2024
Early vigabatrin to augment GABAergic pathways in post-anoxic status epilepticus
Maciel C, Ahmad B, Jose Bruzzone Giraldez M, Eisenschenk S, Ramsay E, Maranchick N, Peloquin C, Hirsch L, Busl K. Early vigabatrin to augment GABAergic pathways in post-anoxic status epilepticus. Epilepsy & Behavior 2024, 160: 110082. PMID: 39393141, DOI: 10.1016/j.yebeh.2024.110082.Peer-Reviewed Original ResearchStatus epilepticusGamma-aminobutyric acidGABAergic pathwayHypoxic-ischemic brain injuryPost-cardiac arrest periodHypoxic-ischemic insultOutcomes of patientsEffective adjunctive therapyInhibition of gamma-aminobutyric acidLondon-Innsbruck ColloquiumAdjunctive therapyAcute seizuresEffective therapyPoor outcomeEpilepticusExclusion criteriaEarly inhibitionSynergistic augmentationGamma-aminobutyric acid catabolismArrest periodTherapeutic nihilismSeizuresClinal trialsAllosteric modulatorsVigabatrinSystematic 1 Hz direct electrical stimulation for seizure induction: A reliable method for localizing seizure onset zone and predicting seizure freedom
Sivaraju A, Quraishi I, Collins E, McGrath H, Ramos A, Turk-Browne N, Zaveri H, Damisah E, Spencer D, Hirsch L. Systematic 1 Hz direct electrical stimulation for seizure induction: A reliable method for localizing seizure onset zone and predicting seizure freedom. Brain Stimulation 2024, 17: 339-345. PMID: 38490472, DOI: 10.1016/j.brs.2024.03.011.Peer-Reviewed Original ResearchSeizure inductionSeizure onset zoneSurgical outcomesHabitual seizuresOnset zonePredicting seizure freedomExcellent surgical outcomesProspective cohort studyMann-Whitney testConsecutive patientsFisher's exactSeizure freedomRefractory epilepsyCohort studyPost-surgeryInsular regionsMann-WhitneyPatientsIntracranial EEGSeizuresLocalizing seizure onset zonesStimulationElectrical stimulationMedial temporal regionsTemporal regions
2022
Electronic seizure diaries for clinical care and research
Gray TE, Hirsch LJ, Quraishi IH. Electronic seizure diaries for clinical care and research. Epileptic Disorders 2022, 24: 803-811. PMID: 35811431, DOI: 10.1684/epd.2022.1451.Peer-Reviewed Original ResearchPrevalence 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 oddsPatientsMedicationsSeizuresUpdated 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 effectsTreatmentReviewEpidemiologyAcute symptomatic seizures: an educational, evidence‐based review
Mauritz M, Hirsch LJ, Camfield P, Chin R, Nardone R, Lattanzi S, Trinka E. Acute symptomatic seizures: an educational, evidence‐based review. Epileptic Disorders 2022, 24: 26-49. PMID: 34789447, DOI: 10.1684/epd.2021.1376.Peer-Reviewed Original Research
2021
Hemisphere-Dependent Ictal Tachycardia Versus Ictal Bradycardia in a Critically Ill Patient
Fong MWK, Norris S, Percy J, Hirsch LJ, Herlopian A. Hemisphere-Dependent Ictal Tachycardia Versus Ictal Bradycardia in a Critically Ill Patient. Journal Of Clinical Neurophysiology 2021, 39: e15-e18. PMID: 34860703, DOI: 10.1097/wnp.0000000000000873.Peer-Reviewed Original ResearchConceptsIctal bradycardiaIll patientsNeuro-intensive care unitTemporal regionsStandard clinical monitoringHigh-risk patientsOvert clinical signsRight-handed manLeft temporal regionRight temporal regionMild tachycardiaSinus bradycardiaSinus pausesCare unitIntraparenchymal hemorrhageSinus tachycardiaIctal phenomenaCardiac investigationsAutonomic changesClinical signsHeart rateClinical monitoringBradycardiaSeizuresIndependent seizuresSimulated driving in the epilepsy monitoring unit: Effects of seizure type, consciousness, and motor impairment
Kumar A, Martin R, Chen W, Bauerschmidt A, Youngblood MW, Cunningham C, Si Y, Ezeani C, Kratochvil Z, Bronen J, Thomson J, Riordan K, Yoo JY, Shirka R, Manganas L, Krestel H, Hirsch LJ, Blumenfeld H. Simulated driving in the epilepsy monitoring unit: Effects of seizure type, consciousness, and motor impairment. Epilepsia 2021, 63: e30-e34. PMID: 34816425, PMCID: PMC8883409, DOI: 10.1111/epi.17136.Peer-Reviewed Original ResearchConceptsSeizure typesFocal seizuresMotor functionMotor impairmentYale-New Haven HospitalVideo-electroencephalographic monitoringAbnormal motor functionEpilepsy monitoring unitNew Haven HospitalImpaired consciousnessMyoclonic seizuresRetrospective studySeizure characteristicsMotor involvementIctal eventsImpaired drivingLarge cohortSeizuresImpairmentPatientsResponsivenessDriving restrictionsVideo reviewMonitoring unitEpilepsyMiglustat Therapy for SCARB2-Associated Action Myoclonus–Renal Failure Syndrome
