scholarly journals Efficacy of levetiracetam monotherapy in epilepsy associated with benign epileptiform discharges of childhood

2019 ◽  
Vol 11 (1) ◽  
pp. 63-68 ◽  
Author(s):  
N. A. Borovkova ◽  
A. G. Malov
Keyword(s):  
Valproic Acid ◽  
Pediatric Patients ◽  
Slow Wave Sleep ◽  
Epileptiform Activity ◽  
Functional Tests ◽  
Antiepileptic Treatment ◽  
Epileptiform Discharges ◽  
First Choice ◽  
Eeg Recordings ◽  
Patients With Epilepsy

Aim. To analyze efficacy of levetiracetam monotherapy in patients with epilepsy associated with benign epileptiform discharges of childhood (BEDC). Materials and methods. We examined 29 pediatric patients with idiopathic and symptomatic BEDC-associated epilepsy, including continuous spike-and-wave epileptiform activity during slow-wave sleep (CSWS) in the stage of clinical remission. Of those, 12 children received antiepileptic treatment with valproic acid, and 17 children received levetiracetam. The examination included passive awake EEG recordings (with functional tests) as well as daytime sleep EEG recordings (within 60 minutes). Results. Levetiracetam was no less efficient in monotherapy of BEDC-associated epilepsy (including the CSWS patterns) than the traditionally used valproic acid, especially in idiopathic forms of epilepsy. Conclusion. Levetiracetam can be recommended for the first-choice basic anti-epileptic monotherapy treatment.

scholarly journals Zero-crossing patterns reveal subtle epileptiform discharges in the scalp EEG

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jan Pyrzowski ◽  
Jean- Eudes Le Douget ◽  
Amal Fouad ◽  
Mariusz Siemiński ◽  
Joanna Jędrzejczak ◽  
...  
Keyword(s):  
Normal Subjects ◽  
Intracranial Eeg ◽  
Zero Crossing ◽  
Temporal Precision ◽  
Scalp Eeg ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
Eeg Recordings ◽  
Patients With Epilepsy ◽  
Low Amplitude

AbstractClinical diagnosis of epilepsy depends heavily on the detection of interictal epileptiform discharges (IEDs) from scalp electroencephalographic (EEG) signals, which by purely visual means is far from straightforward. Here, we introduce a simple signal analysis procedure based on scalp EEG zero-crossing patterns which can extract the spatiotemporal structure of scalp voltage fluctuations. We analyzed simultaneous scalp and intracranial EEG recordings from patients with pharmacoresistant temporal lobe epilepsy. Our data show that a large proportion of intracranial IEDs manifest only as subtle, low-amplitude waveforms below scalp EEG background and could, therefore, not be detected visually. We found that scalp zero-crossing patterns allow detection of these intracranial IEDs on a single-trial level with millisecond temporal precision and including some mesial temporal discharges that do not propagate to the neocortex. Applied to an independent dataset, our method discriminated accurately between patients with epilepsy and normal subjects, confirming its practical applicability.

scholarly journals CYP2C9*3/*3 Gene Expression Affects the Total and Free Concentrations of Valproic Acid in Pediatric Patients with Epilepsy

2021 ◽  
Vol Volume 14 ◽  
pp. 417-430
Author(s):  
Xikun Wu ◽  
Weichong Dong ◽  
Haoran Li ◽  
Xiuling Yang ◽  
Yiran Jin ◽  
...  
Keyword(s):  
Gene Expression ◽  
Valproic Acid ◽  
Pediatric Patients ◽  
Patients With Epilepsy

No Effect of Gender or Age on Binding Characteristics of Valproic Acid to Serum Proteins in Pediatric Patients with Epilepsy

1999 ◽  
Vol 39 (10) ◽  
pp. 1070-1076 ◽  
Author(s):  
Yasuo Kodama ◽  
Hirofumi Kodama ◽  
Masae Kuranari ◽  
Kimiko Tsutsumi ◽  
Shunsuke Ono ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Pediatric Patients ◽  
Serum Proteins ◽  
Binding Characteristics ◽  
Patients With Epilepsy

Dynamic Statistical Parametric Mapping for Analyzing the Magnetoencephalographic Epileptiform Activity in Patients With Epilepsy

