5,789 results match your criteria focal generalized


Relationship Between Epilepsy and Dreaming: Current Knowledge, Hypotheses, and Perspectives.

Front Neurosci 2021 6;15:717078. Epub 2021 Sep 6.

Lyon Neuroscience Research Center, CNRS UMR 5292, INSERM U1028-PAM Team, Lyon, France.

The interactions between epilepsy and sleep are numerous and the impact of epilepsy on cognition is well documented. Epilepsy is therefore likely to influence dreaming as one sleep-related cognitive activity. The frequency of dream recall is indeed decreased in patients with epilepsy, especially in those with primary generalized seizures. Read More

View Article and Full-Text PDF
September 2021

Predictive semiology of psychogenic non-epileptic seizures in an epilepsy monitoring unit.

J Neurol 2021 Sep 22. Epub 2021 Sep 22.

Department of Clinical Neurosciences, St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia.

Introduction: The diagnosis of psychogenic nonepileptic seizures (PNES) is a common clinical dilemma. We sought to assess the diagnostic value of four ictal signs commonly used in differentiating PNES from epileptic seizures (ES).

Methods: We retrospectively reviewed consecutive adult video-electroencephalogram (VEM) studies conducted at a single tertiary epilepsy center between May 2009 and August 2016. Read More

View Article and Full-Text PDF
September 2021

Efficacy and Tolerability of Perampanel as Adjunctive Therapy in Chinese Patients With Focal-Onset Seizures: An Observational, Prospective Study.

Front Neurol 2021 30;12:731566. Epub 2021 Aug 30.

Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

To evaluate the efficacy and tolerability of adjunctive perampanel (PER) in Chinese patients with focal-onset seizures, with or without secondarily generalized tonic-clonic seizures. Fifty-six patients aged 14-72 years were recruited consecutively in this single-center prospective observational study. All patients received PER as add-on treatment on the basis of clinical judgment. Read More

View Article and Full-Text PDF

Temporal Onset Focal Seizures Induced by Intermittent Photic Stimulation.

Front Neurol 2021 30;12:715236. Epub 2021 Aug 30.

Department of Pediatrics, Peking University First Hospital, Beijing, China.

The study aimed to review the clinical, radiological, and pathological findings and electroencephalogram (EEG) of pediatric epilepsy patients with temporal onset focal seizures induced by intermittent photic stimulation (IPS). Four patients with temporal onset photosensitivity focal seizures were analyzed. Three (75%) of the four patients were female. Read More

View Article and Full-Text PDF

Epilepsy, electroclinical features, and long-term outcomes in Pitt-Hopkins syndrome due to pathogenic variants in the TCF4 gene.

Eur J Neurol 2021 Sep 14. Epub 2021 Sep 14.

Department of Pediatrics, University of Perugia, Perugia, Italy.

Background: Pitt-Hopkins syndrome (PTHS) is a rare neurodevelopmental disorder caused by deletions/variants in the TCF4 gene. Seizures may be present in up to half of the patients, leading to a more severe disease burden. This study aims to analyse the electroclinical phenotype, treatment options, and long-term outcomes of epilepsy in PTHS. Read More

View Article and Full-Text PDF
September 2021

Brain pathology in focal status epilepticus: evidence from experimental models.

Neurosci Biobehav Rev 2021 Sep 10. Epub 2021 Sep 10.

Division of Clinical Neurophysiology, Lund University, Sweden; Lund Epilepsy Center, Dept Clinical Sciences, Lund University, Sweden.

Status Epilepticus (SE) is often a neurological emergency characterized by abnormally sustained, longer than habitual seizures. The new ILAE classification reports that SE "…can have long-term consequences including neuronal death, neuronal injury…depending on the type and duration of seizures". While it is accepted that generalized convulsive SE exerts detrimental effects on the brain, it is not clear if other forms of SE, such as focal non-convulsive SE, leads to brain pathology and contributes to long-term deficits in patients. Read More

View Article and Full-Text PDF
September 2021

Neuropathology in the North American sudden unexpected death in epilepsy registry.

