Search

Your search keyword '"Casciato, S."' showing total 150 results
Start Over Author "Casciato, S."
150 results on '"Casciato, S."'

2. Late epileptic seizures following cerebral venous thrombosis: a systematic review and meta-analysis

Author

Gasparini, S., Neri, S., Brigo, F., Cianci, V., Mammì, A., Pascarella, A., Manzo, L., Benna, P., Striano, P., Martino, T., Romoli, M., Muccioli, L., Nilo, A., Valente, M., Cagnetti, C., Labate, A., Gambardella, A., Pisani, F., Casciato, S., Di Gennaro, G., Belcastro, V., Aguglia, U., Ferlazzo, E, and Epilepsy Study Group of the Italian Neurological Society

Subjects
Cerebral venous thrombosis, Epilepsy, Focal signs, Hemorrhage, Predictors, Psychiatry and Mental health, Neurology (clinical), Dermatology, General Medicine
Published
2022

3. Brivaracetam as Early Add-On Treatment in Patients with Focal Seizures: A Retrospective, Multicenter, RealWorld Study

Author

Lattanzi, S., Canafoglia, L., Canevini, M. P., Casciato, S., Cerulli Irelli, E., Chiesa, V., Dainese, F., De Maria, G., Didato, G., Di Gennaro, G., Falcicchio, G., Fanella, M., Ferlazzo, E., Gangitano, M., La Neve, A., Mecarelli, O., Montalenti, E., Morano, A., Piazza, F., Pizzanelli, C., Pulitano, P., Ranzato, F., Rosati, E., Tassi, L., Di Bonaventura, C., Alicino, A., Ascoli, M., Assenza, G., Avorio, F., Badioni, V., Banfi, P., Bartolini, E., Basili, L. M., Belcastro, V., Beretta, S., Berto, I., Biggi, M., Billo, G., Boero, G., Bonanni, P., Bongorno, J., Brigo, F., Caggia, E., Cagnetti, C., Calvello, C., Cesnik, E., Chianale, G., Ciampanelli, D., Ciuffini, R., Cocito, D., Colella, D., Contento, M., Costa, C., Cumbo, E., D'Aniello, A., Deleo, F., Difrancesco, J. C., Di Giacomo, R., Di Liberto, A., Domina, E., Dono, F., Durante, V., Elia, M., Estraneo, A., Evangelista, G., Faedda, M. T., Failli, Y., Fallica, E., Fattouch, J., Ferrari, A., Ferreri, F., Fisco, G., Fonti, D., Fortunato, F., Foschi, N., Francavilla, T., Galli, R., Gazzina, S., Giallonardo, A. T., Giorgi, F. S., Giuliano, L., Habetswallner, F., Izzi, F., Kassabian, B., Labate, A., Luisi, C., Magliani, M., Maira, G., Mari, L., Marino, D., Mascia, A., Mazzeo, A., Meletti, S., Milano, C., Nilo, A., Orlando, B., Paladin, F., Pascarella, M. G., Pastori, C., Pauletto, G., Peretti, A., Perri, G., Pezzella, M., Piccioli, M., Pignatta, P., Pilolli, N., Pisani, F., Pisani, L. R., Placidi, F., Pollicino, P., Porcella, V., Pradella, S., Puligheddu, M., Quadri, S., Quarato, P. P., Quintas, R., Renna, R., Rizzo, G. R., Rum, A., Salamone, E. M., Savastano, E., Sessa, M., Stokelj, D., Tartara, E., Tombini, M., Tumminelli, G., Vaudano, A. E., Ventura, M., Vigano, I., Viglietta, E., Vignoli, A., Villani, F., Zambrelli, E., Zummo, L., Lattanzi, Simona, Canafoglia, Laura, Canevini, Maria Paola, Casciato, Sara, Cerulli Irelli, Emanuele, Chiesa, Valentina, Dainese, Filippo, De Maria, Giovanni, Didato, Giuseppe, Di Gennaro, Giancarlo, Falcicchio, Giovanni, Fanella, Martina, Ferlazzo, Edoardo, Gangitano, Massimo, La Neve, Angela, Mecarelli, Oriano, Montalenti, Elisa, Morano, Alessandra, Piazza, Federico, Pizzanelli, Chiara, Pulitano, Patrizia, Ranzato, Federica, Rosati, Eleonora, Tassi, Laura, and Di Bonaventura, Carlo

