Epileptic Disorders最新文献

{"title":"Reflex \"toothbrushing\" epilepsy: Seizure freedom after focal ablation assisted by ictal fMRI.","authors":"Michael Ginevra, John Archer, Kristian Bulluss, Chris Tailby, Graeme D Jackson, David N Vaughan","doi":"10.1002/epd2.70027","DOIUrl":"https://doi.org/10.1002/epd2.70027","url":null,"abstract":"<p><p>A 22-year-old female presented with drug-resistant focal motor seizures with onset at age 14. This manifested as daily episodes of right facial dystonia triggered by toothbrushing, but also by eating, talking, and strenuous exercise. On ictal scalp EEG, there was low-voltage fast activity over the left pericentral area. Structural MRI did not identify a definite lesion. Functional MRI (fMRI) of a reflex seizure, as well as task-based fMRI during toothbrushing, both demonstrated focal activation at the left low pericentral cortex. Stereoelectroencephalography (sEEG) showed recurrent ictal trains of focal spiking concordant with the fMRI activation. Radiofrequency (RF) thermocoagulation was applied at the posterior bank of the left low pre-central gyrus, with post-operative MRI confirming small ablative lesions immediately deep to the ictal fMRI activation, and the patient remains seizure-free more than 3 years after this treatment. Toothbrushing epilepsy is a rare form of reflex epilepsy where seizures are induced by toothbrushing. In this unique case, ictal fMRI assisted targeting of the sEEG implantation, to confirm seizure onset and enable minimally invasive treatment via RF thermocoagulation, resulting in seizure freedom.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804577","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":"Exploring biomarkers of neurodegeneration in epilepsy: Critical insights.","authors":"Rida Farhan, Syeda Amrah Hashmi, Jaideep Kapur, Anelyssa D'Abreu, Vineet Punia, Carol Manning, Vanessa L Smith, Ifrah Zawar","doi":"10.1002/epd2.70023","DOIUrl":"https://doi.org/10.1002/epd2.70023","url":null,"abstract":"<p><p>The advent of biofluid biomarkers for neurodegenerative disorders has precipitated a surge in recent evidence regarding their role in epilepsy. In this literature review, we examine the diagnostic, prognostic, and therapeutic potential of several biomarkers, including amyloid-beta (Aβ) protein, total (t-tau), phosphorylated tau (p-tau) protein, alpha-synuclein, neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and others in epilepsy. Recent studies highlight mid-life Aβ levels as a risk factor for late-onset epilepsy. Several studies also show that amyloid pathology correlates with cognitive impairment in people with epilepsy (PWE). T-tau and p-tau levels in CSF and serum show diagnostic potential, particularly for temporal lobe epilepsy (TLE). Tau may also have significant prognostic utility in cognition of PWE and status epilepticus. Despite promising findings, larger prospective studies are needed to validate these biomarkers for routine clinical use in older PWE. Mouse models demonstrate tau's association with increased seizure susceptibility and mortality and the association of tau reduction with reduced seizure severity. This further highlights the need to investigate tau-targeting therapies in future studies in older PWE. Recent small-scale retrospective studies link NfL's role in cognitive impairment and status epilepticus, suggest a prognostic role of alpha-synuclein in certain epilepsies, and propose emerging diagnostic and prognostic roles of other biomarkers in epilepsy, including GFAP, cytoskeletal proteins, and S100B. However, larger longitudinal studies are needed to confirm these findings. We propose integrating some of these biomarkers into clinical practice for selected older adults with epilepsy. This integration could improve diagnostic accuracy, prognosticate outcomes, and identify therapeutic targets that may improve seizure control and mitigate the progression of cognitive decline in PWE.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804572","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":"Persistence of EEG abnormalities in KCNT1-related DEE in an adult patient.","authors":"Haania Kakwan, Omar Nofal, Doyle Yuan, Irfan S Sheikh","doi":"10.1002/epd2.70018","DOIUrl":"https://doi.org/10.1002/epd2.70018","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789258","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":"Addressing the long-term growth impact of the modified Atkins diet in pediatric epilepsy: A call for further research.","authors":"Shih-Jie Wang, Lien-Chung Wei","doi":"10.1002/epd2.70022","DOIUrl":"https://doi.org/10.1002/epd2.70022","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784636","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":"Clinical and anatomical characteristics of basal temporal seizures: A systematic review.","authors":"Fabrice Bartolomei, Francesca Pizzo, Stanislas Lagarde","doi":"10.1002/epd2.70020","DOIUrl":"https://doi.org/10.1002/epd2.70020","url":null,"abstract":"<p><p>This review aimed to characterize the clinical semiology and anatomical correlates of seizures originating in the basal temporal region, an underrecognized epilepsy subtype, and to identify features that distinguish it from other forms of temporal lobe epilepsies (TLE). We performed a systematic review of the literature following PRISMA guidelines. The search included terms related to the basal temporal region (e.g., fusiform gyrus and rhinal cortex) and epilepsy, encompassing clinical, anatomical, and neurophysiological studies. Studies with video-EEG monitoring, SEEG evaluations, and surgical outcomes were prioritized. Semiological features, imaging findings, and post-surgical outcomes were extracted and analyzed. Fifteen studies encompassing 83 patients were analyzed. Most cases involved MRI-detectable lesions. Findings revealed that basal temporal seizures frequently present with language disturbances, motor phenomena, and less pronounced emotional and sensory signs compared to other TLE forms. SEEG identified epileptogenic zones predominantly in the fusiform gyrus, rhinal cortices, and parahippocampal region. Post-surgical outcomes revealed 57% of patients achieving Engel Class I results after 1 year, highlighting the potential benefits of accurate diagnosis and intervention. However, diagnostic challenges persist due to overlapping with other TLE subtypes, emphasizing the importance of advanced imaging and SEEG. Further studies are needed to refine diagnostic criteria and improve understanding of the functional implications of basal temporal epilepsies.