Literature Monitor

Infants experiencing spasms will likely respond to standard first-line treatment, whether or not they also have hypsarrhythmia, according to a multicenter study of the National Infantile Spasms Consortium.

• The investigation included infants between 2 months and 2 years who had been enrolled in the Consortium cohort with new onset spasms.
• 82% of the infants had hypsarrthythmia but the condition was not linked to the child’s average age, gender, any preexisting developmental delay or epilepsy, or their response to first line treatment.

First-line treatment, which consisted of vigabatrin, prednisolone, and adrenocorticotropic hormone (ACTH), was by far the most important variable that predicted the infants’ response to therapy, whether or not they had hypsarrhythmia.

The impact of hypsarrhythmia on infantile spasms treatment response: Observational cohort study from the National Infantile Spasms Consortium. Epilepsia. 2017;58:2098-2103.

Infants experiencing spasms will likely respond to standard first-line treatment, whether or not they also have hypsarrhythmia, according to a multicenter study of the National Infantile Spasms Consortium.

• The investigation included infants between 2 months and 2 years who had been enrolled in the Consortium cohort with new onset spasms.
• 82% of the infants had hypsarrthythmia but the condition was not linked to the child’s average age, gender, any preexisting developmental delay or epilepsy, or their response to first line treatment.

First-line treatment, which consisted of vigabatrin, prednisolone, and adrenocorticotropic hormone (ACTH), was by far the most important variable that predicted the infants’ response to therapy, whether or not they had hypsarrhythmia.

The impact of hypsarrhythmia on infantile spasms treatment response: Observational cohort study from the National Infantile Spasms Consortium. Epilepsia. 2017;58:2098-2103.

Infants experiencing spasms will likely respond to standard first-line treatment, whether or not they also have hypsarrhythmia, according to a multicenter study of the National Infantile Spasms Consortium.

• The investigation included infants between 2 months and 2 years who had been enrolled in the Consortium cohort with new onset spasms.
• 82% of the infants had hypsarrthythmia but the condition was not linked to the child’s average age, gender, any preexisting developmental delay or epilepsy, or their response to first line treatment.

First-line treatment, which consisted of vigabatrin, prednisolone, and adrenocorticotropic hormone (ACTH), was by far the most important variable that predicted the infants’ response to therapy, whether or not they had hypsarrhythmia.

The impact of hypsarrhythmia on infantile spasms treatment response: Observational cohort study from the National Infantile Spasms Consortium. Epilepsia. 2017;58:2098-2103.

Black patients are almost twice as likely to be diagnosed with temporal lobe epilepsy than white patients, despite the fact that black patients make up only 20% of the patient population in the Southeastern United States, according to a recent study.

• The University of Alabama at Birmingham reviewed all the video EEG diagnoses in its seizure monitoring unit from 2000 to 2011.
• Researchers performed a statistical analysis that included multivariate logistic regression to detect factors associated with the temporal lobe epilepsy (TLE) diagnosis.
• The diagnoses in the entire patient population included 630 cases of TLE, 1150 cases of psychogenic nonepileptic seizures, 424 additional focal epilepsies, and 224 generalized epilepsies.
• The population included 77.3% white patients, 20% black patients, and 2.3% patients of other races.
• TLE was diagnosed far more often in black patients than white patients (odds ratio: 1.87).

There were more women in the study population, and black women were responsible for most of the statistical difference in TLE diagnoses.

Racial disparities in temporal lobe epilepsy. Epilepsy Res. 2017;16;140:56-60.

Black patients are almost twice as likely to be diagnosed with temporal lobe epilepsy than white patients, despite the fact that black patients make up only 20% of the patient population in the Southeastern United States, according to a recent study.

• The University of Alabama at Birmingham reviewed all the video EEG diagnoses in its seizure monitoring unit from 2000 to 2011.
• Researchers performed a statistical analysis that included multivariate logistic regression to detect factors associated with the temporal lobe epilepsy (TLE) diagnosis.
• The diagnoses in the entire patient population included 630 cases of TLE, 1150 cases of psychogenic nonepileptic seizures, 424 additional focal epilepsies, and 224 generalized epilepsies.
• The population included 77.3% white patients, 20% black patients, and 2.3% patients of other races.
• TLE was diagnosed far more often in black patients than white patients (odds ratio: 1.87).