Subjects
Antiseizure medication, Focal seizures, Brivaracetam, Epilepsy, Neurology, Settore MED/26 - Neurologia, Neurology (clinical), Settore MED/26, Settore MED/39 - Neuropsichiatria Infantile
Abstract

Introduction: In randomized controlled trials, add-on brivaracetam (BRV) reduced seizure frequency in patients with drug-resistant focal epilepsy. Most real-world research on BRV has focused on refractory epilepsy. The aim of this analysis was to assess the 12-month effectiveness and tolerability of adjunctive BRV when used as early or late adjunctive treatment in patients included in the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST). Methods: BRIVAFIRST was a 12-month retrospective, multicenter study including adult patients prescribed adjunctive BRV. Effectiveness outcomes included the rates of sustained seizure response, sustained seizure freedom, and treatment discontinuation. Safety and tolerability outcomes included the rate of treatment discontinuation due to adverse events (AEs) and the incidence of AEs. Data were compared for patients treated with add-on BRV after 1-2 (early add-on) and ≥ 3 (late add-on) prior antiseizure medications. Results: A total of 1029 patients with focal epilepsy were included in the study, of whom 176 (17.1%) received BRV as early add-on treatment. The median daily dose of BRV at 12months was 125 (100-200) mg in the early add-on group and 200 (100-200) in the late add-on group (p

Published
2022

4. Adjunctive Brivaracetam in Focal Epilepsy: Real-World Evidence from the BRIVAracetam add-on First Italian netwoRk STudy (BRIVAFIRST)

Author

Lattanzi, S., Canafoglia, L., Canevini, M. P., Casciato, S., Chiesa, V., Dainese, F., De Maria, G., Didato, G., Falcicchio, G., Fanella, M., Ferlazzo, E., Fisco, G., Gangitano, M., Giallonardo, A. T., Giorgi, F. S., La Neve, A., Mecarelli, O., Montalenti, E., Piazza, F., Pulitano, P., Quarato, P. P., Ranzato, F., Rosati, E., Tassi, L., Di Bonaventura, C., Alicino, A., Ascoli, M., Assenza, G., Avorio, F., Badioni, V., Banfi, P., Bartolini, E., Basili, L. M., Belcastro, V., Beretta, S., Berto, I., Biggi, M., Billo, G., Boero, G., Bonanni, P., Bongorno, J., Brigo, F., Caggia, E., Cagnetti, C., Calvello, C., Irelli, E. C., Cesnik, E., Chianale, G., Ciampanelli, D., Ciuffini, R., Cocito, D., Colella, D., Contento, M., Costa, C., Cumbo, E., D'Aniello, A., Deleo, F., Difrancesco, J. C., Di Gennaro, G., Di Giacomo, R., Di Liberto, A., Domina, E., Donato, F., Dono, F., Durante, V., Elia, M., Estraneo, A., Evangelista, G., Faedda, M. T., Failli, Y., Fallica, E., Fattouch, J., Ferrari, A., Ferreri, F., Fonti, D., Fortunato, F., Foschi, N., Francavilla, T., Galli, R., Gazzina, S., Giuliano, L., Habetswallner, F., Izzi, F., Kassabian, B., Labate, A., Luisi, C., Magliani, M., Maira, G., Mari, L., Marino, D., Mascia, A., Mazzeo, A., Meletti, S., Morano, A., Nilo, A., Orlando, B., Paladin, F., Pascarella, M. G., Pastori, C., Pauletto, G., Peretti, A., Perri, G., Pezzella, M., Piccioli, M., Pignatta, P., Pilolli, N., Pisani, F., Pisani, L. R., Placidi, F., Pollicino, P., Porcella, V., Pradella, S., Puligheddu, M., Quadri, S., Quintas, R., Renna, R., Rossi, J., Rum, A., Salamone, E. M., Savastano, E., Sessa, M., Stokelj, D., Tartara, E., Tombini, M., Tumminelli, G., Ventura, M., Vigano, I., Viglietta, E., Vignoli, A., Villani, F., Zambrelli, E., Zummo, L., Lattanzi S., Canafoglia L., Canevini M.P., Casciato S., Chiesa V., Dainese F., De Maria G., Didato G., Falcicchio G., Fanella M., Ferlazzo E., Fisco G., Gangitano M., Giallonardo A.T., Giorgi F.S., La Neve A., Mecarelli O., Montalenti E., Piazza F., Pulitano P., Quarato P.P., Ranzato F., Rosati E., Tassi L., and Di Bonaventura C.

