Incidence and Clinical Characterization of Unprovoked Seizures in Adults: A Prospective Population‐Based Study

Forsgren, Lars; Bucht, Gösta; Eriksson, Sture; Bergmark, Lars

doi:10.1111/j.1528-1157.1996.tb00017.x

Cited by 334 publications

(257 citation statements)

References 15 publications

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“…aAge‐ranges dictated by epidemiological studies in control populations.bPer 100,000 person‐years.cCompared to Forsgren et al47 dCompared to Caviness et al46.…”

Section: Resultsmentioning

confidence: 99%

“…Among the DLB cases we reviewed, one of four patients with a diagnosed seizure disorder had only nonconvulsive seizures and another 10 patients were suspected to have this type of seizure. Although we compared the incidence of myoclonus and seizures to the best reference populations we could find in the literature,56 our relative rate calculations may be confounded by differences in racial and age distributions in the San Francisco Bay Area versus Rochester, Minnesota and Umeå, Sweden 46, 47. A prospective clinical study is needed to more accurately determine the incidence of seizures and myoclonus in DLB patients.…”

Section: Discussionmentioning

confidence: 99%

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Network dysfunction in α‐synuclein transgenic mice and human Lewy body dementia

Morris

Sanchez

Verret

et al. 2015

Ann Clin Transl Neurol

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ObjectiveDementia with Lewy bodies (DLB) is associated with the accumulation of wild‐type human α‐synuclein (SYN) in neurons and with prominent slowing of brain oscillations on electroencephalography (EEG). However, it remains uncertain whether the EEG abnormalities are actually caused by SYN.MethodsTo determine whether SYN can cause neural network abnormalities, we performed EEG recordings and analyzed the expression of neuronal activity‐dependent gene products in SYN transgenic mice. We also carried out comparative analyses in humans with DLB.ResultsWe demonstrate that neuronal expression of SYN in transgenic mice causes a left shift in spectral power that closely resembles the EEG slowing observed in DLB patients. Surprisingly, SYN mice also had seizures and showed molecular hippocampal alterations indicative of aberrant network excitability, including calbindin depletion in the dentate gyrus. In postmortem brain tissues from DLB patients, we found reduced levels of calbindin mRNA in the dentate gyrus. Furthermore, nearly one quarter of DLB patients showed myoclonus, a clinical sign of aberrant network excitability that was associated with an earlier age of onset of cognitive impairments. In SYN mice, partial suppression of epileptiform activity did not alter their shift in spectral power. Furthermore, epileptiform activity in human amyloid precursor protein transgenic mice was not associated with a left shift in spectral power.InterpretationWe conclude that neuronal accumulation of SYN slows brain oscillations and, in parallel, causes aberrant network excitability that can escalate into seizure activity. The potential role of aberrant network excitability in DLB merits further investigation.

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“…aAge‐ranges dictated by epidemiological studies in control populations.bPer 100,000 person‐years.cCompared to Forsgren et al47 dCompared to Caviness et al46.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Network dysfunction in α‐synuclein transgenic mice and human Lewy body dementia

Morris

Sanchez

Verret

et al. 2015

Ann Clin Transl Neurol

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“…In the British National General Practice Study of Epilepsy (NGPSE), only 252 (44.7%) of the 564 patients with definite epileptic seizures were registered at the time of their first seizure (10). In a Swedish prospective incidence study, the initial seizure was the same as the seizure at time of initial diagnosis in 110 (68.8%) of the 160 adults with unprovoked seizures (11). In the Rochester study, time from the first seizure to diagnosis was >6 months in 50% and >2 years in >30% (12).…”

Section: Discussionmentioning

confidence: 99%

Newly Diagnosed Unprovoked Epileptic Seizures: Presentation at Diagnosis in CAROLE Study

