Incidence, mortality, and management of status epilepticus from 2012 to 2022: An 11-year nationwide study.

Objective: Recent data on status epilepticus (SE) incidence and mortality remain limited, despite the 2015 revision of its definition by the International League Against Epilepsy. The impact of the COVID-19 pandemic also remains unclear. We assessed trends in SE incidence, mortality, and management from 2012 to 2022 and examined the pandemic's impact.

An extreme type of new onset refractory status epilepticus with stimulus-induced seizures in pharmacological isoelectric states.

Objective: Status epilepticus (SE) is a common neurological emergency associated with high morbidity and mortality. SE is classified as refractory when it persists despite benzodiazepine and second-line antiseizure medication. Managing refractory SE in the intensive care setting often requires high doses of sedative drugs, which can induce burst suppression or complete electrical suppression (amplitude < 10 μV).

Standard complete blood count to predict long-term outcomes in febrile infection-related epilepsy syndrome (FIRES): A multicenter study.

Objective: We investigated whether complete blood count (CBC) analyses during intensive care unit stay could predict 12-month outcomes in patients with cryptogenic febrile infection-related epilepsy syndrome (FIRES), a subset of new-onset refractory status epilepticus (NORSE).

Methods: Outcomes at 12 months were classified as "unfavorable" (Glasgow Outcome Score [GOS] 1-3) or "favorable" (GOS 4-5). Demographic, clinical, and serial CBC data were collected across treatment phases: (1) no immunotherapy (before initiation or no treatment), (2) first-line immunotherapy, and (3) second-line immunotherapy.

The Clinical and Genetic Landscape of a French Multicenter Cohort of 2563 Epilepsy Patients Referred for Genetic Diagnosis.

Background: Epileptic disorders are a heterogeneous group of neurological conditions, with many cases linked to monogenic causes, particularly in developmental and epileptic encephalopathies (DEE). Identifying pathogenic variants aids treatment, prognosis, and family planning. In France, genetic testing is coordinated through the EpiGene network.

Representational dynamics during extinction of fear memories in the human brain.

Extinction learning-the suppression of a previously acquired fear response-is critical for adaptive behaviour and core for understanding the aetiology and treatment of anxiety disorders. Electrophysiological studies in rodents have revealed critical roles of theta (4-12 Hz) oscillations in amygdala and hippocampus during both fear learning and extinction, and engram research has shown that extinction relies on the formation of novel, highly context-dependent memory traces that suppress the initial fear memories. Whether similar processes occur in humans and how they relate to previously described neural mechanisms of episodic memory formation and retrieval remains unknown.

Geometric representations of brain networks can predict the surgery outcome in temporal lobe epilepsy.

Epilepsy surgery, particularly for temporal lobe epilepsy (TLE), remains a vital treatment option for patients with drug-resistant seizures. However, accurately predicting surgical outcomes remains a significant challenge. This study introduces a novel biomarker derived from brain connectivity, analyzed using non-Euclidean network geometry, to predict the surgery outcome in TLE.

Longitudinal PET and MRI Evaluation in Late Onset Rasmussen Encephalitis: A Series of Three Cases.

Background: Rasmussen's encephalitis (RE) is a rare, chronic, neurological disorder characterized by progressive focal epilepsy and hemispheric atrophy. Late-onset RE poses diagnostic challenges due to atypical clinical features and nonspecific early MRI findings.

Methods: This case series underscores the value of [18F]FDG PET in detecting unihemispheric hypometabolism and crossed cerebellar diaschisis at diagnosis, before MRI changes appear.

Ultrasound-induced blood-brain barrier opening and selenium-nanoparticle injection lower seizure activity: A mouse model of temporal lobe epilepsy.

Background: Given the limitations of current treatment options for drug-resistant mesial temporal lobe epilepsy (MTLE), the development of novel, nonablative and minimally invasive surgical techniques is essential.

Objective And Methods: In this study, low-intensity pulsed ultrasound (LIPU)- and microbubble-induced (henceforth LIPU) blood-brain barrier (BBB) opening combined with selenium-nanoparticle (SeNP) intravenous injection in a mouse model of mesial temporal lobe optimized the latter's bioavailability in the brain epileptic tissue of the kainic acid (KA) mouse model of MTLE. We aimed to assess the safety and antiepileptic potential of LIPU-enhanced SeNP delivery against KA-induced seizures using long-term intracranial electroencephalogram video recordings and evaluating neuroinflammation, astrogliosis, neuronal apoptosis and neurogenesis in the hippocampal tissues of mice.

Recurrence and Mortality After a First Status Epilepticus: A Retrospective Nationwide Study From the French National Health Data System.

Background And Objectives: Status epilepticus (SE) is associated with high short-term mortality, but data on long-term outcomes, including recurrence and mortality, are limited. The aim of this study was to describe recurrence and postdischarge mortality rates up to 3 years after an initial SE and identify the associated risk factors.

Methods: We conducted a retrospective cohort study involving all patients, infants and adults, who survived their first hospitalization with an ICD-10 code of SE from January 1, 2011, to December 31, 2016, using the French National Health Data System, with a 3-year follow-up.

Identification of Distinct Biological Groups of Patients With Cryptogenic NORSE via Inflammatory Profiling.