2004 ◽  
Vol 19 (3) ◽  
pp. 363-369
Author(s):  
Hideaki Shiraishi ◽  
Steven M. Stufflebeam ◽  
Susanne Knake ◽  
Seppo P. Ahlfors ◽  
Akira Sudo ◽  
...  
Keyword(s):  
Focal Cortical Dysplasia ◽  
Epileptiform Activity ◽  
Rapid Change ◽  
Statistical Parametric Mapping ◽  
Cortical Dysplasia ◽  
Parametric Mapping ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
L2 Norm ◽  
Patients With Epilepsy

Our current purpose is to evaluate the applicability of dynamic statistical parametric mapping, a novel method for localizing epileptiform activity recorded with magnetoencephalography in patients with epilepsy. We report four pediatric patients with focal epilepsies. Magnetoencephalographic data were collected with a 306-channel whole-head helmet-shaped sensor array. We calculated equivalent current dipoles and dynamic statistical parametric mapping movies of the interictal epileptiform discharges that were based in the minimum-L2 norm estimate, minimizing the square sum of the dipole element amplitudes. The dynamic statistical parametric mapping analysis of interictal epileptiform discharges can demonstrate the rapid change and propagation of interical epileptiform discharges. According to these findings, specific epileptogenic lesion—focal cortical dysplasia could be found and patients could be operated on successfully. The presurgical analysis of interictal epileptiform discharges using dynamic statistical parametric mapping seems to be promising in patients with a possible underlying focal cortical dysplasia and might help to guide the placement of invasive electrodes. ( J Child Neurol 2005;20:363—369).

scholarly journals ANALYSIS OF ELECTROENCEPHALOGRAPHIC RECORDINGS FROM EPILEPSY PATIENTS USING RESTRICTED GRANGER CAUSALITY MEASURES

2015 ◽  
Author(s):  
Elsa Siggiridou ◽  
Vasilios Kimiskidis ◽  
D. Kugiumtzis
Keyword(s):  
Granger Causality ◽  
Brain Connectivity ◽  
Brain Regions ◽  
World Population ◽  
Var Models ◽  
Vector Autoregressive ◽  
Epileptiform Discharges ◽  
Eeg Recordings ◽  
Generalized Partial Directed Coherence ◽  
Patients With Epilepsy

Epilepsy is a chronic disorder of the brain that affects 1% of world population. The occurrence of epileptiform discharges (ED) in electroencephalographic (EEG) recordings of patients with epilepsy signifies a change in brain dynamics and particularly brain connectivity. In the last decade, many linear and nonlinear measures have been developed for the analysis of EEG recordings to detect the direct causal effects between brain regions. In many cases the number of EEG channels (the time series variables) is large and the analysis is based on short time intervals, resulting in unstable estimation of vector autoregressive models (VAR models) and subsequently unreliable Granger causality measure. For this, restricted VAR models have been proposed and in our recent study it was found that optimal restriction of VAR for the estimation of Granger causality was obtained by the backward-in-time selection method (BTS). We use the concept of restricted VAR models in measures both in time and frequency domain, namely restricted conditional Granger causality and restricted generalized partial directed coherence. We test the two measures in their ability of detecting changes in brain connectivity during an epileptiform discharge from multi-channel scalp electroencephalograms (EEG).

scholarly journals Excitatory GABAergic signalling is associated with acquired benzodiazepine resistance in status epilepticus

2018 ◽  
Author(s):  
Richard J. Burman ◽  
Joshua S. Selfe ◽  
John Hamin Lee ◽  
Maurits van den Burg ◽  
Alexandru Calin ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Epileptiform Activity ◽  
Brain Slices ◽  
Medical Emergency ◽  
Dependent Manner ◽  
High Concentration ◽  
Cellular Mechanisms ◽  
Epileptiform Discharges ◽  
Threatening Condition ◽  
Eeg Recordings

AbstractStatus epilepticus (SE) is defined as a state of unrelenting seizure activity. Generalised convulsive SE is associated with a rapidly rising mortality rate, and thus constitutes a medical emergency. Benzodiazepines, which act as positive modulators of chloride (Cl-) permeable GABAA receptors, are indicated as first-line treatment, but this is ineffective in many cases. We found that 48% of children presenting with SE were unresponsive to benzodiazepine treatment, and critically, that the duration of SE at the time of treatment is an important predictor of non-responsiveness. We therefore investigated the cellular mechanisms that underlie acquired benzodiazepine resistance, using rodent organotypic and acute brain slices. Removing Mg2+ ions leads to an evolving pattern of epileptiform activity, and eventually to a persistent state of repetitive discharges that strongly resembles clinical EEG recordings of SE. We found that diazepam loses its antiseizure efficacy and conversely exacerbates epileptiform activity during this stage of SE-like activity. Interestingly, a low concentration of the barbiturate phenobarbital had a similar exacerbating effect on SE-like activity, whilst a high concentration of phenobarbital was effective at reducing or preventing epileptiform discharges. We then show that the persistent SE-like activity is associated with a reduction in GABAA receptor conductance and Cl- extrusion capability. We explored the effect on intraneuronal Cl- using both gramicidin, perforated-patch clamp recordings and Cl- imaging. This showed that during SE-like activity, reduced Cl- extrusion capacity was further exacerbated by activity-dependent Cl- loading, resulting in a persistently high intraneuronal Cl-. Consistent with these results, we found that optogenetic stimulation of GABAergic interneurons in the SE-like state, actually enhanced epileptiform activity in a GABAAR dependent manner. Together our findings describe a novel potential mechanism underlying benzodiazepine-resistant SE, with relevance to how this life-threatening condition should be managed in the clinic.

