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Post-Ictal aphasia in focal Epilepsy: Speech-language pathologist Perspectives and insights.

OBJECTIVE: To evaluate the prevalence and speech characteristics of post-ictal aphasia (P-IA) in people with epilepsy (PWE) undergoing long-term video-EEG (VEEG) monitoring (LTM). To investigate the relationship between anatomical and electroclinical data and specific post-ictal speech deficits. METHODS: A multidisciplinary team reviewed the medical records of PWE admitted to the Epilepsy Monitoring Unit between 2017-2020, selecting those who experienced at least one seizure during LTM and underwent postictal speech assessment. Clinical data were compared between patients with and without P-I…

Surgical outcomes for extratemporal lobe epilepsy: A systematic review and meta-analysis.

BACKGROUND: Surgical outcomes of extratemporal lobe epilepsy (ETLE) have traditionally been less favorable than outcomes after surgery for temporal lobe epilepsy (TLE), likely related to challenges with defining the seizure onset zone and epileptogenic network, as well as involvement of eloquent cortex limiting options for surgical resection. This systematic review and meta-analysis aims to identify factors associated with seizure freedom among patients with ETLE. METHODS: We performed a systematic review and one-stage individual patient data (IPD) meta-analysis to identify outcome predictors…

Multilayer Validation Reveals a Glia-Associated Secretome Signature in Temporal Lobe Epilepsy.

Although multi-omics studies have increasingly revealed molecular alterations associated with epilepsy, clinically accessible cerebrospinal fluid (CSF) biomarkers that are stably detectable and biologically relevant remain scarce. This study aimed to identify measurable biomarkers associated with epilepsy-related molecular alterations. Kainic acid (KA)-induced mouse model, single-cell RNA sequencing, and public transcriptomic datasets identified secreted protein-coding genes associated with inflammation, glial activation, and metabolic dysregulation. Candidate biomarkers were validated across …

Obstructive sleep apnea affects interictal epileptiform discharges in patients with focal epilepsy.

OBJECTIVE: Although bidirectional interactions between obstructive sleep apnea (OSA) and epilepsy have long been recognized, the effects of OSA on interictal epileptiform discharges (IEDs) remain unclear. This study examined how respiratory events (RE) modulate IED activity across sleep stages, sleep cycles, and epilepsy localizations in patients with focal epilepsy using combined video-electroencephalography (VEEG) and polysomnography (PSG). METHODS: Combined VEEG-PSG was performed in 300 consecutive patients, of whom 52 with coexisting focal epilepsy and OSA were included in the analysis. I…

Loss of microglial ATM drives synaptic pruning and cognitive impairment in epilepsy.

Microglia are the resident immune cells of the central nervous system, highly sensitive to oxidative stress and essential for maintaining synaptic homeostasis. While epilepsy induces profound redox imbalance, how oxidative stress reshapes microglial function and disrupts synaptic integrity remains unclear. Here we show that epileptic seizures drive early loss of ataxia-telangiectasia mutated (ATM) protein in microglia, independent of canonical DNA damage responses. ATM deficiency shifts microglia into a hyperphagocytic state, with morphological activation and aberrant synaptic engulfment. Sing…

Temporal lobe epilepsy and depression: a dysfunctional lobe overshadows a sclerotic hippocampus.

Depression is one of the most frequent psychiatric comorbidities in drug-resistant patients with epilepsy, reaching up to 60% of them. Studies indicate that the pathophysiology of depression and epilepsy have a lot in common, especially the temporal lobe epilepsy (TLE). Since hippocampal sclerosis (HS) is a frequent histopathology finding in patients with TLE, the purpose of this study was to investigate if there is a frequency relation between depression and the different types of HS. 119 patients with TLE, with and without HS, were selected (HS1 = 40, HS2 = 40, NHS = 39) and their medical re…

Characterizing chapeau de gendarme in pediatric epilepsy through systematic video-EEG evaluation.

