Predictors of focal to bilateral tonic-clonic seizures during long-term video-EEG monitoring.

Abstract:

OBJECTIVE:To determine predictors of focal to bilateral tonic-clonic seizures (FBTCS) during video-electroencephalography (EEG) monitoring (VEM). METHODS:All adult patients undergoing presurgical VEM from 2014 to 2015 in the department of epileptology were eligible (N = 229). Those with refractory focal epilepsy and epileptic seizures recorded during VEM were analyzed (N = 188, Group 1). To assess the effects of antiepileptic drug (AED) taper, the total AED load was calculated as the sum of the ratios of prescribed daily dose and defined daily dose of all AEDs per VEM day and was correlated with the occurrence of focal seizures without bilateral tonic-clonic seizures (FwoBTCS) and FBTCS. To validate the findings, data of patients undergoing VEM in 2004 and 2005 (Group 2, eligible N = 243, analyzed N = 203) were also investigated. RESULTS:In Group 1, 53 patients had FBTCS and 135 patients had exclusively FwoBTCS during VEM. Reduced AED load at seizure onset was the most important modifiable risk factor for FBTCS (receiver-operating characteristic [ROC]: area under the curve [AUC] = 0.78). Furthermore, the risk of FBTCS varied with the history and frequency of FBTCS prior to VEM. For instance, patients had a 50% risk of FBTCS by reducing the AED load to ~20% when no information about history of FBTCS was taken into account, to ~30% when a positive history of FBTCS was taken into account, and to ~50% when a high frequency of FBTCS prior to VEM was taken into account. These findings were largely replicated in Group 2 (59 patients with FBTCS and 144 exclusively with FwoBTCS). SIGNIFICANCE:The risk of FTBCS during VEM depends on the history and frequency of FTBCS prior to VEM and is particularly associated with the extent of AED reduction. Our data underscore the need for appropriate tapering regimens in VEM units.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Pensel MC,Schnuerch M,Elger CE,Surges R

doi

10.1111/epi.16454

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

489-497

issue

3

eissn

0013-9580

issn

1528-1167

journal_volume

61

pub_type

杂志文章
  • Epilepsy in peroxisomal diseases.

    abstract:PURPOSE:To clarify the electroclinical manifestation of epileptic seizures and the evolution of epilepsy in patients with peroxisomal diseases. METHODS:Retrospective review of the medical records and EEGs of 14 patients with peroxisomal diseases: seven with Zellweger syndrome (ZS), two with neonatal adrenoleukodystrop...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1997.tb01095.x

    authors: Takahashi Y,Suzuki Y,Kumazaki K,Tanabe Y,Akaboshi S,Miura K,Shimozawa N,Kondo N,Nishiguchi T,Terada K,Orii T

    更新日期:1997-02-01 00:00:00

  • Detecting epileptic spikes.

    abstract::We present a technique for automatic detection of epileptic spikes in electroencephalogram (EEG) recordings. We used a nonlinear modeling method that enables us to detect rapidly and accurately epileptic behavior in the EEG signal. Our approach is illustrated by an application to interictal activity from a patient wit...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1046/j.1528-1157.43.s.5.7.x

    authors: Diambra L

    更新日期:2002-01-01 00:00:00

  • Effects of prenatal antiepileptic drug exposure on newborn brain activity.

    abstract:OBJECTIVE:Prenatal exposure to antiepileptic drugs (AEDs) is associated with an increased risk of cognitive dysfunction at early school age. Our aim was to investigate whether signs of adverse drug effects on brain function could be detected already during the first 2 weeks of life. METHODS:We studied prospectively 56...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.13281

    authors: Videman M,Tokariev A,Stjerna S,Roivainen R,Gaily E,Vanhatalo S

    更新日期:2016-02-01 00:00:00

  • Patterns of altered functional connectivity in mesial temporal lobe epilepsy.

    abstract:PURPOSE:In mesial temporal lobe epilepsy (MTLE) the epileptogenic area is confined to the mesial temporal lobe, but other cortical and subcortical areas are also affected and cognitive and psychiatric impairments are usually documented. Functional connectivity methods are based on the correlation of the blood oxygen le...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2012.03464.x

    authors: Pittau F,Grova C,Moeller F,Dubeau F,Gotman J

    更新日期:2012-06-01 00:00:00

  • Predictors of intractable epilepsy in childhood: a case-control study.

    abstract::Little is known about what factors predict intractable epilepsy at the time of initial diagnosis. We performed a case-control study to identify early predictors of medically intractable epilepsy in children. Cases were children who had an average of one seizure or more a month over a 2-year period and who, during that...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1996.tb00507.x

    authors: Berg AT,Levy SR,Novotny EJ,Shinnar S

    更新日期:1996-01-01 00:00:00

  • Vigabatrin: clinical evidence supporting rational polytherapy in management of uncontrolled seizures.

