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J Neurosurg 2021 May 14:1-13. Epub 2021 May 14.

Departments of1Neurosurgery and.

Objective: Status epilepticus (SE) is associated with significant mortality, cost, and risk of future seizures. In one of the first studies of SE after neurosurgery, the authors assess the incidence, risk factors, and outcome of postneurosurgical SE (PNSE).

Methods: Neurosurgical admissions from the MarketScan Claims and Encounters database (2007 through 2015) were assessed in a longitudinal cross-sectional sample of privately insured patients who underwent qualifying cranial procedures in the US and were older than 18 years of age. Read More

Epilepsy Res 2021 May 8;174:106663. Epub 2021 May 8.

Department of Neurology, Hospital Materno Infantil Salta, Argentina. Electronic address:

Objective: We analyzed the records of 198 patients with West syndrome (WS) seen at a single pediatric neurology center in Argentina between June 2004 and June 2017. Five patients with infection-related spontaneous remission of the electroclinical manifestations were identified.

Methods: The following parameters were investigated: personal and family history, clinical characteristics of the seizures - mainly spasms - and EEG findings, type of treatment, and outcome. Read More

Brain Stimul 2021 May 11. Epub 2021 May 11.

Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan; Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan. Electronic address:

Background: Transcranial direct current stimulation (tDCS) provides a noninvasive polarity-specific constant current to treat epilepsy, through a mechanism possibly involving excitability modulation and neural oscillation.

Objective: To determine whether EEG oscillations underlie the interictal spike changes after tDCS in rats with chronic spontaneous seizures.

Methods: Rats with kainic acid-induced spontaneous seizures were subjected to cathodal tDCS or sham stimulation for 5 consecutive days. Read More

Brain Behav Immun 2021 May 11. Epub 2021 May 11.

Faculty of Medicine, Hebrew University of Jerusalem, Israel; The Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah - Hebrew University Medical Center, Jerusalem, Israel. Electronic address:

Brain stimulation by electroconvulsive therapy is effective in neuropsychiatric disorders by unknown mechanisms. Microglial toxicity plays key role in neuropsychiatric, neuroinflammatory and degenerative diseases. We examined the mechanism by which electroconvulsive seizures (ECS) regulates microglial phenotype and response to stimuli. Read More

J Neurosurg Pediatr 2020 Jun 21;25(6). Epub 2020 Feb 21.

Division of Pediatric Neurosurgery, Department of Neurosurgery, Brain Institute, Miami Children's Hospital, Miami, Florida.

Objective: Although hemispherectomy is an effective treatment for children with intractable hemispheric epilepsy syndromes, as many as 40% of patients eventually develop seizure recurrence. The causes of seizure recurrence in these patients are incompletely understood. The authors sought to evaluate the efficacy of hemispherectomy at their center and determine whether contralateral MRI abnormalities can predict seizure recurrence. Read More

J Clin Psychiatry 2021 Feb 23;82(2). Epub 2021 Feb 23.

Department of Psychiatry, University of Utah, Salt Lake City, Utah.

Background: The use of electroconvulsive therapy (ECT) in children and adolescents is based on a limited evidence base in the medical literature. We report outcomes of a cohort of youth treated with ECT at a single US academic medical center.

Methods: We conducted a retrospective chart review and analysis of all patients aged 18 years and younger who received ECT at the University of Utah from 1985 through 2016. Read More

Neurol Ther 2021 May 14. Epub 2021 May 14.

School of Medicine and Biomedical Science, University of Queensland, Brisbane, QLD, 4027, Australia.

Over the past 50 years, published studies have provided quantitative data on the control of epileptic seizures during pregnancy. The studies have varied in quality, and particularly in the ways in which seizure control has been assessed. However, most studies have shown that seizure occurrence rates are more likely to worsen than improve during pregnancy, though in most pregnancies the rates have been unaltered. Read More

Neurol Sci 2021 May 13. Epub 2021 May 13.