There were more women in the study population, and black women were responsible for most of the statistical difference in TLE diagnoses.

Racial disparities in temporal lobe epilepsy. Epilepsy Res. 2017;16;140:56-60.

Black patients are almost twice as likely to be diagnosed with temporal lobe epilepsy than white patients, despite the fact that black patients make up only 20% of the patient population in the Southeastern United States, according to a recent study.

• The University of Alabama at Birmingham reviewed all the video EEG diagnoses in its seizure monitoring unit from 2000 to 2011.
• Researchers performed a statistical analysis that included multivariate logistic regression to detect factors associated with the temporal lobe epilepsy (TLE) diagnosis.
• The diagnoses in the entire patient population included 630 cases of TLE, 1150 cases of psychogenic nonepileptic seizures, 424 additional focal epilepsies, and 224 generalized epilepsies.
• The population included 77.3% white patients, 20% black patients, and 2.3% patients of other races.
• TLE was diagnosed far more often in black patients than white patients (odds ratio: 1.87).

There were more women in the study population, and black women were responsible for most of the statistical difference in TLE diagnoses.

Racial disparities in temporal lobe epilepsy. Epilepsy Res. 2017;16;140:56-60.

Pathological changes in the brain’s white matter may contribute to focal epilepsy, suggests a recent review of the scientific research.

• Investigators have uncovered pathological changes in white matter myelination, axonal integrity, and cellular composition among patients with epilepsy, based on ex vivo and postmortem studies.
• Microstructural changes in several areas of the brain’s white matter near and at a distance from the epileptic focus have been discovered with the help of diffusion-weighted magnetic resonance imaging (MRI), including diffusion tensor imaging.
• MRI of the brain’s white matter may also be helpful in predicting patients’ cognitive functioning and how they respond to drug and surgical treatment.
• The literature review focuses on temporal lobe epilepsy and focal cortical dysplasia and the white matter anomalies detected in these disorders.

Histological and MRI markers of white matter damage in focal epilepsy. Epilepsy Res. 2018;140:29-38.

Pathological changes in the brain’s white matter may contribute to focal epilepsy, suggests a recent review of the scientific research.

• Investigators have uncovered pathological changes in white matter myelination, axonal integrity, and cellular composition among patients with epilepsy, based on ex vivo and postmortem studies.
• Microstructural changes in several areas of the brain’s white matter near and at a distance from the epileptic focus have been discovered with the help of diffusion-weighted magnetic resonance imaging (MRI), including diffusion tensor imaging.
• MRI of the brain’s white matter may also be helpful in predicting patients’ cognitive functioning and how they respond to drug and surgical treatment.
• The literature review focuses on temporal lobe epilepsy and focal cortical dysplasia and the white matter anomalies detected in these disorders.

Histological and MRI markers of white matter damage in focal epilepsy. Epilepsy Res. 2018;140:29-38.

Pathological changes in the brain’s white matter may contribute to focal epilepsy, suggests a recent review of the scientific research.

• Investigators have uncovered pathological changes in white matter myelination, axonal integrity, and cellular composition among patients with epilepsy, based on ex vivo and postmortem studies.
• Microstructural changes in several areas of the brain’s white matter near and at a distance from the epileptic focus have been discovered with the help of diffusion-weighted magnetic resonance imaging (MRI), including diffusion tensor imaging.
• MRI of the brain’s white matter may also be helpful in predicting patients’ cognitive functioning and how they respond to drug and surgical treatment.
• The literature review focuses on temporal lobe epilepsy and focal cortical dysplasia and the white matter anomalies detected in these disorders.

Histological and MRI markers of white matter damage in focal epilepsy. Epilepsy Res. 2018;140:29-38.

MRI-guided stereotactic laser ablation (MRI-SLA) seems to offer advantages over more traditional open resection in patients requiring epileptic surgery, according to a recent review of the evidence.