Brain Commun 2021 23;3(3):fcab192. Epub 2021 Aug 23.

Comprehensive Epilepsy Center, NYU Grossman School of Medicine, New York, NY, USA.

Sudden unexpected death in epilepsy is the leading category of epilepsy-related death and the underlying mechanisms are incompletely understood. Risk factors can include a recent history and high frequency of generalized tonic-clonic seizures, which can depress brain activity postictally, impairing respiration, arousal and protective reflexes. Neuropathological findings in sudden unexpected death in epilepsy cases parallel those in other epilepsy patients, with no implication of novel structures or mechanisms in seizure-related deaths. Read More

View Article and Full-Text PDF

CT and MRI Findings of Focal Splenic Lesions and Ascites in Generalized Lymphatic Anomaly, Kaposiform Lymphangiomatosis, and Gorham-Stout Disease.

J Clin Imaging Sci 2021 14;11:44. Epub 2021 Aug 14.

Department of Radiology, Gifu University, Gifu, Japan.

Objectives: This study aimed to evaluate the CT and MRI findings of focal splenic lesions and ascites in generalized lymphatic anomaly (GLA), kaposiform lymphangiomatosis (KLA), and Gorham-Stout disease (GSD).

Material And Methods: Twenty-three patients (10 with GLA, 5 with KLA, and 8 with GSD) who underwent abdominal CT and/or MRI before treatment were included in this study, and their imaging findings were retrospectively evaluated.

Results: Focal splenic lesions were observed in nine patients; these lesions were observed frequently in GLA ( = 5; 50%) or KLA ( = 3; 60%) compared with GSD ( = 1; 13%); however, no significant differences were found between the three groups ( = 0. Read More

View Article and Full-Text PDF

Timing of syncope in ictal asystole as a guide when considering pacemaker implantation.

J Cardiovasc Electrophysiol 2021 Sep 12. Epub 2021 Sep 12.

Stichting Epilepsie Instellingen Nederland (SEIN), Zwolle, The Netherlands.

Introduction: In patients with ictal asystole (IA) both cardioinhibition and vasodepression may contribute to syncopal loss of consciousness. We investigated the temporal relationship between onset of asystole and development of syncope in IA, to estimate the frequency with which pacemaker therapy, by preventing severe bradycardia, may diminish syncope risk.

Methods: In this retrospective cohort study, we searched video-EEG databases for individuals with focal seizures and IA (asystole ≥ 3 s preceded by heart rate deceleration) and assessed the durations of asystole and syncope and their temporal relationship. Read More

View Article and Full-Text PDF
September 2021

Causes and classification of first unprovoked seizures and newly-diagnosed epilepsy in a defined geographical area- an all-comers analysis.

Seizure 2021 Aug 28;92:118-127. Epub 2021 Aug 28.

Department of Neurology, Cork University Hospital, Ireland; College of Medicine and Health, University College Cork, Ireland; FutureNeuro SFI Research Centre for Chronic and Rare Neurological Diseases hosted in RCSI, Dublin 2, Ireland.

Purpose: The ILAE recently updated the operational definition of epilepsy and the classifications of seizures and epilepsy incorporating aetiology into the classification framework. To date, these classifications have not been applied in any whole population incidence study.

Methods: Multiple overlapping methods of case identification were applied to a defined geographical area (population 542,868 adults and children) to identify all first unprovoked seizures and new diagnosis of epilepsy presenting during the calendar year 2017. Read More

View Article and Full-Text PDF

Role of temporal artery resection in Horton's arteritis (Review).

Exp Ther Med 2021 Oct 2;22(4):1099. Epub 2021 Aug 2.