OBJECTIVE: Chapeau de gendarme (CdG) is a subtle but clinically relevant semiology that has been scarcely studied in children. Previous studies have primarily focused on its localizing value in small, surgical cohorts. This study aimed to systematically characterize frequency and clinical features of CdG across the pediatric age spectrum. METHODS: We retrospectively analyzed video-electroencephalography (EEG) monitoring of 264 children with epilepsy (0-17 years). Up to 10 seizures per type were reviewed per patient. CdG was defined as a symmetrical downward contraction of both mouth corners a…

Single-nucleus transcriptomics reveals cell type-specific remodeling and epilepsy-associated microglia.

Temporal lobe epilepsy (TLE) is the most common acquired epilepsy, causing refractory seizures and cognitive deficits. We performed single-nucleus RNA sequencing on hippocampal tissue from mice 3 and 6 weeks following pilocarpine-induced status epilepticus, a robust model of TLE. Epilepsy samples showed reductions in Cck and Lamp5-Lhx6 interneuron subclusters, alongside increases in Cajal-Retzius cells, dentate granule (DG) cell precursors, and a mature DG cell subcluster. Among glia, an astrocyte subcluster and a markedly expanded microglia sublcuster were increased. We term this microglia po…

Увеличение числа либидо после начала бриварского ацетама: доклад по делу Темпорального Лоба Эпилепсии.

Сексуальная дисфункция является широко распространенной коморбидией у пациентов с эпилепсией; она коррелируется с частотой припадков и с правой височной долей эпилепсии и влияет на качество жизни (QOL). Несмотря на ее клиническое значение, сексуальная дисфункция часто недооценивается в клинической практике. Считается, что бриварацетам (БРВ) - лекарство против сединения (АСМ), введенное в последние годы, - имеет мало побочных побочных эффектов для психиатрии, и до настоящего времени не сообщалось о каких-либо связях с сексуальной дисфункцией. Мы сообщаем о случае эпилепсии височной доли, в кото

Совпадение в аннотации оригинала
BACKGROUND: Sexual dysfunction is a common comorbidity in patients with epilepsy; it correlates with seizure frequency and right temporal lobe epilepsy and affects quality of life (QOL). Despite its clinical significance, sexual dysfunction is often underassessed in clinical practice. Brivaracetam (BRV), an anti-seizure medication (ASM) introduced in recent …

Glymphatic-meningeal lymphatic dysfunction in epilepsy: novel mechanistic insights and therapeutic avenues.

Despite advances in pharmacotherapy, approximately one-third of individuals with epilepsy develop drug-resistant epilepsy (DRE), accounting for a disproportionate share of the global disease burden. Emerging evidence implicates dysfunction of the meningeal lymphatic system-a critical regulator of waste clearance and immune surveillance-in the pathogenesis of DRE. This suggests that impaired lymphatic drainage may represent a novel mechanistic pathway and therapeutic target. In this review, we systematically examine the interplay between the lymphatic drainage and neural networks in epileptogen…

An epilepsy-associated KV3.1 potassium channel variant acts via dominant-positive effect.

Variants in KCNC1 encoding the voltage-gated potassium (K+) channel subunit KV3.1 are an emerging cause of a spectrum of neurological disease including developmental delay/intellectual disability, ataxia, myoclonus, and epilepsy, including progressive myoclonus epilepsy and developmental and epileptic encephalopathy. Here, we report novel biophysical properties of a recurrent de novo missense variant in KCNC1 c.1196C>T (p.Thr399Met) associated with epilepsy, mild developmental delay, and nonprogressive ataxia. The variant is localized to the highly conserved pore region of the channel, and vol…

From comorbidity to continuum: Alzheimer's disease and epilepsy are connected-now what?

Alzheimer's disease (AD) and epilepsy are increasingly recognized not merely as comorbid conditions but as disorders lying along a shared pathophysiological continuum, characterized by overlapping clinical features, network hyperexcitability, and convergent molecular mechanisms. Although bidirectional interactions between AD and epilepsy are now well established, critical questions remain regarding how this knowledge can be translated into improved risk prediction, prevention, and treatment. Classical mechanisms such as amyloid-β and tau pathology, neuroinflammation, and synaptic dysfunction, …

STING Mediates Microglial Polarization to Promote Neuroinflammation in Epilepsy-Related Cognitive Dysfunction.

