2022
Prevalence and Predictors of Seizure Clusters in Pediatric Patients With Epilepsy: The Harvard-Yale Pediatric Seizure Cluster Study
Jafarpour S, Fong MWK, Detyniecki K, Khan A, Jackson-Shaheed E, Wang X, Lewis S, Benjamin R, Gaínza-Lein M, O'Bryan J, Hirsch LJ, Loddenkemper T. Prevalence and Predictors of Seizure Clusters in Pediatric Patients With Epilepsy: The Harvard-Yale Pediatric Seizure Cluster Study. Pediatric Neurology 2022, 137: 22-29. PMID: 36208614, DOI: 10.1016/j.pediatrneurol.2022.08.014.Peer-Reviewed Original ResearchConceptsSeizure clustersRescue medicationPediatric patientsSeizure frequencyIntermediate-risk groupEmergency department visitsHigh seizure frequencyTwo-center studyEmergency room visitsHigh-risk groupActive seizuresMore seizuresDepartment visitsStatus epilepticusRoom visitsAdverse outcomesEpilepsy severityIsolated seizureSeizure diariesRisk factorsRisk groupsGreater oddsPatientsMedicationsSeizures
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 factors
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
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
Presurgical language fMRI: Technical practices in epilepsy surgical planning
Benjamin CFA, Dhingra I, Li AX, Blumenfeld H, Alkawadri R, Bickel S, Helmstaedter C, Meletti S, Bronen RA, Warfield SK, Peters JM, Reutens D, Połczyńska MM, Hirsch LJ, Spencer DD. Presurgical language fMRI: Technical practices in epilepsy surgical planning. Human Brain Mapping 2018, 39: 4032-4042. PMID: 29962111, PMCID: PMC6175127, DOI: 10.1002/hbm.24229.Peer-Reviewed Original ResearchConceptsLanguage functional MRIFunctional MRISurgical planningEpilepsy surgical planningEpilepsy surgical programsGeneral linear modelingBlood flowClinical practicePatient careSurgical programsRoutine useMarked heterogeneityClinical applicationVerbal fluencyData highlightFMRI dataMost programsPatientsWidespread useEpilepsyIndividualsMRICareSeizure 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
2017
Surgical 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
Regional and network relationship in the intracranial EEG second spectrum
Joshi RB, Gaspard N, Goncharova II, Duckrow RB, Duncan D, Gerrard JL, Spencer DD, Hirsch LJ, Zaveri HP. Regional and network relationship in the intracranial EEG second spectrum. Clinical Neurophysiology 2016, 127: 3485-3491. PMID: 27692590, DOI: 10.1016/j.clinph.2016.09.003.Peer-Reviewed Original ResearchThe 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 relationshipDevelopment and Feasibility Testing of a Critical Care EEG Monitoring Database for Standardized Clinical Reporting and Multicenter Collaborative Research
Lee JW, LaRoche S, Choi H, Ruiz A, Fertig E, Politsky JM, Herman ST, Loddenkemper T, Sansevere AJ, Korb PJ, Abend NS, Goldstein JL, Sinha SR, Dombrowski KE, Ritzl EK, Westover MB, Gavvala JR, Gerard EE, Schmitt SE, Szaflarski JP, Ding K, Haas KF, Buchsbaum R, Hirsch LJ, Wusthoff CJ, Hopp JL, Hahn CD. Development and Feasibility Testing of a Critical Care EEG Monitoring Database for Standardized Clinical Reporting and Multicenter Collaborative Research. Journal Of Clinical Neurophysiology 2016, 33: 133-140. PMID: 26943901, PMCID: PMC4878836, DOI: 10.1097/wnp.0000000000000230.Peer-Reviewed Original ResearchConceptsCritical Care EEG Monitoring Research ConsortiumAmerican Clinical Neurophysiology SocietyIncidence of seizuresMulticenter feasibility studyIntensive care unitLarge-volume centersInterictal epileptiform dischargesDaily clinical useMulticenter collaborative researchCare unitUnique patientsVolume centersElectroencephalogram monitoringDuration of recordingEpileptiform dischargesMulticenter research studiesRhythmic dischargesClinical reportsResearch DatabaseEEG monitoringClinical data repositoryClinical useConsortium databaseEEG reportsReporting tools
2015
Consensus Statement on Continuous EEG in Critically Ill Adults and Children, Part II