Neurology Medicine Center, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China.

Purpose: The aim of this study was to determine the predictive value of red blood cell distribution width (RDW) in patients with a primary diagnosis of seizures admitted to the intensive care unit (ICU) in terms of in-hospital mortality.

Methods: This was a retrospective study of the eICU Collaborative Research Database of adult patients (aged 18-88 years) with a primary diagnosis of seizures in 2014 and 2015. The prognostic value of RDW was investigated using a receiver operating characteristic (ROC) curve, multiple logistic regression model, and net reclassification index (NRI). Read More

Open Life Sci 2020 28;15:21-29. Epub 2020 Feb 28.

"Victor Babes" National Institute of Pathology, Bucharest Romania.

Chromosomal diseases are heterogeneous conditions with complex phenotypes, which include also epileptic seizures. Each chromosomal syndrome has a range of specific characteristics regarding the type of seizures, EEG findings and specific response to antiepileptic drugs, significant in the context of the respective genetic etiology. Therefore, it is very important to know these particularities, in order to avoid an exacerbation of seizures or some side effects. Read More

Front Vet Sci 2021 27;8:600307. Epub 2021 Apr 27.

Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany.

Sudden unexpected death in human epileptic patients (SUDEP) is defined as death related to recurrent unprovoked seizures, death occurring unexpectedly, and suddenly in a patient with reasonable state of health, without an obvious medical cause of death, trauma, asphyxia, or intractable status epilepticus, and in post mortem examination no obvious reason for death can be found. "Probable SUDEP" (pSUDEP) is defined as SUDEP not confirmed pathologically. The adapted abbreviation for dogs is used in the following: "pSUDED" (probable sudden unexpected death in dogs with epilepsy). Read More

Front Pediatr 2021 27;9:634655. Epub 2021 Apr 27.

Al Jalila Children's Speciality Hospital, Dubai, United Arab Emirates.

Long QT syndactyly syndrome (long QT syndrome type 8), also known as Timothy Syndrome (TS) was first described in 1994 with still <50 case reported in the literature. The full spectrum of the syndrome is not yet known. Here we report a girl who presented with new onset refractory seizures and an undiagnosed cause of intermittent abdominal distention. Read More

Eur J Case Rep Intern Med 2021 21;8(4):002358. Epub 2021 Apr 21.

Service de Rhumatologie, CHRU Besançon, Besançon, France.

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized mainly by arthritis, with the possible occurrence of extra-articular manifestations. We report the case of a patient who developed leptomeningitis as the first sign of RA, one year before the diagnosis of RA. Methylprednisolone 1000 mg was given intravenously. Read More

Cureus 2021 Apr 10;13(4):e14395. Epub 2021 Apr 10.

Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Post-traumatic seizures (PTS) have become an emerging challenge for neurologists worldwide with the rise of brain injuries. Trauma can lead to various outcomes, ranging from naive spasms to debilitating post-traumatic epilepsy (PTE). In this article, we will explore the pathogenesis of convulsions following a concussion. Read More

Cureus 2021 Apr 9;13(4):e14379. Epub 2021 Apr 9.

Pediatric Neurology, Lehigh Valley Health Network (LVHN) Lehigh Valley Reilly Children's Hospital, Allentown, USA.

An 11-year-old female presents to the sleep clinic for evaluation for possible sleep-disordered breathing (SDB). She has a history of frequently intractable seizures for which she was tried on multiple antiepileptic medications. She had vagus nerve stimulation (VNS) implantation two years ago to treat her focal seizures. Read More

Sci Rep 2021 May 13;11(1):10257. Epub 2021 May 13.

Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 05403-900, Brazil.

In about a third of the patients with epilepsy the seizures are not drug-controlled. The current limitation of the antiepileptic drug therapy derives from an insufficient understanding of epilepsy pathophysiology. In order to overcome this situation, it is necessary to consider epilepsy as a disturbed network of interactions, instead of just looking for changes in single molecular components. Read More

Am J Case Rep 2021 May 14;22:e931376. Epub 2021 May 14.