Background And Objectives: Emerging evidence suggests that immune dysregulation plays a pivotal role in triggering cryptogenic new-onset refractory status epilepticus (c-NORSE), prompting a consensus on early initiation of immunotherapy. However, despite similar timing of administration, responses to immunotherapies have been varied and unpredictable, suggesting the presence of heterogeneous underlying mechanisms The aim of this study was to identify distinct inflammatory response subtypes in patients with c-NORSE by analyzing their cytokine profiles. Insights into underlying mechanisms were sought to understand the pathophysiology and guide personalized therapies to improve patient outcomes.

Efficacy of naloxone in reducing hypoxemia and duration of immobility following focal to bilateral tonic-clonic seizures.

Objective: Evaluating the efficacy of an opioid antagonist, naloxone (NLX), to reduce the severity of post-ictal hypoxemia and immobility after focal to bilateral tonic-clonic seizures (FBTCS).

Methods: ENALEPSY is a double-blind placebo (PCB)-controlled trial conducted in patients with focal epilepsy undergoing long-term video-EEG monitoring (LTM). Patients with a FBTCS during LTM were randomized 1:1 to receive intravenous NLX or PCB within the 2 min following the end of FBTCS.

How Reliable Is the G41 Discharge Code for Status Epilepticus?

Introduction: Medico-administrative databases are increasingly used to study the epidemiology of status epilepticus (SE), targeting hospitalizations with the SE G41 ICD-10 code. However, the positive predictive value (PPV) of the G41 code, which measures the percentage of true cases among those identified by the code, is unknown.

Methods: We identified all hospitalizations with a primary or secondary diagnosis coded as G41 in five different hospitals.

Dissociation of value and confidence signals in the orbitofrontal cortex during decision-making: an intracerebral electrophysiology study in humans.

Some decisions, such as selecting a food item in a novel menu, are not based on rational norms, or on trained habits, but on subjective preferences. How the human brain makes these preference-based decisions is still debated in cognitive neuroscience. Classical models focus on the comparison mechanism that achieves the selection of the option with best expected value.

The Mickey Mouse's hand sign in brain MRI points out multinodular and vacuolating neuronal tumors in mesial temporal lobe structures.

Purpose: Multinodular and vacuolating neuronal tumor (MVNT) is a rarely diagnosed neoplastic lesion often associated with adult-onset focal seizures. In some situations, atypical MRI features of MVNT may mimic other long-term epilepsy associated tumors (LEATs) or diffuse low-grade gliomas. In such a context, the identification of distinct clinical markers is recommended.

New onset refractory status epilepticus: Long-term outcomes beyond seizures.

We propose and prioritize important outcome domains that should be considered for future research investigating long-term outcomes (LTO) after new onset refractory status epilepticus (NORSE). The study was led by the international NORSE Institute LTO Working Group. First, literature describing the LTO of NORSE survivors was identified using a PubMed search and summarized to identify knowledge gaps.

Corticolimbic structures activation during preparation and execution of respiratory manoeuvres in voluntary olfactory sampling: An intracranial EEG study.

Volitional respiratory manoeuvres such as sniffing and apnoea play a key role in the active olfactory exploration of the environment. Their impairment by neurodegenerative processes could thus impair olfactory abilities with the ensuing impact on quality of life. Functional brain imaging studies have identified brain networks engaged in sniffing and voluntary apnoea, comprising the primary motor and somatosensory cortices, the insula, the anterior cingulate cortex and the amygdala.

Cannabidiol Treatment for Adult Patients with Drug-Resistant Epilepsies: A Real-World Study in a Tertiary Center.

Background And Purpose: Around 30% of patients with epilepsy show drug-resistant epilepsy (DRE). While cannabidiol has demonstrated efficacy as an adjunctive treatment in Dravet syndrome (DS), Lennox-Gastaut Syndrome (LGS), and epilepsy related to tuberous sclerosis complex (TSC), its more global effectiveness in adult patients with DRE apart from these three specific contexts needs to be clarified.

Methods: We conducted a retrospective study at the epilepsy unit of Pitié Salpêtrière Hospital.

Multimodal Assessment of the Origin of Myoclonus in Lance-Adams Syndrome.

Background And Objectives: Lance-Adams syndrome (LAS), or chronic posthypoxic myoclonus, is a long-term disabling neurologic disorder occurring in survivors of anoxia. The cortical or subcortical origin of this myoclonus is unclear. We aimed to identify the neuroanatomical origin of myoclonus in LAS.

Resective surgery for mesial temporal lobe epilepsy associated with hippocampal sclerosis in patients over 50 years: a case-control study.

Background: Mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE/HS) is the most common cause of drug-resistant focal seizures and surgical resection is the primary treatment option, with seizure-free rates ranging from 60 to 80%. However, data on postsurgical seizure outcomes in patients ≥ 50 years of age are limited. This study aimed to assess the efficacy and safety of surgery in this age group compared to younger patients.

Other causes of neurocognitive impairment than covert hepatic encephalopathy (CHE) are very frequent, either alone or associated with CHE, in cirrhotic patients with cognitive complaints.

Background/aims: Although it is well admitted that cirrhotic patients display various causes of neurocognitive impairment (NI) hampering the diagnosis of covert hepatic encephalopathy (CHE), those are almost never investigated per se. The aims of this study were, in cirrhotic patients displaying cognitive complaints explored by a complete multimodal work-up, to assess: (1) the prevalence of CHE and/or that of other causes of NI and (2) their outcomes, according to the cause of NI.

Methods: Prospective cohort of cirrhotic patients referred in a dedicated clinic because of cognitive complaints.