Literature Monitor

An increase in spike frequency does not help clinicians predict the outcome of surgery in patients with temporal lobe epilepsy. To reach that conclusion, researchers used scalp video monitoring data from patients who had anterior temporal lobe epilepsy to look for interictal epileptiform abnormalities, comparing patients with more than 60 spikes/hour to those with fewer spikes. They found no significant differences in seizure outcomes among patients who had undergone anterior temporal lobectomy.

Ngo L, Sperling MR, Skidmore C, Mintzer S, Nei M. Absolute spike frequency as a predictor of surgical outcome in temporal lobe epilepsy. Seizure. 2017;47:83-86.

An increase in spike frequency does not help clinicians predict the outcome of surgery in patients with temporal lobe epilepsy. To reach that conclusion, researchers used scalp video monitoring data from patients who had anterior temporal lobe epilepsy to look for interictal epileptiform abnormalities, comparing patients with more than 60 spikes/hour to those with fewer spikes. They found no significant differences in seizure outcomes among patients who had undergone anterior temporal lobectomy.

Ngo L, Sperling MR, Skidmore C, Mintzer S, Nei M. Absolute spike frequency as a predictor of surgical outcome in temporal lobe epilepsy. Seizure. 2017;47:83-86.

An increase in spike frequency does not help clinicians predict the outcome of surgery in patients with temporal lobe epilepsy. To reach that conclusion, researchers used scalp video monitoring data from patients who had anterior temporal lobe epilepsy to look for interictal epileptiform abnormalities, comparing patients with more than 60 spikes/hour to those with fewer spikes. They found no significant differences in seizure outcomes among patients who had undergone anterior temporal lobectomy.

Ngo L, Sperling MR, Skidmore C, Mintzer S, Nei M. Absolute spike frequency as a predictor of surgical outcome in temporal lobe epilepsy. Seizure. 2017;47:83-86.

Patients with refractory focal epilepsy seem to have older brains, suggests a study that used whole brain T1-weighted MRI scans to estimate the predicted brain age versus chronological age. On average, the difference between predicted brain age and chronological age in patients with refractory focal epilepsy was 4.5 years greater than the researchers observed in healthy adults. The researchers also found that an earlier onset of refractory focal epilepsy was linked to increased brain age.

Pardoe H, Cole JH, Blackmon K ,et al. Structural brain changes in medically refractory focal epilepsy resemble premature brain aging. Epilepsy Res. 2017;133:28-32.

Patients with refractory focal epilepsy seem to have older brains, suggests a study that used whole brain T1-weighted MRI scans to estimate the predicted brain age versus chronological age. On average, the difference between predicted brain age and chronological age in patients with refractory focal epilepsy was 4.5 years greater than the researchers observed in healthy adults. The researchers also found that an earlier onset of refractory focal epilepsy was linked to increased brain age.

Pardoe H, Cole JH, Blackmon K ,et al. Structural brain changes in medically refractory focal epilepsy resemble premature brain aging. Epilepsy Res. 2017;133:28-32.

Patients with refractory focal epilepsy seem to have older brains, suggests a study that used whole brain T1-weighted MRI scans to estimate the predicted brain age versus chronological age. On average, the difference between predicted brain age and chronological age in patients with refractory focal epilepsy was 4.5 years greater than the researchers observed in healthy adults. The researchers also found that an earlier onset of refractory focal epilepsy was linked to increased brain age.

Pardoe H, Cole JH, Blackmon K ,et al. Structural brain changes in medically refractory focal epilepsy resemble premature brain aging. Epilepsy Res. 2017;133:28-32.

About 5% of patients who have had an ischemic stroke develop seizures, according to an analysis of data from the Framingham Heart Study. When researchers looked at the incidence of strokes between 1982 and 2003 and followed patients for 20 years, they found strokes had occurred in 469 patients, 25 of whom had experienced a seizure (5.3%). A third of these seizures happened within the first 24 hours of the stroke onset; half occurred within 30 days.

Stefanidou M, Das RR, Beiser AS, et al. Incidence of seizures following initial ischemic stroke in a community-based cohort: The Framingham Heart Study. Seizure. 2017;47:105-110.

About 5% of patients who have had an ischemic stroke develop seizures, according to an analysis of data from the Framingham Heart Study. When researchers looked at the incidence of strokes between 1982 and 2003 and followed patients for 20 years, they found strokes had occurred in 469 patients, 25 of whom had experienced a seizure (5.3%). A third of these seizures happened within the first 24 hours of the stroke onset; half occurred within 30 days.