Clinical and Hearing Aid Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Horton's arteritis is found in the literature under various names, such as temporal arteritis, Horton's disease senile arteritis, granulomatous arteritis or giant cell arteritis (GCA). The pathogenic mechanism is the result of an inflammatory cascade triggered by a still unknown factor that causes dendritic cells in vessels to recruit T cells and macrophages, which form granulomatous infiltrates. The clinical picture consists of a daily headache with temporal localization, with moderate to severe intensity, unilateral or bilateral, with a history of months, years. Read More

View Article and Full-Text PDF
October 2021

Whole Genome Sequence Data From Captive Baboons Implicate in Epileptic Seizure Risk.

Front Genet 2021 20;12:714282. Epub 2021 Aug 20.

Department of Neurology, UT Health San Antonio, San Antonio, TX, United States.

In this study, we investigate the genetic determinants that underlie epilepsy in a captive baboon pedigree and evaluate the potential suitability of this non-human primate model for understanding the genetic etiology of human epilepsy. Archived whole-genome sequence data were analyzed using both a candidate gene approach that targeted variants in baboon homologs of 19 genes ( = 20,881 SNPs) previously implicated in genetic generalized epilepsy (GGE) and a more agnostic approach that examined protein-altering mutations genome-wide as assessed by snpEff ( = 36,169). Measured genotype association tests for baboon cases of epileptic seizure were performed using SOLAR, as well as gene set enrichment analyses (GSEA) and protein-protein interaction (PPI) network construction of top association hits genome-wide < 0. Read More

View Article and Full-Text PDF

Electroclinical Features in Duplication Syndrome: Pediatric Case Series.

J Child Neurol 2021 Sep 6:8830738211030804. Epub 2021 Sep 6.

University of Texas Southwestern Medical Center, Dallas, TX, USA.

Objective: duplication syndrome (MECP2DS) is an x-linked recessive syndrome characterized by infantile hypotonia, severe neurodevelopmental delay, intellectual disability, progressive spasticity, recurrent infections, and seizures. More than 50% of cases have been associated with epilepsy. Seizure semiology and electroencephalogram (EEG) findings in these patients are poorly described. Read More

View Article and Full-Text PDF
September 2021

Interleukin-33 and oxidative stress in epilepsy patients.

Epilepsy Res 2021 Oct 17;176:106738. Epub 2021 Aug 17.

Harran University School of Medicine, Department of Family Medicine, Sanliurfa, Turkey. Electronic address:

Objective: İnflammation and oxidative stress plays an important role in the etiology of epilepsy. Interleukin-33 (IL-33), a new member of the cytokine family associated with interleukin-1 (IL-1), has been found to play a role in pathogenesis of central nervous system diseases and cause the production of proinflammatory cytokines and oxidative stress molecules. Our aim was to investigate IL-33 and oxidative stress values (total antioxidant capacity (TAS), total oxidant capacity (TOS), and oxidative stress index (OSI)) in patients with epilepsy and to evaluate their relationship with each other. Read More

View Article and Full-Text PDF
October 2021

Levetiracetam, lamotrigine and carbamazepine: which monotherapy during pregnancy?

Neurol Sci 2021 Sep 1. Epub 2021 Sep 1.

Epilepsy Centre, Department of System Medicine, Policlinico Tor Vergata, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.

Objective: Epilepsy treatment during pregnancy is still challenging. The study is aimed at comparing the efficacy and safety of carbamazepine (CBZ), lamotrigine (LTG) and levetiracetam (LEV) monotherapies during pregnancy in women with focal (FE) or generalized (GE) epilepsy.

Methods: A multicentre retrospective study was conducted to evaluate seizures frequency and seizure freedom (SF) rate during 3 months before pregnancy, each trimester of gestation and post-partum period in women on monotherapy with CBZ, LTG and LEV. Read More

View Article and Full-Text PDF
September 2021

Generalized Deep Learning EEG Models for Cross-Participant and Cross-Task Detection of the Vigilance Decrement in Sustained Attention Tasks.

Sensors (Basel) 2021 Aug 20;21(16). Epub 2021 Aug 20.

