Background
This study aimed to determine the characteristics of computed tomography perfusion (CTP) patterns and their utility in predicting antiseizure medication (ASM) resistance in patients with nonconvulsive status epilepticus (NCSE).
Methods
We retrospectively reviewed patients diagnosed with NCSE at Inje University Haeundae Paik Hospital Epilepsy Center between March 2015 and March 2022. CTP patterns were analyzed for those patients. A hyperperfusion pattern (HPP) in CTP was defined as a region of both increased cerebral blood flow and cerebral blood volume that did not necessarily follow the vascular territories. The primary endpoint was the responses to ASMs according to CTP patterns.
Results
Fourteen (74%) of the 19 included patients met the criteria for definite NCSE, with the remaining 26% showing nonepileptiform activities with fluctuating quasirhythmic delta activities at >0.5 Hz on electroencephalogram. Three of the four patients who had HPPs with thalamic involvement were refractory to ASMs, whereas all eight patients who had HPPs without thalamic involvement were responsive to ASMs (p = 0.018). Although HPPs themselves were not associated with ASM responses, HPPs with thalamic involvement were associated with resistance to ASMs.
Conclusions
HPP with thalamic involvement in CTP might be associated with ASM resistance. Therefore, CTP may be useful for predicting ASM resistance in NCSE patients.

Transient epileptic amnesia and transient global amnesia both exhibit temporary memory loss. The lack of clues of epileptic events and the absence of epileptiform abnormalities in electroencephalography, a clear brain lesion, and interictal cognitive decline can make diagnoses challenging. Here we present a middle-aged female who experienced long-term recurrent transient epileptic amnesia with subtle epileptic features over a period of 3 years.

Tectal glioma is an indolent and benign tumor that occurs predominantly in the pediatric population. It arises in the tectum of the midbrain and, due to its location, contributes to the development of obstructive hydrocephalus, typically presenting with increased intracranial pressure (IICP) symptoms or signs. Here we report a rare case of tectal glioma that presented as adult-onset epileptic seizures without IICP symptoms and was treated with endoscopic third ventriculostomy and antiepileptic drugs.

Background
The purpose of this study was to identify the top-100 cited articles on genetic generalized epilepsy (GGE) published in journals that have made key contributions to the field of epilepsy.
Methods
We searched the Web of Science website produced by Clarivate Analytics for articles on GGE, and sorted them according to the number of citations to identify the top-100 cited articles. We then manually reviewed the contents of the top-100 cited articles, which were designated as “citation classics”.
Results
The top-100 cited articles were published in 27 journals, with the largest proportion appearing in Epilepsia (19 articles). The articles originated from institutions in 17 countries, with 31 articles from the USA. The institution associated with the largest numbers of articles in the field of GGE was the University of Melbourne, Australia (9 articles). Panayiotopoulos C. P. was the first author of three articles, and was listed most frequently in the GGE citation classics. The publication years were concentrated in the 2000s, when 56 articles were published. The most-common study topics were genetics (35 articles) and neuroimaging (17 articles).
Conclusions
This study has identified the top-100 cited articles on GGE. These citation classics represent the landmark articles on GGE, and they provide useful insights into international research leaders and the research trends in the field.

Electroencephalography (EEG) produces time-series data of neural oscillations in the brain, and is one of the most commonly used methods for investigating both normal brain functions and brain disorders. Quantitative EEG analysis enables identification of frequencies and brain activity that are activated or impaired. With studies on the structural and functional networks of the brain, the concept of the brain as a complex network has been fundamental to understand normal brain functions and the pathophysiology of various neurological disorders. Functional connectivity is a measure of neural synchrony in the brain network that refers to the statistical interdependency between neural oscillations over time. In this review, we first discuss the basic methods of EEG analysis, including preprocessing, spectral analysis, and functional-connectivity and graph-theory measures. We then review previous EEG studies of brain network characterization in several neurological disorders, including epilepsy, Alzheimer’s disease, dementia with Lewy bodies, and idiopathic rapid eye movement sleep behavior disorder. Identifying the EEG-based network characteristics might improve the understanding of disease processes and aid the development of novel therapeutic approaches for various neurological disorders.

