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Neurol Clin Pract 2022 Jun;12(3):234-247

Department of Medicine (SM, US, TGP), School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria; and Department of Neurology (SM, US, CD, TGP), Monash Medical Centre, Clayton, Melbourne, Australia.

Background And Objectives: A misdiagnosis of psychogenic nonepileptic seizures (PNES) and epileptic seizures (ES) is common. In the absence of the diagnostic gold standard (video EEG), clinicians rely on semiology and clinical assessment. However, questions regarding the diagnostic accuracy of different signs remain. Read More

J Child Neurol 2022 Jun 23:8830738221103090. Epub 2022 Jun 23.

Department of Pediatrics, 138610Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA.

Objective: To determine the nature of staring spells and factors distinguishing epileptic from nonepileptic staring spells, we studied the clinical and demographic features of children with staring spells referred to a regional new-onset seizure clinic.

Study Design: Our retrospective chart review encompassed 2818 consecutive patients evaluated in the new-onset seizure clinic between September 22, 2015, and March 19, 2018. We identified 121 patients with newly presenting staring spells. Read More

Children (Basel) 2022 May 24;9(6). Epub 2022 May 24.

Study Group for Intensive and Integrated Care of Pediatric Central Nervous System, Department of Pediatrics (iCNS Study Group), Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.

Background: Neonatal encephalopathy is caused by a wide variety of acute brain insults in newborns and presents with a spectrum of neurologic dysfunction, such as consciousness disturbance, seizures, and coma. The increased excitability in the neonatal brain appears to be highly susceptible to seizures after a variety of insults, and seizures may be the first clinical sign of a serious neurologic disorder. Subtle seizures are common in the neonatal period, and abnormal clinical paroxysmal events may raise the suspicion of neonatal seizures. Read More

Harefuah 2022 Jun;161(6):349-354

The Multidisciplinary Center for Functional Neurosurgery, Assuta Medical Centers , Tel Aviv, Israel.

Introduction: About one percent (over 81,000 patients) of the Israeli population suffer from epilepsy. The main treatment for this condition is medication, but about a third of the patients suffer from drug-resistant epilepsy (DRE). Each year about 5,000 new patients are diagnosed with epilepsy, of whom 3,000 are children. Read More

Seizure 2022 Jun 16;100:30-35. Epub 2022 Jun 16.

Hacettepe University Medicine Faculty, Department of Neurology, Ankara, Turkey. Electronic address:

Purpose: Ictal hypoxemia is accepted as one of the mechanisms underlying sudden unexpected death in epilepsy (SUDEP). Although ictal hypoxemia is more common in generalized seizures, it also occurs in focal seizures with or without generalization. In this study, we aimed to show the relationship between clinical and electroencephalographic findings of seizures in patients with temporal lobe epilepsy (TLE) with periictal oxygen saturation. Read More

Seizure 2022 Jun 14;100:21-23. Epub 2022 Jun 14.

Department of Neurology, International University of Health and Welfare, Narita Hospital, Narita, Japan.

J Neurol 2022 Jun 15. Epub 2022 Jun 15.

Epilepsy-Center Berlin-Brandenburg, Institute for Diagnostics of Epilepsy, Berlin, Germany.

Background: Epilepsy surgery cases are becoming more complex and increasingly require invasive video-EEG monitoring (VEM) with intracranial subdural or intracerebral electrodes, exposing patients to substantial risks. We assessed the utility and safety of using foramen ovale (FO) and epidural peg electrodes (FOP) as a next step diagnostic approach following scalp VEM.

Methods: We analyzed clinical, electrophysiological, and imaging characteristics of 180 consecutive patients that underwent FOP VEM between 1996 and 2021. Read More

eNeuro 2022 Jun 10. Epub 2022 Jun 10.

Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, United States of America

To date, post-traumatic epilepsy (PTE) research in large animal models has been limited. Recent advances in neocortical microscopy have made possible new insights into neocortical PTE. However, it is very difficult to engender convincing neocortical PTE in rodents. Read More

Epilepsia Open 2022 Jun 4. Epub 2022 Jun 4.

Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands.

