Epilepsy & Surgery

1. Automated detection of complex zebrafish seizure behavior at scale

   Convulsive seizure behaviors are a hallmark feature of epilepsy, but automated detection of these events in freely moving animals is difficult. Here, we employed a high-resolution multi-camera array microscope with high-speed video acquisition and custom supervised machine learning (ML) for automated detection of larval zebrafish between 3- and 7-days post-fertilization (dpf). We assessed data from over 2700 zebrafish either exposed to a chemoconvulsant (pentylenetetrazole, PTZ) or genetic...

2. Collapse of interictal suppressive networks permits seizure spread

   How do brain networks limit seizure activity? In the Interictal Suppression Hypothesis, we recently postulated that high inward connectivity to seizure onset zones (SOZs) from non-involved zones (NIZs) is a sign of broader network suppression. If broad networks appear to be responsible for interictal SOZ suppression, what changes during seizure initiation, spread, and termination? For patients with drug-resistant epilepsy, intracranial monitoring offers a view into the electrographic networks...

3. Radiation Therapy Combined With 5-Aminolevulinic Acid: Effect on Primary Human Meningioma Cells

   CONCLUSION: Our data suggest that 5-ALA significantly enhances the antitumor antitumour effects of RT, offering a new option for further exploration of 5-ALA combined with RT as a valuable strategy for meningioma treatment.

4. Stakeholders' perspectives on implementing and integrating patient-reported outcome measures (PROMs) in health systems - insights from Alberta, Canada

   CONCLUSIONS: The study highlights factors influencing PROMs adoption in Alberta, including the need for a unified understanding, workflow integration, and electronic data use. Key strategies involve fostering patient-centered care, ensuring organizational support, addressing resource and policy issues, and providing targeted education. Engaging early adopters and offering incentives can improve PROMs integration and patient outcomes.

5. Trends in prescription of new antiseizure medications in a single center in Latin America: evidence of clinical practice

   CONCLUSION: These findings demonstrate a preference for second- and third-generation ASMs in tertiary hospitals in Latin America, which is concordant with global trends. First-generation ASMs are still prescribed but at lower rates. These results provide insights into changing prescription practices and access to newer medications, informing future research and hospital policies.

6. Real-world use of adjunctive perampanel for focal-onset seizures in Italy: A mirroring clinical practice study of perampanel in adults and adolescents (AMPA)

   OBJECTIVE: The AMPA study (Study 501; NCT04257604) was a multicenter, prospective, 12-month observational study in Italy that evaluated the effectiveness and safety of adjunctive perampanel in patients with focal-onset seizures (FOS), with or without focal to bilateral tonic-clonic seizures (FBTCS).

7. Seizure outcomes after cortical stimulation-induced seizures: A systematic review and meta-analysis

   CONCLUSIONS: Stimulation-induced seizures were not statistically associated with surgical outcomes, but our meta-analysis was limited to a small number of studies and pooled results at both high and low frequency stimulation. Low frequency stimulation induced seizures were more consistently associated with favorable surgical outcomes in patients who had resection compared to high frequency stimulation induced seizures.

8. Evaluation of limbic microstructural abnormalities in temporal lobe epilepsy: A neurite orientation distribution and density imaging study

   OBJECTIVE: Widespread structural pathology in the limbic system is a hallmark of temporal lobe epilepsy (TLE). In this work, we sought to describe a comprehensive readout of limbic abnormalities in TLE using neurite orientation distribution and density imaging (NODDI).

9. Functional improvement by tendon transfer for residual wrist dysfunction after botulinum therapy for severe upper limb spasticity: a case report

   CONCLUSIONS: This case report demonstrates the successful application of a stepwise treatment approach, combining repetitive botulinum toxin A therapy, occupational therapy, and tendon transfer surgery, for severe upper limb spasticity with residual wrist joint impairments. These findings highlight the importance of tailoring treatment strategies to individual patient characteristics, particularly the presence of residual voluntary muscle activity and the absence of structural joint deformities....

10. Transcranial direct current stimulation neuromodulates intracranial cognitive evoked activity in humans

    Transcranial direct current stimulation (tDCS) is an easy to use, noninvasive brain stimulation technique that gained prominence for its potential in cognitive rehabilitation. Electroencephalography (EEG), which records electrical brain activity with a high temporal resolution, is well suited to quantify tDCS-induced neuromodulation in humans. However, most studies relying on scalp EEG recordings or event-related potentials showed low reliability and only indirect correlations. Here, we combined...

