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2. Rasmussen’s encephalitis: structural, functional, and clinical correlates of contralesional epileptiform activity

Author

Bauer, Tobias, von Wrede, Randi D., Pujar, Suresh, Rácz, Attila, Hoppe, Christian, Baumgartner, Tobias, Varadkar, Sophia, Held, Nina R., Reiter, Johannes T., Enders, Selma, David, Bastian, Prillwitz, Conrad C., Brugues, Mar, Keil, Vera C. W., Jeub, Monika, Borger, Valeri, Sander, Josemir W., Kunz, Wolfram S., Radbruch, Alexander, Weber, Bernd, Helmstaedter, Christoph, Vatter, Hartmut, Baldeweg, Torsten, Becker, Albert J., Cross, J. Helen, Surges, Rainer, and Rüber, Theodor

Published
2024
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4. First epileptic seizure and epilepsies in adulthood: Abridged version of the S2k guideline of the German Society for Neurology in cooperation with the German Society for Epileptology. English Version

Author

Holtkamp, Martin, May, Theodor W., Berkenfeld, Ralf, Bien, Christian G., Coban, Ingrid, Knake, Susanne, Michaelis, Rosa, Rémi, Jan, Seeck, Margitta, Surges, Rainer, Weber, Yvonne, Baum, Petra, Baumgartner, Christoph, Beyenburg, Stefan, Brandt, Christian, Brodisch, Peter, Brückner, Sabine, Chatzikonstantinou, Anastasios, Conrad, Stefan, Fauser, Susanne, Focke, Niels, Freiman, Thomas, Freitag, Hedwig, Fudali, Monika, Geiger-Riess, Mirijam, Greshake, Benedikt, Grimmer, Anja, Hebel, Jonas, Held, Lynna, Kaufmann, Elisabeth, Kerling, Frank, Knieß, Tobias, Kollmar, Rainer, Krämer, Günter, Kürsten, Kathrin, Laufs, Helmut, Lüsebrink, Arne, Lutz, Martin, Möddel, Gabriel, Müffelmann, Birgitt, Noachtar, Soheyl, Rösche, Johannes, Rozinat, Klaus, Rüegg, Stephan, Schäfer, Ulrike, Schmidt, Pia Magdalena, Schmitt, Friedhelm C., Schmitt, Jörg, Schneider, Ulf C., Schulze-Bonhage, Andreas, Speicher, Pascal, Strzelczyk, Adam, Stutterheim, Katrin, Thorbecke, Rupprecht, Trollmann, Regina, Urbach, Horst, von Oertzen, Tim J., von Podewils, Felix, von Wrede, Randi, Wagner, Kathrin, Weber, Raimund, Wehner, Tim, Wendtland, Frank, Winter, Yaroslav, Woermann, Friedrich, and Zieglgänsberger, Dominik

Published
2024
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6. Erster epileptischer Anfall und Epilepsien im Erwachsenenalter: Kurzfassung S2k-Leitlinie der Deutschen Gesellschaft für Neurologie in Zusammenarbeit mit der Deutschen Gesellschaft für Epileptologie

Author

Holtkamp, Martin, May, Theodor W., Berkenfeld, Ralf, Bien, Christian G., Coban, Ingrid, Knake, Susanne, Michaelis, Rosa, Rémi, Jan, Seeck, Margitta, Surges, Rainer, Weber, Yvonne, Baum, Petra, Baumgartner, Christoph, Beyenburg, Stefan, Brandt, Christian, Brodisch, Peter, Brückner, Sabine, Chatzikonstantinou, Anastasios, Conrad, Stefan, Fauser, Susanne, Focke, Niels, Freiman, Thomas, Freitag, Hedwig, Fudali, Monika, Geiger-Riess, Mirijam, Greshake, Benedikt, Grimmer, Anja, Hebel, Jonas, Held, Lynna, Kaufmann, Elisabeth, Kerling, Frank, Knieß, Tobias, Kollmar, Rainer, Krämer, Günter, Kürsten, Kathrin, Laufs, Helmut, Lüsebrink, Arne, Lutz, Martin, Möddel, Gabriel, Müffelmann, Birgitt, Noachtar, Soheyl, Rösche, Johannes, Rozinat, Klaus, Rüegg, Stephan, Schäfer, Ulrike, Schmidt, Pia Magdalena, Schmitt, Friedhelm C., Schmitt, Jörg, Schneider, Ulf C., Schulze-Bonhage, Andreas, Speicher, Pascal, Strzelczyk, Adam, Stutterheim, Katrin, Thorbecke, Rupprecht, Trollmann, Regina, Urbach, Horst, von Oertzen, Tim J., von Podewils, Felix, von Wrede, Randi, Wagner, Kathrin, Weber, Raimund, Wehner, Tim, Wendtland, Frank, Winter, Yaroslav, Woermann, Friedrich, and Zieglgänsberger, Dominik

