2025
Risk of unprovoked seizures after discontinuation of antiseizure medication at discharge following acute symptomatic seizures
Punia V, Byrnes M, Thompson N, Ayub N, Rubinos C, Zafar S, Sivaraju A, investigators F. Risk of unprovoked seizures after discontinuation of antiseizure medication at discharge following acute symptomatic seizures. Epilepsia 2025 PMID: 40387211, DOI: 10.1111/epi.18464.Peer-Reviewed Original ResearchAcute symptomatic seizuresAntiseizure medicationsUnprovoked seizuresRisk of unprovoked seizuresSymptomatic seizuresAssociated with electrographic seizuresMedian Follow-UpRetrospective cohort studyCox proportional hazards modelsCause-specific Cox proportional hazards modelsProportional hazards modelIncidence of unprovoked seizuresASyS patientsConsecutive adultsSingle-centerElectrographic seizuresNo significant differenceCumulative incidenceFollow-upCohort studyPatient populationFunctional outcomesSeizure riskPatientsHospital dischargeStatus epilepticus in older adults: A critical review
Woodward M, Armahizer M, Wang T, Badjatia N, Johnson E, Gilmore E. Status epilepticus in older adults: A critical review. Epilepsia 2025 PMID: 40365943, DOI: 10.1111/epi.18453.Peer-Reviewed Original ResearchEstablished Status Epilepticus Treatment TrialStatus epilepticusOlder adultsTreatment trialsMortality associated with SEIncidence of status epilepticusAssociated with poor outcomesSensitivity to benzodiazepinesMen aged >Analysis of older adultsPhysiologic changes of agingAdults aged <Incidence of SERandomized clinical trialsEfficacy of treatmentPost Hoc AnalysisHigh morbidityPoor outcomeAntiseizure medicationsEstablished treatmentTreatment selectionChanges of agingOlder trialsHigher incidenceIncidence increasesAntiseizure Medications in Poststroke Seizures
Misra S, Wang S, Quinn T, Dawson J, Zelano J, Tanaka T, Grotta J, Khan E, Beriwal N, Funaro M, Perla S, Dev P, Larsson D, Hussain T, Liebeskind D, Yasuda C, Altalib H, Zaveri H, Elshahat A, Hitawala G, Wang E, Kitagawa R, Pathak A, Scalzo F, Ihara M, Sunnerhagen K, Walters M, Zhao Y, Jette N, Kasner S, Kwan P, Mishra N. Antiseizure Medications in Poststroke Seizures. Neurology 2025, 104: e210231. PMID: 39808752, DOI: 10.1212/wnl.0000000000210231.Peer-Reviewed Original ResearchConceptsRisk of biasLow-certainty evidenceModerate to high certainty evidenceNon-randomized Studies of Interventions toolDrug discontinuation ratesCochrane risk of bias toolRisk of bias toolAntiseizure medicationsSeizure recurrenceHigh risk of biasAdverse eventsCertainty of evidenceHigh-certainty evidencePoststroke seizuresModerate-certainty evidenceMortality rateRandomized Controlled TrialsDiscontinuation ratesAntiseizure medication useRecommendations AssessmentCochrane riskBias toolElectronic databasesNon-randomized studiesAssociated with high mortality rates
2024
A selective small-molecule agonist of G protein-gated inwardly-rectifying potassium channels reduces epileptiform activity in mouse models of tumor-associated and provoked seizures