Department of Electrical and Computer Engineering, Air Force Institute of Technology, Wright-Patterson Air Force Base, OH 45433, USA.

Tasks which require sustained attention over a lengthy period of time have been a focal point of cognitive fatigue research for decades, with these tasks including air traffic control, watchkeeping, baggage inspection, and many others. Recent research into physiological markers of mental fatigue indicate that markers exist which extend across all individuals and all types of vigilance tasks. This suggests that it would be possible to build an EEG model which detects these markers and the subsequent vigilance decrement in any task (i. Read More

View Article and Full-Text PDF

Acquired cervical scoliosis in two dogs with inflammatory central nervous system disease.

J Vet Intern Med 2021 Aug 27. Epub 2021 Aug 27.

Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, United Kingdom.

Acquired cervical scoliosis previously has been reported in dogs as a clinical sign associated with Chiari-like malformation and syringomyelia but has not been described with inflammatory central nervous system disease. A 9-month-old Flat-Coated Retriever was presented with an acute onset of cervical scoliosis with no other neurological deficits. Magnetic resonance imaging identified a focal, poorly defined intramedullary lesion within the cranial cervical spinal cord. Read More

View Article and Full-Text PDF

Spectrum and Evolution of EEG Changes in Anti-NMDAR Encephalitis.

Ann Indian Acad Neurol 2021 May-Jun;24(3):396-400. Epub 2020 Nov 6.

Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.

Background: NMDA receptor encephalitis (NMDARE) is the most prevalent autoimmune encephalitis and it encompasses a spectrum of clinical features. It is most commonly associated with alteration in consciousness, seizures, neuro-psychiatric symptoms, and movement disorders. Electroencephalography (EEG) plays a vital role and can give clues to diagnosis in a subset of patients. Read More

View Article and Full-Text PDF
November 2020

Sleep and other Non-motor Symptoms in Patients with Idiopathic Oromandibular Dystonia and Meige Syndrome: A Questionnaire-based Study.

Ann Indian Acad Neurol 2021 May-Jun;24(3):351-355. Epub 2021 Jul 1.

Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.

Introduction: Non-motor symptoms are an essential cause of comorbidity in generalized and focal dystonia. However, there are few studies on dystonia involving the craniofacial regions.

Methods: We studied non-motor symptoms in patients with oromandibular dystonia (OMD) and Meige syndrome using a questionnaire, and validated instruments for depression, anxiety, REM behaviour disorder, restless leg syndrome, sleep quality, excessive daytime sleepiness, and self-esteem. Read More

View Article and Full-Text PDF

Genotype-phenotype correlations in SCN8A-related disorders reveal prognostic and therapeutic implications.

Brain 2021 Aug 25. Epub 2021 Aug 25.

National Centre for Rare Epilepsy-Related Disorders, Oslo University Hospital, 0001 Oslo, Norway.

We report detailed functional analyses and genotype-phenotype correlations in 392 individuals carrying disease-causing variants in SCN8A, encoding the voltage-gated Na+ channel NaV1.6, with the aim of describing clinical phenotypes related to functional effects. Six different clinical subgroups could be identified: 1) Benign familial infantile epilepsy (BFIE) (n = 15, normal cognition, treatable seizures), 2) intermediate epilepsy (n = 33, mild ID, partially pharmaco-responsive), 3) developmental and epileptic encephalopathy (DEE, n = 177, severe ID, majority pharmaco-resistant), 4) generalized epilepsy (n = 20, mild to moderate ID, frequently with absence seizures), 5) unclassifiable epilepsy (n = 127), and 6) neurodevelopmental disorder without epilepsy (n = 20, mild to moderate ID). Read More

View Article and Full-Text PDF

Gabab Receptors: Are They Missing In Action In Focal Epilepsy Research?

Curr Neuropharmacol 2021 Aug 22. Epub 2021 Aug 22.

