2020
Development and validation of a predictive model of drug-resistant genetic generalized epilepsy.
Choi H, Detyniecki K, Bazil C, Thornton S, Crosta P, Tolba H, Muneeb M, Hirsch LJ, Heinzen EL, Sen A, Depondt C, Perucca P, Heiman GA, Adcock J, Andrade D, Cavalleri G, Costello D, Delanty N, Dugan P, Goldstein D, Kwan P, Nascimento F, O’Brien T, Radthke R, Smith P, Thomas R. Development and validation of a predictive model of drug-resistant genetic generalized epilepsy. Neurology 2020, 95: e2150-e2160. PMID: 32759205, PMCID: PMC7713754, DOI: 10.1212/wnl.0000000000010597.Peer-Reviewed Original ResearchConceptsGenetic generalized epilepsyCatamenial epilepsyGeneralized epilepsyPsychiatric conditionsOngoing longitudinal observational studyGeneralized tonic clonicTertiary epilepsy centerNegative prognostic factorCase-control studyLongitudinal observational studyClinical prediction modelAED resistanceTonic clonicPrognostic factorsSeizure typesEpilepsy centersAntiepileptic drugsAbsence seizuresObservational studyOngoing longitudinal studyEpilepsyCase statusAED responsePatientsExternal testing datasetAssessment of the Predictive Value of Outpatient Smartphone Videos for Diagnosis of Epileptic Seizures
Tatum WO, Hirsch LJ, Gelfand MA, Acton EK, LaFrance WC, Duckrow RB, Chen DK, Blum AS, Hixson JD, Drazkowski JF, Benbadis SR, Cascino GD. Assessment of the Predictive Value of Outpatient Smartphone Videos for Diagnosis of Epileptic Seizures. JAMA Neurology 2020, 77: 593-600. PMID: 31961382, PMCID: PMC6990754, DOI: 10.1001/jamaneurol.2019.4785.Peer-Reviewed Original ResearchConceptsPhysical examination resultsPsychogenic nonepileptic attacksVideo electroencephalogram monitoringEpileptic seizuresVideo electroencephalogramEpilepsy centersPhysical examinationElectroencephalogram monitoringNonepileptic attacksCorrect diagnosisPhysiologic nonepileptic eventsEvaluation of epilepsyExamination resultsMisdiagnosis of epilepsyDiagnostic accuracy studiesPsychogenic attacksMotor signsNonepileptic eventsDefinitive diagnosisPatient historyMAIN OUTCOMEClinic outpatientsPredictive valueSeizuresDiagnosisMesial 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
Early detection rate changes from a brain‐responsive neurostimulation system predict efficacy of newly added antiseizure drugs
Quraishi IH, Mercier MR, Skarpaas TL, Hirsch LJ. Early detection rate changes from a brain‐responsive neurostimulation system predict efficacy of newly added antiseizure drugs. Epilepsia 2019, 61: 138-148. PMID: 31849045, PMCID: PMC7003822, DOI: 10.1111/epi.16412.Peer-Reviewed Original ResearchConceptsPositive predictive valueEpisode startsLonger episodesSystem patientsPredictive valueFirst weekLong-term treatment trialsBrain-responsive neurostimulationSingle epilepsy centerSingle-center cohortRefractory focal epilepsyGreater reductionMedication adjustmentsClinical improvementClinical responseSeizure frequencyAntiseizure drugsCenter cohortMulticenter cohortEpilepsy centersMedication trialsEffective medicationsEfficacy measuresTreatment trialsFocal epilepsyThe connectivity index: an effective metric for grading epileptogenicity.