Department of Infectious Disease, Rockledge Regional Medical Center, Rockledge, FL, USA.

BACKGROUND Convexal subarachnoid hemorrhage (cSAH), a rare form of non-aneurysmal subarachnoid hemorrhage, is confined to cerebral convexities without extension into basal cisterns or ventricles. Typical presentation includes thunderclap/progressive headache or transient focal neurological symptoms; rare manifestations include seizures, intractable vomiting, or altered mental status. Here, we report the first case of convexal subarachnoid hemorrhage and multifocal ischemic lesions caused by infective endocarditis (IE) in a treatment-naïve advanced HIV patient. Read More

Sleep Med Clin 2021 Jun;16(2):389-408

UCLA Seizure Disorder Center, Brain Research Institute, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA.

Electroencephalogram (EEG) recording is essential in the evaluation of complex movement and behaviors during sleep, but in particular for differentiating epileptic versus nonepileptic events. In general, epileptiform discharges occur with greater density in the first few nonerapid eye movement cycles, and approximately 12% to 20% of seizures occur exclusively at night. This review examines the epilepsy types and syndromes whose presentation is strongly influenced by the sleep state, with an appraisal about the role that sleep plays in facilitating seizures, while deleaneatign EEG findings and clinical manifestation. Read More

Epilepsy Behav 2021 May 10;120:108004. Epub 2021 May 10.

Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Psychology, Western University, London, Ontario, Canada.

Objective: To identify predictors of Psychogenic NonEpileptic Seizure (PNES) improvement and anti-seizure medication (ASM) discontinuation in patients with PNES only.

Methods: This is a retrospective study of a consecutively enrolled cohort of 271 patients diagnosed with PNES by video-EEG (vEEG) telemetry in our Epilepsy Monitoring Unit (EMU) between May 2000 and February 2010. Patients with any possibility of past or present comorbid epilepsy based on clinical, EEG, and neuroimaging, or less than one year of follow-up after discharge were excluded. Read More

Invest Ophthalmol Vis Sci 2021 May;62(6):15

University of Washington, Department of Ophthalmology, Seattle, Washington, United States.

Purpose: Children with cerebral visual impairment (CVI) often have abnormal visual orienting behaviors due to impaired or damaged visual cortex. Alternatively, visual-cortical function is intact but visual information is not transformed downstream into an appropriate oculomotor output (visuomotor dysfunction). We examined visual, anatomic, and oculomotor assessments to distinguish visuomotor dysfunction from CVI associated with severely reduced visual-cortical response. Read More

J Med Cases 2021 Apr 8;12(4):152-156. Epub 2021 Feb 8.

Department of Anesthesiology and Critical Care, Saint Louis University Hospital, 1201 S. Grand Boulevard, St. Louis, MO 63104, USA.

Propionic acidemia (PA) is a rare, multi-systemic inborn error of metabolism. PA results from an impaired activity of the mitochondrial enzyme, propionyl-CoA carboxylase (PCC). PCC holds an essential role in the catabolic pathways for odd-chain fatty acids, cholesterol side-chains and branched-chain amino acids. Read More

J Neurol 2021 May 13. Epub 2021 May 13.

Clinical Neurology Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, ASUFC, Udine, Italy.

Episodic ataxia type 2 (EA2) is a hereditary disorder characterized by paroxysmal attacks of ataxia, vertigo and nausea, due to mutations in the CACNA1A gene, which encodes for α1 subunit of the P/Q-type voltage-gated Ca channel (CaV2.1). Other manifestations may be associated to CACNA1A mutations, such as migraine and epilepsy. Read More

Epilepsia 2021 May 13. Epub 2021 May 13.

Department of Biological Sciences, Hunter College of City University of New York, New York, New York, USA.

