Literature Monitor

Neuropsychological testing may help differentiate epileptic seizures from psychogenic nonepileptic seizures (PNES) according to a study that evaluated data from 72 patients with epilepsy and 33 patients with PNES.

• In the past, psychometric testing has been shown to have limited utility in differentiating PNES from epileptic seizures.
• The new research suggests that multivariate assessment using several psychological tests is more effective in making the differential diagnosis.
• Using logistic regression, investigators found that a combination of 7 neuropsychological tests accurately classified about 85% of patients.
• The researchers acknowledged that video-EEG monitoring remains the gold standard for separating PNES from epileptic seizures but suggest that a standardized battery of neuropsychological tests may improve the clinical decision-making process.

Tyson BT, Baker S, Greenacre M, et al. Differentiating epilepsy from psychogenic nonepileptic seizures using neuropsychological test data. Epilepsy Behav. 2018;87:39-45.

Neuropsychological testing may help differentiate epileptic seizures from psychogenic nonepileptic seizures (PNES) according to a study that evaluated data from 72 patients with epilepsy and 33 patients with PNES.

• In the past, psychometric testing has been shown to have limited utility in differentiating PNES from epileptic seizures.
• The new research suggests that multivariate assessment using several psychological tests is more effective in making the differential diagnosis.
• Using logistic regression, investigators found that a combination of 7 neuropsychological tests accurately classified about 85% of patients.
• The researchers acknowledged that video-EEG monitoring remains the gold standard for separating PNES from epileptic seizures but suggest that a standardized battery of neuropsychological tests may improve the clinical decision-making process.

Tyson BT, Baker S, Greenacre M, et al. Differentiating epilepsy from psychogenic nonepileptic seizures using neuropsychological test data. Epilepsy Behav. 2018;87:39-45.

Neuropsychological testing may help differentiate epileptic seizures from psychogenic nonepileptic seizures (PNES) according to a study that evaluated data from 72 patients with epilepsy and 33 patients with PNES.

• In the past, psychometric testing has been shown to have limited utility in differentiating PNES from epileptic seizures.
• The new research suggests that multivariate assessment using several psychological tests is more effective in making the differential diagnosis.
• Using logistic regression, investigators found that a combination of 7 neuropsychological tests accurately classified about 85% of patients.
• The researchers acknowledged that video-EEG monitoring remains the gold standard for separating PNES from epileptic seizures but suggest that a standardized battery of neuropsychological tests may improve the clinical decision-making process.

Tyson BT, Baker S, Greenacre M, et al. Differentiating epilepsy from psychogenic nonepileptic seizures using neuropsychological test data. Epilepsy Behav. 2018;87:39-45.

Health-related quality of life for children with epilepsy appears to be dependent in part on their parents’ ability to cope with the disorder, according to a recent study published in Epilepsy and Behavior.

• The analysis of 108 children and teens with epilepsy also revealed an association between parental helplessness and poorer quality of life.
• As expected, the severity of the child’s epilepsy was linked to poorer quality of life as well.
• These conclusions were based on parents’ responses to the Illness Cognition Questionnaire-Parent (ICQ-P), and the Quality of Life in Childhood Epilepsy questionnaire (QOLCE).
•  ICQ-P evaluates a parent’s ability to cope with disease with the help of constructs of illness cognition.
• QOLCE helps clinicians evaluates the overall functioning of a child as perceived by parents.

McLaughlin RM, Schraegle WA, Nussbaum NL, et al. Parental coping and its role in predicting health-related quality of life in pediatric epilepsy. [Published online ahead of print August 23, 2018] Epilepsy Behav. doi: 10.1016/j.yebeh.2018.08.009

Health-related quality of life for children with epilepsy appears to be dependent in part on their parents’ ability to cope with the disorder, according to a recent study published in Epilepsy and Behavior.

