Epileptic Disorders最新文献

{"title":"Ictal Cotard delusion as a manifestation of nonconvulsive status epilepticus: A case report and commentary","authors":"Bernardo Crespo Pimentel,&nbsp;Giorgi Kuchukhidze,&nbsp;Marta Heyduk,&nbsp;Aljoscha Thomschewski,&nbsp;Eugen Trinka,&nbsp;Julia Höfler","doi":"10.1002/epd2.20221","DOIUrl":"10.1002/epd2.20221","url":null,"abstract":"<p>Psychosis of epileptic origin can present a wide range of cognitive and affective symptoms and is often underrecognized. Usually occurring in the inter- and postictal phase, epileptic psychosis is mostly related to temporal lobe epilepsy. Here, we describe the clinical presentation and diagnostic workup including routine EEG recording and brain MRI of a 63-year-old woman expressing isolated nihilistic delusions comprising belief of being dead and denial of self-existence. EEG showed an ictal pattern fulfilling the Salzburg criteria of nonconvulsive status epilepticus and brain MRI revealed extensive peri-ictal hyperperfusion. Delusional symptoms and EEG abnormalities subsided after acute antiseizure treatment. Our case illustrates how nihilistic delusions can occur as a direct clinical correlate of seizure activity, thereby expanding the spectrum of ictal neuropsychiatric phenomena in temporal lobe epilepsy and highlighting the need to consider an epileptic origin in patients presenting with psychotic symptoms.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/epd2.20221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140839615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized controlled educational pilot trial of interictal epileptiform discharge identification for neurology residents","authors":"Fábio A. Nascimento,&nbsp;Jin Jing,&nbsp;Christopher Traner,&nbsp;Wan Yee Kong,&nbsp;Marcia Olandoski,&nbsp;Srishti Kapur,&nbsp;Erik Duhaime,&nbsp;Roy Strowd,&nbsp;Jeremy Moeller,&nbsp;M. Brandon Westover","doi":"10.1002/epd2.20229","DOIUrl":"10.1002/epd2.20229","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the effectiveness of an educational program leveraging technology-enhanced learning and retrieval practice to teach trainees how to correctly identify interictal epileptiform discharges (IEDs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a bi-institutional prospective randomized controlled educational trial involving junior neurology residents. The intervention consisted of three video tutorials focused on the six IFCN criteria for IED identification and rating 500 candidate IEDs with instant feedback either on a web browser (intervention 1) or an iOS app (intervention 2). The control group underwent no educational intervention (“inactive control”). All residents completed a survey and a test at the onset and offset of the study. Performance metrics were calculated for each participant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one residents completed the study: control (<i>n</i> = 8); intervention 1 (<i>n</i> = 6); intervention 2 (<i>n</i> = 7). All but two had no prior EEG experience. Intervention 1 residents improved from baseline (mean) in multiple metrics including AUC (.74; .85; <i>p</i> &lt; .05), sensitivity (.53; .75; <i>p</i> &lt; .05), and level of confidence (LOC) in identifying IEDs/committing patients to therapy (1.33; 2.33; <i>p</i> &lt; .05). Intervention 2 residents improved in multiple metrics including AUC (.81; .86; <i>p</i> &lt; .05) and LOC in identifying IEDs (2.00; 3.14; <i>p</i> &lt; .05) and spike–wave discharges (2.00; 3.14; <i>p</i> &lt; .05). Controls had no significant improvements in any measure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This program led to significant subjective and objective improvements in IED identification. Rating candidate IEDs with instant feedback on a web browser (intervention 1) generated greater objective improvement in comparison to rating candidate IEDs on an iOS app (intervention 2). This program can complement trainee education concerning IED identification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140802390","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":"Anticipatory anxiety of seizures in epilepsy: A common, complex, and underrecognized phenomenon?","authors":"Andres M. Kanner,&nbsp;Enrique Carrazana,&nbsp;Heidi M. Munger Clary,&nbsp;Adrian L. Rabinowicz,&nbsp;Edward Faught","doi":"10.1002/epd2.20224","DOIUrl":"10.1002/epd2.20224","url":null,"abstract":"<p>The diagnosis of epilepsy is associated with loss of predictability, which invariably results in the fear of when and if future seizures will occur. For a subset of patients with epilepsy (PWE), there may be a pathological persistent fear of seizure occurrence, resulting in limitations to daily activities through avoidant behaviors. Paradoxically, the research of anticipatory anxiety of seizures (AAS; also referred to as seizure phobia) has been practically nonexistent and, not surprisingly, this condition remains underrecognized by clinicians. The available data are derived from three small case series of patients followed in tertiary epilepsy centers. In this study, we review the available data on the reported clinical manifestations of AAS in PWE, and of the potential role of variables associated with it, such as personal and family psychosocial and psychiatric history and epilepsy-related variables. In addition, we review the need for the creation of screening tools to identify patients at risk of AAS and discuss potential treatment strategies, which could be considered as part of the comprehensive management for PWE.