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 ResearchMeSH KeywordsAnticonvulsantsBrain Damage, ChronicChildEpilepsyEpilepsy, GeneralizedHumansPrevalenceRisk FactorsStatus EpilepticusConceptsSeizure 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 ResearchMeSH KeywordsAnticonvulsantsEpilepsyEpilepsy, GeneralizedHumansQuality of LifeSeizuresStatus EpilepticusConceptsRescue medicationProlonged seizuresSeizure clustersTreatment of epilepsyQuality of lifeOngoing seizuresFurther seizuresRefractory seizuresRecurrent seizuresRescue treatmentSeizure activitySeizure episodesIntranasal formulationRisk factorsClinical careEffective treatmentMedicationsSeizuresEpilepsyMorbidityClinical opportunitiesAdverse effectsTreatmentReviewEpidemiologyPregabalin 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 ResearchMeSH KeywordsAdultAgedAnticonvulsantsCritical IllnessFemaleHumansMalePregabalinRetrospective StudiesSeizuresConceptsCyclic 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
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 ResearchMeSH KeywordsAnticonvulsantsChildCost of IllnessHumansPrevalenceProspective StudiesQuality of LifeRisk FactorsSeizuresConceptsSeizure 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 factorsPharmacotherapy for Nonconvulsive Seizures and Nonconvulsive Status Epilepticus
Bravo P, Vaddiparti A, Hirsch LJ. Pharmacotherapy for Nonconvulsive Seizures and Nonconvulsive Status Epilepticus. Drugs 2021, 81: 749-770. PMID: 33830480, DOI: 10.1007/s40265-021-01502-4.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusAntiseizure medicationsNonconvulsive seizuresStatus epilepticusIll patientsRefractory nonconvulsive status epilepticusFurther neurological injuryMultiple antiseizure medicationsAdverse neurological outcomesContinuous electroencephalogram monitoringLong-term outcomesHemodynamic labilityRecent neurosurgerySeizure burdenNeurological outcomePharmacological managementBrain infectionGlobal hypoxiaNeurological injuryEarly recognitionMost seizuresUnderlying conditionClinical trialsElectroencephalogram monitoringHepatic functionAnti-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 ResearchMeSH KeywordsAnticonvulsantsCarbamatesChlorophenolsEpilepsy, Tonic-ClonicHumansSeizuresSudden Unexpected Death in EpilepsyTetrazolesConceptsAnti-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 associationSUDEPPreventionMedicationsTiagabineEfficacyLamotrigineBrivaracetam
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 ResearchWhen and How to Treat Status Epilepticus: The Tortoise or the Hare?
Fong MWK, Hirsch LJ. When and How to Treat Status Epilepticus: The Tortoise or the Hare? Journal Of Clinical Neurophysiology 2020, 37: 393-398. PMID: 32890060, DOI: 10.1097/wnp.0000000000000656.Peer-Reviewed Original ResearchConceptsType of SEStatus epilepticusTreatment of SECessation of seizuresCurrent treatment guidelinesConvulsive status epilepticusTreatment guidelinesFull dosesNeuronal responsesVariety of subtypesPromising future approachUnnecessary harmEpilepticusPatientsTherapyTreatmentFuture approachesCollective termMisperceptions on the chance of seizure freedom with antiseizure medications after two failed trials
Blond BN, Hirsch LJ, Mattson RH. Misperceptions on the chance of seizure freedom with antiseizure medications after two failed trials. Epilepsia 2020, 61: 1789-1790. PMID: 32640071, DOI: 10.1111/epi.16594.Peer-Reviewed Original ResearchChoosing Anticonvulsant Medications to Manage Status Epilepticus
