Direct cortical electrical stimulation remains the gold standard for delineation of the primary motor cortex in patients with drug-resistant epilepsy (DRE) undergoing epilepsy surgery evaluation OBJECTIVE: This study aimed to explore the efficacy and safety of functional motor mapping through Stereo-EEG (SEEG) electrode contacts in children with DRE at our institute.

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is clinically characterized by biphasic seizures associated with mild to severe neurological sequelae and is the most common subtype of acute encephalopathy in Japan, accounting for around 30 % of cases. The present study retrospectively analyzed the utility of electroencephalography (EEG) in determining the optimal method of diagnosing AESD at the early stage.

Pediatric status epilepticus (SE) is a life-threatening, time-sensitive neurological emergency. The adequate treatment of pediatric patients with SE is challenging, especially when the principles of time are considered. Various clinical trials and studies [especially one of the most important randomized controlled trials of the present time, 'ESETT (Established Status Epilepticus Treatment Trial)'] compared the effectiveness of 3 antiseizure medications (ASMs) in patients with SE, providing robust evidence for clinical practice. Meticulous analysis of care delivery is an essential component as far as optimal management of pediatric SE is concerned. We performed an evidence-based comprehensive review on documented non-compliance and deviations from standard-treatment guidelines (STGs), focusing on time-elapsed from pediatric SE onset to ASM administration and escalation to subsequent classes. We have found significant gaps in real-world clinical practice. A literature review and a pooled-analysis of 12 studies on pediatric SE showed prehospital time to SE treatment was 29.5 minutes. Time to EMS arrival and hospital admission was 23 minutes and 48 minutes, respectively. Time-elapsed from SE onset to first-line ASM administration was 25.5 minutes, compared to evidence-based guidelines recommended time of 5-10 minutes. Similar delays were also observed in second- and third-line ASM administration. We have reviewed the factors affecting time-delays and impact on clinical outcomes. This review also highlights quality-improvement avenues that may help in improvising time for SE treatment and associated outcomes in pediatrics.

For young children with intractable epilepsy caused by congenital abnormalities or acquired cortical lesions, pediatric hemispherectomy surgery (pHS) may offer the only path to seizure remediation. Although some sensory and motor outcomes of pHS are highly predictable, the long-term cognitive and functional sequelae of pHS are far more variable. With the aim of identifying potential post-pHS intervention targets, the current study examined daily executive functioning and self-awareness in adults with pHS and broadly intact cognitive outcomes (indicated by average or above performance on intelligence tests).

To study the effects of extracellular bromide in a novel immature rat pilocarpine model compared to the standard adolescent rat model.

Mutations in methyl CpG binding protein 2 (MeCP2) are linked to Rett syndrome, in which epilepsy is one of the most well-described disorders. However, little is known about the specific role of MeCP2 during epileptogenesis. Our previous study has demonstrated that MeCP2 has a unique control on the development of mossy fiber sprouting (MFS) in the epileptic hippocampus. This study aimed to (1) examine whether MeCP2 affects spontaneous recurrent seizures (SRSs) and cognitive deficits in mice with pilocarpine-induced epilepsy, and (2) profile MeCP2's downstream molecular events. In the dentate gyrus (DG), we found that over-expression or suppression of MeCP2 significantly reduced or increased the frequency, duration, and number of stage 5 seizures of SRSs during the chronic stage after the SE. Over-expression of MeCP2 improved cognitive deficits in TLE mice, while exacerbated cognitive performances were observed following MeCP2 knockdown. Chromatin immunoprecipitation sequencing (ChIP-seq) and RNA-sequence analyses revealed that MeCP2-targeted genes have far‑reaching impacts on the pathophysiological events during epileptogenesis, including neuron differentiation, neurogenesis, axon guidance, and so on.

Data regarding the timing of puberty in adolescents with childhood-onset epilepsy is scarce. This study aimed to explore whether pre-pubertal valproate intake negatively affects the timing of puberty.

We explored the temporal patterns of haemodynamic parameters in four seizures of three patients using the log-ratio method.

To investigate the potential of using artificial intelligence (AI), specifically large language models (LLMs), for synthesizing information in a simulated randomized clinical trial (RCT) for an anti-seizure medication, cenobamate, demonstrating the feasibility of inductive reasoning via medical chart review.

Dural arteriovenous fistulas (DAVFs) are an unusual cause of seizures. In this systematic review, we aim to describe the clinical features, paraclinical findings, management, and prognosis of cases of DAVF-related seizures, raising awareness for a potentially treatable cause of epilepsy.

Responsive neurostimulation of the centromedian nucleus of the thalamus (CM RNS) is being investigated for treatment of drug-resistant generalized epilepsy with promising results. The aim of this study is to report outcomes of seven patients with pediatric-onset drug-resistant generalized epilepsy, including both genetic generalized epilepsy (GGE) and Lennox-Gastaut syndrome (LGS), who underwent treatment with bilateral CM RNS.

To evaluate the electrophysiological properties of three HCN1 variant sites found in Chinese epileptic patients and to explore the potential relationship between genotype and phenotype.

This study aimed to assess the long-term outcome and prognostic factors of vagus nerve stimulation (VNS) for drug-resistant epilepsy (DRE) using real-world data.

Haploinsufficient deletions of GABA transporter 1 (GAT-1)- encoding SLC6A1, and GABA transporter 3 (GAT-3)-encoding SLC6A11 are implicated in epileptic syndromes. Despite their significance, the impact of these deletions has not been characterized. Our previous work on SLC6A1 missense mutations prompted a clinical trial for Ravicti (NCT04937062), a glycerol formulation of 4-phenylbutyrate (PBA), for treatment-resistant epilepsy. We observed phenotypic overlap between trial-eligible SLC6A1 mutation patients and 3p- syndrome patients carrying deletions of SLC6A1 and SLC6A11. This study characterizes the functional impact of these deletions and assesses the urgent question of whether 3p- syndrome patients could benefit from this treatment.

Epilepsy is a widespread neurological disorder that increases the risk of cognitive impairment (CI) or dementia. We aimed to assess the relationship between cognition and interictal electroencephalogram (EEG) in epilepsy patients, using the Grand Total EEG (GTE) score. Additionally, we investigated the GTE score's utility in the early detection of CI in these patients.

FCD is a developmental disorder associated with drug-resistant seizures. Alterations in GABA receptor-mediated activity contribute to seizures in FCD. However, the exact mechanism of altered GABAergic synaptic activity is still unclear. Previously, we showed increased GABA receptor α4 subunit expression in FCD. In this study, we investigated whether changes in GABA receptor configuration at synaptic or extrasynaptic sites contribute to enhanced GABAergic activity in the resected samples of FCD patients. Results showed increase in the frequency and amplitude of spontaneous inhibitory postsynaptic currents on treatment with gaboxadol (agonist for α4δ-containing GABA receptors). In the presence of tetrodotoxin (voltage-gated Na channel inhibitor), frequency and amplitude of miniature inhibitory postsynaptic currents were also increased upon treatment with gaboxadol. However, higher magnitude of change was observed in spontaneous inhibitory postsynaptic currents compared to miniature inhibitory postsynaptic currents on gaboxadol treatment, suggesting action potential-dependent α4-containing GABA receptor activity may influence epileptogenicity in FCD.

Febrile seizure (FS) is the most common convulsive disorder in children. Understanding its time-of-day pattern can provide insight into mechanisms and prevention.

Patient-recorded videos offer a practical alternative for diagnosing epilepsy and psychogenic nonepileptic seizures (PNES), yet their diagnostic value across sequential clinical questions remains underexplored.