Yan Q, Gaspard N, Zaveri HP, Blumenfeld H, Hirsch LJ, Spencer DD, Alkawadri R. The connectivity index: an effective metric for grading epileptogenicity. Journal Of Neurosurgery 2019, 133: 971-978. PMID: 31561212, DOI: 10.3171/2019.4.jns195.Peer-Reviewed Original ResearchSingle-pulse electrical stimulationSeizure onset zoneSite of stimulationSOZ contactsIrritative zoneComprehensive Epilepsy CenterControl contactsStimulation current intensityHabitual aurasHabitual seizuresEpilepsy centersSeizure generationBrain sitesFrequency stimulationEpileptic activityElectrical stimulationOnset zonePatientsRecording contactsStimulation sessionsBrain regionsFunctional connectivityStimulationOutcome casesSeizuresEffectiveness of Levetiracetam Monotherapy in Pediatric Patients With Epilepsy
Mazur RD, Wang B, Kato B, Buchsbaum B, Bonito B, Choi H, Hirsch L, Detyniecki K. Effectiveness of Levetiracetam Monotherapy in Pediatric Patients With Epilepsy. Journal Of Child Neurology 2019, 34: 593-597. PMID: 31113283, DOI: 10.1177/0883073819846804.Peer-Reviewed Original ResearchConceptsLevetiracetam monotherapySeizure freedomPediatric patientsTertiary epilepsy centerNumber of patientsCohort of childrenAdverse eventsRetrospective reviewEpilepsy centersEntire cohortProspective studyMean ageMonotherapyPatientsEpilepsyAdverse effectsRetention rateCohortOne-thirdChildrenSeizuresIrritabilityMonths
2018
Seizure cluster: Definition, prevalence, consequences, and management
Jafarpour S, Hirsch LJ, Gaínza-Lein M, Kellinghaus C, Detyniecki K. Seizure cluster: Definition, prevalence, consequences, and management. Seizure 2018, 68: 9-15. PMID: 29871784, DOI: 10.1016/j.seizure.2018.05.013.Peer-Reviewed Original ResearchConceptsRescue medicationSeizure clustersAcute managementEpilepsy patientsRectal diazepam gelTertiary epilepsy centerEmergency room visitsHealth care utilizationRefractory epilepsy patientsQuality of lifeAcute seizuresBuccal midazolamClinical characteristicsMost patientsCare utilizationEpilepsy centersRoom visitsRisk factorsOnly FDAHigh riskMedicationsPatientsSeizuresPrevalenceCaregivers
2016
Drug‐resistant epilepsy in adults: Outcome trajectories after failure of two medications
Choi H, Hayat MJ, Zhang R, Hirsch LJ, Bazil CW, Mendiratta A, Kato K, Javed A, Legge AW, Buchsbaum R, Resor S, Heiman GA. Drug‐resistant epilepsy in adults: Outcome trajectories after failure of two medications. Epilepsia 2016, 57: 1152-1160. PMID: 27265407, DOI: 10.1111/epi.13406.Peer-Reviewed Original ResearchConceptsDrug-resistant epilepsySeizure freedomAntiepileptic drugsAdult patientsEpilepsy typeFocal epilepsyContinuous seizure freedomThird antiepileptic drugTertiary epilepsy centerSeizure-free periodMultiple ordinal logistic regression modelsLogistic regression modelsOrdinal logistic regression modelsClinical factorsIndependent predictorsEpilepsy centersMedical managementFluctuating courseOccipital lobeTemporal lobeEligibility criteriaPatientsEpilepsyTrajectory outcomesOutcome trajectories
2015
Human bedside evaluation versus automatic responsiveness testing in epilepsy (ARTiE)