Quraishi IH, Szekely AM, Shirali AC, Mistry PK, Hirsch LJ. Miglustat Therapy for SCARB2-Associated Action Myoclonus–Renal Failure Syndrome. Neurology Genetics 2021, 7: e614. PMID: 34337151, PMCID: PMC8320328, DOI: 10.1212/nxg.0000000000000614.Peer-Reviewed Original ResearchAction myoclonus-renal failure syndromeNeurologic symptomsAction myoclonusFailure syndromeProgressive myoclonic epilepsySubstrate reduction therapyWhole-exome sequencingMiglustat therapyAvailable medicationsEarly mortalityReduction therapyMyoclonic epilepsySteady worseningGaucher diseaseMyoclonusGlycosphingolipid metabolismExome sequencingGene mutationsGlucosylceramide accumulationPatientsSeizuresMiglustatSyndromeTherapySymptomsPatient‐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 recognitionEpilepsyAnti-seizure medications and efficacy against focal to bilateral tonic-clonic seizures: A systematic review with relevance for SUDEP prevention
Cutillo G, Tolba H, Hirsch LJ. Anti-seizure medications and efficacy against focal to bilateral tonic-clonic seizures: A systematic review with relevance for SUDEP prevention. Epilepsy & Behavior 2021, 117: 107815. PMID: 33640562, DOI: 10.1016/j.yebeh.2021.107815.Peer-Reviewed Original ResearchConceptsAnti-seizure medicationsBilateral tonic-clonic seizuresTonic-clonic seizuresSUDEP preventionSystematic reviewPlacebo-controlled clinical trialFocal impaired awareness seizuresRisk of SUDEPSudden unexpected deathMajor risk factorAwareness seizuresRisk factorsClinical trialsUnexpected deathFBTCSHigh dosesSeizuresStrong associationSUDEPPreventionMedicationsTiagabineEfficacyLamotrigineBrivaracetamBrief potentially ictal rhythmic discharges and paroxysmal fast activity as scalp electroencephalographic biomarkers of seizure activity and seizure onset zone
Yoo JY, Jetté N, Kwon C, Young J, Marcuse LV, Fields MC, Gaspard N, Hirsch LJ. Brief potentially ictal rhythmic discharges and paroxysmal fast activity as scalp electroencephalographic biomarkers of seizure activity and seizure onset zone. Epilepsia 2021, 62: 742-751. PMID: 33576500, DOI: 10.1111/epi.16822.Peer-Reviewed Original ResearchConceptsParoxysmal fast activitySeizure onset zoneIctal rhythmic dischargesClinical significanceElectrographic seizuresSeizure activityRhythmic dischargesFast activityOnset zoneUncontrolled seizure activityPosterior dominant rhythmSimilar clinical significancePatient demographicsElectroencephalographic biomarkerLocalizing signFocal slowingClinical historySeizure riskEEG backgroundPatientsAdult cohortDominant rhythmSeizuresDistinct entityEEG biomarkers
2020
Detecting Seizures and Epileptiform Abnormalities in Acute Brain Injury
Singla S, Garcia GE, Rovenolt GE, Soto AL, Gilmore EJ, Hirsch LJ, Blumenfeld H, Sheth KN, Omay SB, Struck AF, Westover MB, Kim JA. Detecting Seizures and Epileptiform Abnormalities in Acute Brain Injury. Current Neurology And Neuroscience Reports 2020, 20: 42. PMID: 32715371, PMCID: PMC9353690, DOI: 10.1007/s11910-020-01060-4.Peer-Reviewed Original ResearchConceptsIctal-interictal continuumBrain injuryAcute brain injuryBetter clinical outcomesTraumatic brain injuryRecent FindingsCurrent literatureIncreased morbidityClinical outcomesEpileptiform abnormalitiesEEG findingsMortality riskEEG monitoringEpileptiform patternsPrognostic modelSeizuresClinical settingInjuryLogistical barriersElectroencephalogram studyUse of EEGABIPractical barriersEEG analysisEEGMorbidityValidation of an algorithm of time-dependent electro-clinical risk stratification for electrographic seizures (TERSE) in critically ill patients
Cissé FA, Osman GM, Legros B, Depondt C, Hirsch LJ, Struck AF, Gaspard N. Validation of an algorithm of time-dependent electro-clinical risk stratification for electrographic seizures (TERSE) in critically ill patients. Clinical Neurophysiology 2020, 131: 1956-1961. PMID: 32622337, DOI: 10.1016/j.clinph.2020.05.031.Peer-Reviewed Original ResearchConceptsElectrographic seizuresRisk stratificationIll patientsAcute brain injuryContinuous electroencephalography monitoringElectrographic status epilepticusSubgroup of patientsDuration of EEGClinical seizuresConsecutive patientsStatus epilepticusElectroencephalography monitoringBrain injuryMedical recordsSubstantial burdenPatientsClinical practiceCEEGClinical neurophysiologistsSeizuresClinical implementationEEG recordingsTwo-thirdsFuture studiesEEG timeAssessment of the Predictive Value of Outpatient Smartphone Videos for Diagnosis of Epileptic Seizures