Published
2024
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7. Translational imaging of TSPO reveals pronounced innate inflammation in human and murine CD8 T cell–mediated limbic encephalitis

Author

Gallus, Marco, Roll, Wolfgang, Dik, Andre, Barca, Cristina, Zinnhardt, Bastian, Hicking, Gordon, Mueller, Christoph, Naik, Venu Narayanan, Anstötz, Max, Krämer, Julia, Rolfes, Leoni, Wachsmuth, Lydia, Pitsch, Julika, van Loo, Karen MJ, Räuber, Saskia, Okada, Hideho, Wimberley, Catriona, Strippel, Christine, Golombeck, Kristin S, Johnen, Andreas, Kovac, Stjepana, Groß, Catharina C, Backhaus, Philipp, Seifert, Robert, Lewerenz, Jan, Surges, Rainer, Elger, Christian E, Wiendl, Heinz, Ruck, Tobias, Becker, Albert J, Faber, Cornelius, Jacobs, Andreas H, Bauer, Jan, Meuth, Sven G, Schäfers, Michael, and Melzer, Nico

Subjects
Biomedical and Clinical Sciences, Immunology, Neurosciences, Biomedical Imaging, Clinical Research, 2.1 Biological and endogenous factors, Aetiology, Animals, Humans, Mice, Carrier Proteins, Inflammation, Limbic Encephalitis, Positron-Emission Tomography, Receptors, GABA
Abstract

Autoimmune limbic encephalitis (ALE) presents with new-onset mesial temporal lobe seizures, progressive memory disturbance, and other behavioral and cognitive changes. CD8 T cells are considered to play a key role in those cases where autoantibodies (ABs) target intracellular antigens or no ABs were found. Assessment of such patients presents a clinical challenge, and novel noninvasive imaging biomarkers are urgently needed. Here, we demonstrate that visualization of the translocator protein (TSPO) with [18F]DPA-714-PET-MRI reveals pronounced microglia activation and reactive gliosis in the hippocampus and amygdala of patients suspected with CD8 T cell ALE, which correlates with FLAIR-MRI and EEG alterations. Back-translation into a preclinical mouse model of neuronal antigen-specific CD8 T cell-mediated ALE allowed us to corroborate our preliminary clinical findings. These translational data underline the potential of [18F]DPA-714-PET-MRI as a clinical molecular imaging method for the direct assessment of innate immunity in CD8 T cell-mediated ALE.

Published
2023

11. An open presurgery MRI dataset of people with epilepsy and focal cortical dysplasia type II

Author

Schuch, Fabiane, Walger, Lennart, Schmitz, Matthias, David, Bastian, Bauer, Tobias, Harms, Antonia, Fischbach, Laura, Schulte, Freya, Schidlowski, Martin, Reiter, Johannes, Bitzer, Felix, von Wrede, Randi, Rácz, Atilla, Baumgartner, Tobias, Borger, Valeri, Schneider, Matthias, Flender, Achim, Becker, Albert, Vatter, Hartmut, Weber, Bernd, Specht-Riemenschneider, Louisa, Radbruch, Alexander, Surges, Rainer, and Rüber, Theodor

Published
2023
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13. Automatic Seizure Detection Using the Pulse Transit Time