• The analysis of 108 children and teens with epilepsy also revealed an association between parental helplessness and poorer quality of life.
• As expected, the severity of the child’s epilepsy was linked to poorer quality of life as well.
• These conclusions were based on parents’ responses to the Illness Cognition Questionnaire-Parent (ICQ-P), and the Quality of Life in Childhood Epilepsy questionnaire (QOLCE).
•  ICQ-P evaluates a parent’s ability to cope with disease with the help of constructs of illness cognition.
• QOLCE helps clinicians evaluates the overall functioning of a child as perceived by parents.

McLaughlin RM, Schraegle WA, Nussbaum NL, et al. Parental coping and its role in predicting health-related quality of life in pediatric epilepsy. [Published online ahead of print August 23, 2018] Epilepsy Behav. doi: 10.1016/j.yebeh.2018.08.009

Health-related quality of life for children with epilepsy appears to be dependent in part on their parents’ ability to cope with the disorder, according to a recent study published in Epilepsy and Behavior.

• The analysis of 108 children and teens with epilepsy also revealed an association between parental helplessness and poorer quality of life.
• As expected, the severity of the child’s epilepsy was linked to poorer quality of life as well.
• These conclusions were based on parents’ responses to the Illness Cognition Questionnaire-Parent (ICQ-P), and the Quality of Life in Childhood Epilepsy questionnaire (QOLCE).
•  ICQ-P evaluates a parent’s ability to cope with disease with the help of constructs of illness cognition.
• QOLCE helps clinicians evaluates the overall functioning of a child as perceived by parents.

McLaughlin RM, Schraegle WA, Nussbaum NL, et al. Parental coping and its role in predicting health-related quality of life in pediatric epilepsy. [Published online ahead of print August 23, 2018] Epilepsy Behav. doi: 10.1016/j.yebeh.2018.08.009

Among patients who have experienced a traumatic brain injury (TBI), the likelihood of developing post-traumatic epilepsy (PTE) increases with age, the early onset of seizures, and the severity of the brain injury, according to an analysis of insurance claims from 2004 to 2014.

• There were approximately 2.8 million emergency room visits, hospitalizations and deaths from traumatic brain injuries in the US in 2013.
• Early seizures occurred in 0.5% of patients with TBI.
• Over a 9 year period, the incidence of post-traumatic epilepsy (PTE) increased from 1 to 4% in this population.
• Early onset of seizures, older age, and TBI severity increased the likelihood of PTE.
• Prophylactic acetazolamide seemed to reduce the risk of PTE, when compared to patients who had received no anti-epilepsy drugs.

DeGrauw X, Thurman D, Xu L, et al. Epidemiology of traumatic brain injury-associated epilepsy and early use of anti-epilepsy drugs: An analysis of insurance claims data, 2004-2014. [Published online ahead of print July 23, 2018] Epilepsy Res. doi: 10.1016/j.eplepsyres.2018.07.012

Among patients who have experienced a traumatic brain injury (TBI), the likelihood of developing post-traumatic epilepsy (PTE) increases with age, the early onset of seizures, and the severity of the brain injury, according to an analysis of insurance claims from 2004 to 2014.

• There were approximately 2.8 million emergency room visits, hospitalizations and deaths from traumatic brain injuries in the US in 2013.
• Early seizures occurred in 0.5% of patients with TBI.
• Over a 9 year period, the incidence of post-traumatic epilepsy (PTE) increased from 1 to 4% in this population.
• Early onset of seizures, older age, and TBI severity increased the likelihood of PTE.
• Prophylactic acetazolamide seemed to reduce the risk of PTE, when compared to patients who had received no anti-epilepsy drugs.

DeGrauw X, Thurman D, Xu L, et al. Epidemiology of traumatic brain injury-associated epilepsy and early use of anti-epilepsy drugs: An analysis of insurance claims data, 2004-2014. [Published online ahead of print July 23, 2018] Epilepsy Res. doi: 10.1016/j.eplepsyres.2018.07.012

Among patients who have experienced a traumatic brain injury (TBI), the likelihood of developing post-traumatic epilepsy (PTE) increases with age, the early onset of seizures, and the severity of the brain injury, according to an analysis of insurance claims from 2004 to 2014.