Jallon¹,

Loiseau²,

Loiseau³

2001

Epilepsia

214

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Summary:Purpose: We describe first unprovoked seizures and newly diagnosed epilepsies at initial presentation, with a special emphasis on epilepsy syndromes, in a large cohort recruited in the mid-1990s in France.Methods: The French Foundation for Research on Epilepsy set up a network to conduct a prospective study of patients with newly diagnosed unprovoked seizures. Information was provided by 243 child or adult neurologists. Four neurologists classified each case according to the International League Against Epilepsy (ILAE) criteria. First-seizure patients and patients with previously undiagnosed seizures were compared.Results: Between May 1, 1995, and June 30, 1996, 1,942 patients aged from 1 month to 95 years were identified: 926 (47.7%) with a single seizure and 1,016 (52.3%) with newly diagnosed epilepsy. All but 17 patients had EEGs. In the firstseizure and newly-diagnosed-epilepsy groups, neuroimaging studies were performed in 78.2 and 68.3% of patients, and medication prescribed in 54.1 and 89.6%, respectively. There were significant differences between the two groups with respect to age at onset and diagnosis, sex, etiology, several specific syndromes, as well as the type and presentation of initial seizure. In patients for whom the first seizure was convulsive, only sex, multiple seizures in a day or status epilepticus, and cryptogenic localization-related syndrome differed between the two groups.Conclusions: Approximately half of patients who first came to attention for an unprovoked seizure already met epidemiologic criteria for epilepsy. There were significant differences between the types of patients with a first seizure and those with newly diagnosed epilepsy. One or several seizures at diagnosis did not influence the diagnostic assessment of the patients but had a strong influence on the initiation of treatment.

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“…NCC is the most common cause of acquired adult epilepsy worldwide 4, 7, 8, 9, 10, 11, 12, 13. Epilepsy due to NCC can lead to severe health consequences as seizures are associated with an increased risk of sudden death14, 15, 16, 17 and 20–30% of NCC patients with epilepsy continue to have seizures despite treatment 9…”

Section: Introductionmentioning

confidence: 99%

Inflammation is a key risk factor for persistent seizures in neurocysticercosis

Herrick

Maharathi

Kim

et al. 2018

Ann Clin Transl Neurol

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ObjectiveWe conducted a retrospective, case–control study of neurocysticercosis patients to ascertain early markers that identify subjects likely to develop treatment‐resistant seizures.MethodsClinical histories and imaging studies from 38 neurocysticercosis patients who had been followed for 18 months after treatment were evaluated. Both pairwise and multifactorial analyses were conducted to identify factors associated with continued seizures.ResultsEleven of 38 patients continued to have seizures during the follow‐up period. On univariate analysis, the number of neurocysticercosis lesions, number of bands on the baseline neurocysticercosis western blot, edema volumes on follow‐up MRI scans, edema volume changes between baseline and follow‐up images, and proportion of calcified lesions with perilesional edema were all significantly increased in subjects who had persistent seizures during the 18‐month follow‐up period. On multivariate analyses using recursive partition and random forest algorithms, variables associated with persistent seizures included: the number of total and calcified lesions, presence of perilesional edema, the rate of change in the lesion and edema volumes from baseline to follow‐up, and the number of bands on the neurocysticercosis western blot.InterpretationMeasures of both inflammation and disease burden are key risk factors for persistent seizures despite anticonvulsant treatments in patients with neurocysticercosis. Inflammation is therefore a potentially modifiable risk factor for the frequently seen severe seizure disorders in patients with neurocysticercosis.

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Incidence and Clinical Characterization of Unprovoked Seizures in Adults: A Prospective Population‐Based Study

Cited by 334 publications

References 15 publications

Network dysfunction in α‐synuclein transgenic mice and human Lewy body dementia

Network dysfunction in α‐synuclein transgenic mice and human Lewy body dementia

Newly Diagnosed Unprovoked Epileptic Seizures: Presentation at Diagnosis in CAROLE Study

Inflammation is a key risk factor for persistent seizures in neurocysticercosis

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