Subjects
medicine.medical_specialty, business.industry, Context (language use), Brivaracetam, medicine.disease, Discontinuation, law.invention, Psychiatry and Mental health, Epilepsy, Randomized controlled trial, Tolerability, focal epilepsy, add-on therapy, seizure, law, Concomitant, Internal medicine, Medicine, Pharmacology (medical), Neurology (clinical), Levetiracetam, Original Research Article, business, medicine.drug
Abstract

Background: In randomized controlled trials, add-on brivaracetam (BRV) reduced seizure frequency in patients with drug-resistant focal epilepsy. Studies performed in a naturalistic setting are a useful complement to characterize the drug profile. Objective: This multicentre study assessed the effectiveness and tolerability of adjunctive BRV in a large population of patients with focal epilepsy in the context of real-world clinical practice. Methods: The BRIVAFIRST (BRIVAracetam add-on First Italian netwoRk STudy) was a retrospective, multicentre study including adult patients prescribed adjunctive BRV. Patients with focal epilepsy and 12-month follow-up were considered. Main outcomes included the rates of seizure‐freedom, seizure response (≥50% reduction in baseline seizure frequency), and treatment discontinuation. The incidence of adverse events (AEs) was also considered. Analyses by levetiracetam (LEV) status and concomitant use of strong enzyme-inducing antiseizure medications (EiASMs) and sodium channel blockers (SCBs) were performed. Results: A total of 1029 patients with a median age of 45years (33–56) was included. At 12 months, 169 (16.4%) patients were seizure-free and 383 (37.2%) were seizure responders. The rate of seizure freedom was 22.3% in LEV-naive patients, 7.1% in patients with prior LEV use and discontinuation due to insufficient efficacy, and 31.2% in patients with prior LEV use and discontinuation due to AEs (p&nbsp

Published
2021

5. Correction to: Adjunctive Brivaracetam in Focal Epilepsy: Real‑World Evidence from the BRIVAracetam add‑on First Italian netwoRk Study (BRIVAFIRST) (CNS Drugs, (2021), 35, 12, (1289-1301), 10.1007/s40263-021-00856-3)