Author

Fiege, Eric, Houta, Salima, Bisgin, Pinar, Surges, Rainer, and Howar, Falk

Subjects
Computer Science - Computer Vision and Pattern Recognition
Abstract

Documentation of epileptic seizures plays an essential role in planning medical therapy. Solutions for automated epileptic seizure detection can help improve the current problem of incomplete and erroneous manual documentation of epileptic seizures. In recent years, a number of wearable sensors have been tested for this purpose. However, detecting seizures with subtle symptoms remains difficult and current solutions tend to have a high false alarm rate. Seizures can also affect the patient's arterial blood pressure, which has not yet been studied for detection with sensors. The pulse transit time (PTT) provides a noninvasive estimate of arterial blood pressure. It can be obtained by using to two sensors, which are measuring the time differences between arrivals of the pulse waves. Due to separated time chips a clock drift emerges, which is strongly influencing the PTT. In this work, we present an algorithm which responds to alterations in the PTT, considering the clock drift and enabling the noninvasive monitoring of blood pressure alterations using separated sensors. Furthermore we investigated whether seizures can be detected using the PTT. Our results indicate that using the algorithm, it is possible to detect seizures with a Random Forest. Using the PTT along with other signals in a multimodal approach, the detection of seizures with subtle symptoms could thereby be improved.

Published
2021

22. Contributors

Author

Almanza Fuerte, Edith, primary, Baram, Tallie Z., additional, Bender, Roland, additional, Brennan, Gary P., additional, Brooks-Kayal, Amy R., additional, Chen, Kevin D., additional, Gallentine, William Brian, additional, Garcia-Curran, Megan M., additional, Goldberg, Ethan M., additional, Goodkin, Howard P., additional, Henshall, David C., additional, Holmes, Gregory L., additional, Howell, Katherine, additional, Juul, Halvor M., additional, Kloc, Michelle L., additional, Lamsam, Layton, additional, Lewis, D.V., additional, Maljevic, Snezana, additional, McGrath, Hari, additional, Mefford, Heather C., additional, Moshé, Solomon L., additional, Nordli, Douglas R., additional, Penn, Rachel, additional, Petrou, Steven, additional, Pittman, Quentin J., additional, Ravizza, Teresa, additional, Reid, Aylin Y., additional, Reid, Christopher A., additional, Richards, Kay, additional, Rosch, Richard E., additional, Scantlebury, Morris H., additional, Scott, Rodney Craig, additional, Seinfeld, Syndi, additional, Shinnar, Ruth C., additional, Shinnar, Shlomo, additional, Spencer, Dennis D., additional, Stafstrom, Carl E., additional, Surges, Rainer, additional, Talos, Delia M., additional, Vezzani, Annamaria, additional, Weiss, Erica F., additional, and Wenzel, Michael, additional

Published
2023
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23. Risk of Seizure Recurrence Due to Autoimmune Encephalitis With NMDAR, LGI1, CASPR2, and GABA B R Antibodies

Author

Rada, Anna, primary, Hagemann, Anne, additional, Aaberg Poulsen, Charlotte, additional, Baumgartner, Tobias, additional, Berki, Timea, additional, Blaabjerg, Morten, additional, Brenner, Juliette, additional, Britton, Jeffrey W., additional, Christiana, Andrew, additional, Ciano-Petersen, Nicolás L., additional, Crijnen, Yvette, additional, Elišák, Martin, additional, Farina, Antonio, additional, Friedman, Alec R., additional, Hayden, Zsófia, additional, Hébert, Julien, additional, Holtkamp, Martin, additional, Hong, Zhen, additional, Honnorat, Jerome, additional, Ilyas-Feldmann, Maria, additional, Irani, Sarosh R., additional, Kovac, Stjepana, additional, Marusic, Petr, additional, Muñiz-Castrillo, Sergio, additional, Ramanathan, Sudarshini, additional, Smith, Kelsey M., additional, Steriade, Claude, additional, Strippel, Christine, additional, Surges, Rainer, additional, Titulaer, Maarten J., additional, Uy, Christopher E., additional, de Vries, Juna M., additional, Bien, Christian G., additional, and Specht, Ulrich, additional