Touloumes G, Morse E, Chen WC, Gober L, Dente J, Lilenbaum R, Katzenstein E, Pacelli A, Johnson E, Si Y, Sivaraju A, Grover E, Khozein R, Cunningham C, Hirsch LJ, Blumenfeld H. Human bedside evaluation versus automatic responsiveness testing in epilepsy (ARTiE). Epilepsia 2015, 57: e28-e32. PMID: 26663137, PMCID: PMC4707993, DOI: 10.1111/epi.13262.Peer-Reviewed Original ResearchConceptsVideo-EEG dataResponsiveness testingClinical careBehavioral testingInpatient video-electroencephalography (EEG) monitoringVideo-electroencephalography monitoringVideo-EEG monitoringAdditional clinical testingPediatric patientsEpilepsy centersPresurgical evaluationBedside evaluationClinical testingEpileptic seizuresBehavioral impairmentsSeizuresAccurate diagnosisNonmedical personnelPatient roomsEpilepsyBehavioral evaluationSeizure detectionBehavioral tasksMedical decisionsAutomatic seizure detection
2014
The spatial and signal characteristics of physiologic high frequency oscillations
Alkawadri R, Gaspard N, Goncharova II, Spencer DD, Gerrard JL, Zaveri H, Duckrow RB, Blumenfeld H, Hirsch LJ. The spatial and signal characteristics of physiologic high frequency oscillations. Epilepsia 2014, 55: 1986-1995. PMID: 25470216, PMCID: PMC5123742, DOI: 10.1111/epi.12851.Peer-Reviewed Original ResearchConceptsPhysiologic high-frequency oscillationsSeizure onsetEpileptic networkNon-rapid eye movement sleepComprehensive Epilepsy CenterMesial temporal structuresEye movement sleepHighest HFO ratesHigh-frequency oscillationsFirst seizureInvasive evaluationEpilepsy centersIntracranial evaluationMovement sleepPerirolandic regionEpileptiform dischargesParietooccipital regionOccipital lobeEpileptic sitesPatientsNonepileptic regionsPhysiologic eventsFast ripplesHFO ratesLonger duration
2010
Comparative Effectiveness of 10 Antiepileptic Drugs in Older Adults With Epilepsy
Arif H, Buchsbaum R, Pierro J, Whalen M, Sims J, Resor SR, Bazil CW, Hirsch LJ. Comparative Effectiveness of 10 Antiepileptic Drugs in Older Adults With Epilepsy. JAMA Neurology 2010, 67: 408-415. PMID: 20385905, DOI: 10.1001/archneurol.2010.49.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAminesAnticonvulsantsCarbamazepineCyclohexanecarboxylic AcidsDose-Response Relationship, DrugDrug ResistanceEpilepsyFemaleFructoseGabapentinGamma-Aminobutyric AcidHumansLamotrigineLevetiracetamMaleMiddle AgedOxcarbazepinePhenytoinPiracetamRetrospective StudiesTopiramateTreatment OutcomeTriazinesConceptsSeizure freedom ratesAntiepileptic drugsSeizure freedomOlder adultsOverall groupColumbia Comprehensive Epilepsy CenterAdverse effectsIntolerable adverse effectsFirst antiepileptic drugPercentage of patientsComprehensive Epilepsy CenterEffective antiepileptic drugGastrointestinal symptomsRefractory diseaseMore patientsRetrospective reviewEpilepsy centersMAIN OUTCOMEDose changesPatientsComparative effectivenessMore monthsOxcarbazepineLevetiracetamRetention rate
2008
Efficacy of Clobazam as Add-on Therapy for Refractory Epilepsy
Montenegro MA, Arif H, Nahm EA, Resor SR, Hirsch LJ. Efficacy of Clobazam as Add-on Therapy for Refractory Epilepsy. Clinical Neuropharmacology 2008, 31: 333-338. PMID: 19050410, DOI: 10.1097/wnf.0b013e31815cd960.Peer-Reviewed Original ResearchConceptsRefractory epilepsyEpilepsy centersColumbia Comprehensive Epilepsy CenterAntiepileptic drug regimenEfficacy of clobazamIntroduction of clobazamUS epilepsy centersUse of clobazamMultiple seizure typesComprehensive Epilepsy CenterAntiepileptic drug trialsPopulation of patientsAddition of clobazamMeasures of efficacyBinary logistic regressionDrug regimenSeizure freedomSeizure typesKaplan-MeierUS CentersDrug trialsPatientsUS FoodClobazamDrug Administration