Rifkin R, Wu X, Pereira B, Gill B, Merricks E, Michalak A, Goldberg A, Humala N, Dovas A, Rai G, McKhann G, Slesinger P, Canoll P, Schevon C. A selective small-molecule agonist of G protein-gated inwardly-rectifying potassium channels reduces epileptiform activity in mouse models of tumor-associated and provoked seizures. Neuropharmacology 2024, 265: 110259. PMID: 39662702, PMCID: PMC11726401, DOI: 10.1016/j.neuropharm.2024.110259.Peer-Reviewed Original ResearchConceptsMouse modelInwardly-rectifying potassium channelRegulation of neuronal excitabilityMouse models of tumorsSeizure-like activityGIRK channelsNeuronal excitabilityModels of tumorsPeritumoral regionEpileptiform activityTumor-associatedTumor progressionAntiseizure medicationsPotassium channelsChronic epilepsyFocal seizuresAnimal modelsTumorBrain tumorsGIRKInadequate treatmentGlioma cellsMiceSeizuresChemoconvulsant modelsAntiseizure Medication Use and Outcomes After Suspected or Confirmed Acute Symptomatic Seizures
Zafar S, Sivaraju A, Rubinos C, Ayub N, Awodutire P, McKee Z, Chandan P, Byrnes M, Bhansali S, Rice H, Smith-Ayala A, Haider M, Tveter E, Erlich-Malona N, Ibanhes F, DeMarco A, Lewis S, Dhakar M, Punia V. Antiseizure Medication Use and Outcomes After Suspected or Confirmed Acute Symptomatic Seizures. JAMA Neurology 2024, 81: 1159-1169. PMID: 39312247, PMCID: PMC11420826, DOI: 10.1001/jamaneurol.2024.3189.Peer-Reviewed Original ResearchAssociated with increased oddsAcute symptomatic seizuresAntiseizure medication treatmentDischarge prescriptionsSymptomatic seizuresAntiseizure medicationsElectrographic seizuresContinuous electroencephalographyOdds of treatmentGlasgow Outcome Scale scoreNeurological intensive care unitOptimal treatment durationMulticenter cohort studyAntiseizure medication useOutcome Scale scorePrescribed antiseizure medicationsAssociated with functional outcomeIntensive care unitAssociated with outcomeMain OutcomesProgressive brain injuryASM treatmentMedication useCohort studyEpileptiform abnormalitiesStability of infraslow correlation structure in time-shifted intracranial EEG signals
Joshi R, Duckrow R, Goncharova I, Hirsch L, Spencer D, Godwin D, Zaveri H. Stability of infraslow correlation structure in time-shifted intracranial EEG signals. Frontiers In Network Physiology 2024, 4: 1441294. PMID: 39258030, PMCID: PMC11384574, DOI: 10.3389/fnetp.2024.1441294.Peer-Reviewed Original ResearchInfraslow activityContact pairsFrequency bandMagnitude-squared coherenceAntiseizure medicationsMedically refractory epilepsy patientsElectrode contact pairsHigher-frequency activityRefractory epilepsy patientsDC-coupled recordingsIcEEG epochsEEG frequency bandsEnvelope correlationOptimal parametersClinical relevanceSeizure riskIntracranial EEGEpilepsy patientsPatientsIntracranial EEG signalsTaperTraditional EEG frequency bandsSeizure Assessment and Forecasting With Efficient Rapid-EEG
Kalkach-Aparicio M, Fatima S, Selte A, Sheikh I, Cormier J, Gallagher K, Avagyan G, Cespedes J, Krishnamurthy P, Elazim A, Khan N, Hussein O, Maganti R, Larocque J, Holla S, Desai M, Westover B, Hirsch L, Struck A. Seizure Assessment and Forecasting With Efficient Rapid-EEG. Neurology 2024, 103: e209621. PMID: 38875512, DOI: 10.1212/wnl.0000000000209621.Peer-Reviewed Original ResearchConceptsMonitoring of at-risk patientsRecords of patientsTertiary care centerReceiver operating characteristic curveCritically ill patientsAt-risk patientsClass II evidenceDiagnostic accuracy studiesOperating characteristics curveMedian ageSecondary endpointsPrevent overtreatmentNo significant differenceEEG reviewRisk stratificationNoninferiority marginAntiseizure medicationsClinical correlatesPrimary outcomeII evidenceEEG technologistsSeizure assessmentIll patientsComparative effectiveness studiesLow riskPathophysiology, Diagnosis, Prognosis, and Prevention of Poststroke Epilepsy
