2024
Combined neuromodulation and resection for functional cortex epilepsy: a case series.
Merenzon M, Sivaraju A, Herlopian A, Gerrard J, Quraishi I, Hirsch L, Spencer D, Damisah E. Combined neuromodulation and resection for functional cortex epilepsy: a case series. Journal Of Neurosurgery 2024, 141: 1527-1535. PMID: 38848588, DOI: 10.3171/2024.3.jns24122.Peer-Reviewed Original ResearchMedically Refractory EpilepsySeizure onset zoneFunctional cortexSeizure outcomeRefractory epilepsyMonths of follow-up dataMaximal safe resectionMedian Follow-UpTreated with resectionImprove seizure outcomeFocal neuromodulationFollow-up dataPreservation of functionRetrospective analysis of individualsSafe resectionPartial resectionMedian intervalCase seriesPreoperative assessmentSurgical interventionRNS deviceNeurological deficitsNo significant changesResectionRetrospective analysisSingle-Cell Transcriptomic Analyses of Brain Parenchyma in Patients With New-Onset Refractory Status Epilepticus (NORSE)
Hanin A, Zhang L, Huttner A, Plu I, Mathon B, Bielle F, Navarro V, Hirsch L, Hafler D. Single-Cell Transcriptomic Analyses of Brain Parenchyma in Patients With New-Onset Refractory Status Epilepticus (NORSE). Neurology Neuroimmunology & Neuroinflammation 2024, 11: e200259. PMID: 38810181, PMCID: PMC11139018, DOI: 10.1212/nxi.0000000000200259.Peer-Reviewed Original ResearchConceptsNew-onset refractory status epilepticusTemporal lobe epilepsyGABAergic neuronsExcitatory neuronsInfiltrating MacrophagesProportion of GABAergic neuronsChronic temporal lobe epilepsyRefractory status epilepticusInhibitory GABAergic neuronsSingle-cell transcriptome analysisDecreased expression of genesDegree of demyelinationImmune disturbancesNeuronal excitabilityImmune dysregulationNew-onsetStatus epilepticusPoor outcomeRefractory epilepsyHealthy childrenMicroglial reactivitySingle-nucleus RNA sequencingNLRP3 inflammasome activationInflammatory responseLobe epilepsySystematic 1 Hz direct electrical stimulation for seizure induction: A reliable method for localizing seizure onset zone and predicting seizure freedom
Sivaraju A, Quraishi I, Collins E, McGrath H, Ramos A, Turk-Browne N, Zaveri H, Damisah E, Spencer D, Hirsch L. Systematic 1 Hz direct electrical stimulation for seizure induction: A reliable method for localizing seizure onset zone and predicting seizure freedom. Brain Stimulation 2024, 17: 339-345. PMID: 38490472, DOI: 10.1016/j.brs.2024.03.011.Peer-Reviewed Original ResearchSeizure inductionSeizure onset zoneSurgical outcomesHabitual seizuresOnset zonePredicting seizure freedomExcellent surgical outcomesProspective cohort studyMann-Whitney testConsecutive patientsFisher's exactSeizure freedomRefractory epilepsyCohort studyPost-surgeryInsular regionsMann-WhitneyPatientsIntracranial EEGSeizuresLocalizing seizure onset zonesStimulationElectrical stimulationMedial temporal regionsTemporal regions
2022
Factors Predicting Outcome After Intracranial EEG Evaluation in Patients With Medically Refractory Epilepsy
Sivaraju A, Hirsch L, Gaspard N, Farooque P, Gerrard J, Xu Y, Deng Y, Damisah E, Blumenfeld H, Spencer DD. Factors Predicting Outcome After Intracranial EEG Evaluation in Patients With Medically Refractory Epilepsy. Neurology 2022, 99: e1-e10. PMID: 35508395, PMCID: PMC9259091, DOI: 10.1212/wnl.0000000000200569.Peer-Reviewed Original ResearchConceptsTemporal lobe onsetSeizure freedomResective surgeryIndependent predictorsLesional MRIUnfavorable predictorRefractory epilepsyContinued medical treatmentEpilepsy surgical evaluationFactors Predicting OutcomeIntracranial EEG evaluationNonlesional extratemporal epilepsySubsequent seizure freedomSustained seizure freedomThorough presurgical evaluationSeizure-free outcomeClass II evidenceMedically Refractory EpilepsyRetrospective chart reviewKaplan-Meier curvesSelect clinical scenariosMultivariable regression analysisBest multivariable modelIntracranial EEGSeizure onset localizationElectroencephalographic changes in purified pharmaceutical cannabidiol therapy
Herlopian A, Barnett JR, Nascimento FA, Lee H, Thiele EA. Electroencephalographic changes in purified pharmaceutical cannabidiol therapy. Epilepsy & Behavior 2022, 128: 108558. PMID: 35078115, DOI: 10.1016/j.yebeh.2022.108558.Peer-Reviewed Original ResearchConceptsInterictal epileptiform dischargesElectroencephalographic changesCBD treatmentIctal findingsSleep architectureEEG changesInvestigational New Drug programPredominant seizure typeNew drug programPre-treatment EEGYears of ageSubjective cognitive improvementElectrographic findingsElectrographic improvementRefractory epilepsySeizure typesClinical outcomesElectrographic changesEpileptiform dischargesPatientsCognitive improvementDrug programsSubstantial associationEEG studiesTreatment
2021
Management of patients with medically intractable epilepsy and anterior temporal lobe encephaloceles.
