Epileptic Disorders最新文献

{"title":"Suspicious looking mu rhythm on SEEG.","authors":"Aayesha J Soni, Ana Suller Marti, Giovanni Pellegrino","doi":"10.1002/epd2.70006","DOIUrl":"https://doi.org/10.1002/epd2.70006","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544297","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":"The localizing value of mimic ictal semiology: A systematic review of the spectrum.","authors":"Vasileios Kokkinos, Elizabeth M Cunningham, Cody L Nathan, Dina Ghandour, Morgan Kisinger, Molly Beestrum, Krystal Madkins, Stephan U Schuele","doi":"10.1002/epd2.70004","DOIUrl":"https://doi.org/10.1002/epd2.70004","url":null,"abstract":"<p><p>We performed a systematic review of the localization value of ictal mimic automatisms-including gelastic, dacrystic, fearful, ritualistic, and kissing semiology-in focal epilepsy. We performed a comprehensive literature search (Medline, EMBASE, Cochrane, Scopus) for patient-level studies, following a PRISMA and QUADAS2 approach. Patients with focal epilepsy displaying mimic automatism, defined as \"stereotyped mimicry or behavior that resembles the usual way one expresses oneself to reflect an affect and that is not accompanied by the corresponding emotion\" were included. Patients with subjective emotional experiences during a seizure, which the patient is aware of, were excluded. Analysis included 936 patients from 104 studies. Gelastic semiology was primarily associated with hypothalamic hamartomas (HH), and secondarily with frontal (cingulate; superior frontal gyrus), temporal (hippocampus; amygdala; pole; parahippocampal and fusiform gyri), insular, and orbitofrontal involvement, without consistent hemispheric lateralization. Dacrystic semiology was associated with HH, as well as temporal lobe seizure onset (mesial and anterior), followed by the less frequent involvement of orbitofrontal (anterior; baso-lateral), insular, and frontal regions; also without consistent hemispheric lateralization. Fearful ictal semiology was equally associated with frontal (cingulate; superior frontal gyrus), orbitofrontal (mesial; posterior), and temporal (hippocampus; amygdala) involvement; most often, but not exclusively, of right hemispheric lateralization. Ritualistic behavior was associated with the temporal lobe origin (hippocampus; amygdala; pole), with strong right hemispheric lateralization. Kissing ictal behavior was associated with temporal lobe origin (pole; hippocampus; amygdala), and secondarily with the frontal lobe (cingulate); most often, but not exclusively, of right hemispheric lateralization. Our systematic review-derived localization of the various manifestations of mimic automatisms supports anatomo-clinical correlations and helps guide interpretation of ictal semiology within the framework of pre-surgical evaluation in focal epilepsies.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544300","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":"Expert opinions on pediatric EEG training for non-epilepsy specialists in sub-Saharan Africa.","authors":"Veena Kander, Kette D Valente, Jaime Carrizosa, Jorge Vidaurre, Archana A Patel, Chahnez Charfi Triki, Ghaieb Aljandeel, Gagandeep Singh, Mitsuhiro Kato, Lala Seck, Zeinab Kone, Sándor Beniczky, Melody T Asukile, Gretchen L Birbeck, Kevin Jones, Geraldine Boylan, Joanne Hardman, Jo M Wilmshurst","doi":"10.1002/epd2.70010","DOIUrl":"https://doi.org/10.1002/epd2.70010","url":null,"abstract":"<p><p>Ideally, pediatric electroencephalograms (EEGs) should be performed by accredited neurophysiology technologists and interpreted by specialists trained in epileptology However, low- and middle-income countries (LMICs) lack such specialists.</p><p><strong>Aim: </strong>To collate expert consensus on essential curriculum content for non-epilepsy specialists in EEG interpretation and safe post-training practice.</p><p><strong>Method: </strong>A qualitative study on pediatric EEG training curricula needs was designed in collaboration with an adult education specialist. Data were collected via interviews from 15 epilepsy experts with training experience across high- to low-income settings. Thematic analysis was used to identify sub-themes. The experts voted on the key statements in a two-round Delphi to ascertain consensus.</p><p><strong>Results: </strong>Twelve aspects of pediatric EEG training were identified and categorized thematically: relevance; exposure to pediatrics; focus on pediatrics; barriers; resource-limited setting; entry skills; best pedagogy; assessment; critical skills; reinforcement of skills; training model; and recommendations.</p><p><strong>Conclusion: </strong>This study was driven by the inadequate access to training in pediatric EEG for non-epilepsy specialists, which is further exacerbated by the lack of epileptologists and neurophysiologists. The outcomes from the expert consensus opinions promoted consolidation, adaptation, and evolution of existing models that are viable for practice and to be used worldwide. The Delphi consensus demonstrated alignment among regionally located specialists towards the promotion of effective and maintained training for non-epilepsy specialists, as well as highlighting barriers that should be considered and addressed.