Tanaka T, Ihara M, Fukuma K, Mishra N, Koepp M, Guekht A, Ikeda A. Pathophysiology, Diagnosis, Prognosis, and Prevention of Poststroke Epilepsy. Neurology 2024, 102: e209450. PMID: 38759128, PMCID: PMC11175639, DOI: 10.1212/wnl.0000000000209450.Peer-Reviewed Original ResearchConceptsPoststroke epileptogenesisPoststroke epilepsyStroke survivorsAssociated with high mortalityAttention of health policymakersBurden of stroke worldwideDiagnostic work-upRisk of seizuresRisk-scoring modelSurrogate outcome measuresCortical superficial siderosisPrevention of seizuresSecondary prevention of seizuresPrimary prophylaxisConcomitant medicationsEEG findingsAcute stroke treatmentRecurrence riskSeizure prophylaxisSuperficial siderosisAntiseizure medicationsCardiovascular riskTreatment strategiesEnrolling patientsTissue-based approachComparative analysis of patients with new onset refractory status epilepticus preceded by fever (febrile infection‐related epilepsy syndrome) versus without prior fever: An interim analysis
Jimenez A, Gopaul M, Asbell H, Aydemir S, Basha M, Batra A, Damien C, Day G, Eka O, Eschbach K, Fatima S, Fields M, Foreman B, Gerard E, Gofton T, Haider H, Hantus S, Hocker S, Jongeling A, Aparicio M, Kandula P, Kang P, Kazazian K, Kellogg M, Kim M, Lee J, Marcuse L, McGraw C, Mohamed W, Orozco J, Pimentel C, Punia V, Ramirez A, Steriade C, Struck A, Taraschenko O, Treister A, Yoo J, Zafar S, Zhou D, Zutshi D, Gaspard N, Hirsch L, Hanin A. Comparative analysis of patients with new onset refractory status epilepticus preceded by fever (febrile infection‐related epilepsy syndrome) versus without prior fever: An interim analysis. Epilepsia 2024, 65: e87-e96. PMID: 38625055, DOI: 10.1111/epi.17988.Peer-Reviewed Original ResearchFebrile infection-related epilepsy syndromeRefractory status epilepticusMacrophage inflammatory protein-1 alphaOnset refractory status epilepticusStatus epilepticusCerebrospinal fluidFIRES patientsCerebrospinal fluid interleukin-6Magnetic resonance imaging findingsComparative analysis of patientsAnalysis of patientsChemokine ligand 2Presenting symptomsFebrile infectionsClinical featuresGastrointestinal prodromeImaging findingsInflammatory biomarkersAntiseizure medicationsInterleukin-6Epilepsy syndromesInterim analysisPatientsEpilepticusFeverPredictors of follow-up care for critically-ill patients with seizures and epileptiform abnormalities on EEG monitoring
Rice H, Fernandes M, Punia V, Rubinos C, Sivaraju A, Zafar S. Predictors of follow-up care for critically-ill patients with seizures and epileptiform abnormalities on EEG monitoring. Clinical Neurology And Neurosurgery 2024, 241: 108275. PMID: 38640778, PMCID: PMC11167629, DOI: 10.1016/j.clineuro.2024.108275.Peer-Reviewed Original ResearchConceptsNeurological follow-upFollow-up visitFollow-upAntiseizure medicationsOutpatient follow-upCritically-ill patientsContinuous EEGEpileptiform abnormalitiesPredictors of follow-upPrevent long-term complicationsIllness severityYounger ageRetrospective cohort studyLong-term complicationsFollow-up statusIntensive care unitProbability of follow-upHigher illness severityPredictors of readmissionContinuous EEG recordingsRisk stratificationEEG monitoringCohort studyCritically-illCare unitMolecular Pharmacology of Selective NaV1.6 and Dual NaV1.6/NaV1.2 Channel Inhibitors that Suppress Excitatory Neuronal Activity Ex Vivo