Sandhu MRS, Mandel M, McGrath H, Lamsam L, Farooque P, Bronen RA, Spencer DD, Damisah EC. Management of patients with medically intractable epilepsy and anterior temporal lobe encephaloceles. Journal Of Neurosurgery 2021, 136: 709-716. PMID: 34507290, DOI: 10.3171/2021.3.jns21133.Peer-Reviewed Original ResearchConceptsTemporal lobe encephaloceleIdiopathic intracranial hypertensionRefractory epilepsyEEG findingsSigns of IIHIntractable temporal lobe epilepsyResective epilepsy surgeryManagement of patientsTemporal lobe epilepsyScalp EEG findingsSignificant neuropsychological deficitsRadiological findingsIntracranial hypertensionPreoperative evaluationEpileptogenic lesionsSurgical managementEpilepsy surgeryLobe epilepsySurgical outcomesIntractable epilepsySingle institutionSurgical dataEpileptogenic focusMedical recordsWorse outcomesIncreased branched‐chain amino acids at baseline and hours before a spontaneous seizure in the human epileptic brain
Ong C, Damisah EC, Gruenbaum SE, Dhaher R, Deng Y, Sandhu MRS, Zaveri HP, Spencer DD, Eid T. Increased branched‐chain amino acids at baseline and hours before a spontaneous seizure in the human epileptic brain. Epilepsia 2021, 62: e88-e97. PMID: 33949690, PMCID: PMC11259155, DOI: 10.1111/epi.16920.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAmino Acids, Branched-ChainBrain ChemistryChildChild, PreschoolChromatography, High Pressure LiquidDrug Resistant EpilepsyElectrocorticographyElectroencephalographyEpilepsies, PartialExtracellular SpaceFemaleGlutamic AcidHumansIsoleucineMaleMicrodialysisMiddle AgedSeizuresTandem Mass SpectrometryYoung AdultConceptsSpontaneous seizuresDrug-resistant focal epilepsyExtracellular brain glutamateHuman epileptic brainBranched-chain amino acidsBranched chain amino acids valineRefractory epilepsyBrain microdialysisGlutamatergic neurotransmissionFocal epilepsySeizure onsetBrain glutamateEpileptic brainHuman patientsSeizuresBrain regionsDialysis samplesMammalian targetEpilepsyLiquid chromatography-tandem mass spectrometryBaselineBCAAIntracranial electroencephalographyChromatography-tandem mass spectrometryPatientsDepth Electrode Guided Anterior Insulectomy: 2-Dimensional Operative Video
Mandel M, Lamsam L, Farooque P, Spencer D, Damisah E. Depth Electrode Guided Anterior Insulectomy: 2-Dimensional Operative Video. Operative Neurosurgery 2021, 21: e121-e121. PMID: 33885821, PMCID: PMC8493659, DOI: 10.1093/ons/opab112.Peer-Reviewed Original ResearchConceptsDepth electrodesOperative VideoEntire right hemisphereRight-handed womanIntracranial EEG studiesIctal vocalizationInsular surgeryNeurological deficitsPreoperative evaluationRefractory epilepsyEpileptiform activityEpileptogenic areaEpileptic zoneInsular resectionFrontal operculumNoninvasive resultsPatientsAnterior borderOptimal outcomesRight hemisphereInsulectomyEEG studiesSurgeryIndescribable feelingNeuronavigation
2020
Thalamic Stimulation Improves Postictal Cortical Arousal and Behavior
Xu J, Galardi MM, Pok B, Patel KK, Zhao CW, Andrews JP, Singla S, McCafferty CP, Feng L, Musonza ET, Kundishora AJ, Gummadavelli A, Gerrard JL, Laubach M, Schiff ND, Blumenfeld H. Thalamic Stimulation Improves Postictal Cortical Arousal and Behavior. Journal Of Neuroscience 2020, 40: 7343-7354. PMID: 32826310, PMCID: PMC7534908, DOI: 10.1523/jneurosci.1370-20.2020.Peer-Reviewed Original ResearchConceptsDeep brain stimulationCentral lateral nucleusBilateral deep brain stimulationCortical slow-wave activityPostictal stateSlow wave activityPostictal periodImpaired consciousnessRefractory epilepsyLateral nucleusBrain stimulationNatural slow-wave sleepModest behavioral improvementCortical slow wavesNovel therapeutic strategiesSlow-wave sleepDisorders of consciousnessBehavioral tasksDepressed consciousnessDBS treatmentThalamic stimulationElectrical hippocampal stimulationFemale ratsHigh success rateRat modelResponsive Neurostimulation
