2022
Updated 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 factorsPatient‐detectable responsive neurostimulation as a seizure warning system
Quraishi IH, Hirsch LJ. Patient‐detectable responsive neurostimulation as a seizure warning system. Epilepsia 2021, 62: e110-e116. PMID: 34018182, PMCID: PMC8629031, DOI: 10.1111/epi.16933.Peer-Reviewed Original ResearchConceptsResponsive neurostimulation systemFocal impaired awareness seizuresProportion of patientsQuality of lifeSeizure warningTolerable symptomsClinical seizuresLatter therapySelect patientsAwareness seizuresEpileptiform activityEarly recognitionResponsive neurostimulationEpileptiform patternsCognitive impairmentPatientsNeurostimulation systemSymptomsSeizuresTherapyTreatment of clustersStimulationSeizure warning systemSeizure recognitionEpilepsyHow to Help Your Patients Enroll in the New-Onset Refractory Status Epilepticus (NORSE) and Febrile Infection-Related Epilepsy Syndrome (FIRES) Family Registry, and Other Rare Epilepsy Registries.
Kazazian K, Kellogg M, Wong N, Eschbach K, Moeller RF, Gaspard N, Hirsch LJ, Hocker S, Gofton T. How to Help Your Patients Enroll in the New-Onset Refractory Status Epilepticus (NORSE) and Febrile Infection-Related Epilepsy Syndrome (FIRES) Family Registry, and Other Rare Epilepsy Registries. Epilepsy Currents 2021, 1535759721998329. PMID: 33663265, DOI: 10.1177/1535759721998329.Peer-Reviewed Original ResearchFebrile infection-related epilepsy syndromeNew-onset refractory status epilepticusRefractory status epilepticusStatus epilepticusFamily RegistryRare clinical presentationPast medical historyQuality of lifeEpilepsy registryFebrile infectionsActive epilepsyDisease courseClinical outcomesClinical presentationEpilepsy syndromesMedical historyNeurologic disordersRigorous research studiesEpilepticusRegistryPatient enrollsFamily membersOutcomesMorbidityEpilepsy
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
Randomized controlled trial of motivational interviewing for psychogenic nonepileptic seizures
Tolchin B, Baslet G, Suzuki J, Martino S, Blumenfeld H, Hirsch LJ, Altalib H, Dworetzky BA. Randomized controlled trial of motivational interviewing for psychogenic nonepileptic seizures. Epilepsia 2019, 60: 986-995. PMID: 30980679, DOI: 10.1111/epi.14728.Peer-Reviewed Original ResearchConceptsPsychogenic nonepileptic seizuresQuality of lifeMI participantsPNES frequencyMotivational interviewingControl participantsNonepileptic seizuresQuaternary care medical centerEmergency department visitsEmergency department utilizationSingle neurologistDepartment visitsTreatment adherenceControl armMedical CenterMI armsSeizuresVisitsTrialsAdherenceParticipantsPsychotherapyAdherentArmReferralAdherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures.
Tolchin B, Dworetzky BA, Martino S, Blumenfeld H, Hirsch LJ, Baslet G. Adherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures. Neurology 2019, 92: e675-e679. PMID: 30610097, PMCID: PMC6382361, DOI: 10.1212/wnl.0000000000006848.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAdult Survivors of Child AbuseAgedAged, 80 and overCohort StudiesConversion DisorderEmergency Service, HospitalEthnicityFemaleFollow-Up StudiesHumansMaleMiddle AgedMinority GroupsOdds RatioProspective StudiesPsychotherapyQuality of LifeSeizuresTreatment Adherence and ComplianceTreatment OutcomeYoung AdultConceptsPsychogenic nonepileptic seizuresQuality of lifePNES frequencyNonepileptic seizuresProspective cohort studyEmergency department utilizationTime of referralBaseline characteristicsCohort studyED visitsSeizure frequencyED utilizationPotential confoundersWomen's HospitalTreatment outcomesMedium effect sizeLocal therapistsMultivariate modelAdherenceChildhood abuseSeizuresHospitalSignificant reductionOutcomesEffect size
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
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 ResearchAssessment of Treatment Side Effects and Quality of Life in People with Epilepsy