Goodchild S, Shuart N, Williams A, Ye W, Parrish R, Soriano M, Thouta S, Mezeyova J, Waldbrook M, Dean R, Focken T, Ghovanloo M, Ruben P, Scott F, Cohen C, Empfield J, Johnson J. Molecular Pharmacology of Selective NaV1.6 and Dual NaV1.6/NaV1.2 Channel Inhibitors that Suppress Excitatory Neuronal Activity Ex Vivo. ACS Chemical Neuroscience 2024, 15: 1169-1184. PMID: 38359277, PMCID: PMC10958515, DOI: 10.1021/acschemneuro.3c00757.Peer-Reviewed Original ResearchExcitatory pyramidal neuronsPyramidal neuronsNeuronal action potential firingSeizure modelsActivity of excitatory neuronsInhibition of firingAction potential firingVoltage-gated sodium channelsSuppress epileptiform activityTherapeutic safety marginActivity ex vivoNeuronal hyperexcitabilityInhibitory interneuronsChannel inhibitorsEpileptiform activityInhibitory neuronsPotential firingExcitatory neuronsAntiseizure medicationsExcitatory circuitsBrain slicesReduced excitabilityPharmacological dissectionAntiseizure medication carbamazepineSodium channelsGuidelines for Seizure Prophylaxis in Adults Hospitalized with Moderate–Severe Traumatic Brain Injury: A Clinical Practice Guideline for Health Care Professionals from the Neurocritical Care Society
Frontera J, Gilmore E, Johnson E, Olson D, Rayi A, Tesoro E, Ullman J, Yuan Y, Zafar S, Rowe S. Guidelines for Seizure Prophylaxis in Adults Hospitalized with Moderate–Severe Traumatic Brain Injury: A Clinical Practice Guideline for Health Care Professionals from the Neurocritical Care Society. Neurocritical Care 2024, 40: 819-844. PMID: 38316735, DOI: 10.1007/s12028-023-01907-x.Peer-Reviewed Original ResearchModerate-severe TBITraumatic brain injuryGrading of recommendations assessmentAntiseizure medicationsResultsThe initial literature searchAdverse eventsHealth care professionalsBrain injuryClinical practice guidelinesMeta-analysis of articlesEffects of antiseizure medicationsEarly seizuresLate seizuresCare professionalsCognitive outcomesRecommendations AssessmentDuration of prophylaxisPractice guidelinesSystematic reviewProphylactic antiseizure medicationPICO 1Meta-analysisLiterature searchFunctional outcomesGrading criteriaCharacteristics and Attendance of Patients Eligible for the PASS Clinic: A Transition of Care Model After Acute Symptomatic Seizures.
Byrnes M, Thompson N, Hantus S, Fesler J, Ying Z, Ayub N, Rubinos C, Zafar S, Sivaraju A, Punia V. Characteristics and Attendance of Patients Eligible for the PASS Clinic: A Transition of Care Model After Acute Symptomatic Seizures. Neurology Clinical Practice 2024, 14: e200232. PMID: 38213398, PMCID: PMC10781564, DOI: 10.1212/cpj.0000000000200232.Peer-Reviewed Original ResearchAntiseizure medicationsClinic attendanceASY patientsClinic modelCare modelCause-specific Cox proportional hazards modelsMedicare/Medicaid insuranceCox proportional hazards modelAcute symptomatic seizuresClinic attendance ratesClinic visit attendanceEarly postdischarge mortalityProgressive brain injuryRetrospective cohort studyAttendance of patientsRoutine clinical careProportional hazards modelDischarge planning processASM discontinuationAutoimmune encephalitisPostdischarge mortalitySymptomatic seizuresVisit attendanceSeizure clinicCohort study
2023
Status epilepticus in the ICU
Rossetti A, Claassen J, Gaspard N. Status epilepticus in the ICU. Intensive Care Medicine 2023, 50: 1-16. PMID: 38117319, DOI: 10.1007/s00134-023-07263-w.Peer-Reviewed Original ResearchSuper-refractory status epilepticusIntensive care unitStatus epilepticusAntiseizure medicationsUnderlying causeContinuous video electroencephalographyAcute brain injuryConvulsive status epilepticusNon-pharmacologic approachesNonconvulsive status epilepticusShort-term mortalityCommon medical emergencyAutoimmune encephalitisMedical comorbiditiesInitial managementSignificant morbidityCare unitCardiac arrestResponsive casesVideo electroencephalographyContinuous infusionBrain injuryRapid administrationSevere casesMedical emergencyRole of Deployment History on the Association Between Epilepsy and Traumatic Brain Injury in Post–9/11 Era US Veterans