Tatum WO, Hirsch LJ, Gelfand MA, Acton EK, LaFrance WC, Duckrow RB, Chen DK, Blum AS, Hixson JD, Drazkowski JF, Benbadis SR, Cascino GD. Assessment of the Predictive Value of Outpatient Smartphone Videos for Diagnosis of Epileptic Seizures. JAMA Neurology 2020, 77: 593-600. PMID: 31961382, PMCID: PMC6990754, DOI: 10.1001/jamaneurol.2019.4785.Peer-Reviewed Original ResearchConceptsPhysical examination resultsPsychogenic nonepileptic attacksVideo electroencephalogram monitoringEpileptic seizuresVideo electroencephalogramEpilepsy centersPhysical examinationElectroencephalogram monitoringNonepileptic attacksCorrect diagnosisPhysiologic nonepileptic eventsEvaluation of epilepsyExamination resultsMisdiagnosis of epilepsyDiagnostic accuracy studiesPsychogenic attacksMotor signsNonepileptic eventsDefinitive diagnosisPatient historyMAIN OUTCOMEClinic outpatientsPredictive valueSeizuresDiagnosisDiagnostic Value of Electroencephalography with Ten Electrodes in Critically Ill Patients
Westover MB, Gururangan K, Markert MS, Blond BN, Lai S, Benard S, Bickel S, Hirsch LJ, Parvizi J. Diagnostic Value of Electroencephalography with Ten Electrodes in Critically Ill Patients. Neurocritical Care 2020, 33: 479-490. PMID: 32034656, PMCID: PMC7416437, DOI: 10.1007/s12028-019-00911-4.Peer-Reviewed Original ResearchConceptsDiagnostic valueAncillary clinical informationCritical care settingMassachusetts General HospitalGold standard diagnosisSame raterIll patientsSeizure activityGeneral HospitalIntra-rater agreementCare settingsHospital cliniciansClinical informationInter-rater variabilitySeizuresStandard diagnosisPathological activityEEG patternsPhase IGold standardHigh concordancePhase IIElectroencephalographyDiagnosisPresent study
2019
Author response: Adherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures.
Tolchin B, Dworetzky BA, Martino S, Blumenfeld H, Hirsch LJ, Baslet G. Author response: Adherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures. Neurology 2019, 93: 981. PMID: 31767663, DOI: 10.1212/wnl.0000000000008560.Peer-Reviewed Original ResearchThe connectivity index: an effective metric for grading epileptogenicity.
Yan Q, Gaspard N, Zaveri HP, Blumenfeld H, Hirsch LJ, Spencer DD, Alkawadri R. The connectivity index: an effective metric for grading epileptogenicity. Journal Of Neurosurgery 2019, 133: 971-978. PMID: 31561212, DOI: 10.3171/2019.4.jns195.Peer-Reviewed Original ResearchSingle-pulse electrical stimulationSeizure onset zoneSite of stimulationSOZ contactsIrritative zoneComprehensive Epilepsy CenterControl contactsStimulation current intensityHabitual aurasHabitual seizuresEpilepsy centersSeizure generationBrain sitesFrequency stimulationEpileptic activityElectrical stimulationOnset zonePatientsRecording contactsStimulation sessionsBrain regionsFunctional connectivityStimulationOutcome casesSeizuresNonconvulsive seizures and nonconvulsive status epilepticus in the neuro ICU should or should not be treated aggressively: A debate
Rossetti AO, Hirsch LJ, Drislane FW. Nonconvulsive seizures and nonconvulsive status epilepticus in the neuro ICU should or should not be treated aggressively: A debate. Clinical Neurophysiology Practice 2019, 4: 170-177. PMID: 31886441, PMCID: PMC6921236, DOI: 10.1016/j.cnp.2019.07.001.Peer-Reviewed Original ResearchComparison of machine learning models for seizure prediction in hospitalized patients
Struck AF, Rodriguez‐Ruiz A, Osman G, Gilmore EJ, Haider HA, Dhakar MB, Schrettner M, Lee JW, Gaspard N, Hirsch LJ, Westover MB, Consortium C. Comparison of machine learning models for seizure prediction in hospitalized patients. Annals Of Clinical And Translational Neurology 2019, 6: 1239-1247. PMID: 31353866, PMCID: PMC6649418, DOI: 10.1002/acn3.50817.Peer-Reviewed Original ResearchConceptsLow-risk patientsNegative predictive valueEvaluation cohortContinuous EEGElastic net logistic regressionMulticenter databaseRisk stratificationSeizure riskPatientsPredictive valueComparable AUCSecondary analysisLogistic regressionCohortFirst hourSeizure predictionEEG recordingsEEGRisk calibrationLarge proportionSeizuresComplex neural networks