd2.20326","DOIUrl":"https://doi.org/10.1002/epd2.20326","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breath-holding spells: A typical case with EEG and video correlate.","authors":"Lauren E Chorny, Douglas R Nordli, Fernando Galan","doi":"10.1002/epd2.20324","DOIUrl":"https://doi.org/10.1002/epd2.20324","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressive dementia and seizures as distinguishing features in adult-onset leukoencephalopathy with axonal spheroids and pigmented glia.","authors":"Young-Joon Kim, Tae Jung Kim, Sang-Bae Ko","doi":"10.1002/epd2.20325","DOIUrl":"https://doi.org/10.1002/epd2.20325","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home video review in a pediatric clinical neurophysiology led multidisciplinary team meeting.","authors":"Aneirin Rhys-Potter, Maria Cunha, Matthew Sparkes, Zaloa Agirre-Arrizubieta, Sushma Goyal, Joel S Winston","doi":"10.1002/epd2.20310","DOIUrl":"https://doi.org/10.1002/epd2.20310","url":null,"abstract":"<p><strong>Objective: </strong>Assessment of the value of review of home videos by a pediatric multidisciplinary team (MDT) in a pediatric neurophysiology department.</p><p><strong>Methods: </strong>We describe and evaluate the review of home videos alongside clinical history and previous investigations from patients referred to the Evelina pediatric EEG department at a twice-monthly MDT meeting between 01/2021 and 09/2022. We retrospectively analyzed measures of video quality, quantity and duration, time taken from referral to MDT meeting, pre-MDT and post-MDT meeting proposed diagnosis and clinical outcomes. Feedback from referring doctors was obtained by a survey.</p><p><strong>Results: </strong>There were 36 referrals for 34 patients totalling 123 videos. There was a median delay of 10 days between video upload and final report. After the MDT meeting the number of referrals classified as uncertain fell from 15 to 2. The number of referrals classified as non-epileptic events increased from seven to 18. The number classified as infantile spasms fell from six to two. Overall, 26 of 36 referrals had a change in diagnosis and 26 of 36 referrals were triaged away from the video-EEG telemetry (VT) waiting list. Nine out of ten referring doctors reported that MDT discussion improved their understanding of the events.</p><p><strong>Significance: </strong>HVR is a useful tool that has been successfully incorporated into our neurophysiology department's workflow. These early results suggest benefits from adopting an MDT meeting may include an early diagnosis and management approach based upon consensus. Using HVR in a pediatric population may help triage urgent cases, conserve specialized neurophysiological investigations and streamline workflows to improve the efficiency of pediatric referrals.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketogenic diet therapy for the treatment of pediatric epilepsy.","authors":"Babitha Haridas, Alexander Testino, Eric H Kossoff","doi":"10.1002/epd2.20320","DOIUrl":"https://doi.org/10.1002/epd2.20320","url":null,"abstract":"<p><p>In 1921, the classic ketogenic diet was created at the Mayo Clinic in Rochester, Minnesota to treat epilepsy in children and adults. Over a century later, it is a widely used, standard-of-care therapy for typically treatment-resistant epilepsy worldwide. There are currently five versions of ketogenic diet therapy that can be started either in or out of the hospital setting. It is overall effective in approximately half of children started, usually within a few months. Established indications for ketogenic diet therapy exist, in which this treatment may potentially even be more advantageous than antiseizure medications. Some of these indications include Glut1 deficiency, pyruvate dehydrogenase deficiency, infantile epileptic spasms syndrome, epilepsy with myoclonic-atonic seizures, and formula-fed children. Although most children are also receiving antiseizure medications with ketogenic diet therapy, its use may lead to medication reduction or withdrawal in some cases, and improvement in cognition and quality of life. Supplements are begun when ketogenic diet therapy is initiated in order to prevent common side effects, including constipation, kidney stones, growth disturbance, and dyslipidemia. Typically, after 2 years in most children, ketogenic diet therapy is discontinued gradually.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmented reality for epilepsy surgery: Examining usability and efficacy in presurgical planning.","authors":"Rishit Chilappa, Abhi Kapuria, Jefferson Norwood, Athena Yao, Matthew Vestal, Muhammad Shahzad Zafar","doi":"10.1002/epd2.20322","DOIUrl":"https://doi.org/10.1002/epd2.20322","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this paper was to visualize 3-dimensional (3-D) brain and electrode placement data for epilepsy surgery within an augmented reality (AR) environment using a wearable headset, with the ultimate goal of enhancing presurgical planning for epilepsy surgery and understanding the efficiency and utility of such a program in a clinical setting. The evaluation process for surgical intervention in epilepsy cases involves a series of extensive tests, including EEG, MRI, PET, SPECT, and fMRI. A second phase of assessment incorporates the placement of depth electrodes within the brain to record seizure activity. The culmination of these complex data is presented to the neurosurgery team for the formulation of a surgical plan. However, the conventional presentation of intricate 3-D data on a 2-dimensional (2-D) computer monitor limits the ability to convey the full depth and detail of the patient's brain and electrode data.</p><p><strong>Methods: </strong>Five images were selected from a cohort of patients being evaluated for refractory epilepsy at a single center. Their presurgical MRI scans, SEEG electrode data, and CT scans were utilized to generate 3-D AR representations, which were uploaded onto the Duke Augmented Reality Epilepsy Planner (AREP), an application on the Microsoft HoloLens 2. A survey was administered to faculty members to determine usability and effectiveness of the application.