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  1. Article ; Online: Electrical Stimulation Mapping of the Brain.

    So, Elson L

    Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society

    2018  Volume 35, Issue 2, Page(s) 85

    MeSH term(s) Brain/physiology ; Brain/physiopathology ; Brain Mapping/instrumentation ; Brain Mapping/methods ; Electric Stimulation/instrumentation ; Electric Stimulation/methods ; Humans
    Language English
    Publishing date 2018-03-02
    Publishing country United States
    Document type Editorial ; Introductory Journal Article
    ZDB-ID 605640-4
    ISSN 1537-1603 ; 0736-0258
    ISSN (online) 1537-1603
    ISSN 0736-0258
    DOI 10.1097/WNP.0000000000000432
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Sudden Cardiac Death or Ventricular Arrythmia in Patients Taking Levetiracetam or Oxcarbazepine.

    Cross, Madeline R / Savitz, Samuel T / Sangaralingham, Lindsey R / So, Elson L / Ackerman, Michael J / Noseworthy, Peter A

    Neurology

    2024  Volume 102, Issue 9, Page(s) e209177

    Abstract: Background and objectives: Levetiracetam is a widely used antiseizure medication. Recent concerns have been raised regarding the potential prolongation of the QT interval by levetiracetam and increased risk of sudden cardiac death. This could have ... ...

    Abstract Background and objectives: Levetiracetam is a widely used antiseizure medication. Recent concerns have been raised regarding the potential prolongation of the QT interval by levetiracetam and increased risk of sudden cardiac death. This could have profound implications for patient safety and for prescribing practice. This study assessed the potential association of levetiracetam with cardiac outcomes related to QT interval prolongation. We compared outcomes of patients taking levetiracetam with those taking oxcarbazepine as a comparator medication that has not been associated with prolongation of the QT interval.
    Methods: The sample included patients who were newly prescribed levetiracetam or oxcarbazepine from January 31, 2010, to December 31, 2019, using administrative claims data from the OptumLabs Data Warehouse (OLDW). The analysis focused on a combined endpoint of sudden cardiac death or ventricular arrythmia, which are both linked to QT interval prolongation. We used a new user design and selected oxcarbazepine as an active comparator with levetiracetam to minimize bias. We used propensity score weighting to balance the levetiracetam and oxcarbazepine cohorts and then performed weighted Cox regressions to evaluate the association of levetiracetam with the combined endpoint.
    Results: We identified 104,655 enrollees taking levetiracetam and 39,596 enrollees taking oxcarbazepine. At baseline, enrollees taking levetiracetam were older, more likely to have diagnosed epilepsy, and more likely to have diagnosed comorbidities including hypertension, cerebrovascular disease, and coronary artery disease. In the main analysis, we found no significant difference between levetiracetam and oxcarbazepine in the rate of the combined endpoint for the Cox proportional hazards model (hazard ratio [HR] 0.79, 95% CI 0.42-1.47) or Cox regression with time-varying characteristics (HR 0.78, 95% CI 0.41-1.50).
    Discussion: When compared with oxcarbazepine, levetiracetam does not correlate with increased risk of ventricular arrythmia and sudden cardiac death. Our finding does not support the concern for cardiac risk to indicate restriction of levetiracetam use nor the requirement of cardiac monitoring when using it.
    Classification of evidence: This study provides Class II evidence that sudden cardiac death and ventricular arrythmia are not more frequent in patients older than 17 years newly prescribed levetiracetam, compared with those prescribed oxcarbazepine.
    MeSH term(s) Humans ; Levetiracetam/adverse effects ; Oxcarbazepine/adverse effects ; Anticonvulsants/adverse effects ; Death, Sudden, Cardiac/epidemiology ; Death, Sudden, Cardiac/etiology ; Arrhythmias, Cardiac/chemically induced
    Chemical Substances Levetiracetam (44YRR34555) ; Oxcarbazepine (VZI5B1W380) ; Anticonvulsants
    Language English
    Publishing date 2024-04-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    DOI 10.1212/WNL.0000000000209177
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  3. Article ; Online: A Guide for Cortical Electrical Stimulation Mapping.

