bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing medication adherence after epilepsy surgery
Authors: Liu Jianming , Xu Ruxiang , Liu Zhiliang , You Yu , Meng Fanxin 
Published: August 2019

AbstractAim. In drug‐responsive epilepsy patients, treatment non‐compliance is a major factor in seizure recurrence, but adherence to prescribed regimens following epilepsy surgery has not been examined. We measured adherence to prescribed antiepileptic drugs (AEDs) after epilepsy surgery and investigated factors influencing treatment non‐compliance.Methods. Postsurgical epilepsy patients (n=214) were monitored for 18.1±8.1 months. Adherence was measured using the Medication Possession Ratio (MPR) self‐report questionnaire, with MPR<0.8 defined as non‐adherence.Results. According to the MPR, 58 patients (27.1%) were non‐adherent after surgery. There were no differences in demographic and clinical variables, such as age (p=0.057, t =−1.925), duration of illness (p=0.597, t=0.530), gender ratio (p=0.714, χ2=0.134), and place of residence (urban vs. rural; p=0.874, χ2=0.025), between adherent and non‐adherent patients. Moreover, adherence was not related to surgical outcome as evaluated by the Engel classification (p=0.635, χ2=1.628) or to the types of AEDs after surgery (p=0.165, χ2=6.530). The most common reasons for non‐adherence were seizure‐free status for an extended period (26.5%), forgetfulness (19.1%), and an inability to buy the drugs locally (18.6%).Conclusion. Adherence to AEDs is improved after epilepsy surgery compared to presurgical estimates, but is still a common and serious problem. Targeted postsurgical management programs and communication strategies are necessary to improve adherence to AEDs after epilepsy surgery.
Ring 17 syndrome: first clinical report without intellectual disability
Authors: de Palma Luca , De Carlo Debora , Lenzini Elisabetta , Boniver Clementina , Tarantino Vincenza , Bacci Barbara , Vecchi Marilena 
Published: August 2019

AbstractRing chromosomes are rare abnormalities caused by the fusion of the telomeric regions. Three‐ring chromosome syndromes (Cr 20, Cr 17 and Cr 14) cause epilepsy with variable phenotypes. In ring 17 patients with mild phenotype, some authors have shown an epilepsy syndrome similar to that of ring 20. We report the first case of a girl with ring chromosome 17 and a normal neurological and general cognitive profile. She had had, from 9 years old, focal pharmacoresistant epilepsy associated with episodes of non‐convulsive status epilepticus with mainly autonomic features. Cytogenetic analysis revealed an abnormal karyotype characterised by the presence ofde novoring chromosome 17 in 19% of metaphases. The array CGH (100 KB) did not show any genetic deletion. The clinical and epilepsy phenotype was, to a certain degree, similar to that of ring 20 syndrome.
Auditory aura in frontal opercular epilepsy: sounds from afar
Authors: Thompson Stephen A , Alexopoulos Andreas , Bingaman William , Gonzalez‐Martinez Jorge , Bulacio Juan , Nair Dileep , So Norman K 
Published: August 2019

AbstractAuditory auras are typically considered to localize to the temporal neocortex. Herein, we present two cases of frontal operculum/perisylvian epilepsy with auditory auras. Following a non‐invasive evaluation, including ictal SPECT and magnetoencephalography, implicating the frontal operculum, these cases were evaluated with invasive monitoring, using stereoelectroencephalography and subdural (plus depth) electrodes, respectively. Spontaneous and electrically‐induced seizures showed an ictal onset involving the frontal operculum in both cases. A typical auditory aura was triggered by stimulation of the frontal operculum in one. Resection of the frontal operculum and subjacent insula rendered one case seizure‐ (and aura‐) free. From a hodological (network) perspective, we discuss these findings with consideration of the perisylvian and insular network(s) interconnecting the frontal and temporal lobes, and revisit the non‐invasive data, specifically that of ictal SPECT.
Long‐term health‐related quality of life in drug‐resistant temporal lobe epilepsy after anterior temporal lobectomy
Authors: Chou Chien‐Chen , Shih Yang‐Hsin , Yen Der‐Jen , Kwan Shang‐Yeong , Yu Hsiang‐Yu 
Published: August 2019