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544293","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":"Chronic hyperglycemia-induced gaze-evoked visual seizures.","authors":"Meryem Senem Yildiz, Rahsan Gocmen, F İrsel Tezer","doi":"10.1002/epd2.70008","DOIUrl":"https://doi.org/10.1002/epd2.70008","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544218","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":"Neonatal seizures: A cohort evaluation at a pediatric referral center","authors":"Joana Amaral,&nbsp;Inês Silva Costa,&nbsp;Joana Ribeiro,&nbsp;Cármen Costa,&nbsp;Filipe Palavra,&nbsp;Cristina Pereira,&nbsp;Conceição Robalo","doi":"10.1002/epd2.20331","DOIUrl":"10.1002/epd2.20331","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Neonatal seizures have an incidence of 1–5/1000 newborns. Their clinical, etiology, and therapeutic characterization is a clinical challenge.</p>\u0000 \u0000 <p>The objective of this study was to characterize neonatal seizures recorded over 6 years, considering the clinical presentation, management, and follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of clinical, neurophysiological (video-electroencephalogram), and imaging data of all newborns who had suspected neonatal seizures with electroencephalographic findings (paroxysmal activity, electrographic-only seizures, and/or electroclinical seizures) was performed. The study considered all cases that occurred between January 2010 and December 2015, with the respective follow-up equal to or longer than 7 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seizures were diagnosed in 85 newborns, 87.1% within the first 48 h of life. In 72.9% of suspected cases, only paroxysmal activity in the v-EEG was recorded, in another 16.5% electrical-only seizures were found, and in 10.6% there were electroclinical seizures. Epilepsy was diagnosed in 23.5% of cases, with 14% currently maintaining therapy. Motor sequelae occurred in 44.3% of children and 41.4% had normal neurological examination. There were also 11.4% of deaths in the neonatal period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Neonatal seizures occur mostly in the first 48 h of life and mainly due to hypoxic–ischemic injuries. During follow-up, we recorded epilepsy in ¼ of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"27 2","pages":"255-263"},"PeriodicalIF":1.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469920","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":"Impact of modified Atkins diet on growth in infants and children with epilepsy.","authors":"Joshua Chang, Stephanie Schimpf, Chalongchai Phitsanuwong","doi":"10.1002/epd2.70002","DOIUrl":"https://doi.org/10.1002/epd2.70002","url":null,"abstract":"<p><strong>Objective: </strong>Ketogenic diet (KD) is an effective treatment for epilepsy that has been widely used. Linear growth restriction has been a concern as a potential adverse effect of the KD, especially in young children and infants. Studies on the classic ketogenic diet (CKD) and its potential negative impact on linear growth have had varying results. Additional studies are needed to assess this concern in other varieties of the KD, such as the modified Atkins diet (MAD). The purpose of our study was to assess the impact that MAD had on growth metrics at various time points, paying particular attention to linear growth.</p><p><strong>Methods: </strong>This study was a retrospective analysis of the MAD in children and infants with epilepsy. All participants were patients in the Ketogenic Diet clinic at The University of Chicago Comer Children's Hospital. Data were gathered at initial evaluation and again at visits at the 1-, 6-, and 12-month marks.</p><p><strong>Results: </strong>Twenty-three patients were included in the analysis. Height, weight, and BMI Z-scores were compared from baseline to the 6- and 12-month marks. The analysis of the study showed no statistically significant difference in height Z-score from baseline to 6 months (.12, p = .05) and 12 months (.269, p = .05) after the MAD initiation. When stratified by age group, there was no significant difference in height Z-score from baseline to 12 months, including in the infant age group, age under 3 years, (.07, p = .05). Higher degrees of metabolic acidosis (serum bicarbonate <20 mEq/L), however, showed a statistically significant negative impact on linear growth while this association was not seen with the levels of average ketosis.</p><p><strong>Significance: </strong>In our study, the MAD does not have a significant negative impact on linear growth in infants and children with epilepsy for at least 12 months of treatment.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450907","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":"Hypermotor temporal lobe epilepsy revisited-expanding the spectrum","authors":"Pavan Kumar Rudrabhatla,&nbsp;Jayakumari Nandana,&nbsp;George C. Vilanilam,&nbsp;Bejoy Thomas,&nbsp;Chandrasekharan Kesavadas,&nbsp;Ashalatha Radhakrishnan,&nbsp;Ramshekhar N. Menon","doi":"10.1002/epd2.20327","DOIUrl":"10.1002/epd2.20327","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Typical semiology with associated 5As (Antecedent, Aura, Arrest, Automatisms, and Amnesia) is the prototypical seizure manifestation of temporal lobe epilepsy (TLE) in adults. However, patients with TLE can present with seizure phenomenology referred to as “hypermotor TLE” (HMS-TLE) which can mimic extratemporal focal epilepsy. We studied the clinico-electrographic, imaging profile, and surgical outcomes of drug-resistant HMS-TLE patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed the ictal signs and electroencephalography data of HMS-TLE patients who became seizure free following epilepsy surgery with a minimum follow-up of 1 year and compared them with patients with typical TLE (1:2 ratio). Hypermotor seizures were identified based on the presence of stereotyped ictal complex movements at seizure onset including body rocking, pelvic thrusting, and bimanual and bipedal movements with/without affective components.