Author

Lattanzi, S., Canafoglia, L., Canevini, M. P., Casciato, S., Chiesa, V., Dainese, F., De Maria, G., Didato, G., Falcicchio, G., Fanella, M., Ferlazzo, E., Fisco, G., Gangitano, M., Giallonardo, A. T., Giorgi, F. S., La Neve, A., Mecarelli, O., Montalenti, E., Piazza, F., Pulitano, P., Quarato, P. P., Ranzato, F., Rosati, E., Tassi, L., Di Bonaventura, C., Alicino, A., Ascoli, M., Assenza, G., Avorio, F., Badioni, V., Banfi, P., Bartolini, E., Basili, L. M., Belcastro, V., Beretta, S., Berto, I., Biggi, M., Billo, G., Boero, G., Bonanni, P., Bongorno, J., Brigo, F., Caggia, E., Cagnetti, C., Calvello, C., Irelli, E. C., Cesnik, E., Chianale, G., Ciampanelli, D., Ciuffini, R., Cocito, D., Colella, D., Contento, M., Costa, C., Cumbo, E., D'Aniello, A., Deleo, F., Difrancesco, J. C., Gennaro, G., Di Giacomo, R., Di Liberto, A., Domina, E., Donato, F., Dono, F., Durante, V., Elia, M., Estraneo, A., Evangelista, G., Faedda, M. T., Failli, Y., Fallica, E., Fattouch, J., Ferrari, A., Ferreri, F., Fonti, D., Fortunato, F., Foschi, N., Francavilla, T., Galli, R., Gazzina, S., Giuliano, L., Habetswallner, F., Izzi, F., Kassabian, B., Labate, A., Luisi, C., Magliani, M., Maira, G., Mari, L., Marino, D., Mascia, A., Mazzeo, A., Meletti, S., Morano, A., Nilo, A., Orlando, B., Paladin, F., Pascarella, M. G., Pastori, C., Pauletto, G., Peretti, A., Perri, G., Pezzella, M., Piccioli, M., Pignatta, P., Pilolli, N., Pisani, F., Pisani, L. R., Placidi, F., Pollicino, P., Porcella, V., Pradella, S., Puligheddu, M., Quadri, S., Quintas, R., Renna, R., Rossi, J., Rum, A., Salamone, E. M., Savastano, E., Sessa, M., Stokelj, D., Tartara, E., Tombini, M., Tumminelli, G., Ventura, M., Vigano, I., Viglietta, E., Vignoli, A., Villani, F., Zambrelli, E., and Zummo, L.

Published
2021

6. Correction to: Adjunctive Brivaracetam in Focal Epilepsy: Real‑World Evidence from the BRIVAracetam add‑on First Italian netwoRk Study (BRIVAFIRST) (CNS Drugs, (2021), 10.1007/s40263-021-00856-3)

Author

Lattanzi, S., Canafoglia, L., Canevini, M. P., Casciato, S., Chiesa, V., Dainese, F., De Maria, G., Didato, G., Falcicchio, G., Fanella, M., Ferlazzo, E., Fisco, G., Gangitano, M., Giallonardo, A. T., Giorgi, F. S., La Neve, A., Mecarelli, O., Montalenti, E., Piazza, F., Pulitano, P., Quarato, P. P., Ranzato, F., Rosati, E., Tassi, L., Di Bonaventura, C., Alicino, A., Ascoli, M., Assenza, G., Avorio, F., Badioni, V., Banfi, P., Bartolini, E., Basili, L. M., Belcastro, V., Beretta, S., Berto, I., Biggi, M., Billo, G., Boero, G., Bonanni, P., Bongorno, J., Brigo, F., Caggia, E., Cagnetti, C., Calvello, C., Irelli, E. C., Cesnik, E., Chianale, G., Ciampanelli, D., Ciuffini, R., Cocito, D., Colella, D., Contento, M., Costa, C., Cumbo, E., D'Aniello, A., Deleo, F., Difrancesco, J. C., Gennaro, G., Di Giacomo, R., Di Liberto, A., Domina, E., Donato, F., Dono, F., Durante, V., Elia, M., Estraneo, A., Evangelista, G., Faedda, M. T., Failli, Y., Fallica, E., Fattouch, J., Ferrari, A., Ferreri, F., Fonti, D., Fortunato, F., Foschi, N., Francavilla, T., Galli, R., Gazzina, S., Giuliano, L., Habetswallner, F., Izzi, F., Kassabian, B., Labate, A., Luisi, C., Magliani, M., Maira, G., Mari, L., Marino, D., Mascia, A., Mazzeo, A., Meletti, S., Morano, A., Nilo, A., Orlando, B., Paladin, F., Pascarella, M. G., Pastori, C., Pauletto, G., Peretti, A., Perri, G., Pezzella, M., Piccioli, M., Pignatta, P., Pilolli, N., Pisani, F., Pisani, L. R., Placidi, F., Pollicino, P., Porcella, V., Pradella, S., Puligheddu, M., Quadri, S., Quintas, R., Renna, R., Rossi, J., Rum, A., Salamone, E. M., Savastano, E., Sessa, M., Stokelj, D., Tartara, E., Tombini, M., Tumminelli, G., Ventura, M., Vigano, I., Viglietta, E., Vignoli, A., Villani, F., Zambrelli, E., and Zummo, L.