Interictal 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) is used in the workup for epilepsy surgery when MRI and EEG video monitoring are not conclusive. Timing of FDG-PET is crucial to avoid the metabolically dynamic (post)ictal state that complicates interpretation, but the exact time window is unclear. We performed a systematic review to provide an evidence-based recommendation for the minimal time interval between last seizure and FDG-PET acquisition. Read More

Dtsch Med Wochenschr 2022 Jun 30;147(11):669-675. Epub 2022 May 30.

Klinik für Neurologie, Epileptologie, Krankenhaus Barmherzige Brüder Regensburg.

The incidence rate of epilepsy has importantly increased during the last decades due to the rising expectation of life. Special clinical aspects have to be considered for the correct diagnosis and differential diagnosis of epileptic seizures in the elderly: On one hand, the etiology of epilepsy in the elderly is different from epilepsies of younger people with a higher rate of symptomatic epilepsies compared to younger people. On the other hand, seizures are more often clinically inconclusive as they frequently appear without motor symptoms and therefore require an accurate diagnostic differentiation from other attacks of unconsciousness. Read More

Brain Sci 2022 Apr 27;12(5). Epub 2022 Apr 27.

Josef Ressel Centre for Horizons of Personalised Music Therapy, Department of Health Sciences, Institute for Therapeutic Sciences, IMC University of Applied Sciences Krems, 3500 Krems, Austria.

Interdisciplinary research into the underlying neural processes of music therapy (MT) and subjective experiences of patients and therapists are largely lacking. The aim of the current study was to assess the feasibility of newly developed procedures (including electroencephalography/electrocardiography hyperscanning, synchronous audio-video monitoring, and qualitative interviews) to study the personal experiences and neuronal dynamics of moments of interest during MT with stroke survivors. The feasibility of our mobile setup and procedures as well as their clinical implementation in a rehabilitation centre and an acute hospital ward were tested with four phase C patients. Read More

Epilepsia 2022 May 18. Epub 2022 May 18.

Epilepsy Center, University Medical Center, University of Freiburg, Freiburg, Germany.

Objective: To determine the diagnostic yield of in-hospital video-electroencephalography (EEG) monitoring to document seizures in patients with epilepsy.

Methods: Retrospective analysis of electronic seizure documentation at the University Hospital Freiburg (UKF) and at King's College London (KCL). Statistical assessment of the role of the duration of monitoring, and subanalyses on presurgical patient groups and patients undergoing reduction of antiseizure medication. Read More

Epilepsia 2022 May 11. Epub 2022 May 11.

Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.

Objective: This study was undertaken to review the reported performance of noninvasive wearable devices in detecting epileptic seizures and psychogenic nonepileptic seizures (PNES).

Methods: We conducted a systematic review and meta-analysis of studies reported up to November 15, 2021. We included studies that used video-electroencephalographic (EEG) monitoring as the gold standard to determine the sensitivity and false alarm rate (FAR) of noninvasive wearables for automated seizure detection. Read More

Sci Rep 2022 05 3;12(1):7138. Epub 2022 May 3.

Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea.

Neuroinflammation contributes to epileptogenesis and ictogenesis. Various signals of neuroinflammation lead to neuronal hyper-excitability. Since an interplay between epilepsy, psychiatric comorbidities and neuroinflammation has been suggested, we explored psychiatric symptoms in epilepsy patients, and the relationship with neuroinflammation. Read More

Exp Neurol 2022 Aug 26;354:114090. Epub 2022 Apr 26.

Department of Physiology and Medical Physics, RCSI University of Medicine and Health Sciences, Dublin, Ireland; FutureNeuro SFI Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland. Electronic address:

Objective: Dravet Syndrome (DS) is a catastrophic form of paediatric epilepsy associated with multiple comorbidities mainly caused by mutations in the SCN1A gene. DS progresses in three different phases termed febrile, worsening and stabilization stage. Mice that are haploinsufficient for Scn1a faithfully model each stage of DS, although various aspects have not been fully described, including the temporal appearance and sex differences of the epilepsy and comorbidities. Read More

Sci Data 2022 04 21;9(1):184. Epub 2022 Apr 21.

University of Washington, Department of Biology, Seattle, 98195, USA.