• MRI-SLA has been found to improve several types of cognitive outcomes when compared to open surgery.
• Daniel Drane, MD, from Emory University points out that stereotactic laser ablation reduces collateral neurological damage.
• Stereotatic laser amygdalohippocampotomy may result in better neurological functioning in areas that include category related naming, verbal fluency, and object/familiar person recognition, when compared to traditional resection.
• The evidence suggests that using a neurosurgical technique like MRI-SLE offers advantages in patients undergoing epilepsy surgery by limiting the size of the surgical lesion zone.

Drane DL. MRI-Guided stereotactic laser ablation for epilepsy surgery: Promising preliminary results for cognitive outcome. [Published online ahead of print Sept 23, 2017] Epilepsy Res. https://doi.org/10.1016/j.eplepsyres.2017.09.016

MRI-guided stereotactic laser ablation (MRI-SLA) seems to offer advantages over more traditional open resection in patients requiring epileptic surgery, according to a recent review of the evidence.

• MRI-SLA has been found to improve several types of cognitive outcomes when compared to open surgery.
• Daniel Drane, MD, from Emory University points out that stereotactic laser ablation reduces collateral neurological damage.
• Stereotatic laser amygdalohippocampotomy may result in better neurological functioning in areas that include category related naming, verbal fluency, and object/familiar person recognition, when compared to traditional resection.
• The evidence suggests that using a neurosurgical technique like MRI-SLE offers advantages in patients undergoing epilepsy surgery by limiting the size of the surgical lesion zone.

Drane DL. MRI-Guided stereotactic laser ablation for epilepsy surgery: Promising preliminary results for cognitive outcome. [Published online ahead of print Sept 23, 2017] Epilepsy Res. https://doi.org/10.1016/j.eplepsyres.2017.09.016

MRI-guided stereotactic laser ablation (MRI-SLA) seems to offer advantages over more traditional open resection in patients requiring epileptic surgery, according to a recent review of the evidence.

• MRI-SLA has been found to improve several types of cognitive outcomes when compared to open surgery.
• Daniel Drane, MD, from Emory University points out that stereotactic laser ablation reduces collateral neurological damage.
• Stereotatic laser amygdalohippocampotomy may result in better neurological functioning in areas that include category related naming, verbal fluency, and object/familiar person recognition, when compared to traditional resection.
• The evidence suggests that using a neurosurgical technique like MRI-SLE offers advantages in patients undergoing epilepsy surgery by limiting the size of the surgical lesion zone.

Drane DL. MRI-Guided stereotactic laser ablation for epilepsy surgery: Promising preliminary results for cognitive outcome. [Published online ahead of print Sept 23, 2017] Epilepsy Res. https://doi.org/10.1016/j.eplepsyres.2017.09.016

Resting state functional magnetic resonance imaging (rsfMRI) may prove a valuable tool in evaluating patients with epilepsy postoperatively suggests this report from Epilepsy Research.

• Although task-based fMRI is often used to assess patients after surgery, Boerwinkle et al suggest resting state fMRI may be a useful adjunct and alternative after laser ablation of seizure foci, especially in pediatric patients.
• The researchers have developed software that can merge rsfMRI images with surgical navigation systems so that the technology can be more useful in a clinical setting.
• Boerwinkle et al postulate that performing rsfMRI after laser surgery may help clinicians detect changes in connectivity, determine the location of new seizure foci, and serve as a guide to determine the best course of antiepileptic therapy.

Boerwinkle VL,  Vedantam A, Lam S et al. Connectivity changes after laser ablation: Resting-state fMRI. [Published online ahead of print Sept 28, 2017] Epilepsy Res. https://doi.org/10.1016/j.eplepsyres.2017.09.015

Resting state functional magnetic resonance imaging (rsfMRI) may prove a valuable tool in evaluating patients with epilepsy postoperatively suggests this report from Epilepsy Research.

