المؤلفون: Andreas Schulze‐Bonhage, Mark P. Richardson, Armin Brandt, Nicolas Zabler, Matthias Dümpelmann, Victoria San Antonio‐Arce

المصدر: Annals of Clinical and Translational Neurology, Vol 10, Iss 10, Pp 1863-1872 (2023)

مصطلحات موضوعية: Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, RC346-429

الوصف: Abstract Objective Circadian and multidien cycles of seizure occurrence are increasingly discussed as to their biological underpinnings and in the context of seizure forecasting. This study analyzes if patient reported seizures provide valid data on such cyclical occurrence. Methods We retrospectively studied if circadian cycles derived from patient‐based reporting reflect the objective seizure documentation in 2003 patients undergoing in‐patient video‐EEG monitoring. Results Only 24.1% of more than 29000 seizures documented were accompanied by patient notifications. There was cyclical underreporting of seizures with a maximum during nighttime, leading to significant deviations in the circadian distribution of seizures. Significant cyclical deviations were found for focal epilepsies originating from both, frontal and temporal lobes, and for different seizure types (in particular, focal unaware and focal to bilateral tonic–clonic seizures). Interpretation Patient seizure diaries may reflect a cyclical reporting bias rather than the true circadian seizure distributions. Cyclical underreporting of seizures derived from patient‐based reports alone may lead to suboptimal treatment schemes, to an underestimation of seizure‐associated risks, and may pose problems for valid seizure forecasting. This finding strongly supports the use of objective measures to monitor cyclical distributions of seizures and for studies and treatment decisions based thereon.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2328-9503Test

الوصول الحر: https://doaj.org/article/21532c4a66a54f7fa80dba087583466fTest

المؤلفون: Konstantin L. Makridis, Kerstin Alexandra Klotz, Georgia Ramantani, Lena‐Luise Becker, Victoria San Antonio‐Arce, Steffen Syrbe, Kathrin Wagner, Mukesch Johannes Shah, Ulrich‐Wilhelm Thomale, Anna Tietze, Christian E. Elger, Ingo Borggraefe, Angela M. Kaindl

المصدر: Epilepsia Open, Vol 8, Iss 3, Pp 1182-1189 (2023)

مصطلحات موضوعية: anti‐seizure medication, cognition, epilepsy, epilepsy surgery, infants, neurosurgery, Neurology. Diseases of the nervous system, RC346-429

الوصف: Abstract Although epilepsy surgery is the only curative therapeutic approach for lesional drug‐resistant epilepsy (DRE), there is reluctance to operate on infants due to a fear of complications. A recent meta‐analysis showed that epilepsy surgery in the first 6 months of life can achieve seizure control in about two thirds of children. However, robust data on surgical complications and postoperative cognitive development are lacking. We performed a retrospective multicenter study of infants who underwent epilepsy surgery in the first 6 months of life. 15 infants underwent epilepsy surgery at a median age of 134 days (IQR: 58) at four centers. The most common cause was malformation of cortical development, and 13 patients underwent a hemispherotomy. Two thirds required intraoperative red blood transfusions. Severe intraoperative complications occurred in two patients including death in one infant due to cardiovascular insufficiency. At a median follow‐up of 1.5 years (IQR: 1.8), 57% of patients were seizure‐free. Three patients where reoperated at a later age, resulting in 79% seizure freedom. Anti‐seizure medication could be reduced in two thirds, and all patients improved in their development. Our findings suggest that early epilepsy surgery can result in good seizure control and developmental improvement. However, given the perioperative risks, it should be performed only in specialized centers.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2470-9239Test

الوصول الحر: https://doaj.org/article/042924e4e8514d13ab7940ff51d22b24Test

المؤلفون: Tobias Baumgartner, Mar Carreño, Rodrigo Rocamora, Francesca Bisulli, Antonella Boni, Milan Brázdil, Ondrej Horak, Dana Craiu, Cristina Pereira, Renzo Guerrini, Victoria San Antonio‐Arce, Andreas Schulze‐Bonhage, Sameer M. Zuberi, Tove Hallböök, Reetta Kalviainen, Lieven Lagae, Sylvie Nguyen, Sofia Quintas, Ana Franco, J. Helen Cross, Matthew Walker, Alexis Arzimanoglou, Sylvain Rheims, Tiziana Granata, Laura Canafoglia, Cecilie Johannessen Landmark, Arjune Sen, Rohini Rattihalli, Rima Nabbout, Elena Tartara, Manuela Santos, Rui Rangel, Pavel Krsek, Petr Marusic, Nicola Specchio, Kees P. J. Braun, Patricia Smeyers, Vicente Villanueva, Katarzyna Kotulska, Rainer Surges