Henion A, Wang C, Amuan M, Altalib H, Towne A, Hinds S, Baca C, LaFrance W, Van Cott A, Kean J, Roghani A, Kennedy E, Panahi S, Pugh M. Role of Deployment History on the Association Between Epilepsy and Traumatic Brain Injury in Post–9/11 Era US Veterans. Neurology 2023, 101: e2571-e2584. PMID: 38030395, PMCID: PMC10791059, DOI: 10.1212/wnl.0000000000207943.Peer-Reviewed Original ResearchConceptsTraumatic brain injuryDeployed veteransNondeployed veteransHigher oddsNeurologic conditionsBrain injuryEpilepsy impactDeployment-related traumatic brain injurySevere traumatic brain injuryEpilepsy risk factorsMild traumatic brain injuryVeterans Health AdministrationYears of careDeployment-related exposuresService membersService-connected disabilityHistory of deploymentHealthy warrior effectLogistic regression modelsDeployment historyMilitary service membersEpilepsy preventionICD-9/10TBI exposureAntiseizure medicationsSporadic Creutzfeldt-Jakob Disease Initially Presenting With Posterior Reversible Encephalopathy Syndrome
Mikhaiel J, Parasram M, Manning T, Al-Dulaimi M, Barnes E, Falcone G, Hwang D, Prust M. Sporadic Creutzfeldt-Jakob Disease Initially Presenting With Posterior Reversible Encephalopathy Syndrome. The Neurologist 2023, 29: 14-16. PMID: 37582680, DOI: 10.1097/nrl.0000000000000519.Peer-Reviewed Original ResearchConceptsSporadic Creutzfeldt-Jakob diseaseMagnetic resonance imagingReversible encephalopathy syndromeCreutzfeldt-Jakob diseaseEncephalopathy syndromeAntiseizure medicationsLumbar punctureDiagnosis of sCJDFluid-attenuated inversion recovery changesPosterior reversible encephalopathy syndromeRepeat magnetic resonance imagingCases of sCJDPeriodic dischargesMultiple antiseizure medicationsRepeat lumbar punctureStuporous mental stateInitial lumbar punctureInversion recovery hyperintensityNonconvulsive status epilepticusReal-time quaking-induced conversionFatal neurodegenerative conditionProgressive confusionRadiographic improvementNeurological declineStatus epilepticusContribution of Somatic Ras/Raf/Mitogen-Activated Protein Kinase Variants in the Hippocampus in Drug-Resistant Mesial Temporal Lobe Epilepsy
Khoshkhoo S, Wang Y, Chahine Y, Erson-Omay E, Robert S, Kiziltug E, Damisah E, Nelson-Williams C, Zhu G, Kong W, Huang A, Stronge E, Phillips H, Chhouk B, Bizzotto S, Chen M, Adikari T, Ye Z, Witkowski T, Lai D, Lee N, Lokan J, Scheffer I, Berkovic S, Haider S, Hildebrand M, Yang E, Gunel M, Lifton R, Richardson R, Blümcke I, Alexandrescu S, Huttner A, Heinzen E, Zhu J, Poduri A, DeLanerolle N, Spencer D, Lee E, Walsh C, Kahle K. Contribution of Somatic Ras/Raf/Mitogen-Activated Protein Kinase Variants in the Hippocampus in Drug-Resistant Mesial Temporal Lobe Epilepsy. JAMA Neurology 2023, 80: 578-587. PMID: 37126322, PMCID: PMC10152377, DOI: 10.1001/jamaneurol.2023.0473.Peer-Reviewed Original ResearchConceptsDrug-resistant mesial temporal lobe epilepsyMesial temporal lobe epilepsyPathogenic somatic variantsTemporal lobe epilepsyMedian ageLobe epilepsyTemporal neocortexHippocampal tissueLevel 4 epilepsy centerAvailable frozen tissueSomatic variantsControl brain tissueMedial temporal lobectomyNew therapeutic targetsMolecular assaysGene panel sequencingRas/Raf/MAPK signalingAntiseizure medicationsMost patientsCommon indicationGermline genetic variantsEpilepsy centersTemporal lobectomyEpilepsy surgerySex-matched neurotypical controlsRecent advances in epilepsy surgery