• Although task-based fMRI is often used to assess patients after surgery, Boerwinkle et al suggest resting state fMRI may be a useful adjunct and alternative after laser ablation of seizure foci, especially in pediatric patients.
• The researchers have developed software that can merge rsfMRI images with surgical navigation systems so that the technology can be more useful in a clinical setting.
• Boerwinkle et al postulate that performing rsfMRI after laser surgery may help clinicians detect changes in connectivity, determine the location of new seizure foci, and serve as a guide to determine the best course of antiepileptic therapy.

Boerwinkle VL,  Vedantam A, Lam S et al. Connectivity changes after laser ablation: Resting-state fMRI. [Published online ahead of print Sept 28, 2017] Epilepsy Res. https://doi.org/10.1016/j.eplepsyres.2017.09.015

Resting state functional magnetic resonance imaging (rsfMRI) may prove a valuable tool in evaluating patients with epilepsy postoperatively suggests this report from Epilepsy Research.

• Although task-based fMRI is often used to assess patients after surgery, Boerwinkle et al suggest resting state fMRI may be a useful adjunct and alternative after laser ablation of seizure foci, especially in pediatric patients.
• The researchers have developed software that can merge rsfMRI images with surgical navigation systems so that the technology can be more useful in a clinical setting.
• Boerwinkle et al postulate that performing rsfMRI after laser surgery may help clinicians detect changes in connectivity, determine the location of new seizure foci, and serve as a guide to determine the best course of antiepileptic therapy.

Boerwinkle VL,  Vedantam A, Lam S et al. Connectivity changes after laser ablation: Resting-state fMRI. [Published online ahead of print Sept 28, 2017] Epilepsy Res. https://doi.org/10.1016/j.eplepsyres.2017.09.015

Magnetic resonance-guided stereotactic laser amygdalohippocampotomy (SLAH) is emerging as a promising approach for patients with mesial temporal lobe epilepsy according to a recent review of the literature.

• Laser interstitial thermal therapy that is guided by MRI appears to be a safe, effective way to manage patients with mesial temporal lobe epilepsy—when used in properly selected patients.
• SLAH is less invasive than anterior temporal lobectomy and allows the surgeon to immediately destroy target tissue, which is not the case with radiosurgery.
• SLAH also has the advantage of allowing the surgeon to remove larger amounts of tissue than can be done with radiofrequency ablation.
• Bezchlibnyk et al state that MR-guided laser thermal therapy is less likely to cause neuropsychological deficits, when compared to open surgery.

Bezchlibnyk YB, Willie JT, Gross RE. A neurosurgeon`s view: Laser interstitial thermal therapy of mesial temporal lobe structures. [Published online ahead of print Oct 27 2017] Epilepsy Res. https://doi.org/10.1016/j.eplepsyres.2017.10.015

Magnetic resonance-guided stereotactic laser amygdalohippocampotomy (SLAH) is emerging as a promising approach for patients with mesial temporal lobe epilepsy according to a recent review of the literature.

• Laser interstitial thermal therapy that is guided by MRI appears to be a safe, effective way to manage patients with mesial temporal lobe epilepsy—when used in properly selected patients.
• SLAH is less invasive than anterior temporal lobectomy and allows the surgeon to immediately destroy target tissue, which is not the case with radiosurgery.
• SLAH also has the advantage of allowing the surgeon to remove larger amounts of tissue than can be done with radiofrequency ablation.
• Bezchlibnyk et al state that MR-guided laser thermal therapy is less likely to cause neuropsychological deficits, when compared to open surgery.

Bezchlibnyk YB, Willie JT, Gross RE. A neurosurgeon`s view: Laser interstitial thermal therapy of mesial temporal lobe structures. [Published online ahead of print Oct 27 2017] Epilepsy Res. https://doi.org/10.1016/j.eplepsyres.2017.10.015

Magnetic resonance-guided stereotactic laser amygdalohippocampotomy (SLAH) is emerging as a promising approach for patients with mesial temporal lobe epilepsy according to a recent review of the literature.