Neurologist, 11 years’ experience, USA

2020 ◽  
pp. 63-67
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Epileptiform Activity ◽  
Epileptic Seizures ◽  
Clinical Value ◽  
Interictal Eeg ◽  
Eeg Recordings ◽  
Patients With Epilepsy ◽  
Present Possibility ◽  
Epilepsy Monitoring

This chapter focuses on the clinical value of continued vigilance and neurologic follow-up after video-EEG (VEEG) confirmation of the diagnosis of Psychogenic Non-Epileptic Seizures (PNES), even when long-term EEG recordings over two separate admissions to an epilepsy monitoring unit have not captured any epileptiform activity. It has been shown that 19% of patients with epilepsy will not have interictal epileptiform abnormality during an admission for long-term VEEG monitoring. In particular, patients with extratemporal lobe epilepsies who have deep/mesial seizure foci and those with well-controlled epilepsies will be likely not to have epileptiform interictal EEG activity. In consideration of these observations, it has been advised that patients with PNES and non-epileptiform long-term EEG recordings should be followed by a neurologist for at least six months after discontinuation of antiepileptic drugs (AED). This consideration is due to the small but ever-present possibility of coexisting epilepsy as well as the observation that the risk of breakthrough epileptic seizures is highest during the initial six months after discontinuation of AEDs.

scholarly journals Breakthrough spikes in rapid eye movement sleep from the epilepsy monitoring unit are associated with peak seizure frequency

SLEEP ◽  
2019 ◽  
Vol 43 (5) ◽  
Author(s):  
Marna B McKenzie ◽  
Michelle-Lee Jones ◽  
Aoife O’Carroll ◽  
Demitre Serletis ◽  
Leigh Anne Shafer ◽  
...  
Keyword(s):  
Eye Movement ◽  
Seizure Frequency ◽  
Epileptiform Activity ◽  
Rapid Eye Movement ◽  
Rapid Eye Movement Sleep ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
Patient Reported ◽  
Eeg Recordings ◽  
Epilepsy Monitoring

Abstract Study Objectives Rapid eye movement sleep (REM) usually suppresses interictal epileptiform discharges (IED) and seizures. However, breakthrough IEDs in REM sometimes continue. We aimed to determine if the amount of IED and seizures in REM, or REM duration, is associated with clinical trajectories. Methods Continuous electroencephalogram (EEG) recordings from the epilepsy monitoring unit (EMU) were clipped to at least 3 h of concatenated salient findings per day including all identified REM. Concatenated EEG files were analyzed for nightly REM duration and the “REM spike burden” (RSB), defined as the proportion of REM occupied by IED or seizures. Patient charts were reviewed for clinical data, including patient-reported peak seizure frequency. Logistic and linear regressions were performed, as appropriate, to explore associations between two explanatory measures (duration of REM and RSB) and six indicators of seizure activity (clinical trajectory outcomes). Results The median duration of REM sleep was 43.3 (IQR 20.9–73.2) min per patient per night. 59/63 (93.7%) patients achieved REM during EMU admission. 39/59 (66.1%) patients had breakthrough IEDs or seizures in REM with the median RSB at 0.7% (IQR 0%–8.4%). Every 1% increase in RSB was associated with 1.69 (95% CI = 0.47–2.92) more seizures per month during the peak seizure period of one’s epilepsy (p = 0.007). Conclusions Increased epileptiform activity during REM is associated with increased peak seizure frequency, suggesting an overall poorer epilepsy trajectory. Our findings suggest that RSB in the EMU is a useful biomarker to help guide about what to expect over the course of one’s epilepsy.

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