AbstractEpilepsy surgery is beneficial to patients suffering from drug‐resistant temporal lobe epilepsy in the short term, but fewer reports of long‐term outcomes have been published. To clarify the long‐term outcomes of seizure control and health‐related quality of life after epilepsy surgery, we enrolled 48 patients suffering from drug‐resistant temporal lobe epilepsy. All of the patients received comprehensive presurgical evaluations, including the Quality of Life in Epilepsy Inventory‐89 (QOLIE‐89) questionnaire to measure their health‐related quality of life. Among the patients, 28 patients received surgery (surgical group) and 20 patients remained under medication (medical group). Eight years later, the seizure frequency and QOLIE‐89 were evaluated. The seizure‐free rate was much higher in the surgical group (53.6%) than in the medical group (5%), eight years after the initial evaluation. The follow‐up QOLIE‐89 score was significantly higher in the surgical group than in the medical group. Moreover, the seizure frequency inversely correlated to the QOLIE‐89 score, regardless of the treatment group. Our results provide evidence that epilepsy surgery confers benefits with respect to seizure control and health‐related quality of life for drug‐resistant temporal lobe epilepsy patients based on long‐term follow‐up.
Cardiogenic syncope diagnosed as epileptic seizures: the importance of ECG during video‐EEG recording
Authors: Mayor Luis C , Lemus Hernan N , Burneo Jorge , Palacio Ana Cristina , Linares Sergio 
Published: August 2019

AbstractWe describe four patients with a previous diagnosis of epilepsy. After reviewing the ECG during the video‐EEG recording, cardiogenic syncope, resulting from a cardiac arrhythmia, was identified as the cause of the seizures. Epileptic disorders and cardiogenic syncope may both manifest with convulsions, loss of consciousness, and loss of postural tone, leading to a high level of misdiagnosis. The one‐lead ECG during video‐EEG monitoring is a key component, which may allow correct diagnosis and treatment.
Lesion‐negative anterior cingulate epilepsy
Authors: Lacuey Nuria , Davila Javier Chapa , Zonjy Bilal , Amina Shahram , Couce Marta , Turnbull John , Miller Jonathan , Lüders Hans , Lhatoo Samden D 
Published: August 2019

AbstractMRI‐negative anterior cingulate epilepsy is a rare entity. Herein, we describe a case of MRI and functional imaging‐negative intractable frontal lobe epilepsy in which, initially, secondary bilateral synchrony of surface and intracranial EEG and non‐lateralizing semiology rendered identification of the epileptogenic zone difficult. A staged bilateral stereotactic EEG exploration revealed a very focal, putative ictal onset zone in the right anterior cingulate gyrus, as evidenced by interictal and ictal high‐frequency oscillations (at 250 Hz) and induction of seizures from the same electrode contacts by 50‐Hz low‐intensity cortical stimulation. This was subsequently confirmed by ILAE class 1 outcome following resection of the ictal onset and irritative zones. Histopathological examination revealed focal cortical dysplasia type 1b (ILAE Commission, 2011) as the cause of epilepsy. The importance of anatomo‐electro‐clinical correlation is illustrated in this case in which semiological and electrophysiological features pointed to the anatomical localization of a challenging, MRI‐negative epilepsy. [Published with video sequence]
Fall related to epileptic seizures in the elderly
Authors: Nguyen‐Michel Vi‐Huong , Bornand Anne , Balathazar Aroquia‐Marie‐Edith , Kinugawa Kiyoka , Lâm Xuân‐Yên , Piette François , Mariani Jean , Dupont Sophie 
Published: August 2019

AbstractIt is well known that both falls and epileptic seizures are very frequent and harmful in the elderly. Moreover, although seizures may cause falls, their relationship is poorly documented in this population. We report four women (mean age: 84.5 years) who presented falls with: late‐onset focal seizures of possible parietal (Case 1) or frontal localisation (Case 2), early onset with late aggravation of juvenile myoclonic epilepsy (Case 3), and generalised situation‐related myoclonic seizures (Case 4). Falls were presumably associated with tonic posturing of left (Case 1) or right (Case 2) hemibody, to bilateral and massive myoclonic jerks (Cases 3 and 4) with a loss of consciousness (Case 3). The diagnosis of seizures was difficult and routine EEG was unremarkable in Cases 1 and 2, requiring video‐EEG monitoring to capture the clinical events. Adequate treatment offered recovery from seizures and falls in all patients. Other mechanisms of seizure‐induced falls in older patients and their management are discussed. In conclusion, falls may be caused by different seizure types and appear to be underestimated due to difficulties in seizure diagnosis in the elderly. Recognizing falls related to seizures is important in geriatric practice, as it facilitates adequate management.
Insight into the precuneus: a novel seizure semiology in a child with epilepsy arising from the right posterior precuneus
Authors: Mailo Janette , Tang‐Wai Richard 
Published: August 2019