Published
2021

7. Temporal lobe epilepsy surgery in children and adults: A multicenter study

Author

Barba, C., Cossu, M., Guerrini, R., Di Gennaro, G., Villani, F., De Palma, L., Grisotto, L., Consales, A., Battaglia, Domenica Immacolata, Zamponi, N., D'Orio, P., Revay, M., Rizzi, M., Casciato, S., Esposito, V., Quarato, P. P., Di Giacomo, R., Didato, G., Pastori, C., Pavia, G. C., Pellacani, S., Matta, G., Pacetti, M., Tamburrini, Gianpiero, Cesaroni, E., Colicchio, G., Vatti, G., Asioli, S., Caulo, M., Marras, C. E., Tassi, L., D'Aniello, Aleandra, Morace, R., De Curtis, M., Deleo, F., Giordano, F., De Benedictis, Anna, Prato, G., Perulli, Marco, Battaglia D. (ORCID:0000-0003-0491-4021), Tamburrini G. (ORCID:0000-0002-7139-5711), D'Aniello A., De Benedictis A., Perulli M., Barba, C., Cossu, M., Guerrini, R., Di Gennaro, G., Villani, F., De Palma, L., Grisotto, L., Consales, A., Battaglia, Domenica Immacolata, Zamponi, N., D'Orio, P., Revay, M., Rizzi, M., Casciato, S., Esposito, V., Quarato, P. P., Di Giacomo, R., Didato, G., Pastori, C., Pavia, G. C., Pellacani, S., Matta, G., Pacetti, M., Tamburrini, Gianpiero, Cesaroni, E., Colicchio, G., Vatti, G., Asioli, S., Caulo, M., Marras, C. E., Tassi, L., D'Aniello, Aleandra, Morace, R., De Curtis, M., Deleo, F., Giordano, F., De Benedictis, Anna, Prato, G., Perulli, Marco, Battaglia D. (ORCID:0000-0003-0491-4021), Tamburrini G. (ORCID:0000-0002-7139-5711), D'Aniello A., De Benedictis A., and Perulli M.

Abstract

Objective: To assess seizure and cognitive outcomes and their predictors in children (<16 years at surgery) and adults undergoing temporal lobe epilepsy (TLE) surgery in eight Italian centers. Methods: This is a retrospective multicenter study. We performed a descriptive analysis and subsequently carried out multivariable mixed-effect models corrected for multiple comparisons. Results: We analyzed data from 511 patients (114 children) and observed significant differences in several clinical features between adults and children. The possibility of achieving Engel class IA outcome and discontinuing antiepileptic drugs (AEDs) at last follow-up (FU) was significantly higher in children (P =.006 and <.0001). However, percentages of children and adults in Engel class I at last FU (mean ± SD, 45.9 ± 17 months in children; 45.9 ± 20.6 months in adults) did not differ significantly. We identified different predictors of seizure outcome in children vs adults and at short- vs long-term FU. The only variables consistently associated with class I outcome over time were postoperative electroencephalography (EEG) in adults (abnormal, improved,odds ratio [OR] = 0.414, P =.023, Q = 0.046 vs normal, at 2-year FU and abnormal, improved, OR = 0.301, P =.001, Q = 0.002 vs normal, at last FU) and the completeness of resection of temporal magnetic resonance (MR) abnormalities other than hippocampal sclerosis in children (OR = 7.93, P =.001, Q = 0.003, at 2-year FU and OR = 45.03, P <.0001, Q < 0.0001, at last FU). Cognitive outcome was best predicted by preoperative performances in either age group. Significance: Clinical differences between adult and pediatric patients undergoing TLE surgery are reflected in differences in long-term outcomes and predictors of failures. Children are more likely to achieve sustained seizure freedom and withdraw AEDs after TLE surgery. E