Herman ST, Abend NS, Bleck TP, Chapman KE, Drislane FW, Emerson RG, Gerard EE, Hahn CD, Husain AM, Kaplan PW, LaRoche SM, Nuwer MR, Quigg M, Riviello JJ, Schmitt SE, Simmons LA, Tsuchida TN, Hirsch LJ. Consensus Statement on Continuous EEG in Critically Ill Adults and Children, Part II. Journal Of Clinical Neurophysiology 2015, 32: 96-108. PMID: 25626777, PMCID: PMC4434600, DOI: 10.1097/wnp.0000000000000165.Peer-Reviewed Original ResearchConceptsIll adultsConsensus panelAmerican Clinical Neurophysiology SocietyContinuous EEGCritically Ill AdultsIntensive care unitNon-physician personnelExpert consensus recommendationsNeurodiagnostic technologistsQuantitative EEG techniquesCare unitPatient selectionPatient populationMental statusConsensus statementConsensus recommendationsInfection controlBrain functionCommon procedureEEGTask ForceAdultsEEG techniquesChildrenConsensus Statement on Continuous EEG in Critically Ill Adults and Children, Part I
Herman ST, Abend NS, Bleck TP, Chapman KE, Drislane FW, Emerson RG, Gerard EE, Hahn CD, Husain AM, Kaplan PW, LaRoche SM, Nuwer MR, Quigg M, Riviello JJ, Schmitt SE, Simmons LA, Tsuchida TN, Hirsch LJ. Consensus Statement on Continuous EEG in Critically Ill Adults and Children, Part I. Journal Of Clinical Neurophysiology 2015, 32: 87-95. PMID: 25626778, PMCID: PMC4435533, DOI: 10.1097/wnp.0000000000000166.Peer-Reviewed Original ResearchConceptsIll adultsConsensus panelStatus epilepticusPatient populationMental statusAmerican Clinical Neurophysiology SocietyContinuous EEGCritically Ill AdultsIdentification of ischemiaNonconvulsive status epilepticusIntensive care unitEfficacy of therapyQuantitative EEG trendsExpert consensus recommendationsCerebral ischemiaIntravenous sedationNonconvulsive seizuresCare unitSecondary injuryCardiac arrestConsensus statementConsensus recommendationsHigh riskEEG trendsPatients
2014
The spatial and signal characteristics of physiologic high frequency oscillations
Alkawadri R, Gaspard N, Goncharova II, Spencer DD, Gerrard JL, Zaveri H, Duckrow RB, Blumenfeld H, Hirsch LJ. The spatial and signal characteristics of physiologic high frequency oscillations. Epilepsia 2014, 55: 1986-1995. PMID: 25470216, PMCID: PMC5123742, DOI: 10.1111/epi.12851.Peer-Reviewed Original ResearchConceptsPhysiologic high-frequency oscillationsSeizure onsetEpileptic networkNon-rapid eye movement sleepComprehensive Epilepsy CenterMesial temporal structuresEye movement sleepHighest HFO ratesHigh-frequency oscillationsFirst seizureInvasive evaluationEpilepsy centersIntracranial evaluationMovement sleepPerirolandic regionEpileptiform dischargesParietooccipital regionOccipital lobeEpileptic sitesPatientsNonepileptic regionsPhysiologic eventsFast ripplesHFO ratesLonger durationInterrater agreement for Critical Care EEG Terminology
Gaspard N, Hirsch LJ, LaRoche SM, Hahn CD, Westover MB, Consortium T. Interrater agreement for Critical Care EEG Terminology. Epilepsia 2014, 55: 1366-1373. PMID: 24888711, PMCID: PMC4879939, DOI: 10.1111/epi.12653.Peer-Reviewed Original ResearchConceptsCritical care EEG terminologyEEG terminologyClinical significanceInterrater agreementAmerican Clinical Neurophysiology SocietyUncertain clinical significanceSupporting Information sectionElectrographic seizuresTriphasic morphologyHigh interrater agreementMulticenter researchEEG patternsSeizuresElectroencephalography studyStandardized terminologyInformation sectionIdentical questionsTraining slidesWeb-based testEEG samplesBrief Potentially Ictal Rhythmic Discharges in Critically Ill Adults
Yoo JY, Rampal N, Petroff OA, Hirsch LJ, Gaspard N. Brief Potentially Ictal Rhythmic Discharges in Critically Ill Adults. JAMA Neurology 2014, 71: 454-462. PMID: 24535702, DOI: 10.1001/jamaneurol.2013.6238.Peer-Reviewed Original ResearchConceptsIctal rhythmic dischargesRhythmic dischargesIll patientsContinuous electroencephalographyCritically Ill AdultsPrevalence of seizuresGlasgow Outcome ScaleLarge prospective studiesSingle focal lesionCerebral injuryIll adultsElectrographic seizuresPrognostic significanceProspective studyFunctional outcomeSubclinical seizuresOutcome ScalePrimary diagnosisWorse outcomesHigh prevalenceEarly predictorMAIN OUTCOMEFocal lesionsPatientsSeizures