• There were approximately 2.8 million emergency room visits, hospitalizations and deaths from traumatic brain injuries in the US in 2013.
• Early seizures occurred in 0.5% of patients with TBI.
• Over a 9 year period, the incidence of post-traumatic epilepsy (PTE) increased from 1 to 4% in this population.
• Early onset of seizures, older age, and TBI severity increased the likelihood of PTE.
• Prophylactic acetazolamide seemed to reduce the risk of PTE, when compared to patients who had received no anti-epilepsy drugs.

DeGrauw X, Thurman D, Xu L, et al. Epidemiology of traumatic brain injury-associated epilepsy and early use of anti-epilepsy drugs: An analysis of insurance claims data, 2004-2014. [Published online ahead of print July 23, 2018] Epilepsy Res. doi: 10.1016/j.eplepsyres.2018.07.012

Conventional medical wisdom insists that it is not possible to predict the onset of seizures with any certainty, but recent research suggests otherwise, according to a review published in Nature Reviews Neurology.

• An influential 2007 review of the medical literature concluded that there was insufficient evidence to foresee the onset of seizures.
• However, an international team of experts summarized several recent advances that suggest seizure prediction may be possible.
• The new review discusses a small experiment in which intracranial EEGs were used prospectively to predict seizures.
• Additional advances include EEG databases, seizure prediction competitions, and a better understanding of the mechanism of action behind seizures.

Kuhlmann L, Lehnertz K, Richardson MP, et al. Seizure prediction - ready for a new era. [Published online ahead of print August 21, 2018] Nat Rev Neurol. doi: 10.1038/s41582-018-0055-2

Conventional medical wisdom insists that it is not possible to predict the onset of seizures with any certainty, but recent research suggests otherwise, according to a review published in Nature Reviews Neurology.

• An influential 2007 review of the medical literature concluded that there was insufficient evidence to foresee the onset of seizures.
• However, an international team of experts summarized several recent advances that suggest seizure prediction may be possible.
• The new review discusses a small experiment in which intracranial EEGs were used prospectively to predict seizures.
• Additional advances include EEG databases, seizure prediction competitions, and a better understanding of the mechanism of action behind seizures.

Kuhlmann L, Lehnertz K, Richardson MP, et al. Seizure prediction - ready for a new era. [Published online ahead of print August 21, 2018] Nat Rev Neurol. doi: 10.1038/s41582-018-0055-2

Conventional medical wisdom insists that it is not possible to predict the onset of seizures with any certainty, but recent research suggests otherwise, according to a review published in Nature Reviews Neurology.

• An influential 2007 review of the medical literature concluded that there was insufficient evidence to foresee the onset of seizures.
• However, an international team of experts summarized several recent advances that suggest seizure prediction may be possible.
• The new review discusses a small experiment in which intracranial EEGs were used prospectively to predict seizures.
• Additional advances include EEG databases, seizure prediction competitions, and a better understanding of the mechanism of action behind seizures.

Kuhlmann L, Lehnertz K, Richardson MP, et al. Seizure prediction - ready for a new era. [Published online ahead of print August 21, 2018] Nat Rev Neurol. doi: 10.1038/s41582-018-0055-2

Understanding the relationship between epilepsy and sleep disorders can help clinicians improve the management of both disorders according to a recent review in Epilepsy Research.

• Sleep apnea, insomnia, restless legs syndrome and parasomnias often occur in patients with epilepsy.
• Researchers from Brigham and Women’s Hospital in Boston and Mayo Clinic reviewed the symptoms and diagnosis of these sleep disorders to help clinicians screen patients with epilepsy at risk for these problems.
• The review also explores treatment options and several case reports that illustrate the consequences of said sleep disorders in those with epilepsy.
• Latreille et al believe that employing the latest diagnostic and treatment approaches to co-morbid sleep disorders may improve patients’ functional status, alertness, quality of life and seizure burden.

