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
Seizure clusters, rescue treatments, seizure action plans: Unmet needs and emerging formulations
Gidal B, Klein P, Hirsch LJ. Seizure clusters, rescue treatments, seizure action plans: Unmet needs and emerging formulations. Epilepsy & Behavior 2020, 112: 107391. PMID: 32898744, DOI: 10.1016/j.yebeh.2020.107391.Peer-Reviewed Original Research
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 analysisClinical Correlates of Periodic Discharges and Nonconvulsive Seizures in Posterior Reversible Encephalopathy Syndrome (PRES)
Bastide L, Legros B, Rampal N, Gilmore EJ, Hirsch LJ, Gaspard N. Clinical Correlates of Periodic Discharges and Nonconvulsive Seizures in Posterior Reversible Encephalopathy Syndrome (PRES). Neurocritical Care 2018, 29: 481-490. PMID: 29949000, DOI: 10.1007/s12028-018-0548-2.Peer-Reviewed Original ResearchConceptsPosterior reversible encephalopathy syndromeReversible encephalopathy syndromeContinuous electroencephalography monitoringGlasgow Outcome ScaleNonconvulsive seizuresPeriodic dischargesEncephalopathy syndromeRisk factorsWorse outcomesEpileptiform patternsMagnetic resonance imaging (MRI) abnormalitiesRetrospective cohort studyCEEG findingsEligible patientsRelated seizuresCohort studyHospital dischargeLow disabilityIll patientsImaging abnormalitiesMedical chartsClinical featuresPathophysiological mechanismsEEG findingsFunctional outcome
2017
Prevalence and risk factors of seizure clusters in adult patients with epilepsy
Chen B, Choi H, Hirsch LJ, Katz A, Legge A, Wong RA, Jiang A, Kato K, Buchsbaum R, Detyniecki K. Prevalence and risk factors of seizure clusters in adult patients with epilepsy. Epilepsy Research 2017, 133: 98-102. PMID: 28475999, DOI: 10.1016/j.eplepsyres.2017.04.016.Peer-Reviewed Original ResearchConceptsSymptomatic generalized epilepsyIdiopathic generalized epilepsySeizure clustersEpilepsy typeStatus epilepticusCortical dysplasiaGeneralized epilepsyFocal epilepsySeizure onsetCNS infectionSeizure freedomMore AEDsRisk factorsCentral nervous system infectionCongenital brain injuryEpilepsy risk factorsNervous system infectionPotential clinical factorsComplex partial seizuresEarly seizure onsetEpilepsy detailsRescue medicationAdult patientsPatient demographicsSystem infection
2016
Seizure clusters: A common, understudied and undertreated phenomenon in refractory epilepsy
Komaragiri A, Detyniecki K, Hirsch LJ. Seizure clusters: A common, understudied and undertreated phenomenon in refractory epilepsy. Epilepsy & Behavior 2016, 59: 83-86. PMID: 27116535, DOI: 10.1016/j.yebeh.2016.02.030.Peer-Reviewed Original ResearchMeSH KeywordsDrug Resistant EpilepsyHumansPrevalenceQuality of LifeRisk FactorsSeizuresSyndromeTreatment Outcome
2015
Acute brain failure in severe sepsis: a prospective study in the medical intensive care unit utilizing continuous EEG monitoring
Gilmore EJ, Gaspard N, Choi HA, Cohen E, Burkart KM, Chong DH, Claassen J, Hirsch LJ. Acute brain failure in severe sepsis: a prospective study in the medical intensive care unit utilizing continuous EEG monitoring. Intensive Care Medicine 2015, 41: 686-694. PMID: 25763756, DOI: 10.1007/s00134-015-3709-1.Peer-Reviewed Original ResearchConceptsNonconvulsive seizuresSevere sepsisEEG reactivityPeriodic dischargesLate seizuresSOFA scoreAPACHE IIFunctional outcomeContinuous sedationHigh riskLower riskMedical intensive care unitLong-term cognitive outcomesPresence of sedationAPACHE II scoreGood functional outcomeNonconvulsive status epilepticusIntensive care unitContinuous EEG monitoringAcute brain failureAcademic medical centerNew epilepsyII scoreClinical seizuresMedical ICU
2014
Brief 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
Continuous electroencephalography in a surgical intensive care unit
Kurtz P, Gaspard N, Wahl AS, Bauer RM, Hirsch LJ, Wunsch H, Claassen J. Continuous electroencephalography in a surgical intensive care unit. Intensive Care Medicine 2013, 40: 228-234. PMID: 24240843, DOI: 10.1007/s00134-013-3149-8.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusPeriodic epileptiform dischargesNonconvulsive seizuresPoor outcomeClinical seizuresSICU patientsRetrospective studyCEEG monitoringMental statusSurgical intensive care unit patientsIntensive care unit patientsSurgical intensive care unitCare unit patientsContinuous electroencephalography monitoringMajority of patientsIntensive care unitMultivariable logistic regressionLiver transplantationHospital dischargeUnit patientsAbdominal surgeryPrimary outcomeStatus epilepticusCare unitMean age