Blond BN, Detyniecki K, Hirsch LJ. Assessment of Treatment Side Effects and Quality of Life in People with Epilepsy. Neurologic Clinics 2016, 34: 395-410. PMID: 27086986, DOI: 10.1016/j.ncl.2015.11.002.Peer-Reviewed Original ResearchTreatment of Convulsive Status Epilepticus
Grover EH, Nazzal Y, Hirsch LJ. Treatment of Convulsive Status Epilepticus. Current Treatment Options In Neurology 2016, 18: 11. PMID: 26920416, DOI: 10.1007/s11940-016-0394-5.Peer-Reviewed Original ResearchAnti-epileptic drugsNon-convulsive SEStatus epilepticusRefractory SEPreferred second-line agentNon-convulsive status epilepticusAnti-seizure medicationsHome rescue medicationThird-line agentsAcute side effectsConvulsive status epilepticusFirst-line treatmentNon-convulsive seizuresSecond-line agentsLower health care costsEmergency room visitsImmuno-modulatory agentsRecovery of consciousnessUse of benzodiazepinesQuality of lifeHealth care costsConsecutive seizuresParaneoplastic etiologyRescue medicationBuccal midazolam
2015
Rates and predictors of patient-reported cognitive side effects of antiepileptic drugs: An extended follow-up
Javed A, Cohen B, Detyniecki K, Hirsch LJ, Legge A, Chen B, Bazil C, Kato K, Buchsbaum R, Choi H. Rates and predictors of patient-reported cognitive side effects of antiepileptic drugs: An extended follow-up. Seizure 2015, 29: 34-40. PMID: 26076842, DOI: 10.1016/j.seizure.2015.03.013.Peer-Reviewed Original ResearchConceptsCognitive side effectsAntiepileptic medicationsSide effectsMultiple logistic regression analysisMore antiepileptic medicationsLogistic regression analysisQuality of lifeIndependent predictorsRetrospective studyAntiepileptic drugsAdult outpatientsMedical recordsAdverse effectsIntellectual disabilityPolytherapyLevetiracetamGabapentinRegression analysisLamotrigineLower ratesPredictorsCarbamazepineMonotherapyMedicationsRelative frequencyLong-term treatment with responsive brain stimulation in adults with refractory partial seizures
Bergey GK, Morrell MJ, Mizrahi EM, Goldman A, King-Stephens D, Nair D, Srinivasan S, Jobst B, Gross RE, Shields DC, Barkley G, Salanova V, Olejniczak P, Cole A, Cash SS, Noe K, Wharen R, Worrell G, Murro AM, Edwards J, Duchowny M, Spencer D, Smith M, Geller E, Gwinn R, Skidmore C, Eisenschenk S, Berg M, Heck C, Van Ness P, Fountain N, Rutecki P, Massey A, O'Donovan C, Labar D, Duckrow RB, Hirsch LJ, Courtney T, Sun FT, Seale CG. Long-term treatment with responsive brain stimulation in adults with refractory partial seizures. Neurology 2015, 84: 810-817. PMID: 25616485, PMCID: PMC4339127, DOI: 10.1212/wnl.0000000000001280.Peer-Reviewed Original ResearchConceptsRefractory partial-onset seizuresPartial-onset seizuresRefractory partial seizuresOnset seizuresQuality of lifePartial seizuresResponsive neurostimulatorSerious device-related adverse eventsMedian percent seizure reductionGeneralized tonic-clonic seizuresOpen-label safety studyDevice-related adverse eventsImplant site infectionPercent seizure reductionResponsive brain stimulationClass IV evidenceTonic-clonic seizuresDirect cortical stimulationLong-term efficacyLong-term treatmentRNS SystemDirect neurostimulationSeizure reductionAdverse eventsSite infection
2014
Ictal spread of medial temporal lobe seizures with and without secondary generalization: An intracranial electroencephalography analysis
Yoo JY, Farooque P, Chen WC, Youngblood MW, Zaveri HP, Gerrard JL, Spencer DD, Hirsch LJ, Blumenfeld H. Ictal spread of medial temporal lobe seizures with and without secondary generalization: An intracranial electroencephalography analysis. Epilepsia 2014, 55: 289-295. PMID: 24417694, PMCID: PMC4103687, DOI: 10.1111/epi.12505.Peer-Reviewed Original ResearchConceptsSecondary generalizationTemporal lobe seizuresFocal seizuresTemporal cortexMedial temporal lobe seizuresCortical regionsLow-voltage fast activityProminent activationAnteromedial temporal lobe resectionTonic-clonic seizuresSeizure-onset patternsTemporal lobe resectionLateral temporal cortexQuality of lifePosterior lateral temporal cortexTemporal lobe areasIntracranial electroencephalography studyMedial temporal lobe areasMedial temporal lobePosterior lateral temporal regionsIctal spreadHippocampal sclerosisSeizure spreadLobe resectionTemporal lobe