المصدر: Epilepsia Open, Vol 6, Iss 1, Pp 160-170 (2021)

مصطلحات موضوعية: autoimmune encephalitis, Dravet syndrome, orphan disease, progressive myoclonic epilepsy, targeted therapies, tuberous sclerosis complex, Neurology. Diseases of the nervous system, RC346-429

الوصف: Abstract Objective Clinical care of rare and complex epilepsies is challenging, because evidence‐based treatment guidelines are scarce, the experience of many physicians is limited, and interdisciplinary treatment of comorbidities is required. The pathomechanisms of rare epilepsies are, however, increasingly understood, which potentially fosters novel targeted therapies. The objectives of our survey were to obtain an overview of the clinical practice in European tertiary epilepsy centers treating patients with 5 arbitrarily selected rare epilepsies and to get an estimate of potentially available patients for future studies. Methods Members of the European Reference Network for rare and complex epilepsies (EpiCARE) were invited to participate in a web‐based survey on clinical practice of patients with Dravet syndrome, tuberous sclerosis complex (TSC), autoimmune encephalitis, and progressive myoclonic epilepsies including Unverricht Lundborg and Unverricht‐like diseases. A consensus‐based questionnaire was generated for each disease. Results Twenty‐six of 30 invited epilepsy centers participated. Cohorts were present in most responding centers for TSC (87%), Dravet syndrome (85%), and autoimmune encephalitis (71%). Patients with TSC and Dravet syndrome represented the largest cohorts in these centers. The antiseizure drug treatments were rather consistent across the centers especially with regard to Dravet syndrome, infantile spasms in TSC, and Unverricht Lundborg / Unverricht‐like disease. Available, widely used targeted therapies included everolimus in TSC and immunosuppressive therapies in autoimmune encephalitis. Screening for comorbidities was routinely done, but specific treatment protocols were lacking in most centers. Significance The survey summarizes the current clinical practice for selected rare epilepsies in tertiary European epilepsy centers and demonstrates consistency as well as heterogeneity in the treatment, underscoring the need for controlled trials and recommendations. The survey also provides estimates for potential participants of clinical trials recruited via EpiCARE, emphasizing the great potential of Reference Networks for future studies to evaluate new targeted therapies and to identify novel biomarkers.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2470-9239Test

الوصول الحر: https://doaj.org/article/69517d96215647e1a494c4132cfe2998Test

المؤلفون: Kerstin A. Klotz, Andreas Schulze-Bonhage, Victoria San Antonio-Arce, Julia Jacobs

المصدر: Frontiers in Neurology, Vol 9 (2018)

مصطلحات موضوعية: cannabidiol, cannabinoids, CBD, children, EEG, electroencephalogram, Neurology. Diseases of the nervous system, RC346-429

الوصف: Background: The interest in cannabidiol (CBD) for treatment of epilepsy has been increasing over the last years. However, practitioner's attitudes concerning the use of CBD for epilepsy treatment appears to be divided and data about its clinical use in daily practice are not available.Objective: To improve the knowledge about the current use of CBD amongst European practitioners treating children and adolescents for epilepsy.Methods: Cross-sectional survey using an open-access online questionnaire for physicians treating children or adolescents for epilepsy within eight European countries from December 2017 to March 2018.Results: One-hundred fifty-five physicians participated in the survey. CBD is increasingly used by 45% (69/155) of participants, treating a mean (range) number of 3 (1–35) with CBD. Only 48% of the participants prescribing CBD are exclusively using purified CBD to treat children and adolescents with epilepsy, the remainder also applies preparations containing delta9-tetrahydrocannabinol (THC). Reported daily CBD doses range from < 10 to 50 mg/kg body weight. Management of CBD therapy in regard of monitoring side effects and adjusting concomitant therapy differs widely amongst participants. Their primary objective for commencing CBD is improving patient's quality of life. Participants frequently receive inquiries about CBD treatment but only 40% may actively suggest CBD as a treatment option. Of the 85 participants currently not using CBD for epilepsy treatment, 70% would consider using CBD if available in their country of practice or given the opportunity to become familiar with this treatment option.Conclusions: CBD is increasingly used by participating physicians but individual experience remains limited. There are very diverse opinions about the use of CBD to treat epilepsy in children and adolescents and widely differing views on how to manage the CBD treatment.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/article/10.3389/fneur.2018.00731/fullTest; https://doaj.org/toc/1664-2295Test

