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 oddsPatientsMedicationsSeizures
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 ResearchMeSH KeywordsAnticonvulsantsChildCost of IllnessHumansPrevalenceProspective StudiesQuality of LifeRisk FactorsSeizuresConceptsSeizure 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 abnormalities
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 ResearchValidation of the 2HELPS2B Seizure Risk Score in Acute Brain Injury Patients
Moffet EW, Subramaniam T, Hirsch LJ, Gilmore EJ, Lee JW, Rodriguez-Ruiz AA, Haider HA, Dhakar MB, Jadeja N, Osman G, Gaspard N, Struck AF. Validation of the 2HELPS2B Seizure Risk Score in Acute Brain Injury Patients. Neurocritical Care 2020, 33: 701-707. PMID: 32107733, DOI: 10.1007/s12028-020-00939-x.Peer-Reviewed Original ResearchConceptsAcute brain injuryClinical factorsContinuous EEG monitoringTraumatic brain injurySeizure incidenceEEG findingsClinical seizuresPrimary outcomeSubdural hematomaBrain injuryEEG monitoringAcute brain injury patientsRisk of seizuresBrain injury patientsReceiver operator characteristic curveOperator characteristic curveABI patientsPatient ageHospitalized patientsElectrographic seizuresInjury patientsIntraparenchymal hemorrhageClinical findingsSubarachnoid hemorrhageResultsA total
2017
Time‐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 ResearchMeSH KeywordsDrug Resistant EpilepsyHumansPrevalenceQuality of LifeRisk FactorsSeizuresSyndromeTreatment Outcome
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
2010
Seizures and CNS Hemorrhage
Gilmore E, Choi HA, Hirsch LJ, Claassen J. Seizures and CNS Hemorrhage. The Neurologist 2010, 16: 165-175. PMID: 20445426, DOI: 10.1097/nrl.0b013e3181c7cd0b.Peer-Reviewed Original ResearchConceptsAneurysmal subarachnoid hemorrhageCentral nervous system hemorrhageShort-term prophylaxisNonconvulsive seizuresIntracerebral hemorrhageSpontaneous intracerebral hemorrhageSeizure prophylaxisASAH patientsAdditional injuriesAcute brain injuryPoor clinical gradeEvidence-based guidelinesCommon neurologic conditionsDeleterious effectsAntiepileptic medicationsControlled TrialsConvulsive seizuresCNS hemorrhagePoor outcomeSubarachnoid hemorrhageNeurologic conditionsSurrogate markerBrain injuryClinical gradeRecent injury
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
2008
Focal motor seizures induced by alerting stimuli in critically ill patients
Hirsch LJ, Pang T, Claassen J, Chang C, Khaled KA, Wittman J, Emerson RG. Focal motor seizures induced by alerting stimuli in critically ill patients. Epilepsia 2008, 49: 968-973. PMID: 18177364, DOI: 10.1111/j.1528-1167.2007.01481.x.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAnticonvulsantsArousalBrain Damage, ChronicBrain StemChildCritical CareDominance, CerebralElectroencephalographyEpilepsy, Partial, MotorEpilepsy, ReflexFemaleFrontal LobeHumansMagnetic Resonance ImagingMaleMiddle AgedRisk FactorsSubstance Withdrawal SyndromeTemporal LobeThalamusVideo RecordingConceptsFocal motor seizuresMotor seizuresIll patientsEEG findingsTertiary care medical centerVideo-EEG findingsNonconvulsive status epilepticusReview of chartsElectrographic seizure activityFocal EEG findingsArousal circuitryHyperexcitable cortexEncephalopathic patientsAcute illnessClinical seizuresStatus epilepticusBilateral thalamusComatose patientsElectrographic seizuresUpper brainstemSeizure activityClinical correlatesEpileptiform activityMotor pathwaysNeurological ICU
2007
Generalized convulsive status epilepticus after nontraumatic subarachnoid hemorrhage: the nationwide inpatient sample.
Claassen J, Bateman BT, Willey JZ, Inati S, Hirsch LJ, Mayer SA, Sacco RL, Schumacher HC. Generalized convulsive status epilepticus after nontraumatic subarachnoid hemorrhage: the nationwide inpatient sample. Neurosurgery 2007, 61: 60-4; discussion 64-5. PMID: 17621019, DOI: 10.1227/01.neu.0000279724.05898.e7.Peer-Reviewed Original ResearchConceptsNontraumatic subarachnoid hemorrhageConvulsive status epilepticusNationwide Inpatient SampleSubarachnoid hemorrhageRenal diseaseStatus epilepticusInpatient SampleNonfederal United States hospitalsGeneralized convulsive status epilepticusDatabase of admissionsDuration of hospitalizationMultivariate logistic regressionUnited States hospitalsHospital mortalityHospital stayAdult patientsYounger patientsIndependent predictorsPatient mortalityEmergency departmentPatientsLinear regression analysisState HospitalNeurosurgical proceduresLogistic regressionConvulsive status epilepticus after ischemic stroke and intracerebral hemorrhage: frequency, predictors, and impact on outcome in a large administrative dataset
Bateman BT, Claassen J, Willey JZ, Hirsch LJ, Mayer SA, Sacco RL, Schumacher HC. Convulsive status epilepticus after ischemic stroke and intracerebral hemorrhage: frequency, predictors, and impact on outcome in a large administrative dataset. Neurocritical Care 2007, 7: 187-193. PMID: 17503112, DOI: 10.1007/s12028-007-0056-2.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeConvulsive status epilepticusIntracerebral hemorrhageIschemic strokeICH cohortRenal diseaseStatus epilepticusSodium imbalanceAlcohol abuseAIS cohortDiagnosis of AISAppropriate ICD-9-CM codesICD-9-CM codesHigh rateNationwide Inpatient SampleAfrican American raceMultivariate logistic regressionLower ratesResultsThe cohortHemorrhagic transformationDiabetes mellitusHemorrhagic strokeIndependent predictorsSerious complicationsHispanic race
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
2004
Can sudden unexplained death in epilepsy be prevented?
Hirsch LJ, Hauser WA. Can sudden unexplained death in epilepsy be prevented? The Lancet 2004, 364: 2157-2158. PMID: 15610785, DOI: 10.1016/s0140-6736(04)17605-8.Peer-Reviewed Original Research
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 factorsSUDEPNonconvulsive Status Epilepticus after Subarachnoid Hemorrhage
Dennis LJ, Claassen J, Hirsch LJ, Emerson RG, Connolly ES, Mayer SA. Nonconvulsive Status Epilepticus after Subarachnoid Hemorrhage. Neurosurgery 2002, 51: 1136. PMID: 12383358, DOI: 10.1097/00006123-200211000-00006.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageCEEG monitoringUnexplained comaNeurological deteriorationStatus epilepticusRefractory nonconvulsive status epilepticusNeurological intensive care unitProphylactic anticonvulsant therapyHours of hospitalizationContinuous electroencephalographic monitoringIntensive care unitAnticonvulsant administrationHospital seizuresAnticonvulsant therapyCerebral edemaClinical improvementHess gradeCare unitClinical featuresComatose patientsElectrographic seizuresVentricular drainageMidazolam therapy