Citations

• Augmented Recognition of Distracted Driving State Based on Electrophysiological Analysis of Brain Network
  Geqi Qi, Rui Liu, Wei Guan, Ailing Huang
  Cyborg and Bionic Systems.2024;[Epub]     CrossRef

We performed intraoperative neurophysiological monitoring (INM) during anteromesial temporal resection (AMTR) in a patient with lesional temporal lobe epilepsy. INM revealed a sudden decrease in N20 waves in somatosensory evoked potentials (SSEPs) and poor P100 waves in visual evoked potentials (VEPs). These changes developed after applying electrocoagulation in the right mesial temporal areas. Postoperative brain magnetic resonance imaging demonstrated right thalamic and medial occipital infarctions. SSEPs and VEPs monitoring can be useful for detecting posterior cerebral artery infarction in AMTR.

Citations

• Intraoperative and extraoperative neurophysiological monitoring in epilepsy surgery
  Dae Lim Koo, Dae-Won Seo
  Journal of Intraoperative Neurophysiology.2021; 3(1): 16.     CrossRef

Lennox-Gastaut syndrome (LGS) is an electro-clinical syndrome composed of the triad of mental retardation, multiple seizure types, and the characteristic generalized slow spike-wave complexes in the electroencephalogram. In this article, we report on two patients with LGS whose brain magnetic resonance imaging showed dysgenesis of corpus callosum (CC). We discuss the role of CC in the genesis of secondary bilateral synchrony.

The performance of electroencephalogram (EEG) recordings is affected by electrode type, electronic parameters such as filtering, amplification, signal conversion, data storage; and environmental conditions. However, no single method has been identified for optimal EEG recording quality in all situations. Therefore, we aimed to provide general principles for EEG electrode selection as well as electronic noise reduction, and to present comprehensive information regarding the acquisition of satisfactory EEG signals. The standards provided in this document may be regarded as Korean guidelines for the clinical recording of EEG data. The equipment, types and nomenclature of electrodes, and the details for EEG recording are discussed.

Citations

• Basics of Electroencephalography for Neuropsychiatrist
  Hun Jeong Eun
  Journal of Korean Neuropsychiatric Association.2019; 58(2): 76.     CrossRef

Epilepsy has continued to provide challenges to epileptologists, as a significant proportion of patients continue to sufferfrom seizures despite medical and surgical treatments. Deep brain stimulation (DBS) has emerged as a new therapeutic modalitythat has the potential to improve quality of life and occasionally be curative for patients with medically refractoryepilepsy who are not surgical candidates. Several groups have used DBS in drug-resistant epilepsy cases for which resectivesurgery cannot be applied. The promising subcortical brain structures are anterior and centromedian nucleus of the thalamus,subthalamic nucleus, and other nuclei to treat epilepsy in light of previous clinical and experimental data. Recently tworandomized trials of neurostimulation for controlling refractory epilepsy employed the strategies to stimulate electrodes placedon both anterior thalamic nuclei or near seizure foci in response to electroencephalographically detected epileptiform activity.However, the more large-scale, long-term clinical trials which elucidates optimal stimulation parameters, ideal selection criteriafor epilepsy DBS should be performed before long. In order to continue to advance the frontier of this field, it is imperativeto have a good grasp of the current body of knowledge.

Reflex epilepsies are distinct but not clealy understood clinical entity. Various cerebral activities induced by simple stimulation including visual, auditory, somatosensory, as well as diverse functional tasks such as reading, calculation, complex thinking are believed to be seizure-inducing factors. We experienced two patients whose seizure were readily precipitated by complex, streunuous thinking. Both patients was teen-aged boy at the onset of seizure(13, and 15 years of age each) with normal physical and mental growth. Although first seizure was precipitated by watching TV and playing puzzels in each patient, initial diganosis was idiopathic generalized epilepsy, possible juvenile myoclonic epilepsy(JME). For the first few years, seizures were infrequent but mostly precipitated by the tasks needs concentration such as playing computer games, decision-making, mathematics, reading, or during the examination. EEG revealed various thinking process including reading hard books, drawing complex figure, complex calculation induced epileptic discharges even if it usually needs certain period of concentration. Phenytoin, valproic acid, clonazepam, vigabatrin, and lamotrigine sometimes abated their seizures but none of these made them seizure-free. Complex reflex epilepsy induced by thinking was proposed to be a separate type of epilepsy or a variant of JME, Age, sex, stereotypic seizure-inducing factors, clinical course, and refractory epilepsies in these patients highly suggested this type of epilepsy as a variant of JME but its refractoriness and unique provocation still needs more speculation.