• Laser interstitial thermal therapy that is guided by MRI appears to be a safe, effective way to manage patients with mesial temporal lobe epilepsy—when used in properly selected patients.
• SLAH is less invasive than anterior temporal lobectomy and allows the surgeon to immediately destroy target tissue, which is not the case with radiosurgery.
• SLAH also has the advantage of allowing the surgeon to remove larger amounts of tissue than can be done with radiofrequency ablation.
• Bezchlibnyk et al state that MR-guided laser thermal therapy is less likely to cause neuropsychological deficits, when compared to open surgery.

Bezchlibnyk YB, Willie JT, Gross RE. A neurosurgeon`s view: Laser interstitial thermal therapy of mesial temporal lobe structures. [Published online ahead of print Oct 27 2017] Epilepsy Res. https://doi.org/10.1016/j.eplepsyres.2017.10.015

Psychogenic nonepileptic seizures (PNES) may be distinguished from other seizure disorders with the help of a patient’s medical history and medication history according to a data analysis involving more than 1300 patients with confirmed diagnoses.

• 1365 adult patient case reports were reviewed, all of which involved video-electroencephalography confirmed diagnoses that were performed at one medical center.

• Co-existing disorders that can help separate PNES from epilepsy included asthma, chronic pain, and migraines.
• Comorbidities associated with epileptic seizures included diabetes and nonmetastatic neoplasm.
• Overall, the number of co-existing conditions and medications rather than any specific condition was more predictive.
• The analysis was also able to differentiate PNES from epileptic seizures with a prospective accuracy of 78%.

Kerr WT, Janio EA, Braesch CT, et al. Identifying psychogenic seizures through comorbidities and medication history. Epilepsia. 2017;58(11):1852-1860.

Psychogenic nonepileptic seizures (PNES) may be distinguished from other seizure disorders with the help of a patient’s medical history and medication history according to a data analysis involving more than 1300 patients with confirmed diagnoses.

• 1365 adult patient case reports were reviewed, all of which involved video-electroencephalography confirmed diagnoses that were performed at one medical center.

• Co-existing disorders that can help separate PNES from epilepsy included asthma, chronic pain, and migraines.
• Comorbidities associated with epileptic seizures included diabetes and nonmetastatic neoplasm.
• Overall, the number of co-existing conditions and medications rather than any specific condition was more predictive.
• The analysis was also able to differentiate PNES from epileptic seizures with a prospective accuracy of 78%.

Kerr WT, Janio EA, Braesch CT, et al. Identifying psychogenic seizures through comorbidities and medication history. Epilepsia. 2017;58(11):1852-1860.

Psychogenic nonepileptic seizures (PNES) may be distinguished from other seizure disorders with the help of a patient’s medical history and medication history according to a data analysis involving more than 1300 patients with confirmed diagnoses.

• 1365 adult patient case reports were reviewed, all of which involved video-electroencephalography confirmed diagnoses that were performed at one medical center.

• Co-existing disorders that can help separate PNES from epilepsy included asthma, chronic pain, and migraines.
• Comorbidities associated with epileptic seizures included diabetes and nonmetastatic neoplasm.
• Overall, the number of co-existing conditions and medications rather than any specific condition was more predictive.
• The analysis was also able to differentiate PNES from epileptic seizures with a prospective accuracy of 78%.

Kerr WT, Janio EA, Braesch CT, et al. Identifying psychogenic seizures through comorbidities and medication history. Epilepsia. 2017;58(11):1852-1860.

Performing surgery on patients with intractable temporal lobe epilepsy (TLE) does not alter the underlying pathology of the disease suggests a recent study that compared functional connectivity in patients’ cognitive functional networks.

• Investigators analyzed 17 patients pre- and postoperatively, looking at a set of cognitive functional networks based on typical cognitive tasks, and comparing these findings to 17 controls.
• Functional networks were significantly different in TLE patient when compared to controls.
• Surgery did not have any significant effect on network connectivity, even though it did eliminate seizures.
• Researchers concluded that long-term intractable TLE causes changes in the brain that are “burned in,” suggesting that delayed surgery may lead to irreversible damage.

Maccotta L, Lopez MA, Adeyemo B, et al. Postoperative seizure freedom does not normalize altered connectivity in temporal lobe epilepsy. Epilepsia. 2017;58(11):1842-1851.