Understanding the neural basis of human movement in naturalistic scenarios is critical for expanding neuroscience research beyond constrained laboratory paradigms. Here, we describe our Annotated Joints in Long-term Electrocorticography for 12 human participants (AJILE12) dataset, the largest human neurobehavioral dataset that is publicly available; the dataset was recorded opportunistically during passive clinical epilepsy monitoring. AJILE12 includes synchronized intracranial neural recordings and upper body pose trajectories across 55 semi-continuous days of naturalistic movements, along with relevant metadata, including thousands of wrist movement events and annotated behavioral states. Read More

Eur Rev Med Pharmacol Sci 2022 04;26(7):2343-2352

Department of Pediatric Neurology, Gazi University, Faculty of Medicine, Besevler, Ankara, Turkey.

Objective: Our aim in this study is to evaluate epilepsy classification in children with epilepsy before monitoring (based on information received from the family) and after monitoring (based on video-EEG) by comparing two separate classification systems, namely the 2017 International League Against Epilepsy (ILAE) and Semiological Seizure Classification (SSC) systems. Classifications and methods were compared in terms of simplicity, intelligibility, and applicability during daily outpatient care.

Patients And Methods: The study was performed with 230 recorded seizures of 173 patients aged between 1 and 18 years who underwent video-EEG monitoring and clinical seizure recordings. Read More

Clin Neurol Neurosurg 2022 06 31;217:107221. Epub 2022 Mar 31.

University of Hawai'i at Mānoa, John A. Burns School of Medicine, Honolulu, HI USA; University of California, Davis, School of Medicine, Department of Neurological Surgery, Sacramento, CA, USA. Electronic address:

Introduction: Patients with psychogenic non-epileptic seizures (PNES) experience significant morbidity and early mortality, secondary to delayed diagnosis. Better characterizing risk factors and exploring how PNES differentially affects sex and racial strata may facilitate earlier diagnosis.

Methods: From a Hawai'i neuroscience institution, 101 PNES patients were investigated in relation to sociodemographic and medical comorbidities. Read More

J Healthc Eng 2022 4;2022:5222136. Epub 2022 Apr 4.

Department of Electrophysiology, Huizhou No. 2 Maternal and Child Health Hospital, Huizhou, Guangdong 561000, China.

Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. At the same time, ADHD is prone to coexist with other mental disorders, so the diagnosis of ADHD in children is very important. Electroencephalogram (EEG) is the sum of the electrical activity of local neurons recorded from the extracranial scalp or intracranial. Read More

Pract Neurol 2022 Apr 13. Epub 2022 Apr 13.

Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK

Epilepsy is a clinical diagnosis, based primarily on patient and witness histories. Where there is diagnostic uncertainty or when epilepsy surgery is being considered, long-term video-EEG monitoring in a telemetry unit remains the gold standard investigation for diagnostic clarification or presurgical localisation. We present six illustrative cases, highlighting important points that emerged during video-EEG review including potential pitfalls in video-EEG interpretation, and how the investigation helped with diagnosis and subsequent management. Read More

Brain Behav 2022 May 12;12(5):e2567. Epub 2022 Apr 12.

Epilepsy Center, Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany.

Background: Clinical characteristics, outpatient situation, and outcome in patients with psychogenic nonepileptic seizures (PNES) remain to be elucidated.

Methods: Patients diagnosed with PNES after video-electroencephalography (EEG) monitoring (VEM) 03/2000-01/2016 at the Erlangen Epilepsy Center were surveyed between June 2016 and February 2017. Primary outcome was PNES cessation defined as no PNES episodes within > = 12 months prior to the interview. Read More

Sensors (Basel) 2022 Mar 23;22(7). Epub 2022 Mar 23.

School of Computing, Engineering and Built Environment, Glasgow Caledonian University, Glasgow G4 0BA, UK.

Epileptic seizures are caused by abnormal electrical activity in the brain that manifests itself in a variety of ways, including confusion and loss of awareness. Correct identification of epileptic seizures is critical in the treatment and management of patients with epileptic disorders. One in four patients present resistance against seizures episodes and are in dire need of detecting these critical events through continuous treatment in order to manage the specific disease. Read More

Seizure 2022 May 2;98:27-33. Epub 2022 Apr 2.