Stefanidou M, Das RR, Beiser AS, et al. Incidence of seizures following initial ischemic stroke in a community-based cohort: The Framingham Heart Study. Seizure. 2017;47:105-110.

About 5% of patients who have had an ischemic stroke develop seizures, according to an analysis of data from the Framingham Heart Study. When researchers looked at the incidence of strokes between 1982 and 2003 and followed patients for 20 years, they found strokes had occurred in 469 patients, 25 of whom had experienced a seizure (5.3%). A third of these seizures happened within the first 24 hours of the stroke onset; half occurred within 30 days.

Stefanidou M, Das RR, Beiser AS, et al. Incidence of seizures following initial ischemic stroke in a community-based cohort: The Framingham Heart Study. Seizure. 2017;47:105-110.

Bilateral deep brain stimulation of the anterior nucleus of the thalamus can help control seizures, but there are reports that suggest it also causes memory problems and depression. When Tröster et al analyzed data from a randomized trial (SANTE), they did find subjective evidence of both adverse events but were unable to confirm the presence of these problems with objective neurobehavioral measures. Nonetheless, they recommend that patients undergoing deep brain stimulation be monitored and undergo neuropsychological assessment for depression and memory problems.

Tröster AI, Meador KJ, Irwin CP, Fisher RS. Memory and mood outcomes after anterior thalamic stimulation for refractory partial epilepsy. Seizure. 2017;45:133-141.

Bilateral deep brain stimulation of the anterior nucleus of the thalamus can help control seizures, but there are reports that suggest it also causes memory problems and depression. When Tröster et al analyzed data from a randomized trial (SANTE), they did find subjective evidence of both adverse events but were unable to confirm the presence of these problems with objective neurobehavioral measures. Nonetheless, they recommend that patients undergoing deep brain stimulation be monitored and undergo neuropsychological assessment for depression and memory problems.

Tröster AI, Meador KJ, Irwin CP, Fisher RS. Memory and mood outcomes after anterior thalamic stimulation for refractory partial epilepsy. Seizure. 2017;45:133-141.

Bilateral deep brain stimulation of the anterior nucleus of the thalamus can help control seizures, but there are reports that suggest it also causes memory problems and depression. When Tröster et al analyzed data from a randomized trial (SANTE), they did find subjective evidence of both adverse events but were unable to confirm the presence of these problems with objective neurobehavioral measures. Nonetheless, they recommend that patients undergoing deep brain stimulation be monitored and undergo neuropsychological assessment for depression and memory problems.

Tröster AI, Meador KJ, Irwin CP, Fisher RS. Memory and mood outcomes after anterior thalamic stimulation for refractory partial epilepsy. Seizure. 2017;45:133-141.

Patients vary widely in their response to cortical electric stimulation (CES). A retrospective analysis of 92 patients with medically intractable epilepsy who underwent CES was unable to detect any clinical or demographic factors that would explain the varied response to the procedure. Corley et al also found striking variability and a wide range of motor, sensory, and speech response thresholds between patients and within the different regions of the brain in the same patient.

Corley JA, Nazari P, Rossi VJ, et al. Cortical stimulation parameters for functional mapping. Seizure. 2017;45:36-71.

Patients vary widely in their response to cortical electric stimulation (CES). A retrospective analysis of 92 patients with medically intractable epilepsy who underwent CES was unable to detect any clinical or demographic factors that would explain the varied response to the procedure. Corley et al also found striking variability and a wide range of motor, sensory, and speech response thresholds between patients and within the different regions of the brain in the same patient.

Corley JA, Nazari P, Rossi VJ, et al. Cortical stimulation parameters for functional mapping. Seizure. 2017;45:36-71.

Patients vary widely in their response to cortical electric stimulation (CES). A retrospective analysis of 92 patients with medically intractable epilepsy who underwent CES was unable to detect any clinical or demographic factors that would explain the varied response to the procedure. Corley et al also found striking variability and a wide range of motor, sensory, and speech response thresholds between patients and within the different regions of the brain in the same patient.

Corley JA, Nazari P, Rossi VJ, et al. Cortical stimulation parameters for functional mapping. Seizure. 2017;45:36-71.

Dementia, poor mental status during electroencephalogram (EEG), chronic focal abnormalities on neuroimaging, cardiac arrest, and chronic obstructive pulmonary disease (COPD) were independently associated with increased in-hospital mortality in patients with generalized periodic discharges (GPDs), according to an analysis of 113 patients at 3 hospitals. To determine the prognostic significance of GPDs observed during EEGs, Jadeja et al reviewed EEG tracings of the patients, of whom there were 60 inpatient deaths (53.1%).