    So, Elson L / Alwaki, Abdulrahman

    Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society

    2018  Volume 35, Issue 2, Page(s) 98–105

    Abstract: Electrical stimulation mapping (ESM) of the brain remains a major procedure for guiding epilepsy and tumor surgeries. This article collates available experiences and data in ESM to develop a guide for conducting the procedure. There are many factors that ...

    Abstract Electrical stimulation mapping (ESM) of the brain remains a major procedure for guiding epilepsy and tumor surgeries. This article collates available experiences and data in ESM to develop a guide for conducting the procedure. There are many factors that influence the yield of ESM. The stimulation parameters offered in this article need to be adjusted within safe limits to address the factors. Each ESM procedure should be tailored to the patient's age and baseline mental or psychological capacity. Stimulation-induced seizures and EEG afterdischarges disrupt ESM procedure and render the interpretation of the results difficult. There are specific measures that can lessen the risk of seizures and afterdischarges during ESM. Electrical stimulation mapping procedure requires several tasks on the part of those conducting the procedure, such as operating the stimulator and the EEG recording equipment, administering behavioral or language tests and observing both patient and EEG responses to the stimulation. A team of experienced staff is necessary for individual assumption of each task. Knowledge of the spatial relationship between electrode contacts and underlying normal or abnormal brain structures is essential for interpreting ESM results. When testing for motor or sensory response, be aware of the distinction between responses at the primary motor area and responses at the supplementary sensorimotor area. The anatomy of supplementary sensorimotor area is more variable and functional than it is fixed and structural, although its general confines and somatotopic organization are known. In addition, negative motor responses to stimulation must be recognized to avoid misinterpretation of ESM results, especially in language mapping.
    MeSH term(s) Brain Mapping/methods ; Brain Mapping/standards ; Brain Waves/physiology ; Cerebral Cortex/physiology ; Electric Stimulation/methods ; Electroencephalography ; Guidelines as Topic ; Humans
    Language English
    Publishing date 2018-03-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605640-4
    ISSN 1537-1603 ; 0736-0258
    ISSN (online) 1537-1603
    ISSN 0736-0258
    DOI 10.1097/WNP.0000000000000435
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Symposium on the prognostic significance of interictal epileptiform discharges.

    So, Elson L

    Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society

    2010  Volume 27, Issue 4, Page(s) 227–228

    MeSH term(s) Brain/physiopathology ; Brain Waves ; Congresses as Topic ; Electroencephalography ; Epilepsy/diagnosis ; Epilepsy/physiopathology ; Humans ; Predictive Value of Tests ; Prognosis ; Seizures/diagnosis ; Seizures/physiopathology
    Language English
    Publishing date 2010-08
    Publishing country United States
    Document type Editorial ; Introductory Journal Article
    ZDB-ID 605640-4
    ISSN 1537-1603 ; 0736-0258
    ISSN (online) 1537-1603
    ISSN 0736-0258
    DOI 10.1097/WNP.0b013e3181eaa60e
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Symposium on the neurophysiology of sudden unexpected death in epilepsy.

    So, Elson L

    Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society

    2009  Volume 26, Issue 5, Page(s) 295–296

    MeSH term(s) Death, Sudden ; Epilepsy/physiopathology ; Heart/physiopathology ; Humans ; Respiration
    Language English
    Publishing date 2009-10
    Publishing country United States
    Document type Editorial
    ZDB-ID 605640-4
    ISSN 1537-1603 ; 0736-0258
    ISSN (online) 1537-1603
    ISSN 0736-0258
    DOI 10.1097/WNP.0b013e3181b7f16b
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Interictal epileptiform discharges in persons without a history of seizures: what do they mean?