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/epd2.20224","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Battery depletion in patients treated with anterior thalamic stimulation for drug-resistant epilepsy","authors":"Michał Sobstyl,&nbsp;Magdalena Konopko,&nbsp;Aleksandra Wierzbicka","doi":"10.1002/epd2.20226","DOIUrl":"10.1002/epd2.20226","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140615715","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":"Ma2 antibody-associated limbic encephalitis: The early etiology treatment may modify the disease clinical trajectory","authors":"Pietro Mattioli,&nbsp;Stefano Grisanti,&nbsp;Federico Massa,&nbsp;Silvia Morbelli,&nbsp;Silvia Boni,&nbsp;Alessandro Beronio,&nbsp;Giacomo Rebella,&nbsp;Luca Roccatagliata,&nbsp;Lino Nobili,&nbsp;Diego Franciotta,&nbsp;Elisa Micalizzi,&nbsp;Flavio Nobili,&nbsp;Dario Arnaldi,&nbsp;Flavio Villani,&nbsp;Luana Benedetti","doi":"10.1002/epd2.20225","DOIUrl":"10.1002/epd2.20225","url":null,"abstract":"<p>Paraneoplastic encephalitis includes neurological conditions with autoantibodies against neuronal proteins, likely triggered by the underlying tumor antigens.<span>¹</span> We report two patients with paraneoplastic limbic encephalitis<span>¹</span> with “high-risk-for-cancer” antibodies against Ma2 antigen and non-typical tumors. These cases allow consideration of autoimmune epilepsy's pathogenesis, the importance of early diagnosis, and therapy.</p><p>A 21-year-old male admitted to the Infectious Disease Unit due to confusion, visual hallucinations, and upper limbs myoclonus, following a 4-month history of antipyretic-resistant fever, sore throat, and hyperphagia. Cerebrospinal fluid (CSF) analysis was normal, blood examinations showed pancytopenia. Brain MRI, [¹⁸F]FDG-PET, and EEG (Figure 1A–D) suggested central nervous system inflammation involving basal ganglia and mesial temporal lobes. Screening for infections was negative. Anti-Ma2 antibodies were found in serum and CSF (indirect immunofluorescence on primate cerebellum, and dot-blot; Euroimmun, Germany). IV methylprednisolone (1 g/day for 5 days) and immunoglobulins (IVIg) (.4 g/kg/day for 5 days) yielded no clinical improvement. Total body CT, [¹⁸F]FDG-PET, pelvis, and testicular ultrasound excluded neoplasms, but bone marrow analysis, 6 months after symptoms' onset, showed a clonal population of CD19/CD20dim/CD21 B lymphocytes, indicating a mature B-cell indolent lymphoproliferative disorder not requiring treatment. Hospital-acquired sepsis hindered further immunosuppressive therapies and led to death (7 months after symptoms' onset).</p><p>The second patient, a 30-year-old male, presented with asthenia, insomnia, mild fever, and daily, short-lasting episodes of shivering, horripilation, heart palpitations, and unpleasant taste. Subtle sleep-related involuntary movements were reported. No EEG was performed at the time. 1 month after symptom onset, a right testicular mass was noticed and orchiectomy performed. Pathology disclosed a post-puberal teratoma. 2 months later, a scheduled total body CT showed enlargement of retroperitoneal lymph-nodes, which were completely removed. Pathology disclosed a post-puberal teratoma with embryonal cancer focus. The patients started clinical and radiological follow-up, with no further localizations detected. 5 months later, he presented a focal-to-bilateral seizure, promptingantiseizure medications. Brain MRI and [¹⁸F]FDG-PET indicated limbic encephalitiswith EEG showing interictal epileptiform discharges in left temporal lobe (Figure 1E–H). Anti-Ma2 antibodies were detected in serum and CSF (indirect immunofluorescence on primate cerebellum, and dot-blot; Euroimmun, Germany), but not anti-NMDAR (antigen-specific cell-based assay (Euroimmun, Germany)). IVIg (.4 g/kg/day for 5 days), methylprednisolone (500 mg/day for 3 days) followed by oral prednisone (50 mg/day) led to seizure frequency reduc","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/epd2.20225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A controversial question: Can morphometry and clinical history be enough to diagnose hippocampal dysplasia?","authors":"Ianne Lucena Arruda,&nbsp;Rivus Ferreira Arruda,&nbsp;Rayanne Maria Brandão da Silveira,&nbsp;Jeana Torres Corso Duarte,&nbsp;Mirian Salvadori Bittar Guaranha,&nbsp;Laura Maria Guilhoto,&nbsp;Henrique Carrete Júnior,&nbsp;Joao Norberto Stavale,&nbsp;Ricardo Silva Centeno,&nbsp;Elza Marcia Targas Yacubian,&nbsp;Jose Eduardo Peixoto-Santos","doi":"10.1002/epd2.20222","DOIUrl":"10.1002/epd2.20222","url":null,"abstract":"<p>The presence of dysmorphic neurons with strong cytoplasmatic accumulation of heavy non-phosphorylated neurofilament is crucial for the diagnostics of focal cortical dysplasia type II (FCDII). While ILAE's classification describes neocortical dysplasias, some groups have reported patients with mesial t abnormal neurons in the hippocampus of mesial temporal lobe epilepsy. Here we report a patient with such abnormal neurons in the hippocampus and compared it with previous reports of hippocampal dysplasia. Finally, we discuss the need for diagnostic criteria of hippocampal dysplasia.