Latreille V, St. Louis EK, Pavlova M. Co-morbid sleep disorders and epilepsy: A narrative review and case examples. Epilepsy Res. 2018; 145:185-197. https://doi.org/10.1016/j.eplepsyres.2018.07.005

Understanding the relationship between epilepsy and sleep disorders can help clinicians improve the management of both disorders according to a recent review in Epilepsy Research.

• Sleep apnea, insomnia, restless legs syndrome and parasomnias often occur in patients with epilepsy.
• Researchers from Brigham and Women’s Hospital in Boston and Mayo Clinic reviewed the symptoms and diagnosis of these sleep disorders to help clinicians screen patients with epilepsy at risk for these problems.
• The review also explores treatment options and several case reports that illustrate the consequences of said sleep disorders in those with epilepsy.
• Latreille et al believe that employing the latest diagnostic and treatment approaches to co-morbid sleep disorders may improve patients’ functional status, alertness, quality of life and seizure burden.

Latreille V, St. Louis EK, Pavlova M. Co-morbid sleep disorders and epilepsy: A narrative review and case examples. Epilepsy Res. 2018; 145:185-197. https://doi.org/10.1016/j.eplepsyres.2018.07.005

Understanding the relationship between epilepsy and sleep disorders can help clinicians improve the management of both disorders according to a recent review in Epilepsy Research.

• Sleep apnea, insomnia, restless legs syndrome and parasomnias often occur in patients with epilepsy.
• Researchers from Brigham and Women’s Hospital in Boston and Mayo Clinic reviewed the symptoms and diagnosis of these sleep disorders to help clinicians screen patients with epilepsy at risk for these problems.
• The review also explores treatment options and several case reports that illustrate the consequences of said sleep disorders in those with epilepsy.
• Latreille et al believe that employing the latest diagnostic and treatment approaches to co-morbid sleep disorders may improve patients’ functional status, alertness, quality of life and seizure burden.

Latreille V, St. Louis EK, Pavlova M. Co-morbid sleep disorders and epilepsy: A narrative review and case examples. Epilepsy Res. 2018; 145:185-197. https://doi.org/10.1016/j.eplepsyres.2018.07.005

A self-management program called SMART can help patients with epilepsy reduce the risk of negative health events according to researchers at Case Western Reserve University School of Medicine.

• A 6-month randomized controlled trial of the community-based program included 60 adult patients and was compared to 60 control patients on a waitlist.
• The experiment monitored a variety of events, including seizures, accidents, attempts at self-harm, emergency department visits, and hospitalizations.
• The average patient in this trial was about 41 years old, about 70% were African American, 74% were unemployed.
• Patients who were randomized to the SMART program had fewer negative health events by 6 months compared to controls.
• SMART was also linked to improved scores on the Patient Health Questionnaire (P=.002), the 10 item Quality of Life in Epilepsy Inventory, and the Short Form Health Survey.

Sajatovic  M, Colon-Zimmermann K,  Kahriman M, et al. A 6-month prospective randomized controlled trial of remotely delivered group format epilepsy self-management versus waitlist control for high-risk people with epilepsy. [Published online ahead of print August 10, 2018]. Epilepsia. https://doi.org/10.1111/epi.14527.

A self-management program called SMART can help patients with epilepsy reduce the risk of negative health events according to researchers at Case Western Reserve University School of Medicine.

• A 6-month randomized controlled trial of the community-based program included 60 adult patients and was compared to 60 control patients on a waitlist.
• The experiment monitored a variety of events, including seizures, accidents, attempts at self-harm, emergency department visits, and hospitalizations.
• The average patient in this trial was about 41 years old, about 70% were African American, 74% were unemployed.
• Patients who were randomized to the SMART program had fewer negative health events by 6 months compared to controls.
• SMART was also linked to improved scores on the Patient Health Questionnaire (P=.002), the 10 item Quality of Life in Epilepsy Inventory, and the Short Form Health Survey.

