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 ResearchMeSH KeywordsDrug Resistant EpilepsyElectrocorticographyElectroencephalographyHumansMagnetic Resonance ImagingRetrospective StudiesTreatment OutcomeConceptsTemporal 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
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 ResearchMeSH KeywordsDeep Brain StimulationDrug Resistant EpilepsyEpilepsyHumansSeizuresTreatment OutcomeVagus Nerve StimulationConceptsVagus 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 sitesGerstmann Syndrome Deconstructed by Cortical Stimulation
Vaddiparti A, McGrath H, Benjamin C, Sivaraju A, Spencer DD, Hirsch LJ, Damisah E, Quraishi IH. Gerstmann Syndrome Deconstructed by Cortical Stimulation. Neurology 2021, 97: 420-422. PMID: 34187861, PMCID: PMC9246017, DOI: 10.1212/wnl.0000000000012441.Peer-Reviewed Original ResearchMeSH KeywordsAdultBrain MappingDrug Resistant EpilepsyElectric StimulationFemaleGerstmann SyndromeHumans
2020
Development and validation of a predictive model of drug-resistant genetic generalized epilepsy.
Choi H, Detyniecki K, Bazil C, Thornton S, Crosta P, Tolba H, Muneeb M, Hirsch LJ, Heinzen EL, Sen A, Depondt C, Perucca P, Heiman GA, Adcock J, Andrade D, Cavalleri G, Costello D, Delanty N, Dugan P, Goldstein D, Kwan P, Nascimento F, O’Brien T, Radthke R, Smith P, Thomas R. Development and validation of a predictive model of drug-resistant genetic generalized epilepsy. Neurology 2020, 95: e2150-e2160. PMID: 32759205, PMCID: PMC7713754, DOI: 10.1212/wnl.0000000000010597.Peer-Reviewed Original ResearchConceptsGenetic generalized epilepsyCatamenial epilepsyGeneralized epilepsyPsychiatric conditionsOngoing longitudinal observational studyGeneralized tonic clonicTertiary epilepsy centerNegative prognostic factorCase-control studyLongitudinal observational studyClinical prediction modelAED resistanceTonic clonicPrognostic factorsSeizure typesEpilepsy centersAntiepileptic drugsAbsence seizuresObservational studyOngoing longitudinal studyEpilepsyCase statusAED responsePatientsExternal testing datasetNine-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 epilepsyAuthor response: New onset refractory status epilepticus research: What is on the horizon?
Gofton TE, Hirsch LJ. Author response: New onset refractory status epilepticus research: What is on the horizon? Neurology 2020, 94: 596. PMID: 32229639, DOI: 10.1212/wnl.0000000000009187.Peer-Reviewed Original ResearchMesial temporal resection following long‐term ambulatory intracranial EEG monitoring with a direct brain‐responsive neurostimulation system
Hirsch LJ, Mirro EA, Salanova V, Witt TC, Drees CN, Brown M, Lee RW, Sadler TL, Felton EA, Rutecki P, Shin HW, Hadar E, Hegde M, Rao VR, Mnatsakanyan L, Madhavan DS, Zakaria TJ, Liu AA, Heck CN, Greenwood JE, Bigelow JK, Nair DR, Alexopoulos AV, Mackow M, Edwards JC, Sotudeh N, Kuzniecky RI, Gwinn RP, Doherty MJ, Geller EB, Morrell MJ. Mesial temporal resection following long‐term ambulatory intracranial EEG monitoring with a direct brain‐responsive neurostimulation system. Epilepsia 2020, 61: 408-420. PMID: 32072621, PMCID: PMC7154711, DOI: 10.1111/epi.16442.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnterior Temporal LobectomyDrug Resistant EpilepsyElectric Stimulation TherapyElectrocorticographyEpilepsy, Temporal LobeFemaleHumansImplantable NeurostimulatorsMaleMiddle AgedMonitoring, AmbulatoryNeurosurgical ProceduresRetrospective StudiesTemporal LobeTreatment OutcomeYoung AdultConceptsMTL resectionElectrographic seizuresTemporal lobe seizure onsetClinical seizure reductionMesial temporal resectionIntracranial EEG monitoringRNS SystemBitemporal epilepsySeizure reductionSeizure outcomeTemporal resectionPrimary outcomeRefractory epilepsyAdditional patientsEpilepsy centersUnilateral onsetBilateral onsetIcEEG recordingsSeizure onsetMTL epilepsyMedian reductionResectionPatientsEEG monitoringIcEEG data