2013
Intracranially recorded interictal spikes: Relation to seizure onset area and effect of medication and time of day
Goncharova II, Spencer SS, Duckrow RB, Hirsch LJ, Spencer DD, Zaveri HP. Intracranially recorded interictal spikes: Relation to seizure onset area and effect of medication and time of day. Clinical Neurophysiology 2013, 124: 2119-2128. PMID: 23856192, DOI: 10.1016/j.clinph.2013.05.027.Peer-Reviewed Original ResearchIntracranial EEG evaluation of relationship within a resting state network
Duncan D, Duckrow RB, Pincus SM, Goncharova I, Hirsch LJ, Spencer DD, Coifman RR, Zaveri HP. Intracranial EEG evaluation of relationship within a resting state network. Clinical Neurophysiology 2013, 124: 1943-1951. PMID: 23790525, DOI: 10.1016/j.clinph.2013.03.028.Peer-Reviewed Original ResearchConceptsDefault mode networkIntracranial EEG evaluationMode networkLocalization-related epilepsyCross-approximate entropyNeuronal involvementHemodynamic measurementsIntracranial EEG recordingsEEG evaluationBackground activityGamma powerFMRI studyIntracranial EEGBrain activityPatientsEEG recordingsLow levelsT2EpilepsyMagnitude squared coherenceT1Intravenous ketamine for the treatment of refractory status epilepticus: A retrospective multicenter study
Gaspard N, Foreman B, Judd LM, Brenton JN, Nathan BR, McCoy BM, Al‐Otaibi A, Kilbride R, Fernández IS, Mendoza L, Samuel S, Zakaria A, Kalamangalam GP, Legros B, Szaflarski JP, Loddenkemper T, Hahn CD, Goodkin HP, Claassen J, Hirsch LJ, LaRoche SM. Intravenous ketamine for the treatment of refractory status epilepticus: A retrospective multicenter study. Epilepsia 2013, 54: 1498-1503. PMID: 23758557, PMCID: PMC3731413, DOI: 10.1111/epi.12247.Peer-Reviewed Original ResearchConceptsRefractory status epilepticusTreatment of RSEIntravenous ketamineStatus epilepticusBrain injuryEpisodes of RSEPostanoxic brain injuryAnoxic brain injuryMulticenter retrospective reviewRetrospective multicenter studyRole of ketaminePossible adverse eventsAcademic medical centerKetamine initiationProspective trialAdverse eventsRetrospective reviewRetrospective seriesSE onsetMulticenter studyLast drugMedical recordsMedical CenterSafe drugConcurrent drugs
2010
Use of EEG Monitoring and Management of Non-Convulsive Seizures in Critically Ill Patients: A Survey of Neurologists
Abend NS, Dlugos DJ, Hahn CD, Hirsch LJ, Herman ST. Use of EEG Monitoring and Management of Non-Convulsive Seizures in Critically Ill Patients: A Survey of Neurologists. Neurocritical Care 2010, 12: 382-389. PMID: 20198513, PMCID: PMC2944658, DOI: 10.1007/s12028-010-9337-2.Peer-Reviewed Original ResearchConceptsNon-convulsive seizuresIll patientsEEG monitoringPhenytoin/fosphenytoinCritically Ill PatientsAbnormal eye movementsFurther prospective studiesCommon clinical problemSurvey of neurologistsCEEG indicationsCEEG utilizationResultsThree hundredStatus epilepticusProspective studyMental statusCommon anticonvulsantsClinical problemPatientsAreas of uncertaintyPrior convulsionsCurrent practiceEye movementsLevetiracetamSeizuresNeurologists
2009
Clinical use of ictal SPECT in secondarily generalized tonic–clonic seizures
Varghese GI, Purcaro MJ, Motelow JE, Enev M, McNally KA, Levin AR, Hirsch LJ, Tikofsky R, Paige AL, Zubal IG, Spencer SS, Blumenfeld H. Clinical use of ictal SPECT in secondarily generalized tonic–clonic seizures. Brain 2009, 132: 2102-2113. PMID: 19339251, PMCID: PMC2714057, DOI: 10.1093/brain/awp027.Peer-Reviewed Original ResearchConceptsCerebral blood flow increasesBlood flow increasesGeneralized tonic-clonic seizuresIctal SPECTTonic-clonic seizuresPartial seizuresPost-ictal periodSeizure onsetGeneralized seizuresSecondary generalizationCerebral blood flow decreasesRegional cerebral blood flow increasesPropagation of seizuresBlood flow decreaseCerebral blood flowEpilepsy surgery evaluationUseful clinical toolSingle photon emissionFlow increasesSeizure localizationSurgery evaluationBlood flowSeizuresClinical toolClinical use