Sajatovic  M, Colon-Zimmermann K,  Kahriman M, et al. A 6-month prospective randomized controlled trial of remotely delivered group format epilepsy self-management versus waitlist control for high-risk people with epilepsy. [Published online ahead of print August 10, 2018]. Epilepsia. https://doi.org/10.1111/epi.14527.

A self-management program called SMART can help patients with epilepsy reduce the risk of negative health events according to researchers at Case Western Reserve University School of Medicine.

• A 6-month randomized controlled trial of the community-based program included 60 adult patients and was compared to 60 control patients on a waitlist.
• The experiment monitored a variety of events, including seizures, accidents, attempts at self-harm, emergency department visits, and hospitalizations.
• The average patient in this trial was about 41 years old, about 70% were African American, 74% were unemployed.
• Patients who were randomized to the SMART program had fewer negative health events by 6 months compared to controls.
• SMART was also linked to improved scores on the Patient Health Questionnaire (P=.002), the 10 item Quality of Life in Epilepsy Inventory, and the Short Form Health Survey.

Sajatovic  M, Colon-Zimmermann K,  Kahriman M, et al. A 6-month prospective randomized controlled trial of remotely delivered group format epilepsy self-management versus waitlist control for high-risk people with epilepsy. [Published online ahead of print August 10, 2018]. Epilepsia. https://doi.org/10.1111/epi.14527.

Patients with psychogenic nonepileptic seizures (PNES) are more likely to suffer from sleep complaints than are patients with epilepsy according to an analysis conducted by clinicians at the Brigham and Women’s Hospital.

• 149 patients with PNES and 82 patients with epilepsy completed the Beck Depression Inventory and the Quality of Life in Epilepsy Inventory-10.
• By analyzing item 16 on the Beck Depression Inventory, which looks at changes in sleep patterns, the investigators found that PNES patients were more likely to report moderate to severe changes in sleep patterns, including waking up too early, sleeping less than usual, and having trouble falling back to sleep.
• The sleep complaints were associated with poorer quality of life, suggesting that they need to be addressed more closely in PNES patients.

Latreille V, Baslet G, Sarkis R, et al. Sleep in psychogenic nonepileptic seizures: time to raise a red flag. Epilepsy Behav. 2018;86:6-8.

Patients with psychogenic nonepileptic seizures (PNES) are more likely to suffer from sleep complaints than are patients with epilepsy according to an analysis conducted by clinicians at the Brigham and Women’s Hospital.

• 149 patients with PNES and 82 patients with epilepsy completed the Beck Depression Inventory and the Quality of Life in Epilepsy Inventory-10.
• By analyzing item 16 on the Beck Depression Inventory, which looks at changes in sleep patterns, the investigators found that PNES patients were more likely to report moderate to severe changes in sleep patterns, including waking up too early, sleeping less than usual, and having trouble falling back to sleep.
• The sleep complaints were associated with poorer quality of life, suggesting that they need to be addressed more closely in PNES patients.

Latreille V, Baslet G, Sarkis R, et al. Sleep in psychogenic nonepileptic seizures: time to raise a red flag. Epilepsy Behav. 2018;86:6-8.

Patients with psychogenic nonepileptic seizures (PNES) are more likely to suffer from sleep complaints than are patients with epilepsy according to an analysis conducted by clinicians at the Brigham and Women’s Hospital.

• 149 patients with PNES and 82 patients with epilepsy completed the Beck Depression Inventory and the Quality of Life in Epilepsy Inventory-10.
• By analyzing item 16 on the Beck Depression Inventory, which looks at changes in sleep patterns, the investigators found that PNES patients were more likely to report moderate to severe changes in sleep patterns, including waking up too early, sleeping less than usual, and having trouble falling back to sleep.
• The sleep complaints were associated with poorer quality of life, suggesting that they need to be addressed more closely in PNES patients.

Latreille V, Baslet G, Sarkis R, et al. Sleep in psychogenic nonepileptic seizures: time to raise a red flag. Epilepsy Behav. 2018;86:6-8.