Montreal Neurological Institute-Hospital and Departments of Neurology & Neurosurgery, McGill University, Montreal, QC. Canada.

GABA, the key inhibitory neurotransmitter in the adult forebrain, activates pre- and postsynaptic receptors that have been categorized as GABAA, which directly open ligand-gated (or receptor-operated) ion-channels, and GABAB, which are metabotropic since they operate through second messengers. Over the last three decades, several studies have addressed the role of GABAB receptors in the pathophysiology of generalized and focal epileptic disorders. Here, we will address their involvement in focal epileptic disorders by mainly reviewing in vitro studies that have shown: (i) how either enhancing or decreasing GABAB receptor function can favour epileptiform synchronization and thus ictogenesis, although with different features; (ii) the surprising ability of GABAB receptor antagonism to disclose ictal-like activity when excitatory ionotropic transmission is abolished; and (iii) their contribution to control seizure-like discharges during repetitive electrical stimuli delivered in limbic structures. Read More

View Article and Full-Text PDF

Acute and chronic cardiorespiratory consequences of focal intrahippocampal administration of seizure-inducing agents. Implications for SUDEP.

Auton Neurosci 2021 Nov 4;235:102864. Epub 2021 Aug 4.

Department of Physiology, 2nd Medical School, Motol, Charles University, Prague, Czech Republic; Department of Pharmacology, University of Oxford, Oxford OX1 3QT, UK; Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA.

The risk factors for SUDEP are undoubtedly heterogenous but the main factor is the frequency of generalized tonic-clonic seizures with apnoea and/or cardiac abnormalities likely precipitating the lethal event. By its very nature modelling SUDEP experimentally is challenging, yet insights into the nature of the lethal event and precipitating factors are vital in order to understand and prevent fatalities. Acute animal models, which induce status epilepticus (SE), can be used to help understand pathophysiological processes during and following seizures, which sometimes lead to death. Read More

View Article and Full-Text PDF
November 2021

PERMIT study: a global pooled analysis study of the effectiveness and tolerability of perampanel in routine clinical practice.

J Neurol 2021 Aug 24. Epub 2021 Aug 24.

Department of Neurology, Christian-Doppler University Hospital, Paracelsus Medical University, Affiliated EpiCARE Partner, Centre for Cognitive Neuroscience, Salzburg, Austria.

The PERaMpanel pooled analysIs of effecTiveness and tolerability (PERMIT) study was a pooled analysis of data from 44 real-world studies from 17 countries, in which people with epilepsy (PWE; focal and generalized) were treated with perampanel (PER). Retention and effectiveness were assessed after 3, 6, and 12 months, and at the last visit (last observation carried forward). Effectiveness assessments included 50% responder rate (≥ 50% reduction in seizure frequency from baseline) and seizure freedom rate (no seizures since at least the prior visit); in PWE with status epilepticus, response was defined as seizures under control. Read More

View Article and Full-Text PDF

A web-based algorithm to rapidly classify seizures for the purpose of drug selection.

Epilepsia 2021 Aug 22. Epub 2021 Aug 22.

Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Objective: To develop and validate a pragmatic algorithm that classifies seizure types, to facilitate therapeutic decision-making.

Methods: Using a modified Delphi method, five experts developed a pragmatic classification of nine types of epileptic seizures or combinations of seizures that influence choice of medication, and constructed a simple algorithm, freely available on the internet. The algorithm consists of seven questions applicable to patients with seizure onset at the age of 10 years or older. Read More

View Article and Full-Text PDF

Risk factors predicting intractability in focal epilepsy in children under 3 years of age: A cohort study.

Epilepsy Behav 2021 Aug 17;123:108234. Epub 2021 Aug 17.

Department of Clinical Neurophysiology, University Medical Center Utrecht, The Netherlands.

Background: Focal onset epilepsy carries a higher risk of intractability than generalized onset epilepsy. Knowledge of the risk factors of intractability will help guide the treatment of children with focal epilepsy. In addition to risk factors present at initial diagnosis, the evolution of clinical and electroencephalographic features may also play a role in predicting intractability. Read More

View Article and Full-Text PDF

"West Syndrome-Infantile Spasms": A Pediatric Case Report.