Published
2024
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24. Counseling about sudden unexpected death in epilepsy (SUDEP): A global survey of neurologists’ opinions

Author

Asadi-Pooya, Ali A., Trinka, Eugen, Brigo, Francesco, Hingray, Coraline, Karakis, Ioannis, Lattanzi, Simona, Valente, Kette D., Contreras, Guilca, Turuspekova, Saule T., Kishk, Nirmeen Adel, Aljandeel, Ghaieb, Farazdaghi, Mohsen, Lopez, Yamile Calle, Kissani, Najib, Triki, Chahnez, Krämer, Günter, Surges, Rainer, Mesraoua, Boulenouar, Yu, Hsiang-Yu, Daza-Restrepo, Anilu, Alsaadi, Taoufik, Al-Asmi, Abdullah, Kutlubaev, Mansur A., Pretorius, Chrisma, Jusupova, Asel, Khachatryan, Samson G., Ranganathan, Lakshmi Narasimhan, Ashkanani, Abdulaziz, Tomson, Torbjörn, and Gigineishvili, David

Published
2022
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26. Olfactory Dysfunction and Limbic Hypoactivation in Temporal Lobe Epilepsy.

Author

Schmidt, Markus, Bauer, Tobias, Kehl, Marcel, Minarik, Anna, Walger, Lennart, Schultz, Johannes, Otte, Martin S., Trautner, Peter, Hoppe, Christian, Baumgartner, Tobias, Specht‐Riemenschneider, Louisa, Mormann, Florian, Radbruch, Alexander, Surges, Rainer, and Rüber, Theodor

Abstract

The epileptogenic network in temporal lobe epilepsy (TLE) contains structures of the primary and secondary olfactory cortex such as the piriform and entorhinal cortex, the amygdala, and the hippocampus. Olfactory auras and olfactory dysfunction are relevant symptoms of TLE. This study aims to characterize olfactory function in TLE using olfactory testing and olfactory functional magnetic resonance imaging (fMRI). We prospectively enrolled 20 individuals with unilateral TLE (age 45 ± 20 years [mean ± SD], 65% female, 90% right‐handed) and 20 healthy individuals (age 33 ± 15 years [mean ± SD], 35% female, 90% right‐handed). In the TLE group, the presumed seizure onset zone was left‐sided in 75%; in 45% of the individuals with TLE limbic encephalitis was the presumed etiology; and 15% of the individuals with TLE reported olfactory auras. Olfactory function was assessed with a Screening Sniffin' Sticks Test (Burkhart, Wedel, Germany) during a pre‐assessment. During a pre‐testing, all individuals were asked to rate the intensity, valence, familiarity, and associated memory of five different odors (eugenol, vanillin, phenethyl alcohol, decanoic acid, valeric acid) and a control solution. During the fMRI experiment, all individuals repeatedly smelled eugenol (positively valenced odor), valeric acid (negatively valenced odor), and the control solution and were asked to rate odor intensity on a five‐point Likert scale. We acquired functional EPI sequences and structural images (T1, T2, FLAIR). Compared to healthy individuals, individuals with TLE rated the presented odors as more neutral (two‐sided Mann–Whitney U tests, FDR‐p < 0.05) and less familiar (two‐sided Mann–Whitney U tests, FDR‐p < 0.05). fMRI data analysis revealed a reduced response contrast in secondary olfactory areas (e.g., hippocampus) connected to the limbic system when comparing eugenol and valeric acid in individuals with TLE when compared with healthy individuals. However, no lateralization effect was obtained when calculating a lateralization index by the number of activated voxels in the olfactory system (two‐sided Mann–Whitney U test; U = 176.0; p = 0.525). TLE is characterized by olfactory dysfunction and associated with hypoactivation of secondary olfactory structures connected to the limbic system. These findings contribute to our understanding of the pathophysiology of TLE. This study was preregistered on OSF Registries (www.osf.io). [ABSTRACT FROM AUTHOR]

Published
2024
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27. Interictal blood–brain barrier dysfunction in piriform cortex of people with epilepsy.

