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Unusual Cases in Epilepsy and Epilepsy Surgery
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Unusual Cases in Epilepsy and Epilepsy Surgery

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Chronic Care".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 7302

Special Issue Editor

Dr. Vasileios Kokkinos

E-Mail Website
Guest Editor
Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
Interests: epilepsy; epilepsy surgery; electroencephalography; stereotactic electroencephalography; clinical neurophysiology; functional neuroimaging; neurophysiology of sleep
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In the fields of epilepsy and epilepsy surgery, we all have come across cases that deviate from the textbook descriptions, our training and our clinical experience. Often, these cases are the ones that promote our understanding of epilepsy and provide the initiative for further group studies. In this special issue, I welcome such outlier cases with the aim to shed light in the variability of epilepsy phenomenology and improve our understanding of this disease.

Dr. Vasileios Kokkinos
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Epilepsy
  • Epilepsy surgery

Published Papers (3 papers)

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Research

8 pages, 851 KiB  
Article
Changes in the Brain in Temporal Lobe Epilepsy with Unilateral Hippocampal Sclerosis: An Initial Case Series
by Sung Chul Lim, Juhee Oh, Bo Young Hong and Seong Hoon Lim
Healthcare 2022, 10(9), 1648; https://doi.org/10.3390/healthcare10091648 - 29 Aug 2022
Viewed by 1495
Abstract
Temporal lobe epilepsy (TLE) is a network disorder of the brain. Network disorders predominately involve dysregulation of hippocampal function caused by neuronal hyperexcitability. However, the relationship between the macro- and microscopic changes in specific brain regions is uncertain. In this study, the pattern [...] Read more.
Temporal lobe epilepsy (TLE) is a network disorder of the brain. Network disorders predominately involve dysregulation of hippocampal function caused by neuronal hyperexcitability. However, the relationship between the macro- and microscopic changes in specific brain regions is uncertain. In this study, the pattern of brain atrophy in patients with TLE and hippocampal sclerosis (HS) was investigated using volumetry, and microscopic changes in specific lesions were observed to examine the anatomical correspondence with specific target lesions using diffusion tensor imaging (DTI) with statistical parametric mapping (SPM). This retrospective cross-sectional study enrolled 17 patients with TLE and HS. We manually measured the volumes of the hippocampus (HC), amygdala (AMG), entorhinal cortex, fornix, and thalamus (TH) bilaterally. The mean diffusivity and fractional anisotropy of each patient were then quantified and analyzed by a voxel-based statistical correlation method using SPM8. In right TLE with HS, there was no evidence of any abnormal diffusion properties associated with the volume reduction in specific brain regions. In left TLE with HS, there were significant changes in the volumes of the AMG, HC, and TH. Despite the small sample size, these differences in conditions were considered meaningful. Chronic left TLE with HS might cause structural changes in the AMG, HC, and TH, unlike right TLE with HS. Full article
(This article belongs to the Special Issue Unusual Cases in Epilepsy and Epilepsy Surgery)
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9 pages, 508 KiB  
Article
Status Epilepticus Mortality Risk Factors and a Correlation Survey with the Newly Modified STESS
by Tzu-Hsin Huang, Ming-Chi Lai, Yu-Shiue Chen and Chin-Wei Huang
Healthcare 2021, 9(11), 1570; https://doi.org/10.3390/healthcare9111570 - 18 Nov 2021
Cited by 8 | Viewed by 2153
Abstract
Background: Status epilepticus (SE) is a neurological emergency and is usually associated with significant morbidity and mortality rates. Several clinical scales have been proposed to predict the clinical outcome of such incidents, including the Status Epilepticus Severity Score (STESS), the modified STESS (mSTESS), [...] Read more.
Background: Status epilepticus (SE) is a neurological emergency and is usually associated with significant morbidity and mortality rates. Several clinical scales have been proposed to predict the clinical outcome of such incidents, including the Status Epilepticus Severity Score (STESS), the modified STESS (mSTESS), and the Encephalitis-Nonconvulsive Status Epilepticus-Diazepam Resistance-Image Abnormalities-Tracheal intubation (END-IT). Nevertheless, there is still a need for a more practical and precise predictive scale. Methods: This is a retrospective cohort study which examines data from patients with SE in our Department of Neurology between 2009 and 2020. Based on the outcome of each case, the patients were divided into survivor and non-survivor groups. We analyzed the independent factors and adjusted the STESS to achieve a better prediction of prognosis. The predictive accuracy of our new STESS scale was then compared with that of the mSTESS and the END-IT. Results: Data on a total of 59 patients were collected, with 6 of them classified as non-survivors. The effects of the variables of age, sex, underlying disease(s), and type(s) of antiepileptic drug (AED) use showed no significant differences between the survivor and non-survivor groups. Importantly, the number of AEDs used in the first week and the use of thiobarbiturates predicted non-survival. We adjusted the STESS to create the newly modified STESS (nSTESS), which showed a better predictive capacity than the STESS, the mSTESS, and the END-IT. Conclusions: Our adjustment of the STESS with the addition of the factors “number of AEDs within the first week” and “use of thiobarbiturates”, could have a positive impact on the prediction of mortality rates compared with currently used scales. This nSTESS could potentially be useful in clinical practices, for the early prediction of outcomes for patients with SE. Full article
(This article belongs to the Special Issue Unusual Cases in Epilepsy and Epilepsy Surgery)
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9 pages, 264 KiB  
Article
Association between the Serum Coenzyme Q10 Level and Seizure Control in Patients with Drug-Resistant Epilepsy
by Wei-Chen Liao, Chin-Wei Huang, Ya-Hsin Hsiao, Pi-Shan Sung, Tzu-Fun Fu, Alice Y. W. Chang and Hui Hua Chang
Healthcare 2021, 9(9), 1118; https://doi.org/10.3390/healthcare9091118 - 28 Aug 2021
Cited by 3 | Viewed by 2667
Abstract
Drug-resistant epilepsy (DRE) is a chronic neurological disorder with somatic impacts and increased risk of metabolic comorbidities. Oxidative stress might play an important role in metabolic effects and as a regulator of seizure control, while coenzyme Q10 (CoQ10) could improve insulin sensitivity through [...] Read more.
Drug-resistant epilepsy (DRE) is a chronic neurological disorder with somatic impacts and increased risk of metabolic comorbidities. Oxidative stress might play an important role in metabolic effects and as a regulator of seizure control, while coenzyme Q10 (CoQ10) could improve insulin sensitivity through antioxidant effects. We aimed to investigate the association between CoQ10 level and clinical outcome, represented by the seizure frequency and quality of life, in DRE patients. DRE patients (N = 33) had significantly higher serum insulin levels and lower scores on the physical domain of the World Health Organization Quality of Life questionnaire (WHOQoL) than gender-age matched controls. The serum CoQ10 level (2910.4 ± 1163.7 ng/mL) was much higher in DRE patients than the normal range. Moreover, the serum CoQ10 level was significantly correlated with the seizure frequency (r = −0.412, p = 0.037) and insulin level (r = 0.409, p = 0.038). Based on stratification by insulin resistance (HOMA-IR > 2.4), the subgroup analysis showed that patients with a greater HOMA-IR had higher CoQ10 levels and lower seizure frequency, and had a significantly worse quality of life. In summary, CoQ10 could be a mediator involved in the mechanism of epilepsy and serve as a biomarker of the clinical outcome in DER patients. Full article
(This article belongs to the Special Issue Unusual Cases in Epilepsy and Epilepsy Surgery)
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