Gummadavelli A, Quraishi I, Gerrard J. Responsive Neurostimulation. 2020, 145-173. DOI: 10.1007/978-3-030-34906-6_12.ChaptersResponsive neurostimulationRefractory epilepsyIntracranial EEG activityUse of neurostimulationSurgical implantation techniqueChronic electrophysiological recordingsSeizure progressionTherapeutic approachesNeurological disordersElectrophysiological recordingsNeurostimulationDisease statesEEG activityNetwork synchronyEpilepsyImplantation techniquePathologyMesial temporal resection following long‐term ambulatory intracranial EEG monitoring with a direct brain‐responsive neurostimulation system
Hirsch LJ, Mirro EA, Salanova V, Witt TC, Drees CN, Brown M, Lee RW, Sadler TL, Felton EA, Rutecki P, Shin HW, Hadar E, Hegde M, Rao VR, Mnatsakanyan L, Madhavan DS, Zakaria TJ, Liu AA, Heck CN, Greenwood JE, Bigelow JK, Nair DR, Alexopoulos AV, Mackow M, Edwards JC, Sotudeh N, Kuzniecky RI, Gwinn RP, Doherty MJ, Geller EB, Morrell MJ. Mesial temporal resection following long‐term ambulatory intracranial EEG monitoring with a direct brain‐responsive neurostimulation system. Epilepsia 2020, 61: 408-420. PMID: 32072621, PMCID: PMC7154711, DOI: 10.1111/epi.16442.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnterior Temporal LobectomyDrug Resistant EpilepsyElectric Stimulation TherapyElectrocorticographyEpilepsy, Temporal LobeFemaleHumansImplantable NeurostimulatorsMaleMiddle AgedMonitoring, AmbulatoryNeurosurgical ProceduresRetrospective StudiesTemporal LobeTreatment OutcomeYoung AdultConceptsMTL resectionElectrographic seizuresTemporal lobe seizure onsetClinical seizure reductionMesial temporal resectionIntracranial EEG monitoringRNS SystemBitemporal epilepsySeizure reductionSeizure outcomeTemporal resectionPrimary outcomeRefractory epilepsyAdditional patientsEpilepsy centersUnilateral onsetBilateral onsetIcEEG recordingsSeizure onsetMTL epilepsyMedian reductionResectionPatientsEEG monitoringIcEEG data
2019
Challenges During Epilepsy Surgery in Pediatric Patients
Field R, Rosenbaum A, Kain Z. Challenges During Epilepsy Surgery in Pediatric Patients. 2019, 407-411. DOI: 10.1007/978-3-030-17410-1_63.Peer-Reviewed Original ResearchRefractory epilepsyIntractable seizuresPediatric refractory epilepsyPermanent brain injuryAnti-epileptic medicationsEarly surgical interventionSeverity of seizuresAnti-epileptic drugsCertain epileptic syndromesQuality of lifeBetter patient complianceEpilepsy presentsPediatric patientsEpileptic syndromesEpilepsy surgeryPoor prognosisSurgical interventionPharmacological treatmentCortical malformationsVascular abnormalitiesTherapeutic rangeBrain injuryFocal epilepsyCognitive dysfunctionCommon causeBranched-Chain Amino Acids and Seizures: A Systematic Review of the Literature