Author

Schulte, Freya, Reiter, Johannes T., Bauer, Tobias, Taube, Julia, Bitzer, Felix, Witt, Juri‐Alexander, Piper, Rory, Thanabalasingam, Anoja, von Wrede, Randi, Racz, Attila, Baumgartner, Tobias, Borger, Valeri, Specht‐Riemenschneider, Louisa, Vatter, Hartmut, Hattingen, Elke, Deichmann, Ralf, Helmstaedter, Christoph, Radbruch, Alexander, Friedman, Alon, and Surges, Rainer

Subjects
TEMPORAL lobe epilepsy, PEOPLE with epilepsy, EPILEPSY surgery, VERBAL memory, CONTRAST media, TEMPORAL lobectomy
Abstract

Objective: The piriform cortex is considered to be highly epileptogenic. Its resection during epilepsy surgery is a predictor for postoperative seizure freedom in temporal lobe epilepsy. Epilepsy is associated with a dysfunction of the blood–brain barrier. We investigated blood–brain barrier dysfunction in the piriform cortex of people with temporal lobe epilepsy using quantitative T1‐relaxometry. Methods: Gadolinium‐based contrast agent was administered ictally and interictally in 37 individuals before undergoing quantitative T1‐relaxometry. Postictal and interictal images were co‐registered, and subtraction maps were created as biomarkers for peri‐ictal (∆qT1interictal‐postictal) and interictal (∆qT1noncontrast‐interictal) blood–brain barrier dysfunction. Values were extracted for the piriform cortex, hippocampus, amygdala, and the whole cortex. Results: In temporal lobe epilepsy (n = 14), ∆qT1noncontrast‐interictal was significantly higher in the piriform cortex than in the whole cortex (p = 0.02). In extratemporal lobe epilepsy (n = 23), ∆qT1noncontrast‐interictal was higher in the hippocampus than in the whole cortex (p = 0.05). Across all individuals (n = 37), duration of epilepsy was correlated with ∆qT1noncontrast‐interictal (ß = 0.001, p < 0.001) in all regions, while the association was strongest in the piriform cortex. Impaired verbal memory was associated with ∆qT1noncontrast‐interictal only in the piriform cortex (p = 0.04). ∆qT1interictal‐postictal did not show differences in any region. Interpretation: Interictal blood–brain barrier dysfunction occurs in the piriform cortex in temporal lobe epilepsy. This dysfunction is linked to longer disease duration and worse cognitive deficits, emphasizing the central role of the piriform cortex in the epileptogenic network of temporal lobe epilepsy. [ABSTRACT FROM AUTHOR]

Published
2024
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28. Multimodal Detection of Tonic–Clonic Seizures Based on 3D Acceleration and Heart Rate Data from an In-Ear Sensor

Author

Henze, Jasmin, Houta, Salima, Surges, Rainer, Kreuzer, Johannes, Bisgin, Pinar, Goos, Gerhard, Founding Editor, Hartmanis, Juris, Founding Editor, Bertino, Elisa, Editorial Board Member, Gao, Wen, Editorial Board Member, Steffen, Bernhard, Editorial Board Member, Woeginger, Gerhard, Editorial Board Member, Yung, Moti, Editorial Board Member, Del Bimbo, Alberto, editor, Cucchiara, Rita, editor, Sclaroff, Stan, editor, Farinella, Giovanni Maria, editor, Mei, Tao, editor, Bertini, Marco, editor, Escalante, Hugo Jair, editor, and Vezzani, Roberto, editor

Published
2021
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31. Tumor-associated epilepsy in patients with brain metastases: necrosis-to-tumor ratio forecasts postoperative seizure freedom

Author

Bahna, Majd, Heimann, Muriel, Bode, Christian, Borger, Valeri, Eichhorn, Lars, Güresir, Erdem, Hamed, Motaz, Herrlinger, Ulrich, Ko, Yon-Dschun, Lehmann, Felix, Potthoff, Anna-Laura, Radbruch, Alexander, Schaub, Christina, Surges, Rainer, Weller, Johannes, Vatter, Hartmut, Schäfer, Niklas, Schneider, Matthias, and Schuss, Patrick

