2024
Systematic 1 Hz direct electrical stimulation for seizure induction: A reliable method for localizing seizure onset zone and predicting seizure freedom
Sivaraju A, Quraishi I, Collins E, McGrath H, Ramos A, Turk-Browne N, Zaveri H, Damisah E, Spencer D, Hirsch L. Systematic 1 Hz direct electrical stimulation for seizure induction: A reliable method for localizing seizure onset zone and predicting seizure freedom. Brain Stimulation 2024, 17: 339-345. PMID: 38490472, DOI: 10.1016/j.brs.2024.03.011.Peer-Reviewed Original ResearchSeizure inductionSeizure onset zoneSurgical outcomesHabitual seizuresOnset zonePredicting seizure freedomExcellent surgical outcomesProspective cohort studyMann-Whitney testConsecutive patientsFisher's exactSeizure freedomRefractory epilepsyCohort studyPost-surgeryInsular regionsMann-WhitneyPatientsIntracranial EEGSeizuresLocalizing seizure onset zonesStimulationElectrical stimulationMedial temporal regionsTemporal regions
2022
Factors Predicting Outcome After Intracranial EEG Evaluation in Patients With Medically Refractory Epilepsy
Sivaraju A, Hirsch L, Gaspard N, Farooque P, Gerrard J, Xu Y, Deng Y, Damisah E, Blumenfeld H, Spencer DD. Factors Predicting Outcome After Intracranial EEG Evaluation in Patients With Medically Refractory Epilepsy. Neurology 2022, 99: e1-e10. PMID: 35508395, PMCID: PMC9259091, DOI: 10.1212/wnl.0000000000200569.Peer-Reviewed Original ResearchConceptsTemporal lobe onsetSeizure freedomResective surgeryIndependent predictorsLesional MRIUnfavorable predictorRefractory epilepsyContinued medical treatmentEpilepsy surgical evaluationFactors Predicting OutcomeIntracranial EEG evaluationNonlesional extratemporal epilepsySubsequent seizure freedomSustained seizure freedomThorough presurgical evaluationSeizure-free outcomeClass II evidenceMedically Refractory EpilepsyRetrospective chart reviewKaplan-Meier curvesSelect clinical scenariosMultivariable regression analysisBest multivariable modelIntracranial EEGSeizure onset localization
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 epilepsyMisperceptions on the chance of seizure freedom with antiseizure medications after two failed trials
Blond BN, Hirsch LJ, Mattson RH. Misperceptions on the chance of seizure freedom with antiseizure medications after two failed trials. Epilepsia 2020, 61: 1789-1790. PMID: 32640071, DOI: 10.1111/epi.16594.Peer-Reviewed Original ResearchBeyond implantation effect? Long-term seizure reduction and freedom following intracranial monitoring without additional surgical interventions
Percy J, Zaveri H, Duckrow RB, Gerrard J, Farooque P, Hirsch LJ, Spencer DD, Sivaraju A. Beyond implantation effect? Long-term seizure reduction and freedom following intracranial monitoring without additional surgical interventions. Epilepsy & Behavior 2020, 111: 107231. PMID: 32615416, DOI: 10.1016/j.yebeh.2020.107231.Peer-Reviewed Original ResearchConceptsLong-term seizure freedomSeizure freedomSeizure frequencyElectrode implantationIntracranial studiesLong-term seizure reductionAdditional surgical interventionSeizure onset localizationIntracranial electroencephalogram monitoringSeizure reductionConsecutive patientsSurgical interventionEpileptogenic networksElectroencephalogram monitoringNeuromodulatory effectsRetrospective analysisIntracranial monitoringTransient improvementDepth electrodesPatientsYear 4ImplantationAdequate dataYears
2019
Effectiveness 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
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 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
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
2011
The effect of age and comedication on lamotrigine clearance, tolerability, and efficacy
Arif H, Svoronos A, Resor SR, Buchsbaum R, Hirsch LJ. The effect of age and comedication on lamotrigine clearance, tolerability, and efficacy. Epilepsia 2011, 52: 1905-1913. PMID: 21838791, DOI: 10.1111/j.1528-1167.2011.03217.x.Peer-Reviewed Original ResearchConceptsLTG clearanceOlder adultsYoung adultsOlder patientsSeizure freedomYounger patientsAdverse effectsOne-year retentionEfficacy of lamotrigineIntolerable side effectsHigher serum levelsSpecific adverse effectsSignificant adverse effectsLamotrigine clearanceEffect of ageApparent clearanceSerum levelsLTG levelsOldest tertileAdult outpatientsSide effectsPatientsLamotrigineEnzyme inducersIntolerability
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
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