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 ResearchMeSH KeywordsAnticonvulsantsClinical Trials as TopicDrug Resistant EpilepsyElectric Stimulation TherapyElectrocorticographyHumansRetrospective StudiesTreatment OutcomeConceptsPositive 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 epilepsyTreatment of drug-resistant epilepsy in patients with periventricular nodular heterotopia using RNS® System: Efficacy and description of chronic electrophysiological recordings
Nune G, Arcot Desai S, Razavi B, Agostini MA, Bergey GK, Herekar AA, Hirsch LJ, Lee RW, Rutecki PA, Srinivasan S, Van Ness PC, Tcheng TK, Morrell MJ. Treatment of drug-resistant epilepsy in patients with periventricular nodular heterotopia using RNS® System: Efficacy and description of chronic electrophysiological recordings. Clinical Neurophysiology 2019, 130: 1196-1207. PMID: 31163364, DOI: 10.1016/j.clinph.2019.04.706.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBrain WavesDeep Brain StimulationDrug Resistant EpilepsyFemaleHippocampusHumansMaleMiddle AgedNeocortexPeriventricular Nodular HeterotopiaConceptsPeriventricular nodular heterotopiaClinical seizure frequencySeizure frequencySeizure rateNodular heterotopiaDirect brain-responsive neurostimulationBrain-responsive neurostimulationDrug-resistant epilepsyEffective treatment optionSeizure-onset patternsSeizure propagation patternsChronic electrophysiological recordingsSeizure reductionClinical seizuresSuch patientsElectrographic seizuresPattern of spreadIntractable seizuresTreatment optionsEpileptogenic networksSeizure generationOnset typeMean reductionLead locationPatientsHow long would it take to try all the antiepileptic drugs available?
Montenegro MA, Novais A, Hirsch LJ. How long would it take to try all the antiepileptic drugs available? Epilepsy Research 2019, 154: 77-78. PMID: 31096069, DOI: 10.1016/j.eplepsyres.2019.04.012.Peer-Reviewed Original ResearchNew onset refractory status epilepticus research: What is on the horizon?
Gofton TE, Gaspard N, Hocker SE, Loddenkemper T, Hirsch LJ. New onset refractory status epilepticus research: What is on the horizon? Neurology 2019, 92: 802-810. PMID: 30894443, DOI: 10.1212/wnl.0000000000007322.Peer-Reviewed Original ResearchConceptsNew-onset refractory status epilepticusRefractory status epilepticusStatus epilepticusFebrile infection-related epilepsy syndromeMore rescue medicationsRescue medicationNew onsetActive epilepsyClinical featuresClinical presentationEpilepsy syndromesMetabolic causesNeurologic disordersPediatric EvaluationSpecific diagnosisAge groupsEpilepticusFamily supportFuture collaborative researchMedicationsPatientsFeverEpilepsyPathophysiologySyndrome
2018
Seizure susceptibility and infraslow modulatory activity in the intracranial electroencephalogram
Joshi RB, Duckrow RB, Goncharova II, Gerrard JL, Spencer DD, Hirsch LJ, Godwin DW, Zaveri HP. Seizure susceptibility and infraslow modulatory activity in the intracranial electroencephalogram. Epilepsia 2018, 59: 2075-2085. PMID: 30187919, DOI: 10.1111/epi.14559.Peer-Reviewed Original ResearchConceptsAED taperYale-New Haven HospitalAdult epilepsy patientsSeizure forecasting algorithmsElectrode contact pairsSeizure onset areaSeizure susceptibilityClinical recordsDrug taperElectrophysiological changesEpilepsy patientsIntracranial electroencephalographic dataMagnitude-squared coherenceModulatory activitySeizuresPatientsOnset areaPreseizurePostseizureProgressive desynchronizationIntracranial electroencephalogramDaysIctogenesisEffect of timeHospitalNew‐onset refractory status epilepticus (NORSE) and febrile infection–related epilepsy syndrome (FIRES): State of the art and perspectives
