2022
Prevalence and Predictors of Seizure Clusters in Pediatric Patients With Epilepsy: The Harvard-Yale Pediatric Seizure Cluster Study
Jafarpour S, Fong MWK, Detyniecki K, Khan A, Jackson-Shaheed E, Wang X, Lewis S, Benjamin R, Gaínza-Lein M, O'Bryan J, Hirsch LJ, Loddenkemper T. Prevalence and Predictors of Seizure Clusters in Pediatric Patients With Epilepsy: The Harvard-Yale Pediatric Seizure Cluster Study. Pediatric Neurology 2022, 137: 22-29. PMID: 36208614, DOI: 10.1016/j.pediatrneurol.2022.08.014.Peer-Reviewed Original ResearchConceptsSeizure clustersRescue medicationPediatric patientsSeizure frequencyIntermediate-risk groupEmergency department visitsHigh seizure frequencyTwo-center studyEmergency room visitsHigh-risk groupActive seizuresMore seizuresDepartment visitsStatus epilepticusRoom visitsAdverse outcomesEpilepsy severityIsolated seizureSeizure diariesRisk factorsRisk groupsGreater oddsPatientsMedicationsSeizuresUpdated review of rescue treatments for seizure clusters and prolonged seizures
Blond BN, Hirsch LJ. Updated review of rescue treatments for seizure clusters and prolonged seizures. Expert Review Of Neurotherapeutics 2022, 22: 567-577. PMID: 35862983, DOI: 10.1080/14737175.2022.2105207.Peer-Reviewed Original ResearchConceptsRescue medicationProlonged seizuresSeizure clustersTreatment of epilepsyQuality of lifeOngoing seizuresFurther seizuresRefractory seizuresRecurrent seizuresRescue treatmentSeizure activitySeizure episodesIntranasal formulationRisk factorsClinical careEffective treatmentMedicationsSeizuresEpilepsyMorbidityClinical opportunitiesAdverse effectsTreatmentReviewEpidemiology
2021
A systematic review of seizure clusters: Prevalence, risk factors, burden of disease and treatment patterns
Chung S, Szaflarski JP, Choi EJ, Wilson JC, Kharawala S, Kaur G, Hirsch LJ. A systematic review of seizure clusters: Prevalence, risk factors, burden of disease and treatment patterns. Epilepsy Research 2021, 177: 106748. PMID: 34521043, DOI: 10.1016/j.eplepsyres.2021.106748.Peer-Reviewed Original ResearchConceptsSeizure action planRescue medicationSeizure clustersStatus epilepticusTreatment patternsSeizure remissionTreatment resistanceHigh riskPoor physician-patient communicationSeizure-related hospitalizationHigh seizure frequencyBurden of diseaseProductivity of patientsPhysician-patient communicationNon-SC patientsQuality of lifeSystematic literature searchConsecutive seizuresSeizure frequencyTreatment guidelinesProspective studySC patientsCaregiver QOLDisease burdenRisk factorsElectroencephalographic Abnormalities are Common in COVID‐19 and are Associated with Outcomes
Lin L, Al‐Faraj A, Ayub N, Bravo P, Das S, Ferlini L, Karakis I, Lee JW, Mukerji SS, Newey CR, Pathmanathan J, Abdennadher M, Casassa C, Gaspard N, Goldenholz DM, Gilmore EJ, Jing J, Kim JA, Kimchi EY, Ladha HS, Tobochnik S, Zafar S, Hirsch LJ, Westover MB, Shafi MM. Electroencephalographic Abnormalities are Common in COVID‐19 and are Associated with Outcomes. Annals Of Neurology 2021, 89: 872-883. PMID: 33704826, PMCID: PMC8104061, DOI: 10.1002/ana.26060.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusElectrographic seizuresClinical outcomesEpileptiform abnormalitiesRisk factorsPresence of NCSEMultivariate Cox proportional hazards analysisMulticenter retrospective cohort studyCox proportional hazards analysisCOVID-19Retrospective cohort studyClinical risk factorsContinuous electroencephalogram monitoringAdverse clinical outcomesProportional hazards analysisCoronavirus disease 2019Ann NeurolHospital mortalityHospital lengthClinical seizuresCohort studyIndependent predictorsStatus epilepticusEEG findingsElectroencephalographic abnormalitiesAnti-seizure medications and efficacy against focal to bilateral tonic-clonic seizures: A systematic review with relevance for SUDEP prevention
Cutillo G, Tolba H, Hirsch LJ. Anti-seizure medications and efficacy against focal to bilateral tonic-clonic seizures: A systematic review with relevance for SUDEP prevention. Epilepsy & Behavior 2021, 117: 107815. PMID: 33640562, DOI: 10.1016/j.yebeh.2021.107815.Peer-Reviewed Original ResearchConceptsAnti-seizure medicationsBilateral tonic-clonic seizuresTonic-clonic seizuresSUDEP preventionSystematic reviewPlacebo-controlled clinical trialFocal impaired awareness seizuresRisk of SUDEPSudden unexpected deathMajor risk factorAwareness seizuresRisk factorsClinical trialsUnexpected deathFBTCSHigh dosesSeizuresStrong associationSUDEPPreventionMedicationsTiagabineEfficacyLamotrigineBrivaracetam
2020
Seizure clusters, rescue treatments, seizure action plans: Unmet needs and emerging formulations
Gidal B, Klein P, Hirsch LJ. Seizure clusters, rescue treatments, seizure action plans: Unmet needs and emerging formulations. Epilepsy & Behavior 2020, 112: 107391. PMID: 32898744, DOI: 10.1016/j.yebeh.2020.107391.Peer-Reviewed Original Research