Although patients with epilepsy can benefit from self-management programs, a recent analysis from the Centers for Disease Control and Prevention has found that competency in self-management skills varies considerably across behavioral domains.

• Data from the Prevention Managing Epilepsy Well Network found that competencies in information and lifestyle management were considerably weaker than competencies in medication, safety, and seizure management.
• The Managing Epilepsy Well database analysis included 436 patients with epilepsy from 5 studies in the United States.
• Self-management behavioral skills were stronger in females and among patients with less education.
• The same skills were weaker in patients with depression and in those who reported a lower quality of life.

Begley C, Shegog R, Liu H, et al. Correlates of epilepsy self-management in MEW Network participants: From the Centers for Disease Control and Prevention Managing Epilepsy Well Network. Epilepsy Behav. 2018;85:243-247.

Although patients with epilepsy can benefit from self-management programs, a recent analysis from the Centers for Disease Control and Prevention has found that competency in self-management skills varies considerably across behavioral domains.

• Data from the Prevention Managing Epilepsy Well Network found that competencies in information and lifestyle management were considerably weaker than competencies in medication, safety, and seizure management.
• The Managing Epilepsy Well database analysis included 436 patients with epilepsy from 5 studies in the United States.
• Self-management behavioral skills were stronger in females and among patients with less education.
• The same skills were weaker in patients with depression and in those who reported a lower quality of life.

Begley C, Shegog R, Liu H, et al. Correlates of epilepsy self-management in MEW Network participants: From the Centers for Disease Control and Prevention Managing Epilepsy Well Network. Epilepsy Behav. 2018;85:243-247.

Although patients with epilepsy can benefit from self-management programs, a recent analysis from the Centers for Disease Control and Prevention has found that competency in self-management skills varies considerably across behavioral domains.

• Data from the Prevention Managing Epilepsy Well Network found that competencies in information and lifestyle management were considerably weaker than competencies in medication, safety, and seizure management.
• The Managing Epilepsy Well database analysis included 436 patients with epilepsy from 5 studies in the United States.
• Self-management behavioral skills were stronger in females and among patients with less education.
• The same skills were weaker in patients with depression and in those who reported a lower quality of life.

Begley C, Shegog R, Liu H, et al. Correlates of epilepsy self-management in MEW Network participants: From the Centers for Disease Control and Prevention Managing Epilepsy Well Network. Epilepsy Behav. 2018;85:243-247.

Astrocyte glutamine synthetase may play an important role in the etiology of mesial temporal lobe epilepsy suggests a recent review in the Journal of Neuroscience Research.

• Investigators from the Yale School of Medicine and Southern Illinois School of Medicine believe that inhibition, loss, or dysfunction of the enzyme in astrocytes may be one of the causative factors responsible for mesial temporal lobe epilepsy.
• Their review of the scientific evidence included a study of astrocyte abnormalities related to aquaporin 4, potassium channel Kir4.1, monocarboxylate transporters MCT1 and MCT2, amino acid transporters EAAT1 and EAA2, and glutamine synthetase.
• Their theory on the role of glutamine synthetase prompted the researchers to suggest that the mechanisms that control the enzyme may be worth consideration as targets for new antiepileptic drugs.

Eid T, Lee TW, Patrylo P, Zaveri HP. Astrocytes and glutamine synthetase in epileptogenesis [published online ahead of print July 18, 2018]. J Neurosci Res. 2018: doi: 10.1002/jnr.24267.   

Astrocyte glutamine synthetase may play an important role in the etiology of mesial temporal lobe epilepsy suggests a recent review in the Journal of Neuroscience Research.

