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New Trends in Diagnosis and Treatment of Epilepsy
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New Trends in Diagnosis and Treatment of Epilepsy

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (31 January 2025) | Viewed by 6280

Special Issue Editors

Prof. Dr. Herrmann Stefan

E-Mail Website
Guest Editor
Department of Neurology-Biomagnetism, University Hospital Erlangen, Erlangen, Germany
Interests: temporal lobe epilepsy; epilepsy; electrocorticography; magnetoencephalography; drug resistant epilepsy; magnetic resonance imaging
Prof. Dr. Eugen Trinka

E-Mail Website
Guest Editor
Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University Salzburg, Ignaz Harrer Str 79, A-5020 Salzburg, Austria
Interests: neurophysiology; neurological diseases; cognitive neuroscience; neuroimaging; neuroscience; neurodegeneration; neurorehabilitation; treatment; memory; neurodegenerative diseases

Special Issue Information

Dear Colleagues,

Epilepsies are one of most frequent chronic neurological disorders occurring as a consequence of different aetiologies, e.g., genetic, traumatic, tumoral, vascular, degenerative and inflammatory origin. The spectrum of clinical signs is widely diversified and includes motoric, sensoric, psychical or autonomic phenomena. The disability, more often than not, is restricted to the seizure time only. Secondary health conditions can lead to psychosocial problems, stress, social discrimination and reduced employment prospects. Patients with epilepsy also have a higher risk of comorbidities, mental health problems, depression and SUDEP. It is therefore critical that improvements in early diagnosis, precise information of structural pathology (imaging) or localization (noninvasively by EEG/MEG), individually optimized drug treatment and epilepsy surgery become more advanced and that improvements be informed by evidence-based research. Accordingly, we are announcing a new Special Issue entitled “New Trends in Diagnosis and Treatment of Epilepsy. We invite researchers to submit original research and systematic reviews that investigate features of the nature, diagnosis and treatment of epilepsy, including the presentation of novel interventions that constitute an advance in epilepsy management.

Prof. Dr. Herrmann Stefan
Prof. Dr. Eugen Trinka
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • epilepsy
  • aetiology
  • diagnosis
  • high resolution imaging
  • treatment
  • anti-seizure medication
  • electrophysiology
  • surgery

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Published Papers (6 papers)

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Research

Jump to: Review

11 pages, 1379 KiB  
Article
Stable Yet Destabilised: Towards Understanding Brain Network Dynamics in Psychogenic Disorders
by Mostafa Badr, Timo Bröhl, Nayrin Dissouky, Christoph Helmstaedter and Klaus Lehnertz
J. Clin. Med. 2025, 14(3), 666; https://doi.org/10.3390/jcm14030666 - 21 Jan 2025
Viewed by 465
Abstract
Background: Psychogenic non-epileptic seizures (PNES) are seizure-like episodes that resemble behavioral aspects observed for epileptic seizures but are without the abnormal electrical activity typically seen in epilepsy. The lack of an etiologic model for PNES as well as limitations of available diagnostic methods [...] Read more.
Background: Psychogenic non-epileptic seizures (PNES) are seizure-like episodes that resemble behavioral aspects observed for epileptic seizures but are without the abnormal electrical activity typically seen in epilepsy. The lack of an etiologic model for PNES as well as limitations of available diagnostic methods largely hinders a clear-cut distinction from epilepsy and from a normal functioning brain. Methods: In this study, we investigate the brain dynamics of people with PNES and people with epilepsy during phases far-off seizures and seizure-like events as well as the brain dynamics of a control group. Probing for differences between these groups, we utilise the network ansatz and explore local and global characteristics of time-evolving functional brain networks. We observe subject-specific differences in local network characteristics across the groups, highlighting the physiological functioning of specific brain regions. Furthermore, we observe significant differences in global network characteristics—relating to communication, robustness, and stability aspects of the brain. Conclusions: Our findings may provide new insights into the mechanisms underlying PNES and offer a promising diagnostic approach to differentiate them from epilepsy. Full article
(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)
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17 pages, 2055 KiB  
Article
The Influence of Climatic Factors on the Provocation of Epileptic Seizures
by Thilo Hammen, Sebastian Treib, Philipp Treib, Hermann Stefan, Hajo M. Hamer, Ralf Landwehr, Lynn Lohmann, Sebastian Koch, Johannes Treib and Werner Adler
J. Clin. Med. 2024, 13(12), 3404; https://doi.org/10.3390/jcm13123404 - 11 Jun 2024
Cited by 2 | Viewed by 1343
Abstract
Background/Objectives: Recent studies provide the first indications of the impact of climate factors on human health, especially with individuals already grappling with internal and neurological conditions being particularly vulnerable. In the face of escalating climate change, our research delves into the specific influence [...] Read more.
Background/Objectives: Recent studies provide the first indications of the impact of climate factors on human health, especially with individuals already grappling with internal and neurological conditions being particularly vulnerable. In the face of escalating climate change, our research delves into the specific influence of a spectrum of climatic factors and seasonal variations on the hospital admissions of patients receiving treatment for epileptic seizures at our clinic in Kaiserslautern. Methods: Our study encompassed data from 9366 epilepsy patients who were admitted to hospital due to epileptic seizures. We considered seven climate parameters that Germany’s National Meteorological Service made available. We employed the Kruskal–Wallis test to examine the correlation between the frequency of admittance to our hospital in the mentioned patient group and seasons. Furthermore, we used conditional Poisson regression and distributed lag linear models (DLMs) to scrutinize the coherence of the frequency of patient admittance and the investigated climate parameters. The mentioned parameters were also analyzed in a subgroup analysis regarding the gender and age of patients and the classification of seizures according to ILAE 2017. Results: Our results demonstrate that climatic factors, such as precipitation and air pressure, can increase the frequency of hospital admissions for seizures in patients with general-onset epilepsy. In contrast, patients with focal seizures are less prone to climatic changes. Consequently, admittance to the hospital for seizures is less affected by climatic factors in the latter patient group. Conclusions: The present study demonstrated that climatic factors are possible trigger factors for the provocation of seizures, particularly in patients with generalized seizures. This was determined indirectly by analyzing the frequency of seizure-related emergency admissions and their relation to prevailing climate factors. Our study is consistent with other studies showing that climate factors, such as cerebral infarcts or cerebral hemorrhages, influence patients’ health. Full article
(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)
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Review

