More than half of adults with drug-resistant epilepsy achieve long-term seizure freedom after resective surgery, allowing for the possibility of ASM withdrawal. The study provides predictive models that can assist clinicians in discussing ASM withdrawal with patients.
Vaccination against COVID-19 in persons with epilepsy is associated with a low incidence of increased seizure frequency and status epilepticus, suggesting that the benefits of vaccination may outweigh the risks for this population.
Post-treatment, 75% of subjects exhibited increased network small-worldness, suggesting improved brain network organization. The most significant changes were observed in regions associated with cognitive functions, indicating potential improvements in cognitive performance.
One subject was seizure-free for 17 months post-implantation, while two subjects experienced a mean seizure frequency reduction of 73%, and two others had a 35% reduction.
The review highlights that patients with an abnormal MRI have a significantly higher chance of achieving seizure freedom post-surgery (66.9%) compared to those with a normal MRI (45.5%).
The study reported a one-year seizure freedom rate of 73% among resection patients, with no significant variation in outcomes based on the classification of the epileptogenic zone. The approach demonstrated high classification accuracy (90% for semiological features and 97% for electrode location).
The study found that improved feature selection and larger sample sizes could enhance the predictive accuracy of post-operative seizure outcomes, with the best performance achieved through data-driven feature selection.
Clonazepam, clobazam, topiramate, and levetiracetam were found to significantly reduce seizure frequency and/or maintain seizure freedom in patients with early-onset seizures and epileptic spasms.
Identification of novel KCNC2 variants in 27 patients and the demonstration of genotype-phenotype correlation, leading to potential precision medicine approaches.
Significant reduction in the amplitude of evoked potentials from remote regions after prolonged high-frequency stimulation, indicating effective modulation of the targeted brain network.
The study found that background EEG features tracked multidien cycles in dIEA, suggesting a relationship between brain state and seizure occurrence, which could lead to improved monitoring and management of epilepsy.
Early identification of clinical features associated with genetic diagnoses can lead to timely and more effective treatment strategies, reducing hospitalizations and improving prognostication.
The application of SPES resulted in power suppression in connected electrodes and a decrease in IED rates, suggesting that stimulation can effectively modulate neural activity in the epileptogenic network. This approach may provide a new template for identifying optimal stimulation sites for epilepsy treatment.
The study found that larger virtual resections targeting FR sites were associated with improved seizure freedom in patients. In nine patients who were not initially seizure free, amending the resection boundaries based on FR metrics resulted in five patients becoming virtually seizure free. Additionally, targeting RNS stimulation to FR sites showed potential for improving seizure outcomes.
The study found that elevated thalamic spikes and fast ripples during sleep were associated with unfavorable surgical outcomes, while lower rates of these activities correlated with better outcomes. Additionally, diminished thalamic activity and connectivity were linked to longer epilepsy duration and older age, suggesting that these factors may inform treatment decisions and prognostic assessments.
The results showed a high percentage of seizure freedom post-treatment: 80% for unilateral PVNH without other imaging abnormalities, 63% for PVNH with MTS or PMG, and 50% for bilateral PVNH. The percentage of SoZ ablation significantly impacted surgical outcomes, indicating that effective targeting of the seizure-generating tissue is crucial for success.
Patients with ganglioglioma harboring specific mutations (e.g., BRAFV600E) had a significantly better outcome, with 85% achieving seizure freedom compared to those with RAS/MAP-Kinase alterations.
The study found that surgical responders exhibited a higher spectral content of fast ripples in the seizure-onset zone compared to non-responders. The classification accuracy for identifying non-responders was 0.92 using graph theoretical measures, supporting the epileptic network hypothesis.
Ictal EEG changes were consistently detected in the CM and AN of the thalamus during neocortical seizures, suggesting the feasibility of using thalamic RNS for seizure control.
The study found that peri-ictal changes in synchronizability can distinguish between good and poor responders to RNS therapy, with an area under the receiver operating characteristic curve of 0.75, indicating a promising predictive capability.
Identification of somatic variants can lead to improved surgical outcomes, refinement of histopathological classifications, and potential pharmacological targets for treatment.
The study found that 68.2% of patients achieved seizure freedom (SF) at a median follow-up of 19.5 months, indicating a positive outcome for a significant portion of the cohort.
A median disabling seizure reduction of 93% was observed, with a 100% responder rate (≥50% reduction in seizure frequency). Improvements in seizure severity (3.5 points), life satisfaction (4.5 points), and quality of sleep (3 points) were reported.
Resection of the area expressing the dominant H pattern independently predicted seizure freedom after surgery.
The study found a highly significant reduction in interictal epileptiform discharge (IED) frequency, with reductions ranging from 37% to 81% over the five days of stimulation, indicating effective control of epileptic activity.
Improved understanding of brain connectivity in epilepsy, leading to better surgical targeting and potentially higher rates of post-operative seizure freedom.
Quantitative analysis of interictal epileptiform discharges (IEDs) consistently lateralized seizure foci based on pre-operative data, while post-operative data confirmed the effectiveness of high-frequency metrics in identifying the pathological hemisphere.