Gruenbaum SE, Chen EC, Sandhu MRS, Deshpande K, Dhaher R, Hersey D, Eid T. Branched-Chain Amino Acids and Seizures: A Systematic Review of the Literature. CNS Drugs 2019, 33: 755-770. PMID: 31313139, DOI: 10.1007/s40263-019-00650-2.Peer-Reviewed Original ResearchConceptsGenetic absence epilepsyBCAA supplementationAbsence epilepsyAnimal modelsBranched-chain amino acid supplementationSystematic reviewLong-term BCAA supplementationEpilepsy experience seizuresAnti-seizure effectsEffect of BCAAMost animal modelsPossible underlying mechanismsAmino acid supplementationChain amino acidsBCAA administrationBCAA mixtureRefractory epilepsyNeuron lossSeizure disorderAntiepileptic drugsSeizure modelSeizure propagationCochrane LibrarySeizure activityKainic acidEffects of Branched-Chain Amino Acid Supplementation on Spontaneous Seizures and Neuronal Viability in a Model of Mesial Temporal Lobe Epilepsy
Gruenbaum SE, Dhaher R, Rapuano A, Zaveri HP, Tang A, de Lanerolle N, Eid T. Effects of Branched-Chain Amino Acid Supplementation on Spontaneous Seizures and Neuronal Viability in a Model of Mesial Temporal Lobe Epilepsy. Journal Of Neurosurgical Anesthesiology 2019, 31: 247-256. PMID: 29620688, PMCID: PMC6170745, DOI: 10.1097/ana.0000000000000499.Peer-Reviewed Original ResearchConceptsMesial temporal lobe epilepsyTemporal lobe epilepsyLobe epilepsySpontaneous seizuresNeuron lossSeizure propagationBranched-chain amino acid supplementationChronic oral supplementationSpontaneous recurrent seizuresEffect of BCAAPotential novel treatmentBranched-chain amino acid leucineAmino acid supplementationAcute seizuresBCAA supplementationChronic seizuresConvulsive seizuresOral supplementationRecurrent seizuresRefractory epilepsyDentate hilusNeuronal viabilityAcid supplementationImmunohistochemical analysisNovel treatmentsSyncope after administration of epidural analgesia in an obstetric patient with a vagus nerve stimulator
Tang JE, Hyman JB. Syncope after administration of epidural analgesia in an obstetric patient with a vagus nerve stimulator. International Journal Of Obstetric Anesthesia 2019, 38: 134-137. PMID: 30765185, DOI: 10.1016/j.ijoa.2018.12.011.Peer-Reviewed Case Reports and Technical NotesConceptsVagus nerve stimulationEpidural analgesiaObstetric patientsNerve stimulationEpisodes of syncopeVagus nerve stimulatorAdjunctive therapyRare complicationRefractory epilepsyCase reportNerve stimulatorVNS deviceCardiac arrhythmiasAnalgesiaSyncopePatientsStimulationArrhythmiasFirst reportReportAsystoleComplicationsEpilepsyTherapyAdministration
2018
Expanding Brain–Computer Interfaces for Controlling Epilepsy Networks: Novel Thalamic Responsive Neurostimulation in Refractory Epilepsy
Gummadavelli A, Zaveri HP, Spencer DD, Gerrard JL. Expanding Brain–Computer Interfaces for Controlling Epilepsy Networks: Novel Thalamic Responsive Neurostimulation in Refractory Epilepsy. Frontiers In Neuroscience 2018, 12: 474. PMID: 30108472, PMCID: PMC6079216, DOI: 10.3389/fnins.2018.00474.Peer-Reviewed Original ResearchResponsive neurostimulationRefractory epilepsyThalamic nucleiComplex network disorderIntralaminar thalamic nucleiSubcortical brain structuresCortical onsetSeizure controlGeneralized epilepsySeizure networkSeizure onsetEpilepsy networkNeuromodulatory techniquesEpilepsyExcitatory eventsClinical treatmentBrain regionsBrain structuresSeizuresPotential targetIntracranial electroencephalographyNetwork disorderPatientsFeasible targetNeurostimulation
2017
Brief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Noncritically Ill Adults