Objective: Fibroblast growth factor homologous factors (FHFs) are brain and cardiac sodium channel-binding proteins that modulate channel density and inactivation gating. A recurrent de novo gain-of-function missense mutation in the FHF1(FGF12) gene (p.Arg52His) is associated with early infantile epileptic encephalopathy 47 (EIEE47; Online Mendelian Inheritance in Man database 617166). Read More

Neurol Sci 2021 May 12. Epub 2021 May 12.

Department of Neurology, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China.

Anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor encephalitis is an anti-neuronal surface antigen autoimmune encephalitis and is relatively rare. Our study evaluated a patient who developed anti-AMPA2 receptor encephalitis with memory deficits and refractory focal seizures as paroxysmal jerking on right face as well as dystonic seizure on right hand. On this patient, the combination treatment of levetiracetam, carbamazepine, and clonazepam, monthly periodic intravenous immunoglobin and immunosuppressive therapies for 5 months was not effective for the focal seizures, while his memory loss was slightly improved. Read More

Epilepsy Behav Rep 2021 3;16:100443. Epub 2021 Apr 3.

Pediatric Neurology, Department of Pediatrics, Kalawati Saran Children's Hospital, Delhi, India.

Pyridox(am)ine- 5- phosphate Oxidase deficiency (PNPO) is a rare cause of neonatal metabolic encephalopathy associated with refractory status epilepticus. We report a case of a premature neonate presenting with drug-resistant seizures beginning at 2 hours of life. The baby showed initial transient response to pyridoxine followed by recurrence. Read More

Eur Heart J Case Rep 2021 May 5;5(5):ytab168. Epub 2021 May 5.

Department of Cardiology, Kettering General Hospital, NHS, Rothwell Road, Kettering, NN16 8UZ, UK.

Background: Myocardial infarction (MI) with non-obstructive coronary arteries presenting with ST-segment elevation can be challenging. Understanding the cardiac and non-cardiac causes aid in identifying the underlying diagnosis and deciding on the management. Neurological insult resulting in a mismatch of oxygen supply or demand to cardiomyocytes can lead to type 2 MI. Read More

Mov Disord Clin Pract 2021 May 3;8(4):600-603. Epub 2021 Apr 3.

Center for Parkinson's Disease and Movement Disorders Clinic Vikram Hospitals Bangalore India.

Cureus 2021 Apr 10;13(4):e14402. Epub 2021 Apr 10.

Neurology, Universidad San Francisco de Quito, Quito, ECU.

Griscelli syndrome (GS) is a rare syndrome characterized by hypopigmentation, immunodeficiency, and neurological features. The genes Ras-related protein (RAB27A) and Myosin-Va (MYO5A) are involved in this condition's pathogenesis. We present a GS type 1 (GS1) case with developmental delay, hypotonia, and refractory seizures despite multiple medications, which included clobazam, cannabinol, zonisamide, and a ketogenic diet. Read More

BMJ Case Rep 2021 May 12;14(5). Epub 2021 May 12.

Epworth Hospital, Richmond, Victoria, Australia.

A nulliparous patient in her early 20s was referred to a fertility specialist for fertility preservation, before commencing chemo-radiation therapy for a recently diagnosed malignant brain tumour. Two weeks prior, she had presented with seizures and undergone emergency craniotomy and tumour resection. Taking into consideration of the tight time frame and her comorbidities, several measures were undertaken to minimise the potential increase in intracranial pressure that may lead to cerebral oedema during laparoscopy. Read More

Epilepsy Behav 2021 May 9;120:107987. Epub 2021 May 9.

Department of Medicine (RMH), The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Parkville, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Australia.

Objective: To compare the clinical, psychiatric, and cognitive characteristics of older with younger patients presenting to a video-EEG monitoring (VEM) unit.

Method: This was a retrospective case-control study involving patients admitted for VEM over a two-year period (from April 2018 to April 2020) at two comprehensive epilepsy units. Patients were categorized into an older (≥60 years) and a younger (<60 years) group. Read More