• Investigators from the Yale School of Medicine and Southern Illinois School of Medicine believe that inhibition, loss, or dysfunction of the enzyme in astrocytes may be one of the causative factors responsible for mesial temporal lobe epilepsy.
• Their review of the scientific evidence included a study of astrocyte abnormalities related to aquaporin 4, potassium channel Kir4.1, monocarboxylate transporters MCT1 and MCT2, amino acid transporters EAAT1 and EAA2, and glutamine synthetase.
• Their theory on the role of glutamine synthetase prompted the researchers to suggest that the mechanisms that control the enzyme may be worth consideration as targets for new antiepileptic drugs.

Eid T, Lee TW, Patrylo P, Zaveri HP. Astrocytes and glutamine synthetase in epileptogenesis [published online ahead of print July 18, 2018]. J Neurosci Res. 2018: doi: 10.1002/jnr.24267.   

Astrocyte glutamine synthetase may play an important role in the etiology of mesial temporal lobe epilepsy suggests a recent review in the Journal of Neuroscience Research.

• Investigators from the Yale School of Medicine and Southern Illinois School of Medicine believe that inhibition, loss, or dysfunction of the enzyme in astrocytes may be one of the causative factors responsible for mesial temporal lobe epilepsy.
• Their review of the scientific evidence included a study of astrocyte abnormalities related to aquaporin 4, potassium channel Kir4.1, monocarboxylate transporters MCT1 and MCT2, amino acid transporters EAAT1 and EAA2, and glutamine synthetase.
• Their theory on the role of glutamine synthetase prompted the researchers to suggest that the mechanisms that control the enzyme may be worth consideration as targets for new antiepileptic drugs.

Eid T, Lee TW, Patrylo P, Zaveri HP. Astrocytes and glutamine synthetase in epileptogenesis [published online ahead of print July 18, 2018]. J Neurosci Res. 2018: doi: 10.1002/jnr.24267.   

The presence of interictal ripples in an intracranial EEG may serve as useful biomarkers suggests an analysis of data from 27 children who underwent epilepsy surgery.

• The average rate of onset ripples located inside a resected area of the brain predicted a patient’s outcome (odds ratio, 5.37, P=.02)
• Mean onset ripple rate was associated with the Engel class metric for measuring outcomes.
• Resection of the onset ripple zone was linked to good surgical outcomes (P=.047).
• On the other hand, there was no correlation between spread ripple zone, isolated-ripple zone, or spike zones and outcomes.

Tamilia E, Park EH, Percivati S, et al. Surgical resection of ripple onset predicts outcome in pediatric epilepsy [published online ahead of print July 18, 2018]. Ann Neurol.  2018: doi: 10.1002/ana.25295

The presence of interictal ripples in an intracranial EEG may serve as useful biomarkers suggests an analysis of data from 27 children who underwent epilepsy surgery.

• The average rate of onset ripples located inside a resected area of the brain predicted a patient’s outcome (odds ratio, 5.37, P=.02)
• Mean onset ripple rate was associated with the Engel class metric for measuring outcomes.
• Resection of the onset ripple zone was linked to good surgical outcomes (P=.047).
• On the other hand, there was no correlation between spread ripple zone, isolated-ripple zone, or spike zones and outcomes.

Tamilia E, Park EH, Percivati S, et al. Surgical resection of ripple onset predicts outcome in pediatric epilepsy [published online ahead of print July 18, 2018]. Ann Neurol.  2018: doi: 10.1002/ana.25295

The presence of interictal ripples in an intracranial EEG may serve as useful biomarkers suggests an analysis of data from 27 children who underwent epilepsy surgery.

• The average rate of onset ripples located inside a resected area of the brain predicted a patient’s outcome (odds ratio, 5.37, P=.02)
• Mean onset ripple rate was associated with the Engel class metric for measuring outcomes.
• Resection of the onset ripple zone was linked to good surgical outcomes (P=.047).
• On the other hand, there was no correlation between spread ripple zone, isolated-ripple zone, or spike zones and outcomes.

Tamilia E, Park EH, Percivati S, et al. Surgical resection of ripple onset predicts outcome in pediatric epilepsy [published online ahead of print July 18, 2018]. Ann Neurol.  2018: doi: 10.1002/ana.25295