Published
2022
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33. The importance of early immunotherapy in patients with faciobrachial dystonic seizures

Author

Thompson, Julia, Bi, Mian, Murchison, Andrew G, Makuch, Mateusz, Bien, Christian G, Chu, Kon, Farooque, Pue, Gelfand, Jeffrey M, Geschwind, Michael D, Hirsch, Lawrence J, Somerville, Ernest, Lang, Bethan, Vincent, Angela, Leite, Maria I, Waters, Patrick, Irani, Sarosh R, Dogan-Onugoren, Müjgan, Rae-Grant, Alexander, Illes, Zsolt, Szots, Monika, Malter, Michael, Widman, Guido, Surges, Rainer, Archibald, Neil, Reid, John, Duncan, Callum, Richardson, Anna, Lilleker, James, Iorio, Rafaelle, Blaabjerg, Morten, Abeler, Karin, and Shin, Y

Subjects
Brain Disorders, Neurosciences, Prevention, Clinical Research, Epilepsy, Neurodegenerative, Rare Diseases, ADAM Proteins, Adult, Aged, Aged, 80 and over, Analysis of Variance, Antibodies, Anticonvulsants, Cognition Disorders, Disabled Persons, Female, Flow Cytometry, Follow-Up Studies, Green Fluorescent Proteins, HEK293 Cells, Humans, Immunotherapy, Intracellular Signaling Peptides and Proteins, Limbic Encephalitis, Male, Middle Aged, Nerve Tissue Proteins, Protein Transport, Proteins, Retrospective Studies, Seizures, Surveys and Questionnaires, Transfection, Young Adult, faciobrachial dystonic seizures, leucine-rich glioma-inactivated 1, seizures, immunotherapy, cognitive impairment, Faciobrachial Dystonic Seizures Study Group, Medical and Health Sciences, Psychology and Cognitive Sciences, Neurology & Neurosurgery
Abstract

Faciobrachial dystonic seizures and limbic encephalitis closely associate with antibodies to leucine-rich glioma-inactivated 1 (LGI1). Here, we describe 103 consecutive patients with faciobrachial dystonic seizures and LGI1 antibodies to understand clinical, therapeutic and serological differences between those with and without cognitive impairment, and to determine whether cessation of faciobrachial dystonic seizures can prevent cognitive impairment. The 22/103 patients without cognitive impairment typically had normal brain MRI, EEGs and serum sodium levels (P < 0.0001). Overall, cessation of faciobrachial dystonic seizures with antiepileptic drugs alone occurred in only 9/89 (10%) patients. By contrast, 51% showed cessation of faciobrachial dystonic seizures 30 days after addition of immunotherapy (P < 0.0001), with earlier cessation in cognitively normal patients (P = 0.038). Indeed, expedited immunotherapy (P = 0.031) and normal cognition (P = 0.0014) also predicted reduced disability at 24 months. Furthermore, of 80 patients with faciobrachial dystonic seizures as their initial feature, 56% developed cognitive impairment after 90 days of active faciobrachial dystonic seizures. Whereas only one patient developed cognitive impairment after cessation of faciobrachial dystonic seizures (P < 0.0001). All patients had IgG4-LGI1 antibodies, but those with cognitive impairment had higher proportions of complement-fixing IgG1 antibodies (P = 0.03). Both subclasses caused LGI1-ADAM22 complex internalization, a potential non-inflammatory epileptogenic mechanism. In summary, faciobrachial dystonic seizures show striking time-sensitive responses to immunotherapy, and their cessation can prevent the development of cognitive impairment.awx323media15681705685001.