Published
2021

13. HCN ion channels and accessory proteins in epilepsy: genetic analysis of a large cohort of patients and review of the literature

Author

Difrancesco, J, Castellotti, B, Milanesi, R, Ragona, F, Freri, E, Canafoglia, L, Franceschetti, S, Ferrarese, C, Magri, S, Taroni, F, Costa, C, Labate, A, Gambardella, A, Solazzi, R, Binda, A, Rivolta, I, Di Gennaro, G, Casciato, S, D'Incerti, L, Barbuti, A, Difrancesco, D, Granata, T, Gellera, C, DiFrancesco, Jacopo C., Castellotti, Barbara, Milanesi, Raffaella, Ragona, Francesca, Freri, Elena, Canafoglia, Laura, Franceschetti, Silvana, Ferrarese, Carlo, Magri, Stefania, Taroni, Franco, Costa, Cinzia, Labate, Angelo, Gambardella, Antonio, Solazzi, Roberta, Binda, Anna, Rivolta, Ilaria, Di Gennaro, Giancarlo, Casciato, Sara, D'Incerti, Ludovico, Barbuti, Andrea, DiFrancesco, Dario, Granata, Tiziana, Gellera, Cinzia, Difrancesco, J, Castellotti, B, Milanesi, R, Ragona, F, Freri, E, Canafoglia, L, Franceschetti, S, Ferrarese, C, Magri, S, Taroni, F, Costa, C, Labate, A, Gambardella, A, Solazzi, R, Binda, A, Rivolta, I, Di Gennaro, G, Casciato, S, D'Incerti, L, Barbuti, A, Difrancesco, D, Granata, T, Gellera, C, DiFrancesco, Jacopo C., Castellotti, Barbara, Milanesi, Raffaella, Ragona, Francesca, Freri, Elena, Canafoglia, Laura, Franceschetti, Silvana, Ferrarese, Carlo, Magri, Stefania, Taroni, Franco, Costa, Cinzia, Labate, Angelo, Gambardella, Antonio, Solazzi, Roberta, Binda, Anna, Rivolta, Ilaria, Di Gennaro, Giancarlo, Casciato, Sara, D'Incerti, Ludovico, Barbuti, Andrea, DiFrancesco, Dario, Granata, Tiziana, and Gellera, Cinzia

Abstract

The Hyperpolarization-activated Cyclic Nucleotide-gated (HCN) channels are highly expressed in the Central Nervous Systems, where they are responsible for the I h current. Together with specific accessory proteins, these channels finely regulate neuronal excitability and discharge activity. In the last few years, a substantial body of evidence has been gathered showing that modifications of I h can play an important role in the pathogenesis of epilepsy. However, the extent to which HCN dysfunction is spread among the epileptic population is still unknown. The aim of this work is to evaluate the impact of genetic mutations potentially affecting the HCN channels’ activity, using a NGS approach. We screened a large cohort of patients with epilepsy of unknown etiology for mutations in HCN1, HCN2 and HCN4 and in genes coding for accessory proteins (MiRP1, Filamin A, Caveolin-3, TRIP8b, Tamalin, S-SCAM and Mint2). We confirmed the presence of specific mutations of HCN genes affecting channel function and predisposing to the development of the disease. We also found several previously unreported additional genetic variants, whose contribution to the phenotype remains to be clarified. According to these results and data from literature, alteration of HCN1 channel function seems to play a major role in epilepsy, but also dysfunctional HCN2 and HCN4 channels can predispose to the development of the disease. Our findings suggest that inclusion of the genetic screening of HCN channels in diagnostic procedures of epileptic patients should be recommended. This would help pave the way for a better understanding of the role played by I h dysfunction in the pathogenesis of epilepsy.