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 684 patients with drug-resistant TLE who underwent surgery during 2010–2020, 16 patients (2.34%) met criteria for HMS-TLE and were compared with 32 patients with typical TLE. Predominant “hypermotor” components included motor agitation, bicycling/kicking movements, body gyration followed by violent automatisms, and pelvic thrusting. Age at epilepsy onset, age at video telemetry recording, age at surgery, duration of epilepsy at surgery, gender distribution, and presence of aura were comparable between the two groups. History of febrile seizures (31.3% vs. 65.6%; <i>p</i>-value = .024), presence of hippocampal sclerosis on MRI, and histopathology (56.3% vs. 90.6%; <i>p</i>-value = .006 and 50% vs. 96.9%; <i>p</i>-value = .002, respectively) were lower, and temporal neocortical abnormalities on MRI (87.5% vs. 59.4%, <i>p</i>-value = .048), dysplasia on histopathological evaluation (25% vs. 0%, <i>p</i>-value = .003) were higher in HMS-TLE. HMS-TLE group had lower number of patients with focal-onset ictal patterns (37.5% vs. 90.6%, <i>p</i>-value = .0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Hypermotor seizures are rare in TLE, however it does not preclude non-invasive selection for surgery. Hence, physicians should be aware of this subtype of drug-resistant TLE as early intervention can have good surgical outcomes, akin to typical TLE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"27 2","pages":"244-254"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442653","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":"Super refractory status epilepticus secondary to autoimmune glial fibrillary acidic protein Astrocytopathy.","authors":"Mahima Sriram, Tejas Shivarthi, Sreelakshmi Narayanan, Pula Rohan, Muddana Nikhilesh, Sudheeran Kannoth, Siby Gopinath, Udit Saraf, Vivek Nambiar, Gopikrishnan Unnikrishnan, Anandkumar Anandakuttan, Annamma Mathai, Meena Thevarkalam, Suprabha Panicker","doi":"10.1002/epd2.70001","DOIUrl":"https://doi.org/10.1002/epd2.70001","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392410","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":"Navigating epilepsy care in the wake of climate change.","authors":"William Alves Martins","doi":"10.1002/epd2.70000","DOIUrl":"https://doi.org/10.1002/epd2.70000","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374011","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 MRI changes in status epilepticus: Associations with seizure characteristics, EEG findings, and prognosis in patients without large lesions","authors":"Munevver Ece Guven,&nbsp;Nevin Kuloglu Pazarci","doi":"10.1002/epd2.20338","DOIUrl":"10.1002/epd2.20338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the role, frequency, and pattern of signal changes in cranial MRI associated with status epilepticus (SE) and their correlation with EEG and clinical findings in patients with large lesions, such as tumors, strokes, or major space-occupying anomalies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 44 patients diagnosed with SE between January 2013 and June 2019. Data on demographic and clinical characteristics, seizure semiology, SE features (type and prognosis), and EEG and MRI findings were collected from hospital records. The relationships between periictal MRI abnormalities, MRI lateralization, clinical semiology, EEG findings, SE prognosis, and outcome at discharge were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age of participants was 61.5 years, with 65.91% being female. Bilateral MRI signals were significantly more common in patients with generalized convulsive SE. Patients with SWI signal changes had a significantly lower median age and a higher percentage of previous epilepsy history. Increased signal intensity on DWI and T2-FLAIR sequences was observed in 86.4% and 22.7% of patients, respectively. Among those with increased DWI signals, the neocortex was a common localization (45.45%). The group with T2-FLAIR signal increases had a significantly lower median age, a higher percentage of generalized convulsive SE, and a lower percentage of non-convulsive SE. Poor prognosis was observed in 40.91% of patients, with generalized EEG findings significantly more frequent in this group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Periictal MRI findings in SE patients demonstrated significant associations with clinical presentation but showed no correlation with EEG or prognosis. Further research is needed to explore the link between MRI findings and SE prognosis in the acute phase.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":"27 2","pages":"264-274"},"PeriodicalIF":1.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374963","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}