Performing surgery on patients with intractable temporal lobe epilepsy (TLE) does not alter the underlying pathology of the disease suggests a recent study that compared functional connectivity in patients’ cognitive functional networks.

• Investigators analyzed 17 patients pre- and postoperatively, looking at a set of cognitive functional networks based on typical cognitive tasks, and comparing these findings to 17 controls.
• Functional networks were significantly different in TLE patient when compared to controls.
• Surgery did not have any significant effect on network connectivity, even though it did eliminate seizures.
• Researchers concluded that long-term intractable TLE causes changes in the brain that are “burned in,” suggesting that delayed surgery may lead to irreversible damage.

Maccotta L, Lopez MA, Adeyemo B, et al. Postoperative seizure freedom does not normalize altered connectivity in temporal lobe epilepsy. Epilepsia. 2017;58(11):1842-1851.

Performing surgery on patients with intractable temporal lobe epilepsy (TLE) does not alter the underlying pathology of the disease suggests a recent study that compared functional connectivity in patients’ cognitive functional networks.

• Investigators analyzed 17 patients pre- and postoperatively, looking at a set of cognitive functional networks based on typical cognitive tasks, and comparing these findings to 17 controls.
• Functional networks were significantly different in TLE patient when compared to controls.
• Surgery did not have any significant effect on network connectivity, even though it did eliminate seizures.
• Researchers concluded that long-term intractable TLE causes changes in the brain that are “burned in,” suggesting that delayed surgery may lead to irreversible damage.

Maccotta L, Lopez MA, Adeyemo B, et al. Postoperative seizure freedom does not normalize altered connectivity in temporal lobe epilepsy. Epilepsia. 2017;58(11):1842-1851.

Epileptologists and neurologists usually agree on the diagnosis of epilepsy, although agreement amongst epilepsy specialists is better than agreement among neurologists with a special interest in the disease.

• Thirty cases involving 6 children and 24 adults with 21 epileptic seizures and 9 nonepileptic attacks were presented to an international group of 189 experts for evaluation.
• The analysis, referred to as the EpiNet Study, was designed to undertake clinical trials of epilepsy at multiple centers around the world.
• Among the issues that physicians were asked to resolve: How likely did the patient have epilepsy, were the seizures generalized or focal, and what was the likely etiology.
• Overall there was good agreement for the diagnosis of epilepsy (kappa = 0.61) but fair to moderate agreement on the type of seizure and its cause (kappa 0.40 and 0.41).
• Among 53 epileptologists, agreement on the diagnosis was better (kappa = 0.66) than it was for neurologists with a special interest in epilepsy (kappa= 0.58).

Bergin PS, Beghi E, Sadleir LG, et al. Do neurologists around the world agree when diagnosing epilepsy? – Results of an international EpiNet study. Epilepsy Res. 2017;139(1):43-50.

Epileptologists and neurologists usually agree on the diagnosis of epilepsy, although agreement amongst epilepsy specialists is better than agreement among neurologists with a special interest in the disease.

• Thirty cases involving 6 children and 24 adults with 21 epileptic seizures and 9 nonepileptic attacks were presented to an international group of 189 experts for evaluation.
• The analysis, referred to as the EpiNet Study, was designed to undertake clinical trials of epilepsy at multiple centers around the world.
• Among the issues that physicians were asked to resolve: How likely did the patient have epilepsy, were the seizures generalized or focal, and what was the likely etiology.
• Overall there was good agreement for the diagnosis of epilepsy (kappa = 0.61) but fair to moderate agreement on the type of seizure and its cause (kappa 0.40 and 0.41).
• Among 53 epileptologists, agreement on the diagnosis was better (kappa = 0.66) than it was for neurologists with a special interest in epilepsy (kappa= 0.58).

Bergin PS, Beghi E, Sadleir LG, et al. Do neurologists around the world agree when diagnosing epilepsy? – Results of an international EpiNet study. Epilepsy Res. 2017;139(1):43-50.

Epileptologists and neurologists usually agree on the diagnosis of epilepsy, although agreement amongst epilepsy specialists is better than agreement among neurologists with a special interest in the disease.