    So, Elson L

    Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society

    2010  Volume 27, Issue 4, Page(s) 229–238

    Abstract: Interictal epileptiform discharge (IED) is rarely observed in healthy volunteers without a history of seizures, but higher rates of occurrence are reported in children than in adults. Higher rates are also observed among neurologic inpatients and ... ...

    Abstract Interictal epileptiform discharge (IED) is rarely observed in healthy volunteers without a history of seizures, but higher rates of occurrence are reported in children than in adults. Higher rates are also observed among neurologic inpatients and outpatients without a seizure history, but the risk of subsequent unprovoked seizures or epilepsy is low in healthy volunteers and patients. An exception is the patients with autism spectrum disorders, attention deficit/hyperactivity disorder, or cerebral palsy, who are predisposed to epilepsy development. However, it is currently unclear whether epilepsy risk is higher for patients with incidentally detected IED than for the patients without IED. Hospitalized patients with IED but no prior seizures often have underlying acute or progressive brain disorders. Although they have increased risk of acute seizures, the risk for subsequent unprovoked seizures or epilepsy is unknown and requires assessment on an individual basis. For patients who have psychogenic spells but no seizure history, the rate of IED detection is low, similar to that of healthy volunteers. The association between IED and transitory cognitive impairment has not been established in nonepileptic persons. Evidence thus far does not suggest that routine EEG screening of pilot candidates reduces risk of flight-related accidents.
    MeSH term(s) Activities of Daily Living ; Adult ; Aerospace Medicine ; Aged ; Anticonvulsants/therapeutic use ; Brain/physiopathology ; Brain Waves ; Electroencephalography ; Epilepsy/diagnosis ; Epilepsy/drug therapy ; Epilepsy/etiology ; Epilepsy/physiopathology ; Female ; Humans ; Incidental Findings ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Risk Assessment ; Risk Factors ; Seizures/diagnosis ; Seizures/drug therapy ; Seizures/etiology ; Seizures/physiopathology ; Young Adult
    Chemical Substances Anticonvulsants
    Language English
    Publishing date 2010-08
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605640-4
    ISSN 1537-1603 ; 0736-0258
    ISSN (online) 1537-1603
    ISSN 0736-0258
    DOI 10.1097/WNP.0b013e3181ea42a4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Epilepsy surgery in MRI-negative epilepsies.

    So, Elson L / Lee, Ricky W

    Current opinion in neurology

    2014  Volume 27, Issue 2, Page(s) 206–212

    Abstract: Purpose of review: This study discusses the challenges of MRI-negative epilepsy surgery, and the strategies in using advanced MRI and functional imaging tests and their associated postsurgical outcome.: Recent findings: Several methods for processing ...

    Abstract Purpose of review: This study discusses the challenges of MRI-negative epilepsy surgery, and the strategies in using advanced MRI and functional imaging tests and their associated postsurgical outcome.
    Recent findings: Several methods for processing MRI postacquisition data have identified either previously undetectable or overlooked MRI abnormalities. The resection of these abnormalities is associated with excellent postsurgical seizure control. There have been major advances in functional imaging as well, one of which is the application of statistical parametric mapping analysis for comparing patient data against normative data. This approach has specifically improved the usefulness of both PET and single-photon emission computed tomography in MRI-negative epilepsy surgery evaluation. One other development of importance is that of PET-MRI coregistration, which has recently been shown to be superior to conventional PET. More recent publications on magnetoencephalography have added to the literature of its use in MRI-negative epilepsy surgery evaluation, which up to now remains somewhat limited. However, recent data now indicate that single magnetoencephalography cluster is associated with better chance of concordance with intracranial EEG localization, and with excellent postsurgical seizure control if completely resected.
    Summary: Advanced MRI and functional imaging and subsequent intracranial EEG confirmation of the seizure-onset zone are essential to make MRI-negative epilepsy surgery possible and worthwhile for the patient.
    MeSH term(s) Cerebral Cortex/diagnostic imaging ; Cerebral Cortex/pathology ; Cerebral Cortex/surgery ; Epilepsy/diagnosis ; Epilepsy/surgery ; Humans ; Magnetoencephalography ; Neuroimaging ; Neurosurgery ; Radionuclide Imaging ; Treatment Outcome
    Language English
    Publishing date 2014-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1182686-1
    ISSN 1473-6551 ; 1350-7540
    ISSN (online) 1473-6551
    ISSN 1350-7540
    DOI 10.1097/WCO.0000000000000078
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  8. Article ; Online: What is known about the mechanisms underlying SUDEP?

