A 15-year epileptogenic period after perinatal brain injury

Pisani, Francesco

doi:10.11138/fneur/2017.32.1.049

Cited by 8 publications

(3 citation statements)

References 20 publications

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“…In addition, the pediatric brain in particular is susceptible to developing other complications such as seizures if an area of the brain becomes injured. 24,30 Our patient developed focal epilepsy, and the MRI study of the brain before treatment revealed a small right MCA distribution infarct (Fig. 1D).…”

Section: Sequelae Of Rupturementioning

confidence: 84%

Endovascular treatment of a large ruptured middle cerebral artery bifurcation aneurysm in a 5-week-old infant: case report

Lyon

Arrey

Haider

et al. 2017

Journal of Neurosurgery: Pediatrics

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Ruptured intracranial aneurysms are extremely rare in infants. The optimal treatment strategy is not well established. Both microsurgical and endovascular techniques and strategies have been tried, and in the literature there is a significant variability in outcome. The authors report the presentation and successful endovascular treatment of a large, ruptured, middle cerebral artery bifurcation aneurysm in a 5-week-old girl, one of only a few reported in the literature. Clinical and radiological findings at follow-up are also presented. The authors then review the literature on aneurysmal subarachnoid hemorrhage in infants, with particular regard to outcome after either endovascular or open surgical management. They also provide recommendations for follow-up in pediatric patients whose intracranial aneurysms have been treated with coil embolization.

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Section: Sequelae Of Rupturementioning

confidence: 84%

Endovascular treatment of a large ruptured middle cerebral artery bifurcation aneurysm in a 5-week-old infant: case report

Lyon

Arrey

Haider

et al. 2017

Journal of Neurosurgery: Pediatrics

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“…Usually, unprovoked epileptic seizures in these children coincide with other significant disabilities such as cerebral palsy and cognitive impairment [19,80]. In conditions such as perinatal arterial ischemic stroke, the risk of developing post-neonatal epilepsy is rather high, with a latency of over a decade from the acute brain insult to the post-neonatal epilepsy [81]. In children with perinatal arterial ischemic stroke, the incidence of active epilepsy during the first decade of life is 54 % for those with a history of neonatal seizures, and neonatal seizures themselves have been acknowledged as the only independent predictor of remote seizures in this population [82].…”

Section: Clinical Scenarios In the Neonatal Periodmentioning

confidence: 99%

Seizures in the neonate: A review of etiologies and outcomes

Pisani

Spagnoli

Falsaperla

et al. 2021

Seizure

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Neonatal seizures occur in their majority in close temporal relation to an acute brain injury or systemic insult, and are accordingly defined as acute symptomatic or provoked seizures. However less frequently, unprovoked seizures may also present in the neonatal period as secondary to structural brain abnormalities, thus corresponding to structural epilepsies, or to genetic conditions, thus corresponding to genetic epilepsies. Unprovoked neonatal seizures should be thus considered as the clinical manifestation of early onset structural or genetic epilepsies that often have the characteristics of early onset epileptic encephalopathies. In this review, we address the conundrum of neonatal seizures including acute symptomatic, remote symptomatic, provoked, and unprovoked seizures, evolving to post-neonatal epilepsies, and neonatal onset epilepsies. The different clinical scenarios involving neonatal seizures, each with their distinct post-neonatal evolution are presented. The structural and functional impact of neonatal seizures on brain development and the concept of secondary epileptogenesis, with or without a following latent period after the acute seizures, are addressed. Finally, we underline the need for an early differential diagnosis between an acute symptomatic seizure and an unprovoked seizure, since it is associated with fundamental differences in clinical evolution. These are crucial aspects for neonatal management, counselling and prognostication. In view of the above aspects, we provide an outlook on future strategies and potential lines of research in this field.

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“…Epileptic seizures arise due to abnormal or excessive electrical brain activity and are usually marked by repetitive paroxysmal attacks resulting in an altered state of consciousness, confusion, and uncontrolled jerking movements (Panayiotopoulos, 2010). Epileptic seizures can result from traumatic brain injury (DeGrauw et al., 2018; Lucke‐Wold et al., 2015), perinatal causes (Matsushita et al., 2019; Pisani et al., 2017), genetic factors (Berkovic, 2015; Heuser et al., 2010), developmental abnormalities (Bozzi et al., 2012; Giannotti et al., 2008), infection (Ibrahim & Haddad, 2014; Lowenstein et al., 2014), brain tumors (Chang et al., 2010; Wells et al., 2012), or even stroke (Sciascia et al., 2013; Yang et al., 2018). However, 50% of epilepsy cases are of unknown cause (Neligan et al., 2012).…”

Section: Introductionmentioning

confidence: 99%

Possible interplay between the theories of pharmacoresistant epilepsy

Juvale

Has

2020

Eur J of Neuroscience

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Epilepsy is one of the oldest known neurological disorders and is characterized by recurrent seizure activity. It has a high incidence rate, affecting a broad demographic in both developed and developing countries. Comorbid conditions are frequent in patients with epilepsy and have detrimental effects on their quality of life. Current management options for epilepsy include the use of anti-epileptic drugs, surgery, or a ketogenic diet. However, more than 30% of patients diagnosed with epilepsy exhibit drug resistance to anti-epileptic drugs. Further, surgery and ketogenic diets do little to alleviate the symptoms of patients with pharmacoresistant epilepsy. Thus, there is an urgent need to understand the underlying mechanisms of pharmacoresistant epilepsy to design newer and more effective anti-epileptic drugs. Several theories of pharmacoresistant epilepsy have been suggested over the years, the most common being the gene variant hypothesis, network hypothesis, multidrug transporter hypothesis, and target hypothesis. In our review, we discuss the main theories of pharmacoresistant epilepsy and highlight a possible interconnection between their mechanisms that could lead to the development of novel therapies for pharmacoresistant epilepsy.

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A 15-year epileptogenic period after perinatal brain injury

Cited by 8 publications

References 20 publications

Endovascular treatment of a large ruptured middle cerebral artery bifurcation aneurysm in a 5-week-old infant: case report

Endovascular treatment of a large ruptured middle cerebral artery bifurcation aneurysm in a 5-week-old infant: case report

Seizures in the neonate: A review of etiologies and outcomes

Possible interplay between the theories of pharmacoresistant epilepsy

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