Neurology/Epileptology

This seminar in epileptology discusses advancements in the field and provides specific didactic material for the care of patients with focal drug-resistant epilepsy. It reviews indications for a comprehensive presurgical evaluation and the benefits of early surgical intervention, covering diagnostic techniques such as video-EEG monitoring, imaging, neuropsychological testing, and patient selection for invasive monitoring.

The accurate interpretation of scalp EEG remains an instrumental diagnostic component of epilepsy care. This Seminar in Epileptology addresses the International League Against Epilepsy (ILAE) learning objectives related to the assessment and interpretation of EEG background activity, normal sleep patterns, provocation methods, interictal abnormalities, and ictal patterns, as well as a brief discussion on relevant advances in scalp EEG analysis and future perspectives on this topic.

This educational topical review and ILAE Task Force report develops a glossary of commonly used terms to describe seizure semiology. It provides definitions, signs, and symptoms, summarizing their clinical value in localizing and lateralizing focal seizures based on consensus in the published literature.

A comprehensive clinical guideline detailing pharmacological, dietary, and surgical recommendations for infants and children (1 to 36 months of age) diagnosed with new-onset or drug-resistant focal or unknown epilepsy. Includes evidence summaries, methodology, and PICO questions.

A comprehensive guide analyzing conditions that clinically resemble epileptic seizures, focusing on differential diagnosis. Topics include the role of EEG, movement disorders, migraine, and age-specific presentations of nonepileptic spells in neonates, children, and the elderly.

Seizures originating from the anterior cingulate cortex (ACC) have distinct clinical features but can be difficult to identify in frontal lobe epilepsy (FLE). This systematic review examines the key semiology of ACC seizures and their anatomical correlations, finding that ACC seizures are predominantly characterized by emotional, autonomic, and striking behavior manifestations contrasting with preserved awareness. Studies included invasive EEG findings and high surgical success rates (80% Engel class I outcome).

This population-based study determined the proportion of individuals with childhood and youth onset epilepsy who attain seizure freedom across seizure types, epilepsy types, etiologies, and syndromes using the latest International League Against Epilepsy (ILAE) classifications. Using data from the Norwegian Mother, Father, and Child Cohort Study (N=1044), researchers found that 78% achieved seizure freedom. Predictors of reduced likelihood of seizure freedom included early or adolescent onset, multiple seizure types, status epilepticus, developmental comorbidities, and abnormal neurologic findings.

Analyzes the role of electroencephalography (EEG) in defining and classifying epilepsy syndromes. This report, written by the International League Against Epilepsy (ILAE) Neurophysiology Task Force, discusses how the concept of epilepsy syndromes has evolved since the 1989 definition, emphasizing the importance of electro-clinical features as a critical tool for practicing clinicians, and noting the need to integrate neuroimaging and genetics following the 2017 ILAE classification update.