الوصول الحر: https://doaj.org/article/c6cf184edb5d4c9faa033ec4f3c68536Test

المؤلفون: Victoria San Antonio Arce, Friederike Wilbert, Andreas Schulze-Bonhage

المصدر: Pädiatrie. 35:27-29

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::efd0df41aac6182fe2bab5bfe1a1f60aTest
https://doi.org/10.1007/s15014-022-4798-2Test

المؤلفون: Horst Urbach, Christian Scheiwe, Muskesh J. Shah, Julia M. Nakagawa, Marcel Heers, Maria Victoria San Antonio-Arce, Dirk-Matthias Altenmueller, Andreas Schulze-Bonhage, Hans-Juergen Huppertz, Theo Demerath, Soroush Doostkam

المصدر: Clinical Neuroradiology.

مصطلحات موضوعية: Radiology, Nuclear Medicine and imaging, Neurology (clinical)

الوصف: Purpose To evaluate the diagnostic accuracy of epilepsy-dedicated 3 Tesla MRI including post-processing by correlating MRI, histopathology, and postsurgical seizure outcomes. Methods 3 Tesla-MRI including a magnetization-prepared two rapid acquisition gradient echo (MP2RAGE) sequence for post-processing using the morphometric analysis program MAP was acquired in 116 consecutive patients with drug-resistant focal epilepsy undergoing resection surgery. The MRI, histopathology reports and postsurgical seizure outcomes were recorded from the patient’s charts. Results The MRI and histopathology were concordant in 101 and discordant in 15 patients, 3 no hippocampal sclerosis/gliosis only lesions were missed on MRI and 1 of 28 focal cortical dysplasia (FCD) type II associated with a glial scar was considered a glial scar only on MRI. In another five patients, MRI was suggestive of FCD, the histopathology was uneventful but patients were seizure-free following surgery. The MRI and histopathology were concordant in 20 of 21 glioneuronal tumors, 6 cavernomas, and 7 glial scars. Histopathology was negative in 10 patients with temporal lobe epilepsy, 4 of them had anteroinferior meningoencephaloceles. Engel class IA outcome was reached in 71% of patients. Conclusion The proposed MRI protocol is highly accurate. No hippocampal sclerosis/gliosis only lesions are typically MRI negative. Small MRI positive FCD can be histopathologically missed, most likely due to sampling errors resulting from insufficient harvesting of tissue.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::0d2ba021e9ce12b3347dcf0cf17d5cb0Test
https://doi.org/10.1007/s00062-023-01265-3Test

المؤلفون: Dorin Cristian, Antal, Thomas Gabriel, Schreiner, Theona Eliza, Crihan, Bogdan Emilian, Ignat, Victoria, San Antonio-Arce, Iulian Dan, Cuciureanu

المصدر: Experimental and Therapeutic Medicine. 24

مصطلحات موضوعية: Cancer Research, Immunology and Microbiology (miscellaneous), General Medicine

الوصف: In order to increase the quality of life of patients with epilepsy, it is essential to develop tools that facilitate early disease diagnosis and encourage the use of individualized therapies. The association between seizures and other neurological pathologies is well known but incompletely explained, with multiple sclerosis (MS)-seizures correlation being a relevant example. In this context, the present review aimed to highlight the most important facts related to the association between the heterogeneous group of epileptic pathology and MS, in order to provide initial directions for establishing a diagnostic and therapeutic protocol. The first part reviewed the most relevant epidemiological and clinical data on seizures; MS association. Subsequently, it highlighted the most common and actually accepted pathophysiological mechanisms that try to explain the association between the two pathologies. Finally, the importance of paraclinical investigations and the optimal choice of antiseizure-based therapies with respect to seizures associated with MS are presented, also revealing several directions that should be explored in the near future.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dc7726fd4017b5b807a0bdc3b961246dTest
https://doi.org/10.3892/etm.2022.11625Test

المؤلفون: Andreas Schulze‐Bonhage, Elisa Bruno, Armin Brandt, Anthony Shek, Pedro Viana, Marcel Heers, Eva Martinez‐Lizana, Dirk‐Matthias Altenmüller, Mark Philip Richardson, Victoria San Antonio‐Arce

المصدر: Epilepsia.