Published
2018

35. Intact functional brain networks in the isolated hemisphere of people after hemispherotomy

Author

Bauer, Tobias, primary, Gauvry, Charlotte, additional, Markett, Sebastian, additional, Kreter-Schönleber, Thomas, additional, Hoppe, Christian, additional, Borger, Valeri, additional, Vatter, Hartmut, additional, Sander, Josemir, additional, Gabriel, Markus, additional, Mormann, Florian, additional, Radbruch, Alexander, additional, Surges, Rainer, additional, and Rüber, Theodor, additional

Published
2024
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36. Evidence for interictal blood–brain barrier dysfunction in people with epilepsy

Author

Reiter, Johannes T., primary, Schulte, Freya, additional, Bauer, Tobias, additional, David, Bastian, additional, Endler, Christoph, additional, Isaak, Alexander, additional, Schuch, Fabiane, additional, Bitzer, Felix, additional, Witt, Juri‐Alexander, additional, Hattingen, Elke, additional, Deichmann, Ralf, additional, Attenberger, Ulrike, additional, Becker, Albert J., additional, Helmstaedter, Christoph, additional, Radbruch, Alexander, additional, Surges, Rainer, additional, Friedman, Alon, additional, and Rüber, Theodor, additional

Published
2024
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38. Seizure-mediated iron accumulation and dysregulated iron metabolism after status epilepticus and in temporal lobe epilepsy

Author

Zimmer, Till S., David, Bastian, Broekaart, Diede W. M., Schidlowski, Martin, Ruffolo, Gabriele, Korotkov, Anatoly, van der Wel, Nicole N., van Rijen, Peter C., Mühlebner, Angelika, van Hecke, Wim, Baayen, Johannes C., Idema, Sander, François, Liesbeth, van Eyll, Jonathan, Dedeurwaerdere, Stefanie, Kessels, Helmut W., Surges, Rainer, Rüber, Theodor, Gorter, Jan A., Mills, James D., van Vliet, Erwin A., and Aronica, Eleonora

Published
2021
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44. Risk of Seizure Recurrence Due to Autoimmune Encephalitis With NMDAR, LGI1, CASPR2, and GABABR Antibodies:Implications for Return to Driving

Author

Rada, Anna, Hagemann, Anne, Aaberg Poulsen, Charlotte, Baumgartner, Tobias, Berki, Timea, Blaabjerg, Morten, Brenner, Juliette, Britton, Jeffrey W., Christiana, Andrew, Ciano-Petersen, Nicolás L., Crijnen, Yvette, Elišák, Martin, Farina, Antonio, Friedman, Alec R., Hayden, Zsófia, Hébert, Julien, Holtkamp, Martin, Hong, Zhen, Honnorat, Jerome, Ilyas-Feldmann, Maria, Irani, Sarosh R., Kovac, Stjepana, Marusic, Petr, Muñiz-Castrillo, Sergio, Ramanathan, Sudarshini, Smith, Kelsey M., Steriade, Claude, Strippel, Christine, Surges, Rainer, Titulaer, Maarten J., Uy, Christopher E., De Vries, Juna M., Bien, Christian G., Specht, Ulrich, Rada, Anna, Hagemann, Anne, Aaberg Poulsen, Charlotte, Baumgartner, Tobias, Berki, Timea, Blaabjerg, Morten, Brenner, Juliette, Britton, Jeffrey W., Christiana, Andrew, Ciano-Petersen, Nicolás L., Crijnen, Yvette, Elišák, Martin, Farina, Antonio, Friedman, Alec R., Hayden, Zsófia, Hébert, Julien, Holtkamp, Martin, Hong, Zhen, Honnorat, Jerome, Ilyas-Feldmann, Maria, Irani, Sarosh R., Kovac, Stjepana, Marusic, Petr, Muñiz-Castrillo, Sergio, Ramanathan, Sudarshini, Smith, Kelsey M., Steriade, Claude, Strippel, Christine, Surges, Rainer, Titulaer, Maarten J., Uy, Christopher E., De Vries, Juna M., Bien, Christian G., and Specht, Ulrich