    So, Elson L

    Epilepsia

    2008  Volume 49 Suppl 9, Page(s) 93–98

    Abstract: This article highlights studies in three major domains of potential mechanisms of sudden unexplained death in epilepsy (SUDEP): cardiac, respiratory, and autonomic. Ictal cardiac arrest is a clinically rare but well-recognized potential mechanism of ... ...

    Abstract This article highlights studies in three major domains of potential mechanisms of sudden unexplained death in epilepsy (SUDEP): cardiac, respiratory, and autonomic. Ictal cardiac arrest is a clinically rare but well-recognized potential mechanism of SUDEP. Studies have failed to identify preexisting cardiac electrophysiologic or structural abnormalities that distinguish SUDEP persons. Some degree of pulmonary congestion is a common autopsy finding, but severe pulmonary edema occurs very rarely with seizures. In contrast, periictal apnea and hypoxia occur commonly with generalized tonic-clonic seizures and, to a lesser degree, with complex partial seizures. There are several animal models of postictal respiratory arrest. Postictal respiratory arrest in audiogenic seizure mice can be induced by serotonin receptor inhibition or prevented by selective serotonin reuptake inhibitor (SSRI) drugs. Reduced heart rate variability occurs in patients with refractory epilepsy and can be induced in animal seizure models, but its precise role in predisposing persons to sudden death requires further investigation.
    MeSH term(s) Animals ; Autonomic Nervous System/physiopathology ; Death, Sudden/etiology ; Death, Sudden/pathology ; Epilepsy/complications ; Heart Diseases/complications ; Humans ; Lung Diseases/complications
    Language English
    Publishing date 2008-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 216382-2
    ISSN 1528-1167 ; 0013-9580
    ISSN (online) 1528-1167
    ISSN 0013-9580
    DOI 10.1111/j.1528-1167.2008.01932.x
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  9. Article ; Online: Cardiovascular Disease Burden, Mortality, and Sudden Death Risk in Epilepsy: A UK Biobank Study.

    Shah, Ravi A / Chahal, C Anwar A / Ranjha, Shaheryar / Sharaf Dabbagh, Ghaith / Asatryan, Babken / Limongelli, Ivan / Khanji, Mohammed / Ricci, Fabrizio / De Paoli, Federica / Zucca, Susanna / Tristani-Firouzi, Martin / St Louis, Erik K / So, Elson L / Somers, Virend K

    The Canadian journal of cardiology

    2023  Volume 40, Issue 4, Page(s) 688–695

    Abstract: Background: Sudden death is the leading cause of mortality in medically refractory epilepsy. Middle-aged persons with epilepsy (PWE) are under investigated regarding their mortality risk and burden of cardiovascular disease (CVD).: Methods: Using UK ... ...