2007
Diagnostic Utility of an Epilepsy Monitoring Unit
Smolowitz JL, Hopkins SC, Perrine T, Eck KE, Hirsch LJ, Mundinger M. Diagnostic Utility of an Epilepsy Monitoring Unit. American Journal Of Medical Quality 2007, 22: 117-122. PMID: 17395968, DOI: 10.1177/1062860606298295.Peer-Reviewed Original ResearchConceptsEpilepsy monitoring unitSymptom onsetAntiepileptic drugsDefinitive diagnosisDiagnostic utilityAdult epilepsy monitoring unitEpilepsy surgery referralSpecialized epilepsy centersStandard antiepileptic drugsVideo-electroencephalographic monitoringMedian durationEpilepsy centersReferral patternsAdmissionMonitoring unitDiagnosisEpilepsyDrugsTreatmentGuidelinesOnsetReviewYearsPatientsSeizures
2006
Predictors of Lamotrigine‐associated Rash
Hirsch LJ, Weintraub DB, Buchsbaum R, Spencer HT, Straka T, Hager M, Resor SR. Predictors of Lamotrigine‐associated Rash. Epilepsia 2006, 47: 318-322. PMID: 16499755, DOI: 10.1111/j.1528-1167.2006.00423.x.Peer-Reviewed Original ResearchConceptsAntiepileptic drugsRisk factorsColumbia Comprehensive Epilepsy CenterDrug-related rashStevens-Johnson syndromeToxic epidermal necrolysisComprehensive Epilepsy CenterHistory of rashGreatest risk factorEpidermal necrolysisSevere rashEpilepsy centersMedical historyRemote historyRetrospective analysisRashMedication variablesMultivariate analysisPotential predictorsPatientsStrongest predictorPredictorsLTGTitration rateChildren
2005
Effect of Antiepileptic Drug Comedication on Lamotrigine Clearance
Weintraub D, Buchsbaum R, Resor SR, Hirsch LJ. Effect of Antiepileptic Drug Comedication on Lamotrigine Clearance. JAMA Neurology 2005, 62: 1432-1436. PMID: 16157751, DOI: 10.1001/archneur.62.9.1432.Peer-Reviewed Original ResearchConceptsLamotrigine clearanceLamotrigine serum concentrationsNewer AEDsSerum concentrationsColumbia Comprehensive Epilepsy CenterComprehensive Epilepsy CenterLamotrigine monotherapyAdjunctive therapyMedical chartsEpilepsy centersComedicationMonotherapyBody weightPhenytoinValproatePatientsML/hAEDsClearanceSignificant predictorsCarbamazepineOxcarbazepinePredictorsLamotrigineTherapy
2004
Correlating lamotrigine serum concentrations with tolerability in patients with epilepsy
Hirsch LJ, Weintraub D, Du Y, Buchsbaum R, Spencer HT, Hager M, Straka T, Bazil CW, Adams DJ, Resor SR, Morrell MJ. Correlating lamotrigine serum concentrations with tolerability in patients with epilepsy. Neurology 2004, 63: 1022-1026. PMID: 15452293, DOI: 10.1212/01.wnl.0000138424.33979.0c.Peer-Reviewed Original ResearchMeSH KeywordsAnticonvulsantsDose-Response Relationship, DrugDrug EruptionsDrug InteractionsDrug Therapy, CombinationEpilepsyFemaleGastrointestinal DiseasesHeadacheHumansLamotrigineMaleMental DisordersNervous System DiseasesRetrospective StudiesSleep Initiation and Maintenance DisordersTriazinesValproic AcidConceptsLamotrigine serum concentrationsSpecific side effectsAntiepileptic drugsSide effectsSerum levelsLTG levelsSerum concentrationsColumbia Comprehensive Epilepsy CenterConcomitant antiepileptic drugsLTG serum levelsComprehensive Epilepsy CenterRates of toxicityDuration of useInitial target rangeAED regimensRefractory patientsToxic regimenConcurrent medicationsSeizure freedomAdditional efficacyClinical toxicityEpilepsy centersLTG concentrationsClinical trialsDose changes