Department of Epileptology and Neurology, RWTH University Hospital Aachen, Germany. Electronic address:

Objective: Establishing the diagnosis of epilepsy can be challenging if interictal epileptic discharges (IEDs) or seizures are undetectable. Many individuals with epilepsy experience sleep disturbances. A reduced percentage of REM sleep (REM%) has been observed following seizures. Read More

Seizure 2022 Apr 24;97:102-105. Epub 2022 Mar 24.

Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, 6701 Fannin Street, Suite 1250, Houston, TX, 77030, USA.

Introduction: Epileptic spasms (ES) are the ictal manifestation of West syndrome. Due to poor interrater reliability in diagnosing hypsarrhythmia, identification of ES - ideally on video EEG monitoring - is important to start proper treatment.

Methods: We retrospectively analyzed inpatient video EEG recordings of 42 patients with new onset ES and calculated the time needed to capture the first ES, along with time to first sleep epoch, among other data. Read More

Neurol Ther 2022 Jun 4;11(2):763-779. Epub 2022 Apr 4.

Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China.

Introduction: The aim was to evaluate the clinical characteristics and prognostic significance of subclinical seizures (SCSs) on scalp video-electroencephalogram (VEEG) monitoring with or without intracranial electroencephalogram (IEEG) monitoring in patients who had epilepsy surgery.

Methods: We reviewed 286 epileptic patients who underwent subsequent epilepsy surgery during scalp-VEEG evaluation with or without IEEG monitoring between 2013 and 2020, with a minimum follow-up of 1 year. The prevalence and clinical characteristics of SCSs, as well as their prognostic significance, were analyzed. Read More

Clin Neurophysiol 2022 06 15;138:97-107. Epub 2022 Mar 15.

Department of Neurology Vanderbilt University Medical Center, Nashville, TN 37232, USA; Tennessee Valley Health System, Department of Veteran's Affairs, Nashville, TN 37212, USA. Electronic address:

Objective: To determine EEG spatiospectral activation and connectivity in the generalized tonic-clonic seizure (GTCS) semiological subtypes.

Methods: 39 patients with genetic generalized epilepsy (GGE) who had GTCS (n = 58) during video-EEG monitoring were identified in the Vanderbilt Epilepsy database. GTCSs were classified as absence tonic-clonic, myoclonic tonic-clonic, or tonic-clonic. Read More

Transl Stroke Res 2022 Apr 2. Epub 2022 Apr 2.

Department of Neuroscience, University of New Mexico, Albuquerque, NM, USA.

Touch and other types of patient stimulation are necessary in critical care and generally presumed to be beneficial. Recent pre-clinical studies as well as randomized trials assessing early mobilization have challenged the safety of such routine practices in patients with acute neurological injury such as stroke. We sought to determine whether patient stimulation could result in spreading depolarization (SD), a dramatic pathophysiological event that likely contributes to metabolic stress and ischemic expansion in such patients. Read More

Epilepsia 2022 Mar 31. Epub 2022 Mar 31.

Epilepsy Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Objectives: High counts of averaged interictal epileptiform discharges (IEDs) are key components of accurate interictal electric source imaging (ESI) in patients with focal epilepsy. Automated detections may be time-efficient, but they need to identify the correct IED types. Thus we compared semiautomated and automated detection of IED types in long-term video-EEG (electroencephalography) monitoring (LTM) using an extended scalp EEG array and short-term high-density EEG (hdEEG) with visual detection of IED types and the seizure-onset zone (SOZ). Read More

BMJ Case Rep 2022 Mar 29;15(3). Epub 2022 Mar 29.

Neurology, Faculty of Medicine, Ludwig Maximilians University Munich, Munich, Germany.

We describe a man in his 30s who presented with paroxysmal right-sided dyskinesias of the arm and neck, misdiagnosed with drug-resistant focal epilepsy. Two months earlier he had undergone surgery for chronic sinusitis. Immediately after this procedure, he developed hemiparesis, hemiataxia, paresthesias and disturbances in verbal fluency. Read More