The study found that patients with lower variability in functional connectivity (Engel classification Ia and IIa) had better surgical outcomes, while those with higher variability (Engel classification IV) experienced no meaningful improvement post-surgery.
The study found that the HFO area was accurately identified, leading to a sensitivity of 90% for predicting recurrent seizures and an overall accuracy of 79% in predicting seizure freedom post-surgery.
The proposed drugs have the potential to improve seizure control in patients with DR-TLE, offering new therapeutic options for those who have not responded to existing treatments. The identification of these candidates through transcriptomic profiling represents a significant advancement in the search for effective therapies for drug-resistant epilepsy.
The response-adaptive crossover design resulted in a modest increase in statistical power to identify effective treatments while maximizing the time participants spent in groups producing a positive response. Only 8% of participants remained in the placebo group for the entire duration of the simulated trials, indicating effective treatment reallocation.
Half of the physicians evaluated the effect of medical cannabinoids as moderate, indicating some level of efficacy in managing symptoms associated with CP.
The study suggests that biperiden may have a role in preventing the development of post-traumatic epilepsy, although the evidence is currently insufficient to draw definitive conclusions. Further research is needed to confirm these findings and explore the potential benefits of biperiden in this patient population.
Patients with gain-of-function mutations in early-onset epilepsies responded well to sodium channel blockers. Phenytoin and topiramate were reported as effective treatments.
The study demonstrated a strong correlation (average signal correlation of 0.90) between the mjn-SERAS device and standard EEG recordings, supporting its use for monitoring brain activity in epilepsy patients. The device's ability to detect preictal periods may enhance seizure management and patient safety.
The study found that seizure freedom rates varied significantly based on the location of the FCD, with rates as high as 75% in superior temporal and frontal gyri, compared to around 30% in visual, motor, and premotor areas. The predictive model developed in the study has a positive predictive value of 70% and a negative predictive value of 61% for postsurgical seizure freedom.
The study found that variables such as less than 4 years of epilepsy duration before VNS and the presence of focal motor seizures were associated with a better response to VNS. The clinical prediction model developed showed an area under the curve (AUC) of 0.7013 for the training sample, indicating a reasonable ability to predict VNS response.
Patients treated with SAH exhibited less postoperative cortical thinning compared to those treated with ATL, suggesting a potential advantage in preserving cognitive function.
Positive outcomes include a 63.7% rate of seizure remission within one year of treatment, with effective management leading to improved quality of life and reduced risk of developing pharmacoresistant epilepsy.
The study found that early intervention with specific medications led to reduced seizures in the first year of life, and that individuals with neonatal seizures followed by seizure offset had more predictable seizure trajectories.
Sodium channel blockers have been associated with improved seizure control and quality of life for some patients, although many still face significant treatment challenges and unmet needs.
The study found that 41 out of 235 children had likely or pathogenic variants, with 26 of these supporting precision therapy. The identification of neonatal or infantile-onset seizures and movement abnormalities as predictive factors for positive genetic findings enhances the potential for early intervention.
The use of high-density µECoG electrode arrays resulted in a significantly higher detection rate of microseizures in the epileptic cortex (2.01 events/min) compared to non-epileptic cortex (0.01 events/min). This suggests improved localization of epileptogenic tissue, which may enhance surgical planning and outcomes for epilepsy patients.
The proposed method achieved 98% sensitivity and 59% specificity in localizing the EZ for seizure-free patients. It also highlighted significant differences in connectivity patterns between seizure-free and non-seizure-free patients, suggesting that network centrality is a key factor in determining surgical outcomes.
The application of multisensory flicker significantly decreased the rate of interictal epileptiform discharges in patients with focal seizure onsets, indicating a potential therapeutic benefit for managing abnormal neural activity.
The study highlights the need for careful management of epilepsy in pregnant women, emphasizing the importance of balancing the risks of seizures against the potential adverse effects of AEDs on both mother and child. It also underscores the significance of ongoing discussions regarding the safety and efficacy of different AEDs during pregnancy, particularly in light of the increased risk of Sudden and Unexpected Death in Epilepsy (SUDEP) among mothers.
Despite the lack of identifiable genetic causes, the study highlights a heterogeneous range of treatment strategies and the need for further research into novel diagnostic and treatment approaches for FIRES.
The study found that epilepsy is frequent and polymorphic in ASA patients, with early-onset epilepsy and electroencephalographic background asymmetry being significant predictors of pharmacoresistance. It also identified a higher incidence of neurodevelopmental complications in epileptic patients compared to non-epileptic patients.
The study successfully identified and validated mosaic variants in DNA extracted from trace brain tissue on sEEG electrodes, demonstrating a relationship between genetic abnormalities and seizure activity. This approach holds promise for advancing precision medicine in DRE patients.
The study found that 53% of patients who were seizure-free for at least one year had documented discussions about ASM discontinuation, and 21% planned to discontinue at least one ASM. For those seizure-free for at least two years, these figures increased to 65% and 26%, respectively.
Involving users in the MDD process is shown to improve device quality and patient outcomes. The review indicates that user feedback can lead to better-designed devices that meet the needs of individuals with epilepsy, enhancing their overall quality of life.