Background: Semi-quantitative electroencephalogram (EEG) analysis is easy to perform and has been used to differentiate dementias, as well as idiopathic and vascular Parkinson's disease. Purpose: To study whether a semi-quantitative EEG analysis can aid in distinguishing idiopathic Parkinson's disease (IPD) from atypical parkinsonian disorders (APDs), and furthermore, whether it can help to distinguish between APDs. Materials and Methods: A comprehensive retrospective review of charts was performed to include patients with parkinsonian disorders who had at least one EEG recording available. A modified grand total EEG (GTE) score evaluating the posterior background activity, and diffuse and focal slow wave activities was used in further analyses. Results: We analyzed data from 76 patients with a final diagnosis of either IPD, probable corticobasal degeneration (CBD), multiple system atrophy (MSA), or progressive supra-nuclear palsy (PSP). IPD patients had the lowest mean GTE score, followed those with CBD or MSA, while PSP patients scored the highest. However, none of these differences were statistically significant. A GTE score of ≤9 distinguished IPD patients from those with APD (p < 0.01) with a sensitivity of 100% and a specificity of 33.3%. Conclusion: The modified GTE score can distinguish patients with IPD from those with CBD, PSP or MSA at a cut-off score of 9 with excellent sensitivity but poor specificity. However, this score is not able to distinguish a particular form of APD from other forms of the disorder.

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Objective:The mechanisms underlying accelerated long-term forgetting (ALF) in patients with epilepsy are still under investigation. We examined the contribution of hippocampal subfields and their morphology to long-term memory performance in patients with focal epilepsy. Methods:We prospectively assessed long-term memory and performed magnetic resonance imaging in 80 patients with focal epilepsy (61 with temporal lobe epilepsy and 19 with extratemporal lobe epilepsy) and 30 healthy controls. The patients also underwent electroencephalography recording. Verbal and visuospatial memory was tested 30 s, 10 min, and 1 week after learning. We assessed the volumes of the whole hippocampus and seven subfields and deformation of the hippocampal shape. The contributions of the hippocampal volumes and shape deformation to long-term forgetting, controlling for confounding factors, including the presence of interictal epileptiform discharges, were assessed by multiple regression analyses.Results: Patients with focal epilepsy had lower intelligence quotients and route recall scores at 10 min than controls. The focal epilepsy group had smaller

Objective The impact of the coronavirus disease 2019 (COVID‐19) pandemic on epilepsy care across Japan was investigated by conducting a multicenter retrospective cohort study. Methods This study included monthly data on the frequency of (1) visits by outpatients with epilepsy, (2) outpatient electroencephalography (EEG) studies, (3) telemedicine for epilepsy, (4) admissions for epilepsy, (5) EEG monitoring, and (6) epilepsy surgery in epilepsy centers and clinics across Japan between January 2019 and December 2020. We defined the primary outcome as epilepsy center‐specific monthly data divided by the 12‐month average in 2019 for each facility. We determined whether the COVID‐19 pandemic‐related factors (such as year [2019 or 2020], COVID‐19 cases in each prefecture in the previous month, and a state of emergency) were independently associated with these outcomes. Results In 2020, the frequency of outpatient EEG studies (−10.7%, P < .001) and cases with telemedicine (+2608%, P = .031) were affected. The number of COVID‐19 cases was an independent associated factor for epilepsy admission (−3.75 × 10 −3 % per case, P < .001) and EEG monitoring (−3.81 × 10 −3 % per case, P = .004). Furthermore, a state of emergency was an independent factor associated with outpatient with epilepsy (−11.9%, P < .001), outpatient EEG (−32.3%, P < .001), telemedicine for epilepsy (+12,915%, P < .001), epilepsy admissions (−35.3%; P < .001), EEG monitoring (−24.7%: P < .001), and epilepsy surgery (−50.3%, P < .001). Significance We demonstrated the significant impact that the COVID‐19 pandemic had on epilepsy care. These results support those of previous studies and clarify the effect size of each pandemic‐related factor on epilepsy care.

PurposeInterictal epileptic discharges (IEDs) are known to affect cognitive function in patients with epilepsy, but the mechanism has not been elucidated. Sleep spindles appearing in synchronization with IEDs were recently demonstrated to impair memory consolidation in rat, but this has not been investigated in humans. On the other hand, the increase of sleep spindles at night after learning is positively correlated with amplified learning effects during sleep for motor sequence learning. In this study, we examined the effects of IEDs and IED-coupled spindles on motor sequence learning in patients with epilepsy, and clarified their pathological significance.Materials and methodsPatients undergoing long-term video-electroencephalography (LT-VEEG) at our hospital from June 2019 to November 2021 and age-matched healthy subjects were recruited. Motor sequence learning consisting of a finger-tapping task was performed before bedtime and the next morning, and the improvement rate of performance was defined as the sleep-dependent learning effect. We searched for factors associated with the changes in learning effect observed between the periods of when antiseizure medications (ASMs) were withdrawn for LT-VEEG and when they were returned to usual doses after LT-VEEG.ResultsExcluding six patients who had epileptic seizures at night after learning, nine patients and 11 healthy subjects were included in the study. In the patient group, there was no significant learning effect when ASMs were withdrawn. The changes in learning effect of the patient group during ASM withdrawal were not correlated with changes in sleep duration or IED density; however, they were significantly negatively correlated with changes in IED-coupled spindle density.ConclusionWe found that the increase of IED-coupled spindles correlated with the decrease of sleep-dependent learning effects of procedural memory. Pathological IED-coupled sleep spindles could hinder memory consolidation, that is dependent on physiological sleep spindles, resulting in cognitive dysfunction in patients with epilepsy.

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Chromosomally integrated human herpesvirus 6 (ciHHV6) is a condition where HHV6‐DNA is integrated into the host germline genome. ciHHV6 can be misdiagnosed as active HHV6 infection. We report a 30‐year‐old woman presenting with psychological symptoms without a history of immunodeficiency. She had an ovarian teratoma and anti‐N‐methyl‐D‐aspartate receptor (NMDAR) antibodies in the cerebrospinal fluid (CSF) with HHV6‐DNA in the serum and CSF. The final diagnosis was anti‐NMDAR encephalitis and ciHHV6 because laparoscopic oophorectomy and immunotherapy ameliorated her symptoms and HHV6‐DNA was detected in her oral mucosa cells. This case suggests the need to assess whether HHV6‐DNA is related to infection or ciHHV6 when HHV6‐DNA is detected in the CSF of patients with encephalitis.