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 oddsPatientsMedicationsSeizuresPregabalin for Recurrent Seizures in Critical Illness: A Promising Adjunctive Therapy, Especially for cyclic Seizures
Busl KM, Fong MWK, Newcomer Z, Patel M, Cohen SA, Jadav R, Smith CN, Mitropanopoulos S, Bruzzone M, Hella M, Eisenschenk S, Robinson CP, Roth WH, Ameli PA, Babi MA, Pizzi MA, Gilmore EJ, Hirsch LJ, Maciel CB. Pregabalin for Recurrent Seizures in Critical Illness: A Promising Adjunctive Therapy, Especially for cyclic Seizures. Neurocritical Care 2022, 37: 140-148. PMID: 35217998, DOI: 10.1007/s12028-022-01459-6.Peer-Reviewed Original ResearchConceptsCyclic seizuresSeizure burdenSeizure frequencyRecurrent seizuresMin/hourAntiseizure medicationsElectrographic seizure burdenMedian seizure frequencyNeurocritical care settingPromising adjunctive therapyEffective adjunctive treatmentVoltage-gated calcium channelsNeurointensive care unitRetrospective case seriesTreatment of seizuresAlpha2-delta subunitExcitatory neurotransmitter releaseCoprimary outcomesIll cohortPGB administrationAntiseizure effectsSeizure recurrenceAdjunctive therapyCritical illnessRefractory seizures
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 ResearchConceptsVagus 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 sitesA 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 factorsPreferred practices for rescue treatment of seizure clusters: A consensus-driven, multi-stakeholder approach
Buchhalter J, Shafer PO, Buelow JM, French JA, Gilchrist B, Hirsch LJ, Nasuta M, Santilli N. Preferred practices for rescue treatment of seizure clusters: A consensus-driven, multi-stakeholder approach. Epilepsy & Behavior 2021, 117: 107836. PMID: 33640567, DOI: 10.1016/j.yebeh.2021.107836.Peer-Reviewed Original ResearchConceptsSeizure action planRescue therapySeizure clustersConsensus-derived recommendationsCare of peoplePreferred termPhase 2Seizure frequencyPreferred practicesRescue treatmentEpilepsy expertsRescue medicineSpecialist physiciansTreatment interventionsEpilepsyHealthcare professionalsEpilepsy FoundationPWEIndividualized mannerShort durationTherapyFinal consensusPhase 1Education/communicationCaregivers
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 epilepsyBeyond 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
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 ResearchConceptsPositive 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 ResearchConceptsPeriventricular 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 locationPatientsAdherence 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
Prevalence and predictors of seizure clusters: A prospective observational study of adult patients with epilepsy
Detyniecki K, O'Bryan J, Choezom T, Rak G, Ma C, Zhang S, Bonito J, Hirsch LJ. Prevalence and predictors of seizure clusters: A prospective observational study of adult patients with epilepsy. Epilepsy & Behavior 2018, 88: 349-356. PMID: 30344026, DOI: 10.1016/j.yebeh.2018.09.035.Peer-Reviewed Original ResearchConceptsRescue medication useProspective observational studyEmergency department visitsHigh seizure frequencySeizure clustersAdult patientsRescue medicationClinical characteristicsSeizure frequencyActive epilepsyDepartment visitsMedication useObservational studyExact testSeizure-related outcomesFisher's exact testLogistic regression modelsSeizure clusteringAdverse outcomesEpilepsy severitySeizure diariesIndividual patientsPatientsEpilepsyFinal analysis
2017
The use and yield of continuous EEG in critically ill patients: A comparative study of three centers
Alvarez V, Ruiz A, LaRoche S, Hirsch LJ, Parres C, Voinescu PE, Fernandez A, Petroff OA, Rampal N, Haider HA, Lee JW, Consortium T. The use and yield of continuous EEG in critically ill patients: A comparative study of three centers. Clinical Neurophysiology 2017, 128: 570-578. PMID: 28231475, DOI: 10.1016/j.clinph.2017.01.001.Peer-Reviewed Original ResearchConceptsHigh-volume centersIll patientsVolume centersDoses of levetiracetamTertiary care sitesContinuous EEG monitoringDetection rateCEEG useSeizure frequencyFirst seizureMedian timeSeizure detection rateCEEG monitoringRecent guidelinesPatient managementCare sitesValproic acidASD useEEG monitoringDrug usageContinuous EEGSignificant differencesPatientsReporting toolsCEEG
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
2007
A Randomized, Double‐Blind, Placebo‐Controlled Trial of Donepezil to Improve Memory in Epilepsy
Hamberger MJ, Palmese CA, Scarmeas N, Weintraub D, Choi H, Hirsch LJ. A Randomized, Double‐Blind, Placebo‐Controlled Trial of Donepezil to Improve Memory in Epilepsy. Epilepsia 2007, 48: 1283-1291. PMID: 17484756, DOI: 10.1111/j.1528-1167.2007.01114.x.Peer-Reviewed Original ResearchMeSH KeywordsCholinesterase InhibitorsCognition DisordersCross-Over StudiesDonepezilDose-Response Relationship, DrugDouble-Blind MethodEpilepsyHealth StatusHumansIndansMemory DisordersNeuropsychological TestsPiperidinesPlacebosQuality of LifeSeverity of Illness IndexSocial AdjustmentTreatment OutcomeConceptsSubjective memory difficultyMemory difficultiesPsychological functionsCognitive functionSocial functioningSelf-rated memoryAssessment of memorySubjective memory complaintsTrial of donepezilDonepezil treatmentSubjective memoryMemory complaintsSelf-rated qualityMemoryTreatment phaseEpilepsy patientsMoodFunctioningParticular epilepsy syndromesGroup resultsDonepezilAcetylcholinesterase inhibitorsDifficultiesPlacebo treatmentSeizure frequency