Wu K, Hirsch LJ, Babl FE, Josephson SA. Choosing Anticonvulsant Medications to Manage Status Epilepticus. New England Journal Of Medicine 2020, 382: 2569-2572. PMID: 32579819, DOI: 10.1056/nejmclde2004317.Peer-Reviewed Original Research
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 epilepsyComparison of intranasal midazolam versus intravenous lorazepam for seizure termination and prevention of seizure clusters in the adult epilepsy monitoring unit
Owusu KA, Dhakar MB, Bautista C, McKimmy D, Cotugno S, Sukumar N, Deng Y, Farooque P, Hirsch LJ, Maciel CB. Comparison of intranasal midazolam versus intravenous lorazepam for seizure termination and prevention of seizure clusters in the adult epilepsy monitoring unit. Epilepsy & Behavior 2019, 98: 161-167. PMID: 31374472, DOI: 10.1016/j.yebeh.2019.07.021.Peer-Reviewed Original ResearchConceptsEpilepsy monitoring unitAdult epilepsy monitoring unitIntravenous lorazepamIntensive care unitIntranasal midazolamRescue therapySeizure clustersSeizure terminationSingle tertiary academic centerStandard rescue therapyDouble-blind studyTertiary academic centerIndex seizureAdverse eventsBaseline characteristicsConsecutive adultsMedian durationRetrospective cohortRecurrent seizuresStatus epilepticusCare unitRetrospective studyEpilepsy severityBenzodiazepine administrationMedian numberEffectiveness 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-thirdChildrenSeizuresIrritabilityMonthsHow long would it take to try all the antiepileptic drugs available?
Montenegro MA, Novais A, Hirsch LJ. How long would it take to try all the antiepileptic drugs available? Epilepsy Research 2019, 154: 77-78. PMID: 31096069, DOI: 10.1016/j.eplepsyres.2019.04.012.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 analysisCross-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 increasePsychosisDepressionZNSConfoundersEpilepsyDoseSeizure susceptibility and infraslow modulatory activity in the intracranial electroencephalogram
Joshi RB, Duckrow RB, Goncharova II, Gerrard JL, Spencer DD, Hirsch LJ, Godwin DW, Zaveri HP. Seizure susceptibility and infraslow modulatory activity in the intracranial electroencephalogram. Epilepsia 2018, 59: 2075-2085. PMID: 30187919, DOI: 10.1111/epi.14559.Peer-Reviewed Original ResearchConceptsAED taperYale-New Haven HospitalAdult epilepsy patientsSeizure forecasting algorithmsElectrode contact pairsSeizure onset areaSeizure susceptibilityClinical recordsDrug taperElectrophysiological changesEpilepsy patientsIntracranial electroencephalographic dataMagnitude-squared coherenceModulatory activitySeizuresPatientsOnset areaPreseizurePostseizureProgressive desynchronizationIntracranial electroencephalogramDaysIctogenesisEffect of timeHospitalRandomized trial of lacosamide versus fosphenytoin for nonconvulsive seizures
Husain AM, Lee JW, Kolls BJ, Hirsch LJ, Halford JJ, Gupta PK, Minazad Y, Jones JM, LaRoche SM, Herman ST, Swisher CB, Sinha SR, Palade A, Dombrowski KE, Gallentine WB, Hahn CD, Gerard EE, Bhapkar M, Lokhnygina Y, Westover MB, Consortium F. Randomized trial of lacosamide versus fosphenytoin for nonconvulsive seizures. Annals Of Neurology 2018, 83: 1174-1185. PMID: 29733464, PMCID: PMC6785201, DOI: 10.1002/ana.25249.Peer-Reviewed Original ResearchConceptsTreatment-emergent adverse eventsNonconvulsive seizuresContinuous electroencephalographyConfidence intervalsEmergent adverse eventsAnn NeurolPrimary endpointAdverse eventsAntiseizure drugsIll patientsElectrographic seizuresMean ageTreatment trialsOptimal treatmentRisk ratioRelative riskComparative effectivenessSeizuresFosphenytoinNoninferiorityPatientsTreatmentTrialsEquivalents/SubjectsComparative 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 internalization