Epidemiology of status epilepticus in adults: A population-based study on incidence, causes, and outcomes

In 2015, the International League Against Epilepsy (ILAE) proposed a new definition of status epilepticus (SE): 5 minutes of ongoing seizure activity to diagnose convulsive SE (CSE, ie, bilateral tonic-clonic SE) and 10 minutes for focal SE and absence SE, rather than the earlier criterion of 30 minutes. Based on semiology, several types of SE with prominent motor phenomena at any time (including CSE) were distinguished from those without (ie, nonconvulsive SE, NCSE). We present the first population-based incidence study applying the new 2015 ILAE definition and classification of SE and report the impact of the evolution of semiology and level of consciousness (LOC) on outcome

Current View of Autonomic Findings During Epileptic Seizures

Autonomic findings during epileptic seizures frequently associate other ictal symptoms or may appear isolated. These changes are often overshadowed by other dramatic motor symptoms and not recognized. Cardiovascular system changes are thought to play a particular role in sudden unexplained death in epilepsy (SUDEP). In the literature, information about the features of peri-ictal autonomic symptoms and their lateralizing value are controversial. It is important to identify patients who are at high risk for SUDEP and plan early and appropriate medical treatment, as well as epilepsy surgery options to reduce mortality related with seizures. This paper will review the literature of the frequency of peri-ictal autonomic findings and their lateralizing and localizing information with didactic case examples. Furthermore, the relation between cardiac rhythm disorders, other electroclinical data, and risk of SUDEP will be evaluated

Pilomotor Seizures: An Update on This Rare Semiologic Manifestation and its Etiology

Ictal piloerection is a rare seizure manifestation and usually reported with temporal lobe epilepsy. There was no specific etiology associated with pilomotor seizures which were described in a wide variety of lesional as well as nonlesional epilepsies. This paper will review the association of piloerection and epileptic seizures and recently recognized important relationship with autoimmunity as a newly described potential etiology. Furthermore at the end of the review we will discuss the etiology, localizing and lateralizing features of our illustrative case examples with pilomotor seizures. We would like also to draw attention to sudden unexplained death in epilepsy in one of our cases with pilomotor aura who had drug-resistant epilepsy associated with hippocampal sclerosis

Assessment of Early Cognitive Impairment in Patients with Clinically Isolated Syndromes and Multiple Sclerosis

WOS: 000335016500001PubMed ID: 25944978Objective. The aim of our study was to investigate the frequency and pattern of cognitive impairment in patients with clinically isolated syndromes and definite diagnosis of multiple sclerosis within the last 2 years. Methods. We assessed the cognitive status of 46 patients aged 18-49 years with clinically isolated syndromes or definite diagnosis of multiple sclerosis who have onset of their symptoms within the last 2 years. Patients were matched with 40 healthy participants for age, sex, and educational level. Neuropsychological assessment was performed by stroop test, paced auditory serial addition test (PASAT), controlled oral word association test (COWAT), clock drawing test, trail making test (TMT), faces symbol test (FST). Hamilton Depression Scale and Modified Fatigue Impact Scale were used to quantify the severity of any depression and fatigue the subjects might suffer. Results. 19.6% of early MS/CIS group failed at 4 and more tests and had significant cognitive impairment focused on attention, executive functions, memory, and learning. No significant relationship was found between cognitive impairment and disability and fatigue scores. Discussion. Cognitive impairment can be present from the earliest stage of multiple sclerosis. It should be considered among the main manifestations of MS even in the earliest stages of the disease

Small-cell lung carcinoma and acute onset of antiglial nuclear antibody-positive limbic encephalitis

Limbic encephalitis (LE) can present as a nonspecific manifestation preceding neoplastic disease. Having high clinical suspicion and using newer onconeural antibodies, like antiglial nuclear antibody (AGNA), can lead to an earlier diagnosis. We report a patient with AGNA‐positive LE who is later diagnosed and treated for small‐cell lung carcinoma