Epilepsy

Epilepsy is a condition characterised by recurrent, unprovoked seizures, or a high probability (>60 per cent) of seizure recurrence following a single seizure (Fisher et al., 2014). Most neurological conditions (MS, AD, etc.) are unified by a common underlying process within the brain, giving rise to a number of symptoms. Epilepsy is different in that the diagnosis is conferred on the basis of the defining symptom, seizures. The abnormalities and pathologies that can result in seizures are multiple and varied and may be structurally apparent or cryptogenic, genetic or acquired (Berg et al., 2010). This makes epilepsy both the most common neurological disorder worldwide and the most common neurological comorbidity of other neurological conditions. It follows that people with epilepsy form an extremely heterogeneous population

Uniform shrinking and expansion under isotropic Brownian flows

We study some finite time transport properties of isotropic Brownian flows. Under a certain nondegeneracy condition on the potential spectral measure, we prove that uniform shrinking or expansion of balls under the flow over some bounded time interval can happen with positive probability. We also provide a control theorem for isotropic Brownian flows with drift. Finally, we apply the above results to show that under the nondegeneracy condition the length of a rectifiable curve evolving in an isotropic Brownian flow with strictly negative top Lyapunov exponent converges to zero as $t\to \infty$ with positive probability

Epilepsy

Epilepsy is a condition characterised by recurrent, unprovoked seizures, or a high probability (>60 per cent) of seizure recurrence following a single seizure (Fisher et al., 2014). Most neurological conditions (MS, AD, etc.) are unified by a common underlying process within the brain, giving rise to a number of symptoms. Epilepsy is different in that the diagnosis is conferred on the basis of the defining symptom, seizures. The abnormalities and pathologies that can result in seizures are multiple and varied and may be structurally apparent or cryptogenic, genetic or acquired (Berg et al., 2010). This makes epilepsy both the most common neurological disorder worldwide and the most common neurological comorbidity of other neurological conditions. It follows that people with epilepsy form an extremely heterogeneous population

Neuropsychological assessment in epilepsy

The role of the neuropsychological assessment in the management of people with epilepsy has evolved considerably over the past 25 years. This paper describes some of the most common applications of a neuropsychological assessment in the diagnosis, management and treatment of people with epilepsy. It describes the factors that influence the interpretation of neuropsychological test scores in this patient group and outlines the limitations of the investigation. It gives guidelines for the optimal timing of a referral, together with timelines and indications for reassessment, and provides a checklist to help the referring clinician get the most from a neuropsychological assessment for their patients with epileps

Electricity crackles with authenticity

Since the dawn of cinema, epilepsy has been employed by film makers as shorthand to convey madness, stupidity, or both. In 1929, in one of the first British talking pictures (To What Red Hell?), an aristocratic young man named Harold murders a woman while having a seizure. In the climax of the film, Harold is told he has epilepsy and that the murder is not his fault; his immediate relief that he is not morally culpable for his crime is short-lived. Within seconds, he realises that the diagnosis means he will be a danger to his friends, family, and indeed anyone he may come into contact with

A comprehensive review of flow chemistry techniques tailored to the flavours and fragrances industries

Due to their intrinsic physical properties, which includes being able to perform as volatile liquids at room and biological temperatures, fragrance ingredients/intermediates make ideal candidates for continuous-flow manufacturing. This review highlights the potential crossover between a multibillion dollar industry and the flourishing sub-field of flow chemistry evolving within the discipline of organic synthesis. This is illustrated through selected examples of industrially important transformations specific to the fragrances and flavours industry and by highlighting the advantages of conducting these transformations by using a flow approach. This review is designed to be a compendium of techniques and apparatus already published in the chemical and engineering literature which would constitute a known solution or inspiration for commonly encountered procedures in the manufacture of fragrance and flavour chemicals

Reprint of: The new approach to epilepsy classification: Cognition and behavior in adult epilepsy syndromes

The revised terminology and concepts for the organization of seizures and epilepsy proposed by the ILAE Commission on Classification and Terminology in 2010 allows for a number of new opportunities in the study of cognition and behavior in adults. This review examines the literature that has looked for behavioral and cognitive correlates of the newly recognized genetic epilepsies in adults. While some studies report clear cognitive phenotypes associated with specific genetic mutations in adults with epilepsy, others report remarkable clinical heterogeneity. In the second part of this review, we discuss some of the factors that may influence the findings in this literature. Cognitive function is the product of both genetic and environmental influences. Neuropsychological phenotypes under direct genetic influence may be wider and more subtle than specific deficits within discreet cognitive domains and may be reflected in broader, multidimensional measures of cognitive function than those tapped by scores on standardized tests of function. Future studies must be carefully designed to reflect these factors. It is also imperative that studies with negative findings are assigned as much value as those with positive results and published accordingly

Inspiring the next generation: the RCUK School-University Partnership Initiative (SUPI) summary report

Copy of the final report of the RCUK-SUPI Project (2014-2018). Provides an overview of key lessons relating to engagement activities designed to inspire the next generation of researchers

Red flags in epilepsy surgery: Identifying the patients who pay a high cognitive price for an unsuccessful surgical outcome

Preoperative estimates of cognitive and seizure outcome must be as accurate as possible if the candidate is to make an informed decision about epilepsy surgery. Significant declines in memory function are reported in approximately 30% of temporal lobe surgery patients. The percentage varies according to the ways in which a postoperative deterioration is defined but since the majority of outcome studies do not take into account the patient's capacity to deteriorate if they are functioning at or close to the floor of a memory test prior to surgery, the published percentages may be an underrepresentation of the true extent of memory decline following epilepsy surgery. We examined the cognitive ‘cost’ of epilepsy surgery in a consecutive series of 474 patients who underwent elective surgery for medically intractable epilepsy. All patients underwent a presurgical assessment prior to and 1 year after the surgery. Reliable change indices were used to identify significant postoperative memory decline. Postoperative outcome was dichotomized using the ILAE 2008 classification. All patients in class one were classified as seizure-free (67.5% of the sample). Excluding patients already functioning at or below the 2nd percentile on standardized memory tests, 37.8% experienced a significant postoperative decline in memory function. Twelve percent experienced the ‘double hit’ of significant postoperative memory decline and ongoing seizures following surgery. Patients with pathologies other than hippocampal sclerosis and with signs of limited cognitive reserve, both in terms of memory function and overall intellectual ability were most likely to suffer a double hit. Our results indicate that caution should be exercised when operating on these patients and preoperative counseling should be tailored to reflect the likely risk/benefit ratio of a temporal lobe resection for medically intractable epilepsy in this group

The new approach to epilepsy classification: Cognition and behavior in adult epilepsy syndromes

The revised terminology and concepts for the organization of seizures and epilepsy proposed by the ILAE Commission on Classification and Terminology in 2010 allows for a number of new opportunities in the study of cognition and behavior in adults. This review examines the literature that has looked for behavioral and cognitive correlates of the newly recognized genetic epilepsies in adults. While some studies report clear cognitive phenotypes associated with specific genetic mutations in adults with epilepsy, others report remarkable clinical heterogeneity. In the second part of this review, we discuss some of the factors that may influence the findings in this literature. Cognitive function is the product of both genetic and environmental influences. Neuropsychological phenotypes under direct genetic influence may be wider and more subtle than specific deficits within discreet cognitive domains and may be reflected in broader, multidimensional measures of cognitive function than those tapped by scores on standardized tests of function. Future studies must be carefully designed to reflect these factors. It is also imperative that studies with negative findings are assigned as much value as those with positive results and published accordingly