Abstract

Background and Objectives:Patients with ongoing seizures are usually not allowed to drive. The prognosis for seizure freedom is favorable in patients with autoimmune encephalitis (AIE) with antibodies against NMDA receptor (NMDAR), leucine-rich glioma-inactivated 1 (LGI1), contactin-associated protein-like 2 (CASPR2), and the gamma-aminobutyric-acid B receptor (GABABR). We hypothesized that after a seizure-free period of 3 months, patients with AIE have a seizure recurrence risk of <20% during the subsequent 12 months. This would render them eligible for noncommercial driving according to driving regulations in several countries.Methods:This retrospective multicenter cohort study analyzed follow-up data from patients aged 15 years or older with seizures resulting from NMDAR-, LGI1-, CASPR2-, or GABABR-AIE, who had been seizure-free for ≥3 months. We used Kaplan-Meier (KM) estimates for the seizure recurrence risk at 12 months for each antibody group and tested for the effects of potential covariates with regression models.Results:We included 383 patients with NMDAR-, 440 with LGI1-, 114 with CASPR2-, and 44 with GABABR-AIE from 14 international centers. After being seizure-free for 3 months after an initial seizure period, we calculated the probability of remaining seizure-free for another 12 months (KM estimate) as 0.89 (95% confidence interval [CI] 0.85-0.92) for NMDAR, 0.84 (CI 0.80-0.88) for LGI1, 0.82 (CI 0.75-0.90) for CASPR2, and 0.76 (CI 0.62-0.93) for GABABR.Discussion:Taking a <20% recurrence risk within 12 months as sufficient, patients with NMDAR-AIE and LGI1-AIE could be considered eligible for noncommercial driving after having been seizure-free for 3 months.

Published
2024

45. Seizure Semiology in Antibody-Associated Autoimmune Encephalitis

Author

Kaaden, Tillman, Madlener, Marie, Angstwurm, Klemens, Bien, Christian G., Bogarin, Yuri, Doppler, Kathrin, Finke, Alexander, Gerner, Stefan T., Reimann, Gernot, Häusler, Martin, Handreka, Robert, Hellwig, Kerstin, Kaufmann, Max, Kellinghaus, Christoph, Koertvelyessy, Peter, Kraft, Andrea, Lewerenz, Jan, Menge, Til, Paliantonis, Asterios, von Podewils, Felix, Prüss, Harald, Rauer, Sebastian, Ringelstein, Marius, Rostásy, Kevin, Schirotzek, Ingo, Schwabe, Julia, Sokolowski, Piotr, Suesse, Marie, Sühs, Kurt-Wolfram, Surges, Rainer, Tauber, Simone C., Thaler, Franziska, Bergh, Florian Then, Urbanek, Christian, Wandinger, Klaus-P., Wildemann, Brigitte, Mues, Sigrid, Zettl, Uwe, Leypoldt, Frank, Melzer, Nico, Geis, Christian, Malter, Michael, and Kunze, Albrecht

Published
2022
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49. Severe memory decline along with unaffected executive functions under 400 mg/day of cenobamate leading to a collapse in school performance.

Author

Witt, Juri-Alexander, Moskau-Hartmann, Susanna, Olaciregui Dague, Karmele, Surges, Rainer, and Helmstaedter, Christoph

Subjects
EXECUTIVE function, EPISODIC memory, SEIZURES (Medicine), MEMORY disorders, VALPROIC acid
Abstract

Cenobamate (CNB) is one of the newer antiseizure medications for the treatment of focal-onset seizures. The cognitive profile of CNB is not yet known in detail. Here we present the case of an 18-year-old male high school student with epilepsy who received adjunctive CNB. Under 400 mg/d of CNB in combination with lamotrigine, a neuropsychological reassessment revealed a severe deterioration of the formerly normal episodic memory functions, while executive functions remained unaffected. The de novo memory deficit had already led to a collapse in school performance and he unexpectedly failed to obtain the general qualification for university entrance. Given the beneficial effect of CNB on seizure control, a dose reduction of CNB to 200 mg/d and introduction of valproic acid was performed. This led to a full recovery of objective memory performance. To our knowledge this is the very first report of a dose-dependent, selective and severe decline in episodic memory performance under CNB, potentially impeding academic achievement. The findings call for a cognitive monitoring of CNB which also addresses episodic memory in addition to executive functions. Systematic studies on episodic memory upon CNB treatment would help to appreciate the scope of this apparently reversible adverse effect. [ABSTRACT FROM AUTHOR]

Published
2024
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