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781722","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":"Early postoperative seizures in patients with adult-type diffuse gliomas: Incidence, risk factors, and clinical outcomes.","authors":"Jiajia Liu, Gan You, Shengyu Fang, Shimeng Weng, Zhong Zhang, Xing Fan, Hui Qiao","doi":"10.1002/epd2.70019","DOIUrl":"https://doi.org/10.1002/epd2.70019","url":null,"abstract":"<p><strong>Objective: </strong>The current study aimed to clarify the representation of early postoperative seizures (EPSs) in different glioma subtypes under the 2021 WHO classification, explore the risk factors for EPSs in glioma patients, and investigate the clinical impact of EPSs on seizure and survival outcomes.</p><p><strong>Methods: </strong>Data from 78 patients were analyzed. The differences in clinical-pathological features between patients with EPSs and those without were compared using appropriate statistical methods. Multivariate binary logistic regression analysis was subsequently conducted to explore potential risk factors for EPSs. Finally, the Kaplan-Meier method was applied to analyze the correlation of EPSs with progression-free survival and overall survival.</p><p><strong>Results: </strong>Early postoperative seizures occurred in 17 patients (21.8%). The incidence of EPSs was highest in patients with oligodendroglioma, IDH-mutant, and 1p/19q-codeleted (25.7%), followed by astrocytoma, IDH-mutant (20.8%), and glioblastoma, IDH-wildtype (12.5%). An extent of resection (EOR) of less than 92.24% was identified as the only independent predictor for EPSs (Odds ratio 8.490, 95% confidence interval 1.873-38.488, p = .006) through multivariate regression analysis. In addition, EPSs showed no significant impact on late postoperative seizure occurrence and survival outcome.</p><p><strong>Significance: </strong>In glioma patients, EPSs are considered neurological disorders induced by surgery-related factors rather than a tumor-related mechanism. EPSs are more prone to occur in patients with an EOR of less than 92.24%, which can contribute to improving individualized glioma management.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781725","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 SPECT in hypothalamic lesions.","authors":"Christine Van Winssen, Poul Espino Alvarado, Jorge Burneo, David A Steven, Ana Suller-Marti","doi":"10.1002/epd2.70021","DOIUrl":"https://doi.org/10.1002/epd2.70021","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765665","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":"MECP2 duplication syndrome-Typical EEG characteristics.","authors":"Walter Otu, Ritu Sudhakaran, German Garza-Garcia, Krishna Parekh, Irfan S Sheikh","doi":"10.1002/epd2.70015","DOIUrl":"https://doi.org/10.1002/epd2.70015","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755631","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":"Eye closure sensitivity and related EEG findings: Persistence rates and classification of epilepsy syndromes by the International League Against Epilepsy.","authors":"Dilara Mermi Dibek, Betül Baykan","doi":"10.1002/epd2.70014","DOIUrl":"https://doi.org/10.1002/epd2.70014","url":null,"abstract":"<p><strong>Background: </strong>We aimed to investigate the frequency and persistence rates of eye closure-related epileptiform EEG findings in a cohort with epilepsy and classify them according to the latest epilepsy syndrome classification by the International League Against Epilepsy (ILAE).</p><p><strong>Method: </strong>Consecutive patients referred to the EEG laboratory, showing eye closure sensitivity (ECS) and related EEG findings, were included between October 2022 and August 2024. Their epilepsy syndromes were classified according to ILAE. EEG patterns were categorized as ECS, eye-closed sensitivity, and fixation-off sensitivity (FOS). Persistence rates were calculated for each patient by examining all eye closures in the EEG records. The clinical findings and persistence rates were compared between subgroups by SPSSv26.</p><p><strong>Results: </strong>Of 5084 EEG traces, 63 (1.3%) from 35 patients with ECS and related EEG findings were included, with a mean age of 21.28 ± 8.38 years, and 68.6% of them were female. ECS was present in 85.7% of the patients, while 14.3% had eye-closed sensitivity, of which 11.1% had FOS. In the cohort, 25.7% had focal epilepsy, whereas 74.3% had generalized epilepsy. The most frequent generalized epilepsy syndrome was epilepsy with eyelid myoclonia (EEM) in 25.7%. Genetic etiology was disclosed in one patient with propionic acidemia, and another had chromosomal duplication at 8p11.21q11.1. ECS was exacerbated by hyperventilation, awakening, and intermittent photic stimulation. Photoparoxysmal response (PPR) was more frequently associated with ECS than with eye-closed sensitivity (95% vs. 5%, respectively). Although the persistence rates (mean: 47.7% ± 8.3%) did not significantly differ with respect to clinical outcomes (18% vs. 21%, p = .33), age was negatively correlated with this ratio (r = -.521, p = .002).</p><p><strong>Significance: </strong>Eye closure sensitivity and related sensitivities in EEG exhibit heterogeneity across epileptic syndromes and prognosis. Investigating ECS within the framework of the latest epilepsy syndrome classification, alongside co-occurrences of other activation methods, and calculating persistence rates may offer valuable insights for future genetic research and long-term management.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676949","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":"Regional epilepsy: Unraveling the epileptic phenomenon.","authors":"Shreyashish Roy-Chowdhury, Elma Paredes-Aragon, Richard S McLachlan, Jorge G Burneo, David A Steven, Ana Suller Marti","doi":"10.1002/epd2.70007","DOIUrl":"https://doi.org/10.1002/epd2.70007","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617667","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}