2018
Seizures, periodic and rhythmic patterns in primary intraventricular hemorrhage
Stretz C, Sheikh Z, Maciel CB, Hirsch LJ, Gilmore EJ. Seizures, periodic and rhythmic patterns in primary intraventricular hemorrhage. Annals Of Clinical And Translational Neurology 2018, 5: 1104-1111. PMID: 30250866, PMCID: PMC6144442, DOI: 10.1002/acn3.627.Peer-Reviewed Original ResearchPrimary intraventricular hemorrhageFrequency of seizuresIctal-interictal continuumAntiseizure medicationsIntraventricular hemorrhageCEEG monitoringExternal ventricular drain placementPresence of hydrocephalusRhythmic EEG patternsVentricular drain placementCEEG durationCEEG patternsMedian ageNeuronal injuryElectrographic seizuresDrain placementRisk factorsOnly significant differenceGraeb scoreContinuous electroencephalographyCEEG recordingsSeizuresPatientsPeriodic dischargesEEG patternsClinical Correlates of Periodic Discharges and Nonconvulsive Seizures in Posterior Reversible Encephalopathy Syndrome (PRES)
Bastide L, Legros B, Rampal N, Gilmore EJ, Hirsch LJ, Gaspard N. Clinical Correlates of Periodic Discharges and Nonconvulsive Seizures in Posterior Reversible Encephalopathy Syndrome (PRES). Neurocritical Care 2018, 29: 481-490. PMID: 29949000, DOI: 10.1007/s12028-018-0548-2.Peer-Reviewed Original ResearchConceptsPosterior reversible encephalopathy syndromeReversible encephalopathy syndromeContinuous electroencephalography monitoringGlasgow Outcome ScaleNonconvulsive seizuresPeriodic dischargesEncephalopathy syndromeRisk factorsWorse outcomesEpileptiform patternsMagnetic resonance imaging (MRI) abnormalitiesRetrospective cohort studyCEEG findingsEligible patientsRelated seizuresCohort studyHospital dischargeLow disabilityIll patientsImaging abnormalitiesMedical chartsClinical featuresPathophysiological mechanismsEEG findingsFunctional outcomeSeizure 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
2017
Association of an Electroencephalography-Based Risk Score With Seizure Probability in Hospitalized Patients
Struck AF, Ustun B, Ruiz AR, Lee JW, LaRoche SM, Hirsch LJ, Gilmore EJ, Vlachy J, Haider HA, Rudin C, Westover MB. Association of an Electroencephalography-Based Risk Score With Seizure Probability in Hospitalized Patients. JAMA Neurology 2017, 74: 1419-1424. PMID: 29052706, PMCID: PMC5822188, DOI: 10.1001/jamaneurol.2017.2459.Peer-Reviewed Original ResearchConceptsIll patientsSeizure riskContinuous EEGRisk factorsMAIN OUTCOMEScoring systemBilateral independent periodic dischargesEpilepsy Monitoring Unit (EMU) admissionPeriodic dischargesBrief rhythmic dischargesProspective multicenter databaseSeizure risk factorsSporadic epileptiform dischargesRisk of seizuresRhythmic delta activitySimple scoring systemEligible patientsProbability of seizuresUnit admissionAcute illnessHospitalized patientsMulticenter databasePrior seizuresClinical historyClinical indicationsTime‐dependent risk of seizures in critically ill patients on continuous electroencephalogram
Struck AF, Osman G, Rampal N, Biswal S, Legros B, Hirsch LJ, Westover MB, Gaspard N. Time‐dependent risk of seizures in critically ill patients on continuous electroencephalogram. Annals Of Neurology 2017, 82: 177-185. PMID: 28681492, PMCID: PMC5842678, DOI: 10.1002/ana.24985.Peer-Reviewed Original ResearchConceptsEpileptiform EEG abnormalitiesClinical factorsIll patientsEpileptiform findingsRisk factorsEEG abnormalitiesEEG risk factorsClinical risk factorsRisk of seizuresHistory of seizuresPresence of comaDuration of monitoringGreater predictive valueTime-dependent riskAnn NeurolSeizure incidenceAcute illnessPrior seizuresClinical variablesEEG findingsProspective dataSeizure riskBaseline riskMultistate survival modelsPredictive valuePrevalence and risk factors of seizure clusters in adult patients with epilepsy
Chen B, Choi H, Hirsch LJ, Katz A, Legge A, Wong RA, Jiang A, Kato K, Buchsbaum R, Detyniecki K. Prevalence and risk factors of seizure clusters in adult patients with epilepsy. Epilepsy Research 2017, 133: 98-102. PMID: 28475999, DOI: 10.1016/j.eplepsyres.2017.04.016.Peer-Reviewed Original ResearchConceptsSymptomatic generalized epilepsyIdiopathic generalized epilepsySeizure clustersEpilepsy typeStatus epilepticusCortical dysplasiaGeneralized epilepsyFocal epilepsySeizure onsetCNS infectionSeizure freedomMore AEDsRisk factorsCentral nervous system infectionCongenital brain injuryEpilepsy risk factorsNervous system infectionPotential clinical factorsComplex partial seizuresEarly seizure onsetEpilepsy detailsRescue medicationAdult patientsPatient demographicsSystem infectionSurgical outcome in adolescents with mesial temporal sclerosis: Is it different?