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601662","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 kissing: Review of literature and report of 5 cases","authors":"Parthvi Ravat,&nbsp;Neeraj Jain,&nbsp;Mayur Thakkar,&nbsp;Mayuri Kalika,&nbsp;Sangeeta Ravat","doi":"10.1002/epd2.20208","DOIUrl":"10.1002/epd2.20208","url":null,"abstract":"<p>Ictal kissing (IK) is a rare type of automatism observed during epileptic seizures. Despite its uncommon occurrence, understanding the underlying mechanisms, the role of emotions, and the level of consciousness during seizures with IK is essential in providing a comprehensive understanding of epilepsy. We describe five cases (.13%) of IK after performing a retrospective analysis of 3794 long-term, ictal video-EEGs from an epilepsy monitoring unit in Mumbai, India. Our patients with drug-resistant epilepsy showed IK had a wide epileptogenic zone. We discuss the current hypotheses on the mechanisms behind IK, the involvement of temporal lobe structures, and the implications of awareness during seizures. The review concludes by suggesting future directions for research to elucidate the complex phenomenon of IK further.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337550","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":"Epilepsy and ionic channels","authors":"Patrice Roll, Pierre Szepetowski","doi":"10.1684/j.1950-6945.2002.tb00489.x","DOIUrl":"https://doi.org/10.1684/j.1950-6945.2002.tb00489.x","url":null,"abstract":"Ion channels play critical roles in a broad range of physiological processes. In particular, they represent a common basis for the excitable properties of different tissues. Consequently, ion channels of many different types have been implicated in several human genetic disorders of the heart, brain and skelctal muscle. An increasing number of genes encoding neurotransmitter‐ or voltage‐gated ion channel subunits have proved to be mutated in various idiopathic human epilepsies as well as in different animal models. The epilepsies could thus be considered as one of many paroxysmal disorders that are due to mutations in ion channel genes, the so‐called channelopathies. However, recent data supported the hypothesis that other genes with different properties could also be responsible for human idiopathic epilepsies, thus opening new and exciting areas of research. Effort is still needed to identify the genes responsible for the large variety of other epileptic disorders inherited as Mendelian traits and evaluate the role of these genes in the more common and polygenic forms. Defining the genetic bases of the latter will also require that exhaustive association studies are performed. These studies may help understand the pathophysiology of human epilepsies and represent the first step towards the discovery of new therapeutic targets, as exemplified in the case of the KCNQ potassium channels.","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140312913","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":"Congress & Meetings","authors":"","doi":"10.1684/j.1950-6945.2000.tb00451.x","DOIUrl":"https://doi.org/10.1684/j.1950-6945.2000.tb00451.x","url":null,"abstract":"","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140312887","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":"Evolution of epilepsy surgery in childhood: the neurologist's point of view","authors":"Jean Aicardi","doi":"10.1684/j.1950-6945.1999.tb00332.x","DOIUrl":"https://doi.org/10.1684/j.1950-6945.1999.tb00332.x","url":null,"abstract":"Surgical treatment of epilepsy in children has been slow to develop because of uncertainties regarding the prognosis of early epilepsies, difficulties in the diagnosis of causal lesions, the frequency of severe, extensive brain damage, and technical problems. Surgery for epilepsy in infants and children raises problems quite different from those in adults. This applies especially to severe infantile epilepsies for which the aim of treatment may be more to facilitate neurodevelopment than to control the seizures. In addition, intractability cannot be defined in the same terms at different ages, the time scale being usually much shorter in young children and the operations required often extensive. The results of surgery in childhood are comparable to those in adults. However, indications for surgery and assessment of its results in catastrophic epilepsies of infants requires different rules to those that apply to adults and older children.","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140313013","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}