Jadeja N, Zarnegar R, Legatt AD. Clinical outcomes in patients with generalized periodic discharges. Seizure. 2017; 45:114-118.

Dementia, poor mental status during electroencephalogram (EEG), chronic focal abnormalities on neuroimaging, cardiac arrest, and chronic obstructive pulmonary disease (COPD) were independently associated with increased in-hospital mortality in patients with generalized periodic discharges (GPDs), according to an analysis of 113 patients at 3 hospitals. To determine the prognostic significance of GPDs observed during EEGs, Jadeja et al reviewed EEG tracings of the patients, of whom there were 60 inpatient deaths (53.1%).

Jadeja N, Zarnegar R, Legatt AD. Clinical outcomes in patients with generalized periodic discharges. Seizure. 2017; 45:114-118.

Dementia, poor mental status during electroencephalogram (EEG), chronic focal abnormalities on neuroimaging, cardiac arrest, and chronic obstructive pulmonary disease (COPD) were independently associated with increased in-hospital mortality in patients with generalized periodic discharges (GPDs), according to an analysis of 113 patients at 3 hospitals. To determine the prognostic significance of GPDs observed during EEGs, Jadeja et al reviewed EEG tracings of the patients, of whom there were 60 inpatient deaths (53.1%).

Jadeja N, Zarnegar R, Legatt AD. Clinical outcomes in patients with generalized periodic discharges. Seizure. 2017; 45:114-118.

Epilepsy-related research studies that rely on medical claims data have significant limitations that can be improved by choosing better selection algorithms. When Moura et al performed a medical chart review of 1377 patients, they found that the best algorithms to identify people with epilepsy included diagnostic and prescription drug data, as well as current antiepileptic drug usage, the location of the site that patients received medical care, and the specialty of the physician providing that care.

Moura LM, Price M, Cole AJ, et al. Accuracy of claims-based algorithms for epilepsy research: Revealing the unseen performance of claims-based studies. Epilepsia. 2017; Feb 15. doi: 10.1111/epi.13691. [Epub ahead of print]

Epilepsy-related research studies that rely on medical claims data have significant limitations that can be improved by choosing better selection algorithms. When Moura et al performed a medical chart review of 1377 patients, they found that the best algorithms to identify people with epilepsy included diagnostic and prescription drug data, as well as current antiepileptic drug usage, the location of the site that patients received medical care, and the specialty of the physician providing that care.

Moura LM, Price M, Cole AJ, et al. Accuracy of claims-based algorithms for epilepsy research: Revealing the unseen performance of claims-based studies. Epilepsia. 2017; Feb 15. doi: 10.1111/epi.13691. [Epub ahead of print]

Epilepsy-related research studies that rely on medical claims data have significant limitations that can be improved by choosing better selection algorithms. When Moura et al performed a medical chart review of 1377 patients, they found that the best algorithms to identify people with epilepsy included diagnostic and prescription drug data, as well as current antiepileptic drug usage, the location of the site that patients received medical care, and the specialty of the physician providing that care.

Moura LM, Price M, Cole AJ, et al. Accuracy of claims-based algorithms for epilepsy research: Revealing the unseen performance of claims-based studies. Epilepsia. 2017; Feb 15. doi: 10.1111/epi.13691. [Epub ahead of print]

People with epilepsy vary widely in their self-management skills according to a survey of 172 patients with the disease. Using the Epilepsy Self-Management Scale, investigators found that respondents scored better on medication, seizure, and safety management when compared to lifestyle and information management (P<.01). The differences have implications for how patients are counseled and educated, according to Ramon Edmundo D. Bautista of the University of Florida Health Sciences Center.

Bautista RE. Understanding the self-management skills of persons with epilepsy. Epilepsy Behav. 2017;69:7-11.

People with epilepsy vary widely in their self-management skills according to a survey of 172 patients with the disease. Using the Epilepsy Self-Management Scale, investigators found that respondents scored better on medication, seizure, and safety management when compared to lifestyle and information management (P<.01). The differences have implications for how patients are counseled and educated, according to Ramon Edmundo D. Bautista of the University of Florida Health Sciences Center.

Bautista RE. Understanding the self-management skills of persons with epilepsy. Epilepsy Behav. 2017;69:7-11.

People with epilepsy vary widely in their self-management skills according to a survey of 172 patients with the disease. Using the Epilepsy Self-Management Scale, investigators found that respondents scored better on medication, seizure, and safety management when compared to lifestyle and information management (P<.01). The differences have implications for how patients are counseled and educated, according to Ramon Edmundo D. Bautista of the University of Florida Health Sciences Center.