Gaspard N, Hirsch LJ, Sculier C, Loddenkemper T, van Baalen A, Lancrenon J, Emmery M, Specchio N, Farias‐Moeller R, Wong N, Nabbout R. New‐onset refractory status epilepticus (NORSE) and febrile infection–related epilepsy syndrome (FIRES): State of the art and perspectives. Epilepsia 2018, 59: 745-752. PMID: 29476535, DOI: 10.1111/epi.14022.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsConsensusDrug Resistant EpilepsyElectroencephalographyEpileptic SyndromesHumansStatus EpilepticusConceptsNew-onset refractory status epilepticusFebrile infection-related epilepsy syndromeRefractory status epilepticusStatus epilepticusCytokine-mediated mechanismOptimal treatment optionsAdult-onset formStrong scientific evidenceStandardized consensus definitionsMulticenter registryPrompt treatmentKetogenic dietUncontrolled trialsEpilepsy syndromesImmune therapyTreatment optionsEarly recognitionClinical careConsensus definitionClinical situationsPatient careEpilepticusStandardized definitionsElectroencephalography featuresScientific evidenceProposed consensus definitions for new‐onset refractory status epilepticus (NORSE), febrile infection‐related epilepsy syndrome (FIRES), and related conditions
Hirsch LJ, Gaspard N, van Baalen A, Nabbout R, Demeret S, Loddenkemper T, Navarro V, Specchio N, Lagae L, Rossetti AO, Hocker S, Gofton TE, Abend NS, Gilmore EJ, Hahn C, Khosravani H, Rosenow F, Trinka E. Proposed consensus definitions for new‐onset refractory status epilepticus (NORSE), febrile infection‐related epilepsy syndrome (FIRES), and related conditions. Epilepsia 2018, 59: 739-744. PMID: 29399791, DOI: 10.1111/epi.14016.Peer-Reviewed Original ResearchConceptsNew-onset refractory status epilepticusFebrile infection-related epilepsy syndromeRefractory status epilepticusStatus epilepticusConsensus definitionEpilepsy syndromesFebrile infectionsCritical Care EEG Monitoring Research ConsortiumSuper-refractory status epilepticusRelated conditionsHemiconvulsion-HemiplegiaNew onsetActive epilepsyImproved communicationClinical presentationNeurocritical careMetabolic causesPediatric expertsEpilepticusRelevant neurological disordersConsensus conferenceSpecific diagnosisNeurological disordersMulticenter researchSyndrome
2017
Psychiatric and behavioral side effects of antiepileptic drugs in adults with epilepsy
Chen B, Choi H, Hirsch LJ, Katz A, Legge A, Buchsbaum R, Detyniecki K. Psychiatric and behavioral side effects of antiepileptic drugs in adults with epilepsy. Epilepsy & Behavior 2017, 76: 24-31. PMID: 28931473, DOI: 10.1016/j.yebeh.2017.08.039.Peer-Reviewed Original ResearchConceptsBehavioral side effectsSide effectsPractice-based sampleAntiepileptic drug useHigh rateAED regimenAdult patientsNewer AEDsCessation ratesAntiepileptic drugsIntractable epilepsyMedical historyAbsence seizuresMedical recordsPhysician reportsAED usePatientsLevetiracetamDepressive moodDrug useGabapentinLamotriginePatient recordsSuicidal thoughtsPhenytoinBrief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Noncritically Ill Adults
Yoo JY, Marcuse LV, Fields MC, Rosengard JL, Traversa MV, Gaspard N, Hirsch LJ. Brief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Noncritically Ill Adults. Journal Of Clinical Neurophysiology 2017, 34: 222-229. PMID: 28463933, DOI: 10.1097/wnp.0000000000000357.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAlpha RhythmBrain WavesDrug Resistant EpilepsyElectroencephalographyFemaleHumansMaleMiddle AgedPeriodicityYoung AdultConceptsIctal rhythmic dischargesIll adultsRhythmic dischargesSeizure onset areaAdult patientsElectrographic characteristicsStatus epilepticusAcute findingsIll patientsRefractory epilepsyClinical historySeizure onsetClinical significanceEpileptiform dischargesAmbulatory settingPatientsBenign patternControl groupEpilepsyRhythmic activityOnset areaAlpha activityAdultsBrief runsEEG recordingsBrain‐responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy
