2021
Neuromodulation in epilepsy: state-of-the-art approved therapies
Ryvlin P, Rheims S, Hirsch LJ, Sokolov A, Jehi L. Neuromodulation in epilepsy: state-of-the-art approved therapies. The Lancet Neurology 2021, 20: 1038-1047. PMID: 34710360, DOI: 10.1016/s1474-4422(21)00300-8.Peer-Reviewed Original ResearchConceptsVagus nerve stimulationANT-DBSAdverse eventsNeuromodulation therapiesResponsive neurostimulationCurative surgical treatmentFrequent adverse eventsRefractory focal epilepsyHigh-level evidenceDeep brain stimulationForms of neuromodulationClosed-loop therapyAntiepileptic treatmentSeizure frequencySurgical treatmentNerve stimulationIntracranial hemorrhageIntractable seizuresEpileptogenic zoneFocal epilepsyAnterior nucleusLong-term reductionBrain stimulationTherapyImplant sitesElectrical cortical stimulation can impair production of the alphabet without impairing counting
Rojas PH, Sivaraju A, Quraishi IH, Vanderlind M, Rofes A, Połczynska-Bletsos MM, Spencer DD, Hirsch LJ, Benjamin CFA. Electrical cortical stimulation can impair production of the alphabet without impairing counting. Epilepsy & Behavior Reports 2021, 15: 100433. PMID: 33778464, PMCID: PMC7985277, DOI: 10.1016/j.ebr.2021.100433.Peer-Reviewed Case Reports and Technical NotesElectrical stimulation mappingCortical electrical stimulation mappingDrug-resistant focal epilepsyPatient experienced lossDrug-resistant epilepsyElectrical cortical stimulationLanguage-dominant hemisphereSuperior temporal gyrusPosterior superior temporal gyrusCortical stimulationFocal epilepsyStimulation mappingDominant hemispherePatientsTemporal gyrusSelective impairmentLanguage functionEpilepsyExperienced lossImpairmentBrainRiskLanguage impairmentSurgerySole means
2020
Nine-year prospective efficacy and safety of brain-responsive neurostimulation for focal epilepsy
Nair DR, Laxer KD, Weber PB, Murro AM, Park YD, Barkley GL, Smith BJ, Gwinn RP, Doherty MJ, Noe KH, Zimmerman RS, Bergey GK, Anderson WS, Heck C, Liu CY, Lee RW, Sadler T, Duckrow RB, Hirsch LJ, Wharen RE, Tatum W, Srinivasan S, McKhann GM, Agostini MA, Alexopoulos AV, Jobst BC, Roberts DW, Salanova V, Witt TC, Cash SS, Cole AJ, Worrell GA, Lundstrom BN, Edwards JC, Halford JJ, Spencer DC, Ernst L, Skidmore CT, Sperling MR, Miller I, Geller EB, Berg MJ, Fessler AJ, Rutecki P, Goldman AM, Mizrahi EM, Gross RE, Shields DC, Schwartz TH, Labar DR, Fountain NB, Elias WJ, Olejniczak PW, Villemarette-Pittman NR, Eisenschenk S, Roper SN, Boggs JG, Courtney TA, Sun FT, Seale CG, Miller KL, Skarpaas TL, Morrell MJ. Nine-year prospective efficacy and safety of brain-responsive neurostimulation for focal epilepsy. Neurology 2020, 95: 10.1212/wnl.0000000000010154. PMID: 32690786, PMCID: PMC7538230, DOI: 10.1212/wnl.0000000000010154.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedDepressive DisorderDrug Resistant EpilepsyElectric Stimulation TherapyEpilepsies, PartialFemaleFollow-Up StudiesHumansImplantable NeurostimulatorsIntracranial HemorrhagesMaleMemory DisordersMiddle AgedProspective StudiesProsthesis-Related InfectionsQuality of LifeRandomized Controlled Trials as TopicStatus EpilepticusSudden Unexpected Death in EpilepsySuicideTreatment OutcomeYoung AdultConceptsBrain-responsive neurostimulationQuality of lifeFocal onset seizuresAdverse eventsSeizure frequencyIntractable focal onset seizuresProspective open-label trialOverall QOLOpen-label trialSerious adverse eventsClass IV evidenceMedian percent reductionSudden unexplained deathMedian percent changeSeizure-free periodQOLIE-89SUDEP ratesLabel trialSeizure freedomEpilepsy ratesFocal seizuresOnset seizuresEpilepsy InventoryAcceptable safetyFocal epilepsy
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 epilepsy
2018
Comparative efficacy of unique antiepileptic drug regimens in focal epilepsy: An exploratory study
Legge AW, Detyniecki K, Javed A, Hirsch LJ, Kato K, Buchsbaum R, Chen B, Choi H. Comparative efficacy of unique antiepileptic drug regimens in focal epilepsy: An exploratory study. Epilepsy Research 2018, 142: 73-80. PMID: 29571152, DOI: 10.1016/j.eplepsyres.2018.03.011.Peer-Reviewed Original ResearchConceptsFocal epilepsyLamotrigine monotherapyUnique regimensSeizure freedomAntiepileptic drug polytherapyContinuous seizure freedomUnique antiepileptic drugAED regimensAED treatmentDrug polytherapyPersistent seizuresPhenytoin monotherapyAntiepileptic drugsEpilepsy severityPatient comparisonSix-month periodMonotherapyRegimensSame patientComparative efficacyBetter outcomesPatientsPolytherapyBetter efficacyEpilepsy
2017
Prevalence 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 infection
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