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 dataset
2018
Cross-sensitivity of psychiatric and behavioral side effects with antiepileptic drug use
Chen B, Choi H, Hirsch LJ, Legge A, Buchsbaum R, Detyniecki K. Cross-sensitivity of psychiatric and behavioral side effects with antiepileptic drug use. Seizure 2018, 62: 38-42. PMID: 30273800, DOI: 10.1016/j.seizure.2018.09.014.Peer-Reviewed Original ResearchConceptsBehavioral side effectsMore antiepileptic drugsAntiepileptic drugsSide effectsAdult patientsSpecific antiepileptic drugsAntiepileptic drug useCertain antiepileptic drugsHistory of depressionAED usePatientsDrug useSignificant predictorsSignificant increasePsychosisDepressionZNSConfoundersEpilepsyDoseComparative 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
The importance of early immunotherapy in patients with faciobrachial dystonic seizures
Thompson J, Bi M, Murchison AG, Makuch M, Bien CG, Chu K, Farooque P, Gelfand JM, Geschwind MD, Hirsch LJ, Somerville E, Lang B, Vincent A, Leite MI, Waters P, Irani SR, Dogan-Onugoren M, Rae-Grant A, Illes Z, Szots M, Malter M, Widman G, Surges R, Archibald N, Reid J, Duncan C, Richardson A, Lilleker J, Iorio R, Blaabjerg M, Abeler K, Shin Y. The importance of early immunotherapy in patients with faciobrachial dystonic seizures. Brain 2017, 141: 348-356. PMID: 29272336, PMCID: PMC5837230, DOI: 10.1093/brain/awx323.Peer-Reviewed Original ResearchMeSH KeywordsADAM ProteinsAdultAgedAged, 80 and overAnalysis of VarianceAntibodiesAnticonvulsantsCognition DisordersDisabled PersonsFemaleFlow CytometryFollow-Up StudiesGreen Fluorescent ProteinsHEK293 CellsHumansImmunotherapyIntracellular Signaling Peptides and ProteinsLimbic EncephalitisMaleMiddle AgedNerve Tissue ProteinsProtein TransportProteinsRetrospective StudiesSeizuresSurveys and QuestionnairesTransfectionYoung AdultConceptsFaciobrachial dystonic seizuresDystonic seizuresCognitive impairmentAddition of immunotherapySerum sodium levelsNormal brain MRIEarly immunotherapyLGI1 antibodiesLimbic encephalitisEpileptogenic mechanismsConsecutive patientsAntiepileptic drugsNormal patientsBrain MRIPatientsSodium levelsImmunotherapyIgG1 antibodiesSeizuresNormal cognitionImpairmentEarly cessationCessationAntibodiesComplex internalizationPsychiatric 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 thoughtsPhenytoin
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 trajectoriesThe relationship between seizures, interictal spikes and antiepileptic drugs
Goncharova II, Alkawadri R, Gaspard N, Duckrow RB, Spencer DD, Hirsch LJ, Spencer SS, Zaveri HP. The relationship between seizures, interictal spikes and antiepileptic drugs. Clinical Neurophysiology 2016, 127: 3180-3186. PMID: 27292227, DOI: 10.1016/j.clinph.2016.05.014.Peer-Reviewed Original ResearchConceptsFirst seizureSeizure occurrenceAED taperSpike rateEEG monitoringMarker of inhibitionIntracranial EEG monitoringOccurrence of seizuresScalp EEG monitoringConsecutive patientsAntiepileptic drugsDrug taperHigh spike ratesInterictal spikesSeizuresDay 4Intracranial electrodesPatientsAEDsSignificant relationship
2015
Cross-sensitivity of patient-perceived adverse cognitive effects with antiepileptic drug use
Chen B, Detyniecki K, Hirsch LJ, Moeller J, Javed A, Kato K, Legge A, Buchsbaum R, Choi H. Cross-sensitivity of patient-perceived adverse cognitive effects with antiepileptic drug use. Epilepsy & Behavior 2015, 46: 151-157. PMID: 25935515, DOI: 10.1016/j.yebeh.2015.03.020.Peer-Reviewed Original ResearchConceptsAdverse cognitive effectsMore antiepileptic drugsAntiepileptic drugsAbsence seizure typesSpecific antiepileptic drugsAntiepileptic drug useMultiple antiepileptic drugsCertain antiepileptic drugsCognitive effectsHigh rateAED selectionClinical characteristicsIndependent predictorsSeizure typesSingle centerAED loadIndividual patientsPatientsDrug usePhenytoinIntolerabilityAED mechanismsLamotrigineVPAZNSRates 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 frequency
2014
The consequences of refractory epilepsy and its treatment
Laxer KD, Trinka E, Hirsch LJ, Cendes F, Langfitt J, Delanty N, Resnick T, Benbadis SR. The consequences of refractory epilepsy and its treatment. Epilepsy & Behavior 2014, 37: 59-70. PMID: 24980390, DOI: 10.1016/j.yebeh.2014.05.031.Peer-Reviewed Original ResearchConceptsRefractory epilepsyPractical clinical recommendationsNew drug therapiesPersistent seizuresOngoing seizuresSurgical treatmentAntiepileptic drugsUncontrolled seizuresDrug therapyEpilepsy expertsEpileptogenic processPsychosocial burdenClinical recommendationsNeuropsychiatric impairmentNervous systemEpilepsyProgressive epilepsySeizuresDiagnostic proceduresVocational consequencesAdverse effectsPatientsRiskTreatmentBurden
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