    Abstract Background: Sudden death is the leading cause of mortality in medically refractory epilepsy. Middle-aged persons with epilepsy (PWE) are under investigated regarding their mortality risk and burden of cardiovascular disease (CVD).
    Methods: Using UK Biobank, we identified 7786 (1.6%) participants with diagnoses of epilepsy and 6,171,803 person-years of follow-up (mean 12.30 years, standard deviation 1.74); 566 patients with previous histories of stroke were excluded. The 7220 PWE comprised the study cohort with the remaining 494,676 without epilepsy as the comparator group. Prevalence of CVD was determined using validated diagnostic codes. Cox proportional hazards regression was used to assess all-cause mortality and sudden death risk.
    Results: Hypertension, coronary artery disease, heart failure, valvular heart disease, and congenital heart disease were more prevalent in PWE. Arrhythmias including atrial fibrillation/flutter (12.2% vs 6.9%; P < 0.01), bradyarrhythmias (7.7% vs 3.5%; P < 0.01), conduction defects (6.1% vs 2.6%; P < 0.01), and ventricular arrhythmias (2.3% vs 1.0%; P < 0.01), as well as cardiac implantable electric devices (4.6% vs 2.0%; P < 0.01) were more prevalent in PWE. PWE had higher adjusted all-cause mortality (hazard ratio [HR], 3.9; 95% confidence interval [CI], 3.01-3.39), and sudden death-specific mortality (HR, 6.65; 95% CI, 4.53-9.77); and were almost 2 years younger at death (68.1 vs 69.8; P < 0.001).
    Conclusions: Middle-aged PWE have increased all-cause and sudden death-specific mortality and higher burden of CVD including arrhythmias and heart failure. Further work is required to elucidate mechanisms underlying all-cause mortality and sudden death risk in PWE of middle age, to identify prognostic biomarkers and develop preventative therapies in PWE.
    MeSH term(s) Middle Aged ; Humans ; Cardiovascular Diseases/epidemiology ; UK Biobank ; Biological Specimen Banks ; Risk Factors ; Epilepsy/complications ; Epilepsy/epidemiology ; Death, Sudden/epidemiology ; Death, Sudden/etiology ; Heart Failure ; Death, Sudden, Cardiac/epidemiology ; Death, Sudden, Cardiac/etiology
    Language English
    Publishing date 2023-11-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 632813-1
    ISSN 1916-7075 ; 0828-282X
    ISSN (online) 1916-7075
    ISSN 0828-282X
    DOI 10.1016/j.cjca.2023.11.021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Musicogenic epilepsy: Expanding the spectrum of glutamic acid decarboxylase 65 neurological autoimmunity.

    Smith, Kelsey M / Zalewski, Nicholas L / Budhram, Adrian / Britton, Jeffrey W / So, Elson / Cascino, Gregory D / Ritaccio, Anthony L / McKeon, Andrew / Pittock, Sean J / Dubey, Divyanshu

    Epilepsia

    2021  Volume 62, Issue 5, Page(s) e76–e81

    Abstract: ... evaluations and all had high-titer glutamic acid decarboxylase 65-immunoglobulin G (GAD65-IgG; >20 nmol·L ...

    Abstract The objective of this study was to describe serological association of musicogenic epilepsy and to evaluate clinical features and outcomes of seropositive cases. Through retrospective chart review, musicogenic epilepsy patients were identified. Among 16 musicogenic epilepsy patients, nine underwent autoantibody evaluations and all had high-titer glutamic acid decarboxylase 65-immunoglobulin G (GAD65-IgG; >20 nmol·L
    MeSH term(s) Adult ; Autoantibodies/immunology ; Autoantigens/immunology ; Autoimmune Diseases/immunology ; Autoimmunity/immunology ; Epilepsy, Reflex/immunology ; Epilepsy, Reflex/physiopathology ; Epilepsy, Temporal Lobe/immunology ; Epilepsy, Temporal Lobe/physiopathology ; Female ; Glutamate Decarboxylase/immunology ; Humans ; Male ; Middle Aged ; Retrospective Studies
    Chemical Substances Autoantibodies ; Autoantigens ; anti-GAD65 autoantibody ; Glutamate Decarboxylase (EC 4.1.1.15)
    Language English
    Publishing date 2021-03-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 216382-2
    ISSN 1528-1167 ; 0013-9580
    ISSN (online) 1528-1167
    ISSN 0013-9580
    DOI 10.1111/epi.16888
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