AbstractTo date, there is limited understanding of the role of the precuneus. fMRI studies have suggested its involvement in a wide spectrum of highly integrated tasks, including spatially‐guided behaviour, visuo‐spatial imagery, and consciousness. We present a patient with intractable parietal lobe epilepsy arising from a lesion localized to the right precuneus. Two seizure types with distinct semiologies were captured on video‐EEG monitoring. The first type consisted of an urge described as a “feeling of wanting to move”. On video analysis, the patient is seen to turn his head and body to his left. He remains conscious, he is able to answer questions and when asked, he can look to his right. This seizure was associated with an ictal pattern localized to the right parieto‐occipital region. The second seizure type consisted of reading‐induced visual distortion with macropsia and micropsia. Interictally, intermittent rhythmic slowing and spikes were seen and localized to the parietal midline and the right parieto‐occipital regions. Our patient's seizures are positive phenomena of the right precuneus and its related processing network. They represent unique seizure semiologies that offer further insight into the role of the precuneus in spatial awareness, visuo‐spatial processing and consciousness.
Generalized seizure with falling and unresponsive staring provoked by somatosensory stimulation: a video‐EEG study*
Authors: Suzuki Sayaka , Sassa Kaori , Abe Yuichi , Yamanouchi Hideo 
Published: August 2019

AbstractWe report a 4‐year‐old boy with generalized seizures with abrupt falling and unresponsive staring provoked by somatosensory stimuli of the face. Ictal manifestation comprised a sudden fall immediately after wiping the face, followed by unresponsive staring for around 10 seconds, during which time the video‐EEG recorded paroxysmal 3‐Hz diffuse spike‐wave complexes, which were followed by high‐voltage 3.5 to 4‐Hz delta wave discharges, predominantly appearing in the bilateral frontal areas. Seizures were not controlled by clonazepam, valproate or levetiracetam, but were successfully treated with lamotrigine added to valproate. This type of generalized reflex seizure has so far not been reported in the literature. [Published with video sequence]
Bradycardia from flash stimulation
Authors: Einspenner Michael , Brunet Donald G. , Boissé Lomax Lysa , Spiller Allison E. 
Published: August 2019

AbstractThis case study documents a patient who experienced bradycardia brought on by flash stimulation during a routine outpatient EEG recording. The patient had known photosensitive seizures in the past. During this routine EEG, the patient's heart rate dropped to about 12 beats per minute with the EEG displaying slow‐delta‐frequency waves with no epileptiform spikes or sharp waves. During immediate follow‐up, in our emergency department, the patient had a brief asystolic event, followed by bradycardia. Cardiology examinations were normal. We propose that this response was a photic‐triggered reflex vasovagal reaction.
Epileptic auras: phenomenology and neurophysiology
Authors: Perven Ghazala , So Norman K 
Published: August 2019

AbstractThis review discusses the phenomenology, neurophysiology, and localization of epileptic auras with particular emphasis on how auras can manifest as part of an epileptic network. Epileptic auras, as the first clinical symptom of a seizure, may lead us to infer the site of seizure onset. At the same time, auras can also be a result of activation or alteration in an epileptic network. They can be highly specific or ill‐defined in symptomatology. They occur as a result of limited seizure activation, allowing access of the neural signal to the conscious brain. An understanding of epileptic auras offers a window into understanding fundamental brain functions, and helps the clinician at the bedside to make appropriate diagnostic and therapeutic choices.
A case of recurrent status epilepticus and successful management with progesterone
Authors: Ramanujam Bhargavi , Arora Amit , Malhotra Varun , Dash Deepa , Mehta Santosh , Tripathi Manjari 
Published: August 2019