Geller EB, Skarpaas TL, Gross RE, Goodman RR, Barkley GL, Bazil CW, Berg MJ, Bergey GK, Cash SS, Cole AJ, Duckrow RB, Edwards JC, Eisenschenk S, Fessler J, Fountain NB, Goldman AM, Gwinn RP, Heck C, Herekar A, Hirsch LJ, Jobst BC, King‐Stephens D, Labar DR, Leiphart JW, Marsh WR, Meador KJ, Mizrahi EM, Murro AM, Nair DR, Noe KH, Park YD, Rutecki PA, Salanova V, Sheth RD, Shields DC, Skidmore C, Smith MC, Spencer DC, Srinivasan S, Tatum W, Van Ness PC, Vossler DG, Wharen RE, Worrell GA, Yoshor D, Zimmerman RS, Cicora K, Sun FT, Morrell MJ. Brain‐responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy. Epilepsia 2017, 58: 994-1004. PMID: 28398014, DOI: 10.1111/epi.13740.Peer-Reviewed Original ResearchConceptsMesial temporal lobe epilepsyMesial temporal sclerosisSeizure-free periodTemporal lobe epilepsySeizure reductionAdverse eventsLobe epilepsyIntractable mesial temporal lobe epilepsySerious device-related adverse eventsIntractable partial-onset seizuresMedian percent seizure reductionMesial temporal lobe originBilateral mesial temporal lobe epilepsyDevice-related adverse eventsBrain-responsive neurostimulationImplant site infectionPercent seizure reductionPartial-onset seizuresProspective clinical trialsTemporal lobe originVagus nerve stimulationEffective treatment optionPercent of subjectsPreimplantation baselineTemporal sclerosisBrain‐responsive neurostimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas
Jobst BC, Kapur R, Barkley GL, Bazil CW, Berg MJ, Bergey GK, Boggs JG, Cash SS, Cole AJ, Duchowny MS, Duckrow RB, Edwards JC, Eisenschenk S, Fessler AJ, Fountain NB, Geller EB, Goldman AM, Goodman RR, Gross RE, Gwinn RP, Heck C, Herekar AA, Hirsch LJ, King‐Stephens D, Labar DR, Marsh WR, Meador KJ, Miller I, Mizrahi EM, Murro AM, Nair DR, Noe KH, Olejniczak PW, Park YD, Rutecki P, Salanova V, Sheth RD, Skidmore C, Smith MC, Spencer DC, Srinivasan S, Tatum W, Van Ness P, Vossler DG, Wharen RE, Worrell GA, Yoshor D, Zimmerman RS, Skarpaas TL, Morrell MJ. Brain‐responsive neurostimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas. Epilepsia 2017, 58: 1005-1014. PMID: 28387951, DOI: 10.1111/epi.13739.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBrain MappingCerebral CortexDeep Brain StimulationDrug Resistant EpilepsyElectric Stimulation TherapyElectrodes, ImplantedElectroencephalographyEpilepsies, PartialEpilepsy, Complex PartialEpilepsy, Partial, MotorEpilepsy, Tonic-ClonicFeasibility StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedNeocortexYoung AdultConceptsSeizure-free periodSeizure reductionNeocortical onsetSeizure onsetNeocortical originIntractable partial-onset seizuresMedian percent seizure reductionBrain-responsive neurostimulationChronic neurologic deficitsPercent seizure reductionPrior epilepsy surgeryPartial-onset seizuresPercent of patientsProspective clinical trialsNormal MRI findingsVagus nerve stimulationEffective treatment optionEloquent cortical areasRate of infectionMagnetic resonance imagingPreimplantation baselineMRI lesionsAdverse eventsNeurologic deficitsPerioperative hemorrhage
2016
In response: Drug‐resistant epilepsy in adults: outcome trajectories after failure of two medications
Choi H, Hayat MJ, Zhang R, Hirsch LJ, Bazil C, Mendiratta A, Kato K, Javed A, Legge AW, Buchsbaum R, Resor S, Heiman G. In response: Drug‐resistant epilepsy in adults: outcome trajectories after failure of two medications. Epilepsia 2016, 57: 1526-1527. PMID: 27594402, DOI: 10.1111/epi.13487.Peer-Reviewed Original ResearchDrug‐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 ResearchMeSH KeywordsAdultAgedAged, 80 and overAnticonvulsantsCohort StudiesDrug Resistant EpilepsyFemaleHumansLogistic ModelsMaleMiddle AgedOutcome Assessment, Health CareConceptsDrug-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