    abstract::Monotherapy is the policy for management of patients with epilepsy. With increasing knowledge of the biology of epilepsy and of the modes of action of antiepileptic drugs (AEDs), this concept must be reevaluated. When monotherapy fails to control seizures, subsequent treatment should be based on "rational pharmacology...

    journal_title:Epilepsia

    pub_type: 临床试验,杂志文章

    doi:10.1111/j.1528-1157.1994.tb02447.x

    authors: de Bittencourt PR,Mazer S,Marcourakis T,Bigarella MM,Ferreira ZS,Mumford JP

    更新日期:1994-03-01 00:00:00

  • Distribution of seizures across the menstrual cycle in women with epilepsy.

    abstract::The purpose of this study was to determine whether seizure frequency and cycle days with seizure occurrence vary across the menstrual cycle. The subjects were the first 100 women with intractable focal onset seizures, 13-45 years old, who completed the baseline phase of the National Institutes of Health (NIH) Progeste...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.12969

    authors: Herzog AG,Fowler KM,Sperling MR,Massaro JM,Progesterone Trial Study Group.

    更新日期:2015-05-01 00:00:00

  • Clobazam as a new antiepileptic drug and clorazepate dipotassium as an alternative antiepileptic drug in Japan.

    abstract:PURPOSE:To confirm the efficacy and to clarify the problems of clobazam (CLB) as a new antiepileptic drug (AED) and clorazepate (CLP) as an alternative AED in Japan. METHODS:CLB and CLP were added on or replaced with conventional AEDs in 55 and 170 patients with refractory epilepsies, respectively. Short-term efficacy...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.0013-9580.2004.458005.x

    authors: Sugai K

    更新日期:2004-01-01 00:00:00

  • Predicting frequent emergency department use among children with epilepsy: A retrospective cohort study using electronic health data from 2 centers.

    abstract:OBJECTIVE:Among children with epilepsy, to develop and evaluate a model to predict emergency department (ED) use, an indicator of poor disease control and/or poor access to care. METHODS:We used electronic health record data from 2013 to predict ED use in 2014 at 2 centers, benchmarking predictive performance against ...

    journal_title:Epilepsia

    pub_type: 杂志文章,多中心研究

    doi:10.1111/epi.13948

    authors: Grinspan ZM,Patel AD,Hafeez B,Abramson EL,Kern LM

    更新日期:2018-01-01 00:00:00

  • Variable epilepsy phenotypes associated with a familial intragenic deletion of the SCN1A gene.

    abstract::Deletions and duplications/amplifications of the α1-sodium channel subunit (SCN1A) gene occur in about 12% of patients with Dravet syndrome (DS) who are otherwise mutation-negative. Such genomic abnormalities cause loss of function, with severe phenotypes, reproductive disadvantage and, therefore, sporadic occurrence....

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2010.02790.x

    authors: Guerrini R,Cellini E,Mei D,Metitieri T,Petrelli C,Pucatti D,Marini C,Zamponi N

    更新日期:2010-12-01 00:00:00

  • Clues to the genetic influences of drug responsiveness in epilepsy.

    abstract::Despite the introduction of newer antiepileptic drugs (AEDs), nonresponsiveness to AEDs remains a common problem in epilepsy clinics. There may be important genetic determinants for responsiveness, and this discussion focused on some potential areas: drug transporters; drug-metabolizing enzymes, and ion channels. We r...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1046/j.1528-1157.44.s.1.13.x

    authors: Ramachandran V,Shorvon SD

    更新日期:2003-01-01 00:00:00

  • Eye-closure-triggered paroxysmal activity and cognitive impairment: a case report.

    abstract:PURPOSE:To study the neuropsychological status of an epileptic patient presenting with epileptic activity triggered by eye closure in a 14-year follow-up period. METHODS:The patient was studied at 12 and 26 years of age; during this period he underwent periodical clinical evaluations and EEG investigations; brain magn...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2006.00708.x

    authors: Termine C,Rubboli G,Veggiotti P

    更新日期:2006-01-01 00:00:00

  • Historical vignette: medical treatment of status epilepticus.

    abstract::The treatment of status epilepticus has changed over the past five decades since the first colloquium on status epilepticus, held in Marseille in 1962. New intravenous drugs, such as valproate, levetiracetam, lacosomide or ketamine and new routes of administration, such as intranasal or bucal, as well as high-class ra...

    journal_title:Epilepsia

    pub_type: 历史文章,杂志文章,评审

    doi:10.1111/epi.12264

    authors: Janz D

    更新日期:2013-09-01 00:00:00

  • Demographic impact of epilepsy in Africa: results of a 10-year cohort study in a rural area of Cameroon.