• Thirty cases involving 6 children and 24 adults with 21 epileptic seizures and 9 nonepileptic attacks were presented to an international group of 189 experts for evaluation.
• The analysis, referred to as the EpiNet Study, was designed to undertake clinical trials of epilepsy at multiple centers around the world.
• Among the issues that physicians were asked to resolve: How likely did the patient have epilepsy, were the seizures generalized or focal, and what was the likely etiology.
• Overall there was good agreement for the diagnosis of epilepsy (kappa = 0.61) but fair to moderate agreement on the type of seizure and its cause (kappa 0.40 and 0.41).
• Among 53 epileptologists, agreement on the diagnosis was better (kappa = 0.66) than it was for neurologists with a special interest in epilepsy (kappa= 0.58).

Bergin PS, Beghi E, Sadleir LG, et al. Do neurologists around the world agree when diagnosing epilepsy? – Results of an international EpiNet study. Epilepsy Res. 2017;139(1):43-50.

Among patients with drug resistant focal epilepsy who underwent surgery, an examination of resected brain specimens revealed hippocampal sclerosis to be the most common histopathological diagnosis in adults. The same analysis, published in the New England Journal of Medicine, found children were most likely to have focal cortical dysplasia.

• The study included analysis of brain specimens from 9523 patients who underwent epilepsy surgery in 36 centers in 12 European countries over 25 years.
• About 3 of 4 patients began having seizures before age 18 years.
• 72.5% of patient had surgery as adults.
• On average, adult patients had endured epilepsy for about 20 years before having surgery while children waited 5.3 years for surgical resection.
• Hippocampal sclerosis was found in 36.4% of patients, including 88.7% of adults.
• Tumors were detected in 23.6%, most of which were ganglioglioma.
• Malformations of cortical development affected 19.8% of patients.

Blumcke I, Spreafico R, Haaker G, et al. Histopathological findings in brain tissue obtained during epilepsy surgery. N Engl J Med. 2017;377(17):1648-1656.

Among patients with drug resistant focal epilepsy who underwent surgery, an examination of resected brain specimens revealed hippocampal sclerosis to be the most common histopathological diagnosis in adults. The same analysis, published in the New England Journal of Medicine, found children were most likely to have focal cortical dysplasia.

• The study included analysis of brain specimens from 9523 patients who underwent epilepsy surgery in 36 centers in 12 European countries over 25 years.
• About 3 of 4 patients began having seizures before age 18 years.
• 72.5% of patient had surgery as adults.
• On average, adult patients had endured epilepsy for about 20 years before having surgery while children waited 5.3 years for surgical resection.
• Hippocampal sclerosis was found in 36.4% of patients, including 88.7% of adults.
• Tumors were detected in 23.6%, most of which were ganglioglioma.
• Malformations of cortical development affected 19.8% of patients.

Blumcke I, Spreafico R, Haaker G, et al. Histopathological findings in brain tissue obtained during epilepsy surgery. N Engl J Med. 2017;377(17):1648-1656.

Among patients with drug resistant focal epilepsy who underwent surgery, an examination of resected brain specimens revealed hippocampal sclerosis to be the most common histopathological diagnosis in adults. The same analysis, published in the New England Journal of Medicine, found children were most likely to have focal cortical dysplasia.

• The study included analysis of brain specimens from 9523 patients who underwent epilepsy surgery in 36 centers in 12 European countries over 25 years.
• About 3 of 4 patients began having seizures before age 18 years.
• 72.5% of patient had surgery as adults.
• On average, adult patients had endured epilepsy for about 20 years before having surgery while children waited 5.3 years for surgical resection.
• Hippocampal sclerosis was found in 36.4% of patients, including 88.7% of adults.
• Tumors were detected in 23.6%, most of which were ganglioglioma.
• Malformations of cortical development affected 19.8% of patients.

Blumcke I, Spreafico R, Haaker G, et al. Histopathological findings in brain tissue obtained during epilepsy surgery. N Engl J Med. 2017;377(17):1648-1656.