Yoo JY, Marcuse LV, Fields MC, Rosengard JL, Traversa MV, Gaspard N, Hirsch LJ. Brief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Noncritically Ill Adults. Journal Of Clinical Neurophysiology 2017, 34: 222-229. PMID: 28463933, DOI: 10.1097/wnp.0000000000000357.Peer-Reviewed Original ResearchConceptsIctal rhythmic dischargesIll adultsRhythmic dischargesSeizure onset areaAdult patientsElectrographic characteristicsStatus epilepticusAcute findingsIll patientsRefractory epilepsyClinical historySeizure onsetClinical significanceEpileptiform dischargesAmbulatory settingPatientsBenign patternControl groupEpilepsyRhythmic activityOnset areaAlpha activityAdultsBrief runsEEG recordings
2016
Loss of SYNJ1 dual phosphatase activity leads to early onset refractory seizures and progressive neurological decline
Hardies K, Cai Y, Jardel C, Jansen AC, Cao M, May P, Djémié T, Le Camus C, Keymolen K, Deconinck T, Bhambhani V, Long C, Sajan SA, Helbig KL, Consortium A, Suls A, Balling R, Helbig I, De Jonghe P, Depienne C, De Camilli P, Weckhuysen S, Afawi Z, Baulac S, Barisic N, Caglayan H, Craiu D, De Kovel C, Lopez R, Guerrini R, Hjalgrim H, Lerche H, Jahn J, Klein K, Koeleman B, Leguern E, Lemke J, Marini C, Muhle H, Rosenow F, Serratosa J, Štěrbová K, Møller R, Palotie A, Striano P, Weber Y, Zara F. Loss of SYNJ1 dual phosphatase activity leads to early onset refractory seizures and progressive neurological decline. Brain 2016, 139: 2420-2430. PMID: 27435091, PMCID: PMC4995362, DOI: 10.1093/brain/aww180.Peer-Reviewed Original ResearchConceptsProgressive neurological declineEarly-onset refractory seizuresHomozygous missense variantEarly-onset parkinsonismRefractory seizuresNeurological declineOnset parkinsonismNeurodegenerative disease courseAdditional pathogenic variantsMissense variantsDifferent neurological diseasesHomozygous nonsense variantDual phosphatase activityDisease courseRefractory epilepsyTau pathologyClinical spectrumIntractable epilepsySevere epilepsySeizure pathophysiologySynaptic dysregulationLarge cohortSingle patientNeurological diseasesEpilepsyElevated basal glutamate and unchanged glutamine and GABA in refractory epilepsy: Microdialysis study of 79 patients at the yale epilepsy surgery program
Çavuş I, Romanyshyn JC, Kennard JT, Farooque P, Williamson A, Eid T, Spencer SS, Duckrow R, Dziura J, Spencer DD. Elevated basal glutamate and unchanged glutamine and GABA in refractory epilepsy: Microdialysis study of 79 patients at the yale epilepsy surgery program. Annals Of Neurology 2016, 80: 35-45. PMID: 27129611, DOI: 10.1002/ana.24673.Peer-Reviewed Original ResearchConceptsGABA levelsEpilepsy patientsΓ-aminobutyric acid (GABA) neurotransmissionGlutamine levelsGABAergic antiepileptic drugsEpilepsy surgery programRefractory epilepsy patientsCommon pathological featureAberrant glutamateAnn NeurolNonepileptogenic cortexSeizure-onset sitesRefractory epilepsyBasal glutamateAntiepileptic drugsCortical lesionsMicrodialysis studyPatient groupInterictal levelsPathological featuresDifferent etiologiesNeocortical epilepsyGlutamate levelsSeizure generationElectroencephalogram evaluationSeizure clusters: A common, understudied and undertreated phenomenon in refractory epilepsy
Komaragiri A, Detyniecki K, Hirsch LJ. Seizure clusters: A common, understudied and undertreated phenomenon in refractory epilepsy. Epilepsy & Behavior 2016, 59: 83-86. PMID: 27116535, DOI: 10.1016/j.yebeh.2016.02.030.Peer-Reviewed Original Research
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