Bautista RE. Understanding the self-management skills of persons with epilepsy. Epilepsy Behav. 2017;69:7-11.

Epilepsy-related deaths increased by 47% from 2005 to 2014, according to a new analysis of data from the Centers for Disease Control and Prevention (CDC). Greenlund et al report that age-adjusted epilepsy mortality rates per 100,000 jumped from 0.58 to 0.85 in this time span. The increase warrants more attention be paid to preventive measures and the need for heightened attention and monitoring of epilepsy-related deaths, according to the researchers. Among non-Hispanic Blacks, epilepsy-related deaths were higher than in non-Hispanic Whites in 2014 (1.42/100,000 compared to 0.86/100,000). The report also found that males were more likely to die (1.01/100,000 vs 0.74/100,000).  

Greenlund SF, Croft JB, Kibau R. Epilepsy by the Numbers. Epilepsy Behav. 2017; 69:28-30.

Epilepsy-related deaths increased by 47% from 2005 to 2014, according to a new analysis of data from the Centers for Disease Control and Prevention (CDC). Greenlund et al report that age-adjusted epilepsy mortality rates per 100,000 jumped from 0.58 to 0.85 in this time span. The increase warrants more attention be paid to preventive measures and the need for heightened attention and monitoring of epilepsy-related deaths, according to the researchers. Among non-Hispanic Blacks, epilepsy-related deaths were higher than in non-Hispanic Whites in 2014 (1.42/100,000 compared to 0.86/100,000). The report also found that males were more likely to die (1.01/100,000 vs 0.74/100,000).  

Greenlund SF, Croft JB, Kibau R. Epilepsy by the Numbers. Epilepsy Behav. 2017; 69:28-30.

Epilepsy-related deaths increased by 47% from 2005 to 2014, according to a new analysis of data from the Centers for Disease Control and Prevention (CDC). Greenlund et al report that age-adjusted epilepsy mortality rates per 100,000 jumped from 0.58 to 0.85 in this time span. The increase warrants more attention be paid to preventive measures and the need for heightened attention and monitoring of epilepsy-related deaths, according to the researchers. Among non-Hispanic Blacks, epilepsy-related deaths were higher than in non-Hispanic Whites in 2014 (1.42/100,000 compared to 0.86/100,000). The report also found that males were more likely to die (1.01/100,000 vs 0.74/100,000).  

Greenlund SF, Croft JB, Kibau R. Epilepsy by the Numbers. Epilepsy Behav. 2017; 69:28-30.

Clinicians would be wise to recommend stress reduction techniques to patients with epilepsy, despite the fact that randomized controlled trials have yet to demonstrate that stress management reduces the frequency of seizures. One survey has suggested that most patients who report stress-triggered seizures use some sort of stress reduction methods and most say they are effective. McKee et al also point out that studies have found that stress management does improve quality of life in this patient population. The investigators also recommended that stressed patients with epilepsy should be screened for depression, anxiety, and other treatable mood disorders since they are more common in these patients.

McKee HR, Privitera MD. Stress as a seizure precipitant: Identification, associated factors, and treatment options. Seizure. 2017; 44:21-26.

Clinicians would be wise to recommend stress reduction techniques to patients with epilepsy, despite the fact that randomized controlled trials have yet to demonstrate that stress management reduces the frequency of seizures. One survey has suggested that most patients who report stress-triggered seizures use some sort of stress reduction methods and most say they are effective. McKee et al also point out that studies have found that stress management does improve quality of life in this patient population. The investigators also recommended that stressed patients with epilepsy should be screened for depression, anxiety, and other treatable mood disorders since they are more common in these patients.

McKee HR, Privitera MD. Stress as a seizure precipitant: Identification, associated factors, and treatment options. Seizure. 2017; 44:21-26.

Clinicians would be wise to recommend stress reduction techniques to patients with epilepsy, despite the fact that randomized controlled trials have yet to demonstrate that stress management reduces the frequency of seizures. One survey has suggested that most patients who report stress-triggered seizures use some sort of stress reduction methods and most say they are effective. McKee et al also point out that studies have found that stress management does improve quality of life in this patient population. The investigators also recommended that stressed patients with epilepsy should be screened for depression, anxiety, and other treatable mood disorders since they are more common in these patients.

McKee HR, Privitera MD. Stress as a seizure precipitant: Identification, associated factors, and treatment options. Seizure. 2017; 44:21-26.