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
Patient-reported cognitive side effects of antiepileptic drugs: Predictors and comparison of all commonly used antiepileptic drugs
Arif H, Buchsbaum R, Weintraub D, Pierro J, Resor SR, Hirsch LJ. Patient-reported cognitive side effects of antiepileptic drugs: Predictors and comparison of all commonly used antiepileptic drugs. Epilepsy & Behavior 2008, 14: 202-209. PMID: 19010446, DOI: 10.1016/j.yebeh.2008.10.017.Peer-Reviewed Original ResearchConceptsCognitive side effectsAntiepileptic drugsSide effectsMore antiepileptic drugsWeeks of therapyNonrandomized retrospective studyRetrospective studyMedical recordsAdult outpatientsMultivariate analysisZonisamidePatientsGabapentinLamotrigineDrugsLevetiracetamTopiramateOxcarbazepinePhenytoinCarbamazepinePredictorsMonotherapyOutpatientsEpilepsyTherapyCross-sensitivity of skin rashes with antiepileptic drug use
Hirsch LJ, Arif H, Nahm EA, Buchsbaum R, Resor SR, Bazil CW. Cross-sensitivity of skin rashes with antiepileptic drug use. Neurology 2008, 71: 1527-1534. PMID: 18981374, DOI: 10.1212/01.wnl.0000334295.50403.4c.Peer-Reviewed Original ResearchConceptsRate of rashAntiepileptic drugsValproic acidSpecific antiepileptic drugsAntiepileptic drug useMore antiepileptic drugsCertain antiepileptic drugsAED selectionSkin rashIndividual patientsRashPatientsLamotrigineOxcarbazepineDrug usePhenytoinCarbamazepineLevetiracetamZonisamideGabapentinTiagabineVigabatrinClobazamDrugsMedications
2007
Effect of Age and Comedication on Levetiracetam Pharmacokinetics and Tolerability
Hirsch LJ, Arif H, Buchsbaum R, Weintraub D, Lee J, Chang JT, Resor SR, Bazil CW. Effect of Age and Comedication on Levetiracetam Pharmacokinetics and Tolerability. Epilepsia 2007, 48: 1351-1359. PMID: 17573925, DOI: 10.1111/j.1528-1167.2007.01043.x.Peer-Reviewed Original ResearchConceptsTolerability of levetiracetamLEV clearanceOlder adultsYoung adultsAdverse effectsEnzyme-inducing antiepileptic drugsOlder groupSame serum levelsCommon adverse effectsSubgroup of patientsGroup of patientsSpecific adverse effectsBehavioral side effectsOne-year retentionLevetiracetam pharmacokineticsEffect of ageOlder patientsYounger patientsApparent clearanceSerum levelsAntiepileptic drugsLEV useAdult outpatientsLow doseLevetiracetamDiagnostic Utility of an Epilepsy Monitoring Unit
Smolowitz JL, Hopkins SC, Perrine T, Eck KE, Hirsch LJ, Mundinger M. Diagnostic Utility of an Epilepsy Monitoring Unit. American Journal Of Medical Quality 2007, 22: 117-122. PMID: 17395968, DOI: 10.1177/1062860606298295.Peer-Reviewed Original ResearchConceptsEpilepsy monitoring unitSymptom onsetAntiepileptic drugsDefinitive diagnosisDiagnostic utilityAdult epilepsy monitoring unitEpilepsy surgery referralSpecialized epilepsy centersStandard antiepileptic drugsVideo-electroencephalographic monitoringMedian durationEpilepsy centersReferral patternsAdmissionMonitoring unitDiagnosisEpilepsyDrugsTreatmentGuidelinesOnsetReviewYearsPatientsSeizures
2006
Lamotrigine and its applications in the treatment of epilepsy and other neurological and psychiatric disorders
Malik S, Arif H, Hirsch LJ. Lamotrigine and its applications in the treatment of epilepsy and other neurological and psychiatric disorders. Expert Review Of Neurotherapeutics 2006, 6: 1609-1627. PMID: 17144777, DOI: 10.1586/14737175.6.11.1609.Peer-Reviewed Original ResearchConceptsBroad-spectrum antiepileptic drugBipolar disorder type ILennox-Gastaut syndromeTreatment of epilepsySerious skin rashesTreatment of womenFavorable pharmacokinetic propertiesConcomitant medicationsNeuropathic painElderly patientsSkin rashAdjunctive treatmentDose adjustmentGeneralized seizuresPartial seizuresAntiepileptic drugsSlow titrationNeurological conditionsPsychiatric disordersAdult populationLamotriginePharmacokinetic propertiesSmall riskPreliminary dataEpilepsyPredictors 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
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
2003
Treatment of status epilepticus: a survey of neurologists
Claassen J, Hirsch LJ, Mayer SA. Treatment of status epilepticus: a survey of neurologists. Journal Of The Neurological Sciences 2003, 211: 37-41. PMID: 12767495, DOI: 10.1016/s0022-510x(03)00036-4.Peer-Reviewed Original ResearchConceptsAntiepileptic drugsStatus epilepticusCurrent treatment preferencesElimination of seizuresFourth-line treatmentTreatment of RSESecond-line therapyConvulsive status epilepticusFirst-line therapyNew antiepileptic drugsTraditional treatment paradigmSurvey of neurologistsIntravenous lorazepamSE refractoryTitration goalsMulticenter trialTreatment paradigmTreatment preferencesCritical careValproic acidBurst suppressionAmerican AcademyEpilepticusEpilepsy SectionTherapy