Farooque P, Hirsch L, Levy S, Testa F, Mattson R, Spencer D. Surgical outcome in adolescents with mesial temporal sclerosis: Is it different? Epilepsy & Behavior 2017, 69: 24-27. PMID: 28235653, DOI: 10.1016/j.yebeh.2016.10.028.Peer-Reviewed Original ResearchConceptsMesial temporal sclerosisTemporal sclerosisStatus epilepticusTemporal lobectomySurgical outcomesAdolescent patientsIctal onsetMore lobesEpilepsy surgery databaseScalp EEGSeizure freedomPatient populationSurgery DatabaseRisk factorsPatientsElectrographic dataLobectomyEpilepticusTwo yearsSclerosisHypometabolismNovel findingsAdolescentsMRIOutcomes
2016
Seizure 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
2012
Sudden unexpected death in epilepsy in lamotrigine randomized‐controlled trials
Tomson T, Hirsch LJ, Friedman D, Bester N, Hammer A, Irizarry M, Ishihara L, Krishen A, Spaulding T, Wamil A, Leadbetter R. Sudden unexpected death in epilepsy in lamotrigine randomized‐controlled trials. Epilepsia 2012, 54: 135-140. PMID: 23030403, DOI: 10.1111/j.1528-1167.2012.03689.x.Peer-Reviewed Original ResearchConceptsSudden unexpected deathProbable SUDEPTreatment armsAntiepileptic drugsClinical trialsOdds ratioUnexpected deathTonic-clonic seizure frequencyRate of SUDEPRisk of SUDEPRandomized clinical trialsRandomized-controlled trialPotential risk factorsCause deathPossible SUDEPStudy medicationPatient yearsSeizure frequencyTreatment deathsComparator armActive comparatorNonrandomized studyUnadjusted ratesComparator groupRisk factors
2009
Report of the American Epilepsy Society and the Epilepsy Foundation Joint Task Force on Sudden Unexplained Death in Epilepsy
So EL, Bainbridge J, Buchhalter JR, Donalty J, Donner EJ, Finucane A, Graves NM, Hirsch LJ, Montouris GD, Temkin NR, Wiebe S, Sierzant TL. Report of the American Epilepsy Society and the Epilepsy Foundation Joint Task Force on Sudden Unexplained Death in Epilepsy. Epilepsia 2009, 50: 917-922. PMID: 19054406, DOI: 10.1111/j.1528-1167.2008.01906.x.Peer-Reviewed Original ResearchConceptsSudden unexplained deathAmerican Epilepsy SocietyRisk factorsUnexplained deathEpilepsy SocietyRisk of SUDEPPreventable risk factorsPossible preventive strategiesSurvey of patientsComplete autopsy examinationTask ForceTask Force recommendationsConsortium of centersConvulsive seizuresProspective studyBasic research studiesAutopsy examinationSUDEPSUDEP researchPreventive strategiesPatientsEpilepsy FoundationPosition statementCaregiversMedical examiners
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
2002
Heart rate and EKG changes in 102 seizures: analysis of influencing factors
Opherk C, Coromilas J, Hirsch LJ. Heart rate and EKG changes in 102 seizures: analysis of influencing factors. Epilepsy Research 2002, 52: 117-127. PMID: 12458028, DOI: 10.1016/s0920-1211(02)00215-2.Peer-Reviewed Original ResearchConceptsEKG abnormalitiesIctal heart rateHeart rateGeneralized seizuresEKG changesT-wave inversionMajority of seizuresHippocampal sclerosisSeizure durationST depressionSinus tachycardiaRisk factorsUnexpected deathHigh riskCardiac arrhythmiasEpileptic seizuresSeizuresAbnormalitiesPatientsMajor causeLeft hemisphereEpilepsyEEG recordingsResponsible factorsSUDEP