AbstractCatamenial epilepsy (CE) is a commonly observed phenomenon among women with epilepsy, the management of which is both hormonal and non‐hormonal. Progesterone therapy has been tried in these patients, as the possible mechanism of CE is withdrawal of progesterone and a higher oestrogen/progesterone ratio in the perimenstrual and periovulatory periods. Here, we describe a 24‐year‐old lady with multiple seizure types since childhood, which were refractory to adequate antiepileptic drug therapy after menarche with catamenial clustering of seizures. She went on to have several episodes of non‐convulsive status epilepticus also with similar periodicity, which would abate only with midazolam infusion, without the need for ventilatory support. She was tried on acetazolamide, progesterone vaginal pessaries, and maximum tolerated doses of antiepileptic medications, but finally responded to intramuscular and oral progesterone, and has been seizure‐free for more than a year.
Epilepsia partialis continua triggered by traumatic hand injury: a peripheral tuning of brain excitability?
Authors: Paglioli Eliseu , Alves Martins William , De la Cruz Walter , Andrade Victor , Duval da Silva Vinicius , Menezes Nunes Rafael , Palmini André 
Published: August 2019

AbstractEpilepsia partialis continua is often refractory to antiepileptic medication and its causal relation to peripheral sensory stimuli has only rarely been suggested. We report a man who received surgery for temporal lobe epilepsy 10 years ago, who presented “de novo” epilepsia partialis continua following mild traumatic injury of the left hand. Continuous myoclonus of the left upper limb started the day after injury and persisted unabated for several weeks. Non‐invasive evaluation was inconclusive. Acute electrocorticography during surgery under local anaesthesia revealed continuous, rhythmic spiking over the right sensorimotor cortex. Tailored excision of the posterior bank of the motor and adjacent sensory cortex immediately stopped the continuous myoclonus. Histopathology showed abnormal radial lamination and was compatible with focal cortical dysplasia type IA. Epilepsia partialis continua did not recur for seven years. Afferent stimuli from peripheral injury can disinhibit hyperexcitable sensorimotor cortex leading to epilepsia partialis continua. [Published with video sequences online]
RFT1‐congenital disorder of glycosylation (CDG) syndrome: a cause of early‐onset severe epilepsy
Authors: Aeby Alec , Prigogine Cynthia , Vilain Catheline , Malfilatre Geneviève , Jaeken Jaak , Lederer Damien , Van Bogaert Patrick 
Published: August 2019

AbstractRFT1‐congenital disorder of glycosylation (CDG) syndrome, a recessive N‐glycosylation disorder caused by mutation in the RFT1 gene, is a very rare subtype of CDG syndrome associated with deafness, developmental delay, and non‐specific epilepsy. The aim of this report is to describe the electroclinical presentation of epilepsy associated with this condition. [Published with video sequences online]
From here to epilepsy: the risk of seizure in patients with Alzheimer's disease
Authors: Nicastro Nicolas , Assal Frédéric , Seeck Margitta 
Published: August 2019

AbstractAim. To describe the association between Alzheimer's disease and seizures by reviewing epidemiological data from available literature and to assess the putative pathophysiological links between neurodegeneration and altered cortical excitability. We also discuss specific antiepileptic treatment strategies in patients with Alzheimer's disease, as well as transient epileptic amnesia as a possible crossroads between degeneration and epilepsy.Methods. Regarding epidemiology, we searched publications in Pubmed, Medline, Scopus and Web of Science (until September 2015) using the keywords “incidence”, “prevalence” and “frequency”, as well as “Alzheimer's disease” and “seizures”. In addition, therapeutic aspects for seizures in Alzheimer's disease were searched using the key words “antiepileptic drugs”, “seizure treatment” and “Alzheimer”.Results. The prevalence and incidence rates of seizures were found to be increased 2 to 6‐fold in patients with Alzheimer's disease compared to age‐adjusted control patients. Treatment strategies have mainly been extrapolated from elderly patients without dementia, except for one single randomised trial, in which levetiracetam, lamotrigine and phenobarbital efficacy and tolerance were investigated in patients with Alzheimer's disease. Mouse models appear to show a major role of amyloid precursor protein and its cleavage products in the generation of cortical hyperexcitability.Conclusion. A link between Alzheimer's disease and epilepsy has long been described and recent cohort studies have more clearly delineated risk factors associated with the genesis of seizures, such as early onset and possibly severity of dementia. As genetic forms of Alzheimer's disease and experimental mouse models suggest, beta‐amyloid may play a prominent role in the propagation of synchronised abnormal discharges, perhaps more via an excitatory mode than a direct neurodegenerative effect.
Fibromyalgia and seizures
Authors: Tatum William O. , Langston Michael E. , Acton Emily K. 
Published: August 2019