Published
2019

15. Behavioral and Movement Disorders due to Long-Lasting Myoclonic Status Epilepticus Misdiagnosed as ADHD in a Patient with Juvenile Myoclonic Epilepsy

Author

Fanella, Martina, Carnì, Marco, Morano, Alessandra, Albini, Mariarita, Lapenta, Leonardo, Casciato, S. A. R. A., Fattouch, Jinane, Di Castro, Elisabetta, Colonnese, Claudio, Vaudano, Anna Elisabetta, Giallonardo, Anna Teresa, and Di Bonaventura, Carlo

Subjects
attention-deficit/hyperactivity disorder, juvenile myoclonic epilepsy, long-lasting myoclonic status epilepticus, Attention Deficit Disorder with Hyperactivity, Brain Mapping, Child, Diagnosis, Differential, Electroencephalography, Epilepsies, Myoclonic, False Negative Reactions, Humans, Male, Mental Disorders, Movement Disorders, Neurology, Neurology (clinical)
Published
2016

16. A case of epilepsia partialis continua of abdominal muscles after brain tumor surgery.

Author

CASCIATO, S., MASCIA, A., D'ANIELLO, A., QUARATO, P. P., GRAMMALDO, L. G., SCOPPETTA, C., ALOJ, F., PAOLINI, S., and DI GENNARO, G.

Abstract

Epilepsia partialis continua (EPC) is a rare form of focal motor status epilepticus characterized by continuous muscular twitches or jerks involving a limited part of the body, usually facial region and distal limb. Although the cerebrovascular disease is known to be one of the most common causes of this condition, other reported cases with predominant abdominal involvement have different aetiologies, including, tumors, focal cortical dysplasia, and central nervous system infections. No cases of epilepsia partialis continua of the abdominal wall occurred after brain surgery have been previously reported. We describe the clinical, electrophysiological, and neuroimaging findings in an adult patient presenting with persistent unilateral abdominal myoclonus configuring an EPC as the evolution of a super-refractory hemibody convulsive status epilepticus, occurred after brain tumor surgery. [ABSTRACT FROM AUTHOR]

Published
2019

19. Acute psychiatric presentation of steroid-responsive encephalopathy: the under recognized side of autoimmune thyroiditis

Author

Carlone, C., Todini, L., Marini, I., Majorana, M., Casciato, S., Giallonardo, A. T., Pallagrosi, M., Salviati, M., and massimo biondi

Subjects
Brain Diseases, Acute Disease, brain diseases, diagnosis, humans, basedow-graves disease, brief psychiatric rating scale, steroid responsive encephalopathy associated with autoimmune thyroiditis, child, female, acute disease, autoimmune thyroiditis, basedow- graves disease, hashimoto disease, hashimoto encephalopathy, Encephalitis, Humans, Female, Hashimoto Disease, Child
Abstract

Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), also known as Hashimoto encephalopathy, represents a rare disorder of presumed autoimmune origins that can be diagnosed when a protean variety of psychiatric symptoms are present in association with elevated titers of anti-thyroid antibodies. Symptoms can have a rapid and complete remission with corticosteroid treatment. A 19-year-old girl, with clinical history of Basedow-Graves disease, has been admitted to our department after presenting acute psychiatric symptomatology. Clinical and serological findings were used to formulate the diagnosis of SREAT, confirmed by subsequent positive response to corticosteroid treatment. SREAT can mimic an acute psychiatric symptomatology, thus it seems extremely relevant for psychiatrists to consider this syndrome in differential diagnosis algorithm, especially in those patients presenting a history of autoimmune thyroid disorder, in order to ensure adequate diagnosis and treatment.