11. Managing Refractory Epilepsy in a Resource-Limited Setting-Doing More With Less

    Drug-resistant epilepsy (DRE) disproportionately affects individuals in low- and middle-income countries (LMIC), where access to affordable and effective care remains a significant challenge. Patients with DRE face high healthcare costs, inadequate access to epilepsy surgery, and limited availability of trained professionals. This review explores a multifaceted approach to managing DRE in resource-constrained settings. Key strategies include rational polypharmacy with cost-effective antiseizure...

12. The effect of epilepsy on anxiety, depression, as well as prognostic value among adult low-grade gliomas patients

    CONCLUSION: This study indicated that the prevalence of anxiety and depression were higher in adult LGG patients with epilepsy than without epilepsy. The prognostic value of epilepsy may contribute to early prevention and improvement of prognosis in adult LGG patients with epilepsy.

13. Ultrabright ratiometric Raman-guided epilepsy surgery by intraoperatively visualizing proinflammatory microglia

    Resective surgery is an effective approach for long-term seizure control in drug-resistant focal epilepsy when the epileptic focus (EF) can be accurately delineated and removed. However, intraoperative mapping of EF with electrocorticography is laborious, time-consuming, and highly vulnerable to the effects of anesthesia. Here, we demonstrated that activated microglia can be reliable biomarkers for EF localization. Leveraging a newly developed ratiometric Raman nanosensor, ultraHOCls, we...

14. Minimal invasive vertical hemispherotomy in a 2.5-month-old infant with hemispheric Sturge-Weber Syndrome and recurrent status epilepticus using neuronavigation and augmented reality support

    Hemispherotomy in infants under the age of 3 months is considered a high-risk procedure and is not routinely performed. A 2.5-month-old female infant weighing 5.1 kg successfully underwent a right vertical hemispherotomy after developing status epilepticus due to a right hemispheric Sturge-Weber meningo-angiomatosis. The surgical technique involved skull fixation at the skull base using kid pins to facilitate image-guided surgery with neuronavigation and augmented reality within the eyepiece of...

15. Endovascular embolization for medically refractory pediatric epilepsy: a case series

    CONCLUSIONS: Endovascular embolization is a promising minimally invasive strategy for pediatric patients with refractory epilepsy, particularly when anatomical or medical considerations preclude traditional surgery. Further research is warranted to refine patient selection criteria and assess long-term efficacy compared with established surgical approaches. This series expands the potential applications of endovascular techniques in epilepsy management.

16. Suggestive seizure induction techniques in paediatric functional/dissociative seizures: an extensive protocol

    Functional/Dissociative Seizures (FDS) are complex neuropsychiatric events frequently misdiagnosed as epilepsy, particularly in children and adolescents. Accurate and timely diagnosis remains challenging, especially when standard or prolonged EEG recordings fail to capture typical episodes. This retrospective study evaluated the diagnostic utility and clinical correlates of a structured, non-invasive Suggestive Seizure Induction Technique (SSIT) protocol integrated within video-EEG. Twenty-five...

17. Benefits of routine ICU avoidance following stereo-electroencephalography

    CONCLUSIONS: After a guideline was implemented to identify patients undergoing SEEG who could bypass the ICU immediately after SEEG implantation, resource utilization was reduced without compromising patient safety or clinical outcomes.

18. Case Report: Hematopoietic Stem Cell Transplantation to Treat Severe Acquired Aplastic Anemia in a Pediatric Kidney Transplant Recipient

    CONCLUSIONS: Despite reported favorable outcomes in children who received allogeneic HSCT after kidney transplantation, there is a lack of evidence on how to overcome numerous challenges in these ultrarare cases.

19. The UMPIRE study: A first-in-human multicenter trial of bilateral subscalp monitoring for epileptic seizure detection

    OBJECTIVE: Patient self-report is known to be an inaccurate reflection of true seizure frequency in persons with epilepsy. The current study aimed to assess the safety and performance of the Minder system, a bilateral subscalp electroencephalographic (EEG) acquisition system for continuous long-term EEG recording.

20. Surgical treatment of epilepsy associated with tuberous sclerosis in children: a single-center retrospective study

    CONCLUSION: Surgical treatment is effective for epilepsy in children with tuberous sclerosis. It is advisable to refer children with epilepsy and tuberous sclerosis to specialized centers for preoperative examination if therapy with two drugs is ineffective.