Temporal distributions of seizure occurrence from various epileptogenic regions

Durazzo, Tyler; Spencer, S. S.; Duckrow, Robert B.; Novotny, Edward J.; Spencer, Dennis D.; Zaveri, Hitten P.

doi:10.1212/01.wnl.0000308938.84918.3f

Cited by 169 publications

(160 citation statements)

References 44 publications

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“…Additionally, the amygdala had cortical and subcortical connections with the posterior orbitofrontal cortex 22, 23. Therefore, seizures originating from the amygdala often spread via the orbitofrontal pathway with seizure semiology similar to frontal lobe seizure,24 which were short, frequent, and nocturnal. This may explain our findings that SGTC seizures often occurred during sleep in autoimmune epilepsy patients.…”

Section: Discussionmentioning

confidence: 99%

Seizure semiology: an important clinical clue to the diagnosis of autoimmune epilepsy

Ren

Guan

et al. 2018

Ann Clin Transl Neurol

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ObjectiveThe purpose of this study is to analyze the seizure semiologic characteristics of patients with autoimmune epilepsy (AE) and describe the investigation characteristics of AE using a larger sample size.MethodsThis observational retrospective case series study was conducted from a tertiary epilepsy center between May 2014 and March 2017. Cases of new‐onset seizures were selected based on laboratory evidence of autoimmunity. At the same time, typical mesial temporal lobe epilepsy (MTLE) patients with hippocampal sclerosis (HS) were recruited as the control group from the subjects who underwent presurgical evaluation during the same period.ResultsA total of 61 patients with AE were identified. Specific autoimmune antibodies were detected in 39 patients (63.93%), including anti‐VGKC in 23 patients (37.70%), anti‐NMDA‐R in 9 patients (14.75%), anti‐GABAB‐R in 6 patients (9.84%), and anti‐amphiphysin in 1 patient (1.64%). Regarding the seizure semiology, no significant differences were noted between AE patients with autoantibody and patients with suspected AE without antibody. Compared to typical MTLE patients with HS, both AE patients with autoantibody and patients with suspected AE without antibody had the same seizure semiologic characteristics, including more frequent SPS or CPS, shorter seizure duration, rare postictal confusion, and common sleeping SGTC seizures.SignificanceThis study highlights important seizure semiologic characteristics of AE. Patients with autoimmune epilepsy had special seizure semiologic characteristics. For patients with autoimmune epilepsy presenting with new‐onset seizures in isolation or with a seizure‐predominant neurological disorder, the special seizure semiologic characteristics may remind us to test neuronal nuclear/cytoplasmic antibodies early and initiate immunomodulatory therapies as soon as possible. Furthermore, the absence of neural‐specific autoantibodies does not rule out AE.

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Section: Discussionmentioning

confidence: 99%

Seizure semiology: an important clinical clue to the diagnosis of autoimmune epilepsy

Ren

Guan

et al. 2018

Ann Clin Transl Neurol

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“…seasonal affective disorders) cycles [7]. There is evidence to suggest that seizures may show a circadian rhythm with predilection for occurrence at various times of the day or night [8][9][10]. Further, the time of predilection may vary with the location of the epileptic focus, e.g.…”

Section: Periodicity Of Seizuresmentioning

confidence: 99%

“…Further, the time of predilection may vary with the location of the epileptic focus, e.g. nocturnal predilection of frontal lobe epilepsy versus morning and afternoon occurrence of temporal lobe seizures [8][9][10]. There is also evidence that seizure occurrence may show a circalunar periodicity.…”

Section: Periodicity Of Seizuresmentioning

confidence: 99%

Catamenial epilepsy: Update on prevalence, pathophysiology and treatment from the findings of the NIH Progesterone Treatment Trial

Herzog

2015

Seizure

111

103

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“…The influences of seizures on each other ('interdependencies') are being uncovered, 12 and their frequency and intensity show consistent increases at certain times of the day. 13,14 Development of scalp and extracerebral seizure detection will advance the field even further because its clinical applicability would be broadened beyond that which requires intracranial electrodes. Cardiacbased (EKG) detection 15 is a promising avenue, especially for seizures originating from mesial temporal and insular regions.…”

mentioning

confidence: 99%

Realtime Detection, Quantification, Warning, and Control of Epileptic Seizures—The Foundations of a New Epileptology

Osorio¹,

Frei²

2008

US Neurology

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The aim of abating seizures in a spatio-temporally selective manner is not a modern one. As early as 150 AD, Pelops from Alexandria, the teacher of Galen, was reported to have aborted what would likely be referred to today as 'a simple partial seizure with sensory-motor manifestations' by tying a ligature around the affected limb at the time of the appearance of the first paroxysmal manifestation.1 Brown-Sequard, 2 Jackson, 3 and, later, Gowers,4 who coined the term 'counter-irritation' to denote a strategy to abate seizures, reintroduced the notion of contingent therapy in the 19th century, an objective that since then and until recently was ignored. After nearly two millennia, the seminal tasks of automated seizure detection and contingent warning and delivery of therapy endowed with realtime feedback capabilities are finally not only feasible but also possibly safe and efficacious. 5 This substantive advance, which at this juncture is in an 'embryonic' developmental stage, attempts to address the lack of efficacy of systemically administered pharmacological agents in a large group of patients with epilepsy, 6 together with the relatively high incidence of serious idiosyncratic or intolerable dose-dependent adverse effects, including exacerbation of seizures, 7 and to decrease the risk of injury and the psychosocial burden resulting from their unpredictability. The medical, psychosocial, and economic benefits that will be derived from achieving these objectives are salutary and self-evident to patients, their care-givers, and healthcare providers.Realtime automated seizure detection, the obligatory condition for implementation of contingent warning and therapies, has been attempted with various degrees of success since the mid-1970s. 8 The rationale for the method/algorithm, 9,10 developed by the group of which these authors are members, and its architecture will be described in some detail for the purpose of shedding light on the process and on the value of signal analyses for the implementation of novel clinical epilepsy therapies. This algorithm is discussed herein simply because it is well understood by these authors.References to and comparisons with other algorithms are not germane, because, to date, a formal evaluation of their performance on a common data set has not been carried out.Simply put, and making allowances for lack of mathematical rigor, this modular, adaptable algorithm separates and quantifies (measuring intensity, duration, and extent of spread) in realtime (as 'things' are happening) the seizure, from the non-seizure content in cortical electrical signals by comparing signal features on two timescales, one short (two seconds), containing ongoing ('foreground') activity, and the other long (30 minutes), containing recent past ('background') activity, which is used as a reference against which the current activity is weighed/quantified. It undertakes two different filtering steps: one discards the non-seizure activity and the other the epileptiform activity that does not qualify as a 'seiz...

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Temporal distributions of seizure occurrence from various epileptogenic regions

Cited by 169 publications

References 44 publications

Seizure semiology: an important clinical clue to the diagnosis of autoimmune epilepsy

Seizure semiology: an important clinical clue to the diagnosis of autoimmune epilepsy

Catamenial epilepsy: Update on prevalence, pathophysiology and treatment from the findings of the NIH Progesterone Treatment Trial

Realtime Detection, Quantification, Warning, and Control of Epileptic Seizures—The Foundations of a New Epileptology

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