    abstract:PURPOSE:To evaluate the demographic impact of epilepsy a rural area of Africa. METHODS:A cohort study was conducted between 1991 and 2001 in the Mbam Valley (Cameroon) on two groups of subjects (one of persons with epilepsy, and the other of control individuals matched for sex, age, and village of residence). At the e...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1046/j.1528-1157.2003.59302.x

    authors: Kamgno J,Pion SD,Boussinesq M

    更新日期:2003-07-01 00:00:00

  • In vivo optical properties of cortical tubers in children with tuberous sclerosis complex (TSC): a preliminary investigation.

    abstract:PURPOSE:Medically refractory epilepsy caused by cortical tubers resulting from tuberous sclerosis complex (TSC) often requires surgical intervention. The locations of cortical tubers generally are determined by preoperative magnetic resonance imaging (MRI). In this pilot study, we explored the feasibility of using the ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2011.03167.x

    authors: Oh S,Stewart T,Miller I,Bhatia S,Ragheb J,Duchowny M,Jayakar P,Lin WC

    更新日期:2011-09-01 00:00:00

  • The ketogenic diet inhibits the mammalian target of rapamycin (mTOR) pathway.

    abstract::The ketogenic diet (KD) is an effective treatment for epilepsy, but its mechanisms of action are poorly understood. We investigated the hypothesis that the KD inhibits mammalian target of rapamycin (mTOR) pathway signaling. The expression of pS6 and pAkt, markers of mTOR pathway activation, was reduced in hippocampus ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2011.02981.x

    authors: McDaniel SS,Rensing NR,Thio LL,Yamada KA,Wong M

    更新日期:2011-03-01 00:00:00

  • Benzodiazepines in the acute management of seizures with autonomic manifestations: anticipate complications!

    abstract::The use of rescue benzodiazepines in the management of seizures is widely accepted in emergency pediatric practice. They can, however, cause severe side effects, such as respiratory depression. We describe five patients who presented with severe respiratory depression following benzodiazepine administration for seizur...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2011.03201.x

    authors: Lacroix L,Fluss J,Gervaix A,Korff CM

    更新日期:2011-10-01 00:00:00

  • Changes in regional cerebral blood flow beyond the temporal lobe in unilateral temporal lobe epilepsy.

    abstract:PURPOSE:Single photon emission computed tomography (SPECT) is widely used to evaluate functional abnormalities during the epileptic event. Changes in regional cerebral blood flow (rCBF) are well defined in patients with temporal lobe epilepsy (TLE) undergoing surgical resection. Nonetheless, the interpretation of ictal...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1997.tb01484.x

    authors: Rabinowicz AL,Salas E,Beserra F,Leiguarda RC,Vazquez SE

    更新日期:1997-09-01 00:00:00

  • Return to driving after a diagnosis of epilepsy: A prospective registry study.

    abstract:OBJECTIVE:To determine the frequency and predictors of return to driving within 1 year after a diagnosis of epilepsy. METHODS:SEISMIC (the Sydney Epilepsy Incidence Study to Measure Illness Consequences) was a prospective, multicenter, community-wide study of people of all ages with newly diagnosed epilepsy in Sydney,...

    journal_title:Epilepsia

    pub_type: 临床试验,杂志文章

    doi:10.1111/epi.14001

    authors: Xu Y,Hackett ML,Glozier N,Nikpour A,Somerville E,Bleasel A,Ireland C,Anderson CS

    更新日期:2018-03-01 00:00:00

  • Unverricht-Lundborg disease, a condition with self-limited progression: long-term follow-up of 20 patients.

    abstract:PURPOSE:To assess the long-term evolution of Unverricht-Lundborg disease (ULD), especially concerning myoclonus, seizures, and EEG characteristics. METHODS:We retrospectively evaluated 20 patients (six women, 14 men; mean age, 37.9 years; range, 26-53 years) with ULD who had been closely followed up since the onset of...

    journal_title:Epilepsia

    pub_type: 杂志文章,多中心研究

    doi:10.1111/j.1528-1167.2006.00553.x

    authors: Magaudda A,Ferlazzo E,Nguyen VH,Genton P

    更新日期:2006-05-01 00:00:00

  • Refractory status epilepticus during pregnancy secondary to cavernous angioma.

    abstract:SUMMARY:First-time seizure and status epilepticus during pregnancy have been previously reported as the initial manifestation of intracranial cavernous hemangioma. We report a woman with no history of seizures who presented with refractory status epilepticus at 10 weeks gestation. Cranial MRI revealed a right frontal c...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2008.01639.x

    authors: Aladdin Y,Gross DW

    更新日期:2008-09-01 00:00:00

  • Cliniconeuropathologic correlations show astroglial albumin storage as a common factor in epileptogenic vascular lesions.

