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Article

Diagnosis of Epilepsy after First Seizure. Introducing the SWISS FIRST Study

by
Baudouin Zongxin Jin
1,2,*,
Pia De Stefano
3,
Valentina Petroulia
1,
Christian Rummel
1,
Claus Kiefer
1,
Mauricio Reyes
4,
Kaspar Schindler
2,
Pieter van Mierlo
5,
Margitta Seeck
3 and
Roland Wiest
1
1
Support Center for Advanced Neuroimaging, Inselspital, University of Bern, 3012 Bern, Switzerland
2
Sleep-Wake-Epilepsy Center and Center for Experimental Neurology, Department of Neurology, Inselspital, University Hospital, University of Bern, 3012 Bern, Switzerland
3
Electroencephalography and Epilepsy Unit, Department of Neurology, University Hospitals of Geneva, 1205 Geneva, Switzerland
4
ARTORG Center for Biomedical Engineering, University of Bern/Insel Data Science Center, Inselspital, 3012 Bern, Switzerland
5
Department of Electronics and Information Systems, Ghent University, B-9000 Ghent, Belgium
*
Author to whom correspondence should be addressed.
Clin. Transl. Neurosci. 2020, 4(2), 13; https://doi.org/10.1177/2514183x20939448
Submission received: 1 April 2020 / Accepted: 8 June 2020 / Published: 16 July 2020

Abstract

Diagnosis of epilepsy after a first unprovoked seizure is possible according to the guidelines by the International League Against Epilepsy, if the risk recurrence of a second unprovoked seizure is exceeding 60%. However, this cutoff constitutes only a proxy depending on the patients’ history, magnetic resonance imaging (MRI), and electroencephalography (EEG) findings but nevertheless also from the treating neurologists’ individual experience. In a Switzerland-wide observational study, we aim to recruit patients that were admitted to the emergency department with the referral diagnosis of a first and unprovoked seizure. We make use of optimized MRI protocols to identify potential structural epileptogenic lesions, introduce new imaging-based markers of epileptogenecity, and use most recent postprocessing methods as automatic morphometry, spike map analysis, and functional connectivity. With these diagnostic tools, we aim to segregate patients that present with epileptic seizures versus mimicks and non-epileptic seizures and stratify for every finding in MRI and EEG its predictive value for a second unprovoked seizure. These findings shall support neurologists to calculate and not only estimate the seizure recurrence rate in future.
Keywords: epilepsy; neuroimaging; automatic morphometry; functional connectivity; spike maps epilepsy; neuroimaging; automatic morphometry; functional connectivity; spike maps

Share and Cite

MDPI and ACS Style

Jin, B.Z.; De Stefano, P.; Petroulia, V.; Rummel, C.; Kiefer, C.; Reyes, M.; Schindler, K.; van Mierlo, P.; Seeck, M.; Wiest, R. Diagnosis of Epilepsy after First Seizure. Introducing the SWISS FIRST Study. Clin. Transl. Neurosci. 2020, 4, 13. https://doi.org/10.1177/2514183x20939448

AMA Style

Jin BZ, De Stefano P, Petroulia V, Rummel C, Kiefer C, Reyes M, Schindler K, van Mierlo P, Seeck M, Wiest R. Diagnosis of Epilepsy after First Seizure. Introducing the SWISS FIRST Study. Clinical and Translational Neuroscience. 2020; 4(2):13. https://doi.org/10.1177/2514183x20939448

Chicago/Turabian Style

Jin, Baudouin Zongxin, Pia De Stefano, Valentina Petroulia, Christian Rummel, Claus Kiefer, Mauricio Reyes, Kaspar Schindler, Pieter van Mierlo, Margitta Seeck, and Roland Wiest. 2020. "Diagnosis of Epilepsy after First Seizure. Introducing the SWISS FIRST Study" Clinical and Translational Neuroscience 4, no. 2: 13. https://doi.org/10.1177/2514183x20939448

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