Medina-Pizarro M, Spencer D, Damisah E. Recent advances in epilepsy surgery. Current Opinion In Neurology 2023, 36: 95-101. PMID: 36762633, DOI: 10.1097/wco.0000000000001134.Peer-Reviewed Original ResearchConceptsEpilepsy surgeryEpilepsy centersComprehensive Epilepsy CenterDrug-resistant epilepsySurgical outcome dataReasonable surgical alternativeAdequate trialAntiseizure medicationsPreoperative evaluationSurgical candidacySurgical outcomesSeizure networkSurgical alternativeEpileptogenic networksSurgical techniqueTreatment strategiesEpileptogenic regionInvasive techniquesOutcome dataSurgeryDepth electrodesHigh-resolution structural imagingSubtle abnormalitiesDiagnostic toolStructural imaging
2022
Seizures and epilepsy in multiple sclerosis, aquaporin 4 antibody‐positive neuromyelitis optica spectrum disorder, and myelin oligodendrocyte glycoprotein antibody‐associated disease
Li E, Zheng Y, Cai M, Lai Q, Fang G, Du B, Shen C, Zhang Y, Wu L, Ding M. Seizures and epilepsy in multiple sclerosis, aquaporin 4 antibody‐positive neuromyelitis optica spectrum disorder, and myelin oligodendrocyte glycoprotein antibody‐associated disease. Epilepsia 2022, 63: 2173-2191. PMID: 35652436, DOI: 10.1111/epi.17315.Peer-Reviewed Original ResearchConceptsMyelin oligodendrocyte glycoprotein antibody-associated diseaseAquaporin-4 antibody-positive neuromyelitis optica spectrum disorderNeuromyelitis optica spectrum disorderAntibody-associated diseaseMultiple sclerosisCentral nervous system inflammatory demyelinating diseaseAutoimmune-associated epilepsyCerebral cortical encephalitisConcomitant systemic infectionPresence of status epilepticusAcute disseminated encephalomyelitisInflammatory demyelinating diseaseSecondary to inflammationAcute symptomatic seizuresDrug-drug interactionsAQP4-NMOSDCortical encephalitisMultiple relapsesDisseminated encephalomyelitisImpact of treatmentStatus epilepticusDisease activitySymptomatic seizuresAntiseizure medicationsInflammatory mechanismsPregabalin for Recurrent Seizures in Critical Illness: A Promising Adjunctive Therapy, Especially for cyclic Seizures
Busl KM, Fong MWK, Newcomer Z, Patel M, Cohen SA, Jadav R, Smith CN, Mitropanopoulos S, Bruzzone M, Hella M, Eisenschenk S, Robinson CP, Roth WH, Ameli PA, Babi MA, Pizzi MA, Gilmore EJ, Hirsch LJ, Maciel CB. Pregabalin for Recurrent Seizures in Critical Illness: A Promising Adjunctive Therapy, Especially for cyclic Seizures. Neurocritical Care 2022, 37: 140-148. PMID: 35217998, DOI: 10.1007/s12028-022-01459-6.Peer-Reviewed Original ResearchConceptsCyclic seizuresSeizure burdenSeizure frequencyRecurrent seizuresMin/hourAntiseizure medicationsElectrographic seizure burdenMedian seizure frequencyNeurocritical care settingPromising adjunctive therapyEffective adjunctive treatmentVoltage-gated calcium channelsNeurointensive care unitRetrospective case seriesTreatment of seizuresAlpha2-delta subunitExcitatory neurotransmitter releaseCoprimary outcomesIll cohortPGB administrationAntiseizure effectsSeizure recurrenceAdjunctive therapyCritical illnessRefractory seizures
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