AbstractThe purpose of this case‐matched study was to determine how frequently fibromyalgia is associated with different paroxysmal neurological disorders and explore the utility of fibromyalgia as a predictor for the diagnosis of psychogenic non‐epileptic seizures. The billing diagnosis codes of 1,730 new, non‐selected patient encounters were reviewed over a three‐year period for an epileptologist in a neurology clinic to identify all patients with historical diagnoses of fibromyalgia. The frequency with which epileptic seizures, psychogenic non‐epileptic seizures, and physiological non‐epileptic events were comorbid with fibromyalgia was assessed. Age and gender case‐matched controls were used for a between‐group comparison. Wilcoxon tests were used to analyse interval data, and Chi‐square was used to analyse categorical data (p<0.05). Fibromyalgia was retrospectively identified in 95/1,730 (5.5%) patients in this cohort. Females represented 95% of the fibromyalgia sample (age: 53 years; 95% CI: 57, 51). Forty‐three percent of those with fibromyalgia had a non‐paroxysmal, neurological primary clinical diagnosis, most commonly chronic pain. Paroxysmal events were present in 57% of fibromyalgia patients and 54% of case‐matched controls. Among patients with fibromyalgia and paroxysmal disorders, 11% had epileptic seizures, 74% had psychogenic non‐epileptic seizures, and 15% had physiological non‐epileptic events, compared to case‐matched controls with 37% epileptic seizures, 51% psychogenic non‐epileptic events, and 12% physiological non‐epileptic events (p = 0.009). Fibromyalgia was shown to be a predictor for the diagnosis of psychogenic non‐epileptic seizures in patients with undifferentiated paroxysmal spells. However, our results suggest that the specificity and sensitivity of fibromyalgia as a marker for psychogenic non‐epileptic seizures in a mixed general neurological population of patients is less than previously described.
Surgery for epilepsy: a systematic review of current evidence
Authors: West Siobhan , Nolan Sarah J. , Newton Richard 
Published: August 2019

AbstractThis seminar discusses the history and development of techniques for surgical intervention for people with refractory focal epilepsy. Published surgical success rates and prognostic factors associated with post‐operative seizure freedom from individual studies have been variable and contradictory. We present here the key findings of a Cochrane systematic review of all evidence published since the introduction of magnetic resonance imaging (MRI) to pre‐operative surgical assessment in 1984. Our findings show the usefulness of uncontrolled case series is now past. Future studies with a prospective controlled design should focus on specific research questions to help improve results and provide better‐informed advice.
Initial manifestation of type I diabetes mellitus as an unusual cause of early post‐operative seizures
Authors: Benova Barbora , Krsek Pavel , Sumnik Zdenek , Kudr Martin , Komarek Vladimir , Tichy Michal 
Published: August 2019

AbstractWe present a case of an 18‐year‐old patient who underwent resective epilepsy surgery for intractable epilepsy caused by focal cortical dysplasia. In the early post‐surgical period, the patient started experiencing atypical seizures refractory to antiepileptic treatment. In due course, abnormally low levels of blood sodium and extremely high levels of blood glucose were discovered. Significant hyperglycaemia was initially ascribed to steroid‐induced diabetes, and antibodies specific to type I diabetes mellitus were subsequently detected, confirming the diagnosis. Following stabilization of glucose and electrolyte levels, the patient became seizure‐free. To our knowledge, this is the first report of presentation of type I diabetes as the cause of early post‐operative seizures. We discuss less common aetiologies of seizures in the early post‐operative period, including metabolic disturbances. Based on our experience, we stress the importance of electrolyte and glucose monitoring in the setting of acute post‐operative seizures.