    abstract:PURPOSE:Intracerebral vascular malformations including cavernous angiomas (CAs) and arteriovenous malformations (AVMs) are an important cause of chronic pharmacoresistant epilepsies. Little is known about the pathogenetic basis of epilepsy in patients with vascular malformations. Intracerebral deposits of iron-containi...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2012.03405.x

    authors: Raabe A,Schmitz AK,Pernhorst K,Grote A,von der Brelie C,Urbach H,Friedman A,Becker AJ,Elger CE,Niehusmann P

    更新日期:2012-03-01 00:00:00

  • Epilepsy duration, febrile seizures, and cerebral glucose metabolism.

    abstract:PURPOSE:Studies using magnetic resonance imaging have shown that reduced hippocampal volume is associated with a history of febrile seizures, the duration of epilepsy, and the number of generalized tonic-clonic seizures. It is uncertain whether these factors have the same influence on functional as on structural measur...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.0013-9580.2004.51803.x

    authors: Theodore WH,Kelley K,Toczek MT,Gaillard WD

    更新日期:2004-03-01 00:00:00

  • Potentiation of the antiepileptic activity of phenobarbital by nicotinamide.

    abstract::Nicotinamide is a ligand of the benzodiazepine receptor and has been reported to have anticonvulsant activity. In addition, our previous clinical experience has raised the possibility that it may also potentiate the action of barbiturates. Therefore, we have examined the anticonvulsant activity and neurotoxicity of ni...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1983.tb04885.x

    authors: Bourgeois BF,Dodson WE,Ferrendelli JA

    更新日期:1983-04-01 00:00:00

  • HIPDM single photon emission computed tomography brain imaging in partial onset secondarily generalized tonic-clonic seizures.

    abstract::HIPDM-Single photon emission computed tomography brain imaging was performed during interictal and ictal stages in three patients with complex partial seizures and secondarily generalized tonic-clonic seizures. In all three patients, interictal studies demonstrated decreased regional cerebral perfusion (rCP) and ictal...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1987.tb04223.x

    authors: Lee BI,Markand ON,Wellman HN,Siddiqui AR,Mock B,Krepshaw J,Kung H

    更新日期:1987-05-01 00:00:00

  • Trends in outcomes, complications, and hospitalization costs for hemispherectomy in the United States for the years 2000-2009.

    abstract:OBJECTIVE:Hemispherectomy is an established surgical treatment for carefully selected pediatric patients with intractable epilepsy. Published perioperative data report low mortality rates and seizure reduction rates of 50-89%. This study investigates trends in the demographics, hospital utilization, and in-hospital com...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.12869

    authors: Lin Y,Harris DA,Curry DJ,Lam S

    更新日期:2015-01-01 00:00:00

  • Confirmation of two magnetoencephalographic epileptic foci by invasive monitoring from subdural electrodes in an adolescent with right frontocentral epilepsy.

    abstract:PURPOSE:To report our evaluation of interictal two epileptic spike fields on magnetoencephalography (MEG) by using invasive intracranial monitoring in a patient without lesion on magnetic resonance imaging (MRI). METHODS:A 15-year-old left-handed boy with a 9-year history of refractory simple partial seizures, seconda...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1999.tb05563.x

    authors: Otsubo H,Sharma R,Elliott I,Holowka S,Rutka JT,Snead OC 3rd

    更新日期:1999-05-01 00:00:00

  • Vagus nerve stimulation elevates seizure threshold in the kindling model.

    abstract:PURPOSE:  Vagus nerve stimulation (VNS) provides partial relief of medically refractory partial seizures in a subset of patients. The optimal pattern of stimulation and the mechanism of the antiseizure effects are uncertain. Establishing the efficacy of VNS in an animal model of epilepsy would provide an experimental p...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2012.03646.x

    authors: Alexander GM,McNamara JO

    更新日期:2012-11-01 00:00:00

  • Two different anticonvulsant actions of tiagabine in developing rats.

    abstract:PURPOSE:Our goal was to study the anticonvulsant action of tiagabine (TGB) at different levels of brain maturation in rats. METHODS:Wistar rats in five age groups (7, 12, 18, 25, and 90 days old) were injected intraperitoneally with TGB at doses of 0.5-32 mg/kg. Thirty minutes later, motor seizures were induced by the...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.2000.tb00112.x

    authors: Haugvicová R,Skutová M,Kubová H,Suchomelová L,Mares P

    更新日期:2000-11-01 00:00:00

  • Recruitment of families for genetic studies of epilepsy.

    abstract:PURPOSE:Study of families containing multiple affected individuals is essential for genetic research on the epilepsies, yet practically nothing has been published about methods for identification and recruitment of families or expected participation rates. Here we describe the strategy used for data collection in a gen...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.0013-9580.2005.41904.x

    authors: Ottman R,Berenson K,Barker-Cummings C

    更新日期:2005-02-01 00:00:00