Epilepsy is a chronic neurological disorder characterized by recurrent seizures and frequently accompanied by cognitive deficits for which effective treatments are lacking. Neuroinflammation, particularly microglia-mediated immune responses, is pivotal in epileptogenesis. Although the stimulator of interferon genes (STING) pathway is a key cytosolic DNA-sensing mechanism driving innate immunity, its specific role in epilepsy-related cognitive dysfunction remains unclear. This study investigated the function of the STING pathway in epilepsy pathology and its therapeutic potential. Adult male Sp…

Ganoderic Acid A Ameliorates Pentylenetetrazol-Induced Epilepsy in Mice via Activating KCNQ2.

TRIAL DESIGN: This study aimed to explore the antiepileptic effect of Ganoderic acid A (GA-A) on pentylenetetrazol (PTZ)-induced epilepsy in mice and clarify its underlying mechanism, focusing on the KCNQ2 channel. METHODS: C57BL/6 mice and hippocampal-specific KCNQ2 knockout mice were used to establish PTZ-induced acute epilepsy models. GA-A was pretreated for 7 days. Epileptic seizures were evaluated by the Racine score and electroencephalogram (EEG). Neuronal injury was detected by HE and TUNEL staining. Neuroinflammation and oxidative stress were assessed by measuring inflammatory factors…

CACNA1A c.5610del in a three-generation family: epilepsy with ataxia/migraine.

OBJECTIVE: CACNA1A encodes the Cav2.1 (P/Q-type) channel whose spectrum extends from FHM1/EA2/SCA6 to epilepsy and vertigo, but penetrance-especially sex differences-remains unclear. We report a three-generation family with CACNA1A c.5610del, detail electroclinical features, assess sex-stratified penetrance, and discuss individualised therapy. METHODS: We retrospectively reviewed histories, neurological exams, EEG, treatments, and follow-up. Trio whole-exome sequencing across 13 relatives was Sanger-confirmed and interpreted per ACMG; gnomAD/ClinVar were queried. Sex-stratified penetrance was…

A CLN8 biallelic missense variant causes epilepsy with severe treatment-resistant psychosis.

Epilepsy and psychosis are dysfunctions of the nervous system that may occasionally co-occur. The current study was designed to investigate the causes of psychosis with or without epilepsy in Pakistani families. We identified two consanguineous families in which all affected members had treatment-resistant psychosis while three patients also had epilepsy. Every participant was examined by psychiatrists and a psychologist, while epilepsy was diagnosed by neurologists. The doctors confirmed the presence of severe psychosis with or without epilepsy in the patients and their absence in other parti…

Childhood Absence Epilepsy with Coexisting Centrotemporal Spikes: Frequency, Electroclinical Course and Prognosis.

OBJECTIVE: The objective of this study was to evaluate the frequency, electroclinical course and prognosis of patients with CAE that also pr … ents treated with antiseizure medication (ASM). CAE evolved to other type of idiopathic generalized epilepsy in four (16%) patients. No patient had generalized tonic-clonic seizures, except those with evolution to other type of idiopathic generalized epilepsy. No patient had focal seizures. Remission of the generalized epileptiform discharges correlated wi …

Dose-response analysis of valproate, levetiracetam and lamotrigine in idiopathic generalized epilepsy.

PURPOSE: To evaluate dose-response relationships for valproate, levetiracetam, and lamotrigine in adults with idiopathic generalized epilepsy (IGE). METHOD: A retrospective cohort study was conducted including 473 adults (≥16 years) with IGE treated at Odense University Hospital from 2015 to 2021. Patients were stratified into predefined daily dose categories for levetiracetam, lamotrigine, and valproate. The primary outcome was seizure freedom, defined as no seizures in the past 12 months or three times the longest pre-treatment inter-seizure interval. Dose-response was analyzed using chi-sq…