The burden of chronic drug-refractory focal onset epilepsy: Can it be prevented?

Ben-Menachem, Elinor; Schmitz, Bettina; Kälviäinen, Reetta; Thomas, Rhys H; Klein, Pavel

doi:10.1016/j.yebeh.2023.109435

Cited by 3 publications

(1 citation statement)

References 71 publications

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“…Epilepsy is estimated to affect 50-70 million people worldwide, with anti-seizure medications remaining the mainstay of treatment. Despite continued development of novel medications, an estimated 30-40% of patients with seizures develop drug-resistant epilepsy (DRE) [1][2][3]. DRE, as defined by the International League Against Epilepsy, is the "failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom" [4].…”

Section: Introductionmentioning

confidence: 99%

Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation: Diagnostic and Therapeutic Implications

Castellano,

Singla,

Barot

et al. 2024

Brain Sciences

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Despite recent medical therapeutic advances, approximately one third of patients do not attain seizure freedom with medications. This drug-resistant epilepsy population suffers from heightened morbidity and mortality. In appropriate patients, resective epilepsy surgery is far superior to continued medical therapy. Despite this efficacy, there remain drawbacks to traditional epilepsy surgery, such as the morbidity of open neurosurgical procedures as well as neuropsychological adverse effects. SEEG-guided Radiofrequency Thermocoagulation (SgRFTC) is a minimally invasive, electrophysiology-guided intervention with both diagnostic and therapeutic implications for drug-resistant epilepsy that offers a convenient adjunct or alternative to ablative and resective approaches. We review the international experience with this procedure, including methodologies, diagnostic benefit, therapeutic benefit, and safety considerations. We propose a framework in which SgRFTC may be incorporated into intracranial EEG evaluations alongside passive recording. Lastly, we discuss the potential role of SgRFTC in both delineating and reorganizing epilepsy networks.

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Section: Introductionmentioning

confidence: 99%

Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation: Diagnostic and Therapeutic Implications

Castellano,

Singla,

Barot

et al. 2024

Brain Sciences

View full text Add to dashboard Cite

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Analysis of 1386 epileptogenic brain lesions reveals association with DYRK1A and EGFR

Boßelmann,

Leu,

Brünger

et al. 2024

Nat Commun

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Lesional focal epilepsy (LFE) is a common and severe seizure disorder caused by epileptogenic lesions, including malformations of cortical development (MCD) and low-grade epilepsy-associated tumors (LEAT). Understanding the genetic etiology of these lesions can inform medical and surgical treatment. We conducted a somatic variant enrichment mega-analysis in brain tissue from 1386 individuals who underwent epilepsy surgery, including 599 previously unpublished individuals with ultra-deep ( > 1600x) targeted panel sequencing. Here we confirm four known associations ( BRAF, SLC35A2, MTOR, PTPN11 ), support eight associations without prior statistical support ( FGFR1, PIK3CA, AKT3, NF1, PTEN, RHEB, KRAS, NRAS ), and identify novel associations for two genes, DYRK1A and EGFR . Both novel genes show specific histopathological phenotypes, interact with LFE genes and pathways, and may represent promising candidates as biomarkers and potentially druggable targets.

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Emerging Trends in Neuropalliative Care: A Palliative Approach to Epilepsy and Seizure Management in Adults

Willert,

Kowski

2024

Semin Neurol

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Management of severe (drug-resistant) epilepsy and epilepsy in other serious illnesses is multidimensional and requires consideration of both physical symptoms and psychosocial distress that require individualized treatment. Palliative care offers a holistic approach to disease that focuses on all dimensions of suffering to maintain quality of life. Integration of a palliative care mind- and skillset in the management of severe epilepsy and epilepsy in other serious illnesses can provide person-centered care and support for families and caregivers.

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The burden of chronic drug-refractory focal onset epilepsy: Can it be prevented?

Cited by 3 publications

References 71 publications

Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation: Diagnostic and Therapeutic Implications

Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation: Diagnostic and Therapeutic Implications

Analysis of 1386 epileptogenic brain lesions reveals association with DYRK1A and EGFR

Emerging Trends in Neuropalliative Care: A Palliative Approach to Epilepsy and Seizure Management in Adults

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