</p><p><strong>Results: </strong>AR images of the brain and electrodes, allowing resizing, movement, and rotation, with distinct colors differentiating tissue and electrodes, were presented in AREP. The application featured an interactive image manipulation menu. Survey results from 18 faculty members regarding seven questions indicated that AREP was user-friendly and can be effective in presurgical planning moving forward.</p><p><strong>Significance: </strong>AR integration of medical imaging data for epilepsy surgery transcends its role as a communication tool. It provides a deeper representation of surgical anatomy and serves as a valuable method for fostering communication among clinicians.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localizing value of disturbances of self-integration, depersonalization, and forced thinking: A systematic review.","authors":"Lars Etholm, Jugoslav Ivanovic, Vilde Stangebye Larsen, Markus Handal Sneve, Morten Ingvar Lossius, Kristin Å Alfstad","doi":"10.1002/epd2.20317","DOIUrl":"https://doi.org/10.1002/epd2.20317","url":null,"abstract":"<p><p>We performed a systematic review of the localizational value of disturbances of self-integration, depersonalization and forced thinking in focal epilepsy with the aim to summarize the state-of-the-art anatomo-clinical correlations in the field and help guide interpretation of ictal semiology within the framework of pre-surgical evaluation. The review was performed using a PRISMA- and QUADAS2-based approach. Three separate PubMed and EMBASE searches were undertaken using the keywords self-integration, depersonalization and forced thinking, along with synonyms, in combination with terms to identify epileptogenic zone as defined by surgical outcome, MRI-findings or intracranially recorded EEG. Studies published in peer-reviewed journals with an abstract available, limited to English, French, German, Spanish, or Italian were included for review. Abstracts from scientific meetings were included if precise data on semiology in addition to either localization or surgical outcome was presented. Cases were regarded as eligible if data informing on anatomo-clinical correlations were sufficient to allow determination of an epileptogenic zone and evaluate its level of confidence. For disturbances of self-integration, the search identified 18 publications containing 23 eligible cases, with 10 additional cases identified in the literature. For depersonalization, a single case from a two patient study fulfilled inclusion criteria. For forced thinking, the search identified two publications containing four eligible cases, with six additional cases identified through literature searches. The retrieved cases suggest that disturbances of self-integration often reflect an epileptogenic zone centered around the temporoparietal region, where neighboring areas in the parietal lobe, the posterior insula, and likely depending on the type of disturbance also the adjoining occipital lobe, the anterior and middle cingulum, premotor and supplementary motor in addition to medial temporal structures could be involved. When present, lateralized symptomatology reflects a contralateral focus. Depersonalization, as a localizing ictal phenomenon was quite elusive. Forced thinking either pointed to premotor frontal or temporal epileptogenic zones. Currently, outlined epileptogenic zones of ictal disturbances of self-integration and forced thinking are quite widespread and should be regarded with a low-to-moderate degree of reliability. A focus on such rarer ictal phenomena, in combination with improved imaging techniques and increased use of SEEG, will hopefully lead to an accumulation of cases with better defined epileptogenic zones.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid seizure resolution with cannabidiol in medically refractory epilepsy with myoclonic-atonic seizures.","authors":"Peter F Sarnacki, Elia Pestana-Knight","doi":"10.1002/epd2.20321","DOIUrl":"https://doi.org/10.1002/epd2.20321","url":null,"abstract":"<p><p>Epilepsy with myoclonic-atonic seizures (EMAS) is an early childhood epilepsy syndrome with an explosive onset of multiple seizure types in a previously healthy child. EMAS often evolves to a drug-resistant epileptic encephalopathy before a variable degree of remission around 3 years from onset. Highly purified cannabidiol (CBD, available in United States as Epidiolex®) has demonstrated efficacy and tolerability as an adjunct in medically refractory EMAS. We present two cases of medically refractory EMAS achieving rapid seizure freedom (7-30 days) with CBD, illustrating CBD as a potential effective monotherapy in EMAS.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ILAE genetic literacy series: Focal cortical dysplasia.","authors":"Emma Macdonald-Laurs, Richard J Leventer","doi":"10.1002/epd2.20308","DOIUrl":"https://doi.org/10.1002/epd2.20308","url":null,"abstract":"<p><p>Focal cortical dysplasia (FCD) is a common cause of drug-resistant focal epilepsy in children and young adults and is often surgically remediable. The genetics of FCD are increasingly understood due to the ability to perform genomic testing including deep sequencing of resected FCD tissue specimens. There is clear evidence that FCD type II occurs secondary to both germline and somatic mTOR pathway variants, while emerging literature supports the role of SLC35A2, a glycosylation gene, in mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy (MOGHE). Herein, we provide a review of FCDs focusing on their clinical phenotypes, genetic basis, and management considerations when performing genetic testing in this patient group.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ictal index finger pointing and politician's fist as localizing clinical signs in a pediatric patient.","authors":"Joshua Chang, Mohamed Taha, Douglas Nordli","doi":"10.1002/epd2.20323","DOIUrl":"https://doi.org/10.1002/epd2.20323","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}