Jump to: Research

27 pages, 415 KiB  
Review
Seizure Detection Devices
by Christoph Baumgartner, Jakob Baumgartner, Clemens Lang, Tamara Lisy and Johannes P. Koren
J. Clin. Med. 2025, 14(3), 863; https://doi.org/10.3390/jcm14030863 - 28 Jan 2025
Viewed by 267
Abstract
Goals of automated detection of epileptic seizures using wearable devices include objective documentation of seizures, prevention of sudden unexpected death in epilepsy (SUDEP) and seizure-related injuries, obviating both the unpredictability of seizures and potential social embarrassment, and finally to develop seizure-triggered on-demand therapies. [...] Read more.
Goals of automated detection of epileptic seizures using wearable devices include objective documentation of seizures, prevention of sudden unexpected death in epilepsy (SUDEP) and seizure-related injuries, obviating both the unpredictability of seizures and potential social embarrassment, and finally to develop seizure-triggered on-demand therapies. Automated seizure detection devices are based on the analysis of EEG signals (scalp-EEG, subcutaneous EEG and intracranial EEG), of motor manifestations of seizures (surface EMG, accelerometry), and of physiologic autonomic changes caused by seizures (heart and respiration rate, oxygen saturation, sweat secretion, body temperature). While the detection of generalized tonic-clonic and of focal to bilateral tonic-clonic seizures can be achieved with high sensitivity and low false alarm rates, the detection of focal seizures is still suboptimal, especially in the everyday ambulatory setting. Multimodal seizure detection devices in general provide better performance than devices based on single measurement parameters. Long-term use of seizure detection devices in home environments helps to improve the accuracy of seizure diaries and to reduce seizure-related injuries, while evidence for prevention of SUDEP is still lacking. Automated seizure detection devices are generally well accepted by patients and caregivers. Full article
(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)
9 pages, 215 KiB  
Review
Hyperphosphorylated Tau and Cognition in Epilepsy
by Juri-Alexander Witt, Johanna Andernach, Albert Becker and Christoph Helmstaedter
J. Clin. Med. 2025, 14(2), 514; https://doi.org/10.3390/jcm14020514 - 15 Jan 2025
Viewed by 420
Abstract
In light of the growing interest in the bidirectional relationship between epilepsy and dementia, this review aims to provide an overview of the role of hyperphosphorylated tau (pTau) in cognition in human epilepsy. A literature search identified five relevant studies. All of them [...] Read more.
In light of the growing interest in the bidirectional relationship between epilepsy and dementia, this review aims to provide an overview of the role of hyperphosphorylated tau (pTau) in cognition in human epilepsy. A literature search identified five relevant studies. All of them examined pTau burden in surgical biopsy specimens from patients with temporal lobe epilepsy. The prevalence of pTau reported across the five studies, encompassing a total of 142 patients, ranged from 3.5% to 95%. Findings also varied regarding the location of pTau in the hippocampus and/or temporal cortex. Two of five studies (40%) demonstrated an inverse relationship between pTau burden and cognitive performance, one study with regard to executive functions and the other with regard to naming and verbal short-term memory. The only longitudinal study found a significant link between pTau and cognitive decline in verbal learning and memory, and in part also in naming, from the pre- to the postoperative assessment and from three to 12 months postoperatively. Given the heterogeneity of the study cohorts and the neuropsychological and neuropathological methodologies and findings, no clear picture emerges regarding the association between pTau and cognition in temporal lobe epilepsy. Added to this is the multifactorial etiology of cognitive impairment in epilepsy, including the active epilepsy, the underlying and sometimes dynamic pathology, and anti-seizure medication. Some of these factors may affect pTau expression. Further research should aim to investigate pTau longitudinally and noninvasively on a whole-brain level, using targeted neuropsychological outcome measures and controlling for age and other factors potentially influencing cognitive trajectories in epilepsy. Full article
(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)
13 pages, 403 KiB  
Review
MEG in MRI-Negative Patients with Focal Epilepsy
by Rudolf Kreidenhuber, Kai-Nicolas Poppert, Matthias Mauritz, Hajo M. Hamer, Daniel Delev, Oliver Schnell and Stefan Rampp