Int J Clin Pediatr Dent 2021 Mar-Apr;14(2):323-326

Department of Pedodontics and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India.

West syndrome is a rare, severe form of epilepsy with onset in infancy and early childhood. It combines episodes of epileptic spasms that occur in a cluster, an abnormal pattern of interictal electroencephalogram termed as hypsarrhythmia and neuropsychomotor delay. The syndrome mainly results from brain dysfunction in the prenatal, perinatal, or postnatal period and focal lesions early in life may secondarily affect other sites in the brain presenting with some degree of developmental delay and mental retardation. Read More

View Article and Full-Text PDF

Clinical background of patients with psoriasiform skin lesions due to tumor necrosis factor antagonist administration at a single center.

J Dermatol 2021 Aug 19. Epub 2021 Aug 19.

Department of Dermatology, Tokyo Medical University, Tokyo, Japan.

Paradoxical reaction (PR) occurs when a drug elicits a reaction contrary to what was expected. To clarify the clinical features and genetic background of individuals susceptible to PR, we analyzed the clinical course of patients in whom psoriatic eruptions worsened or newly developed during tumor necrosis factor (TNF) antagonist administration and the role of focal infections and genetic variations. Of 125 patients who received TNF antagonist therapy for psoriasis, acrodermatitis continua of Hallopeau (ACH), generalized pustular psoriasis (GPP), or palmoplantar pustular psoriasis (PPP), eight patients with PR were surveyed at our hospital Dermatology Department between 2010 and 2021. Read More

View Article and Full-Text PDF

Local Field Potential-Based Programming: A Proof-of-Concept Pilot Study.

Neuromodulation 2021 Aug 18. Epub 2021 Aug 18.

Krembil Brain Institute, University Health Network, Toronto, ON, Canada.

Objectives: Programming deep brain stimulation (DBS) is still based on a trial-and-error approach, often becoming a time-consuming process for both treating physicians and patients. Several strategies have been proposed to streamline DBS programming, most of which are preliminary and mainly address Parkinson's disease, a condition readily responsive to DBS adjustments. In the present proof-of-principle pilot study, we successfully demonstrate that local field potentials (LFP)-based programming can be an effective approach when used for DBS indications that have a delayed temporal onset of benefit. Read More

View Article and Full-Text PDF

Cross-Frequency Coupling in Childhood Absence Epilepsy.

Brain Connect 2021 Sep 24. Epub 2021 Sep 24.

Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.

Absence seizures are the prototypic primarily generalized seizures, but there is incomplete understanding regarding their generation and maintenance. A core network for absence seizures has been defined, including focal cortical and thalamic regions that have frequency-dependent interactions. The purpose of this study was to investigate within-frequency coupling and cross-frequency coupling (CFC) during human absence seizures, to identify key regions (hubs) within the absence network that contribute to propagation and maintenance. Read More

View Article and Full-Text PDF
September 2021

[Early infantile epileptic encephalopathy caused by PACS2 gene variation: three cases report and literature review].

Zhonghua Er Ke Za Zhi 2021 Jul;59(7):594-599

Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, China.

To explore the clinical features of three early-onset infantile epileptic encephalopathy (EIEE) patients with variations in phosphofurin acidic cluster sorting protein 2 (PACS2) gene and to review related literature. The clinical data and genetic features of three early infantile epileptic encephalopathy 66 (EIEE66) patients with a PACS2 gene variant diagnosed by the Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2019 to January 2020 were retrospectively analyzed. A literature search with "PACS2 gene" "PACS2" "epileptic encephalopathy, early infantile, 66" and"early infantile epileptic encephalopathy 66" as key words was conducted at PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Data Knowledge Service Platform (up to July 2020). Read More

View Article and Full-Text PDF