Electroencephalogram (EEG) is an indispensable tool for diagnosis of epilepsy and is the only assisting barometer of complete remission of epilepsy, which means prolonged, persistent suppression of cortical excitement in epileptic focus in addition to the clinical control of epileptic seizure. The specific morphologies or distribution of epileptic form discharges give us good information for the classification of seizure or epilepsy and epileptic syndromes, which consists of

Even though the origin and nature of nocturnal paroxysmal dystonia (NPD) remains unclear, it has been considered as a manifestation of the nocturnal frontal lobe epilepsy. We report a 17-year-old man with abnormal stereotyped movement during sleep. Video-EEG monitoring, ictal SPECT and night polysomnography did not show any evidence of epilepsy. However, the partial response to large dose of carbamazepine and the scoring according to the frontal lobe epilepsy and parasomnias (FLEP) scale suggest his events could be classified as epilepsy. Therefore we think the FLEP scale might be a useful tool for differential diagnosis in a patient presenting NPD.

Background
and Objective : Epileptic seizures are frequent complication of lobar hemorrhage. We investigated thefactors affecting development of epilepsy following spontaneous lobar ICH.Methods : From January 1986 to July 1999, 114 patients were admitted to Chungnam National University Hospitalwith spontaneous lobar ICH. We analyzed 75 patients. Excluded were no follow-up(8 patients) and patients died withinfew days(31 patients). All the patient was followed up at least two years aside from two patients who underwent epilepticseizure and died five and eight months later each. Medical history was obtained through medical record and by telephoneinterview. Statistical analyses were performed using Chi-square test, Student

B a c k g r o u n d : An increased frequency of reproductive endocrine disorders and polycystic ovary(PCO) has beenreported in women with epilepsy. A possible role of the seizure disorder or, of the use of antiepileptic drugs(AEDs) hasbeen suggested as the pathogenic mechanism. The objective of the present study was to assess the prevalence of reproductiveendocrine disorders, such as PCO or menstrual abnormalities, in a series of women with epilepsy, examiningthe possible relationships of these disturbances with different epilepsy syndromes and AED treatment.Methods : Thirty epileptic women, all of reproductive age and none pubertal, pregnant, or lactating, were evaluatedby clinical endocrinological assessment, and pelvic ultrasonography. Seven patients were on valproic acid(VPA), nineteenon carbamazepine(CBZ), and four on diphenylhydantoin(DPH) treatment, respectively.Results : Menstrual irregularity was observed in 8 women(26.7%), dysmenorrhea in 7(23.3%), and premenstrual syndromein 1(3.3%). Ultrasonographic examination revealed that one women(3.3%) showed polycystic ovary, 4(13.3%)had ovarian cyst(s), and 2(6.7%) had uterine myoma, respectively. There was no difference in the prevalence of menstrualabnormalities or polycystic ovary according to the different preparations of AEDs.Conclusions : Data from this investigation suggest that, in Korean reproductive age women, the treatment of AEDsand the kind of medication may not have a significant effect on the prevalence of menstrual abnormalities or ultrasonographicpolycystic ovary.

We present a recordings of 37-year-old woman with simultaneous ictal scalp and subdural electrodes. The ictal rhythmon subdural electrocorticography (ECoG) started earlier (median 24.5 sec) and ended later (median 2.0 sec) compared toictal rhythm on scalp EEG. Eight ictal ECoG recordings were well localized to left temporal area, whereas ictal scalp EEGrecordings were not. Our case shows the obvious timing relations between two recordings, and different electrophysiologicinformation about localization of ictal onset zone.