Epilepsy & behavior : E&B
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Epilepsy & behavior : E&B · Oct 2018
Afterdischarges elicited by cortical electric stimulation in humans: When do they occur and what do they mean?
Afterdischarges (ADs) are a common and unwanted byproduct of direct cortical stimulation during invasive electroencephalography (EEG) recordings. Brief pulse stimulation (BPS) can sometimes terminate ADs. This study investigated AD characteristics and their relevance for emergence of stimulation seizures. In addition, AD response to BPS was analyzed. ⋯ Afterdischarges appear in the epileptogenic and nonepileptogenic cortex. Duration and propagation patterns can help to quantify the risk of stimulation seizures, with sequential spikes being most susceptible to seizure elucidation. The hippocampus is highly sensitive to AD release. Brief pulse stimulation is a safe and efficacious way to terminate ADs, especially when delivered quickly after AD onset.
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Epilepsy & behavior : E&B · Sep 2018
The etiology and prognosis of super-refractory convulsive status epilepticus in children.
Both refractory convulsive status epilepticus (SE) and super-refractory SE are medical emergencies. However, there are limited data on super-refractory SE in children. Thus, this study focuses on characterizing the demographics, outcomes, and prognostic factors for super-refractory SE in children. ⋯ Super-refractory SE is associated with significant morbidity and mortality in children. However, the in-hospital mortality rate is much lower compared with adults. The functional outcome in children is associated with acute symptomatic etiology and the number of anesthetic agents and may improve after long-term follow-up.
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Epilepsy & behavior : E&B · Sep 2018
SUDEP and seizure safety communication: Assessing if people hear and act.
Sudden unexpected death in epilepsy (SUDEP) is a leading cause of death among people with chronic epilepsy. People with intellectual disability (ID) are overrepresented in this population. The SUDEP and Seizure Safety Checklist ("Checklist") is a tool to discuss risk factors influencing seizures and the risk of SUDEP. It includes questions about the availability of nocturnal monitoring. In Cornwall UK, people with epilepsy and ID and their relatives and carers are routinely advised to consider nocturnal surveillance to reduce harm from potential nocturnal seizures. We assessed the retention of advice provided on nocturnal monitoring and if there were differences between those in residential care and those living with their families. ⋯ Carers in residential settings are less likely to recall specific person-centered discussion of risks to the individual they support as compared with those living with families although general awareness of SUDEP and implementing advice such as nocturnal monitoring is present equally in both groups. In improving detection of nocturnal seizures, audio monitoring may be a useful strategy to reduce risk of harm for people with ID.
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Epilepsy & behavior : E&B · Aug 2018
Using electrocorticogram baseline seizure frequency to assess the efficacy of responsive neurostimulation.
The effect of direct brain responsive neurostimulation on the frequency of electrographic seizures in patients with medically refractory focal epilepsy has not been evaluated by chronic ambulatory electrocorticographic monitoring. ⋯ Chronic ECoG may provide a more accurate estimate of seizure frequency and provide additional insight into the true efficacy of the RNS system.
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Epilepsy & behavior : E&B · Jul 2018
Intravenous lacosamide (LCM) in status epilepticus (SE): Weight-adjusted dose and efficacy.
Some studies suggest higher efficacy of lacosamide (LCM) in status epilepticus (SE) with higher loading doses; however, this weight-adjusted dose has not been evaluated. ⋯ In adults with benzodiazepine-resistant SE, the response rate to LCM was higher, with weight-adjusted doses above 5.3 mg/kg.