J. Clin. Med. 2024, 13(19), 5746; https://doi.org/10.3390/jcm13195746 - 26 Sep 2024
Cited by 1 | Viewed by 980
Abstract
Objectives: To review the evidence on the clinical value of magnetic source imaging (MSI) in patients with refractory focal epilepsy without evidence for an epileptogenic lesion on magnetic resonance imaging (“MRI-negative” or “non-lesional MRI”). Methods: We conducted a systematic literature search on PUBMED, [...] Read more.
Objectives: To review the evidence on the clinical value of magnetic source imaging (MSI) in patients with refractory focal epilepsy without evidence for an epileptogenic lesion on magnetic resonance imaging (“MRI-negative” or “non-lesional MRI”). Methods: We conducted a systematic literature search on PUBMED, which was extended by researchrabbit.ai using predefined criteria to identify studies that applied MSI in MRI-negative patients with epilepsy. We extracted data on patient characteristics, MSI methods, localization results, surgical outcomes, and correlation with other modalities. Results: We included 23 studies with a total of 512 non-lesional epilepsy patients who underwent MSI. Most studies used equivalent current dipole (ECD) models to estimate the sources of interictal epileptic discharges (IEDs). MEG detected IEDs in 32–100% of patients. MSI results were concordant with other modalities, such as EEG, PET, and SPECT, in 3892% of cases. If MSI concordant surgery was performed, 52–89% of patients achieved seizure freedom. MSI contributed to the decision-making process in 28–75% of cases and altered the surgical plan in 5–33% of cases. Conclusions: MSI is a valuable diagnostic tool for MRI-negative patients with epilepsy, as it can detect and localize IEDs with high accuracy and sensitivity, and provides useful information for surgical planning and predicts outcomes. MSI can also complement and refine the results of other modalities, such as EEG and PET, and optimize the use of invasive recordings. MSI should be considered as part of the presurgical evaluation, especially in patients with non-lesional refractory epilepsy. Full article
(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)
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19 pages, 345 KiB  
Review
New Pharmacological Therapies in the Treatment of Epilepsy in the Pediatric Population
by Karolina Daniłowska, Natalia Picheta, Dominika Żyła, Julia Piekarz, Katarzyna Zych and Paulina Gil-Kulik
J. Clin. Med. 2024, 13(12), 3567; https://doi.org/10.3390/jcm13123567 - 18 Jun 2024
Viewed by 1865
Abstract
Epilepsy is a disorder characterized by abnormal brain neuron activity, predisposing individuals to seizures. The International League Against Epilepsy (ILAE) categorizes epilepsy into the following groups: focal, generalized, generalized and focal, and unknown. Infants are the most vulnerable pediatric group to the condition, [...] Read more.
Epilepsy is a disorder characterized by abnormal brain neuron activity, predisposing individuals to seizures. The International League Against Epilepsy (ILAE) categorizes epilepsy into the following groups: focal, generalized, generalized and focal, and unknown. Infants are the most vulnerable pediatric group to the condition, with the cause of epilepsy development being attributed to congenital brain developmental defects, white matter damage, intraventricular hemorrhage, perinatal hypoxic-ischemic injury, perinatal stroke, or genetic factors such as mutations in the Sodium Channel Protein Type 1 Subunit Alpha (SCN1A) gene. Due to the risks associated with this condition, we have investigated how the latest pharmacological treatments for epilepsy in children impact the reduction or complete elimination of seizures. We reviewed literature from 2018 to 2024, focusing on the age group from 1 month to 18 years old, with some studies including this age group as well as older individuals. The significance of this review is to present and compile research findings on the latest antiseizure drugs (ASDs), their effectiveness, dosing, and adverse effects in the pediatric population, which can contribute to selecting the best drug for a particular patient. The medications described in this review have shown significant efficacy and safety in the studied patient group, outweighing the observed adverse effects. The main aim of this review is to provide a comprehensive summary of the current state of knowledge regarding the newest pharmacotherapy for childhood epilepsy. Full article
(This article belongs to the Special Issue New Trends in Diagnosis and Treatment of Epilepsy)
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