مصطلحات موضوعية: Neurology, Neurology (clinical)

الوصف: To determine the diagnostic yield of in-hospital video-electroencephalography (EEG) monitoring to document seizures in patients with epilepsy.Retrospective analysis of electronic seizure documentation at the University Hospital Freiburg (UKF) and at King's College London (KCL). Statistical assessment of the role of the duration of monitoring, and subanalyses on presurgical patient groups and patients undergoing reduction of antiseizure medication.Of more than 4800 patients with epilepsy undergoing in-hospital recordings at the two institutions since 2005, seizures with documented for 43% (KCL) and 73% (UKF).. Duration of monitoring was highly significantly associated with seizure recordings (p .0001), and presurgical patients as well as patients with drug reduction had a significantly higher diagnostic yield (p .0001). Recordings with a duration of5 days lead to additional new seizure documentation in only less than 10% of patients.There is a need for the development of new ambulatory monitoring strategies to document seizures for diagnostic and monitoring purposes for a relevant subgroup of patients with epilepsy in whom in-hospital monitoring fails to document seizures.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0c759a0e4d4bf8442f8cfcc0b118e8ecTest
https://doi.org/10.1111/epi.17307Test

المؤلفون: Andreas Schulze-Bonhage, Bernhard J. Steinhoff, Thomas Bast, Stephan Petrik, Juergen Beck, Armin Brandt, Victoria San Antonio-Arce, Steffen Syrbe, Christian Scheiwe

المصدر: Epilepsia. 62:1092-1104

مصطلحات موضوعية: Adult, Male, 0301 basic medicine, Drug Resistant Epilepsy, medicine.medical_specialty, Multivariate analysis, Adolescent, Neurosurgical Procedures, Lesion, Young Adult, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Recurrence, Risk Factors, Seizures, medicine, Humans, Epilepsy surgery, Child, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Middle Aged, medicine.disease, Surgery, Functional imaging, Treatment Outcome, 030104 developmental biology, Neurology, Positron emission tomography, Child, Preschool, Cohort, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery

الوصف: OBJECTIVE This study was undertaken to improve understanding of late relapse following epilepsy surgery in pharmacoresistant epilepsy. METHODS Retrospective comparison was made of 99 of 1278 patients undergoing surgery during 1999-2015 with seizure relapses after at least 2 years of complete seizure freedom with matched controls experiencing continued long-term seizure freedom. Univariate and multivariate analyses were performed. RESULTS With a mean follow-up of 9.7 years, mean time to seizure relapse was 56.6 months. In multivariate analysis, incomplete resection based on magnetic resonance imaging (MRI), bilateral lesions on preoperative MRI, and epilepsy onset in the first year of life carried a significantly higher risk of late relapse. In patients with late relapse, additional functional imaging with positron emission tomography had been performed significantly more often. Although the differences were not significant in multivariate analysis, doses of antiepileptic drugs were higher in the relapse group preoperatively and in the first 24 months and complete withdrawal was more frequent in the control group (68% vs. 51%). Regarding seizure frequency, most patients had mild seizure relapse (single relapse seizure or

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dc4e91299c3b60ea868f569d145aee43Test
https://doi.org/10.1111/epi.16893Test

المؤلفون: Andreas Schulze-Bonhage, Julia Männlin, Victoria San Antonio-Arce

المصدر: Clinical Neurophysiology. 141:S67-S68

مصطلحات موضوعية: Neurology, Physiology (medical), Neurology (clinical), Sensory Systems

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::b5f13ad14f1dd7e804b1ae7205575a21Test
https://doi.org/10.1016/j.clinph.2022.07.178Test