Published
2013

22. The preferential mGlu2/3 receptor antagonist, LY341495, reduces the frequency of spike-wave discharges in the WAG/Rij rat model of absence epilepsy

Author

Ngomba, R.T., Biagioni, F., Casciato, S., Willems-van Bree, P.C.M., Battaglia, G., Bruno, V., Nicoletti, F., Luijtelaar, E.L.J.M. van, Ngomba, R.T., Biagioni, F., Casciato, S., Willems-van Bree, P.C.M., Battaglia, G., Bruno, V., Nicoletti, F., and Luijtelaar, E.L.J.M. van

Abstract

Contains fulltext : 54749.pdf (publisher's version ) (Closed access), We examined the expression and function of group-II metabotropic glutamate (mGlu) receptors in an animal model of absence seizures using genetically epileptic WAG/Rij rats, which develop spontaneous non-convulsive seizures after 2-3 months of age. Six-month-old WAG/Rij rats showed an increased expression of mGlu2/3 receptors in the ventrolateral regions of the somatosensory cortex, ventrobasal thalamic nuclei, and hippocampus, but not in the reticular thalamic nucleus and in the corpus striatum, as assessed by immunohistochemistry and Western blotting. In contrast, mGlu2/3 receptor signalling was reduced in slices prepared from the somatosensory cortex of 6-month-old WAG/Rij rats, as assessed by the ability of the agonist, LY379268, to inhibit forskolin-stimulated cAMP formation. None of these changes was found in "pre-symptomatic" 2-month-old WAG/Rij rats. To examine whether pharmacological activation or inhibition of mGlu2/3 receptors affects absence seizures, we recorded spontaneous spike-wave discharges (SWDs) in 6-month-old WAG/Rij rats systemically injected with saline, the mGlu2/3 receptor agonist LY379268 (0.33 or 1 mg/kg, i.p.), or with the preferential mGlu2/3 receptor antagonist, LY341495 (0.33, 1 or 5 mg/kg, i.p.). Injection of 1 mg/kg of LY379268 (1 mg/kg, i.p.) increased the number of SWDs during 3-7 h post-treatment, whereas injection with LY341495 reduced the number of seizures in a dose-dependent manner. It can be concluded that mGlu2/3 receptors are involved in the generation of SWDs and that an upregulation of these receptors in the somatosensory cortex might be involved in the pathogenesis of absence epilepsy.

Published
2005

25. Driving and Seizures Interview

Author

Fattouch, J., primary, Di Bonaventura, C., additional, Lapenta, L., additional, Casciato, S., additional, Fanella, M., additional, Morano, A., additional, Manfredi, M., additional, and Giallonardo, A. T., additional

Published
2012
Full Text
View/download PDF

26. Subacute cerebellar ataxia as presenting symptom of systemic lupus erythematosus.

Author

CASCIATO, S., MASCIA, A., QUARATO, P. P., D'ANIELLO, A., SCOPPETTA, C., and DI GENNARO, G.

Abstract

Neuropsychiatric manifestations are commonly observed in systemic lupus erythematosus (SLE) patients. In particular, neurological involvement is known to be more common in patients with positive anticardiolipin antibodies and lupus anticoagulants. Nevertheless, cerebellar ataxia has rarely been reported, especially as the first clinical manifestation of this systemic autoimmune disorder. Cerebral vascular infarction or ischemia, vasogenic oedema and antibody-mediated cerebral vasculopathy or vasculitic process have been supposed as possible aetiologies of acute cerebellar ataxia related to SLE. We report the clinical and radiological features of a woman who developed a rapidly progressive cerebellar syndrome as first sign of SLE; no other cause explaining her cerebellar ataxia was found. The patient improved after high-dose steroids. The appearance of a cerebellar syndrome with unknown aetiology with associated features of possible systemic autoimmune dysfunction, should be taken into account in clinical practice for appropriate diagnostic workup in order to provide effective therapeutic options. [ABSTRACT FROM AUTHOR]

Published
2018

27. Lethality rate of the two waves of the COVID-19 pandemic in Italy.

Author

Scoppetta, C., Casciato, S., and Di Gennaro, G.

Abstract

The article offers information on lethality rate of the two waves of the COVID-19 pandemic in Italy. Topics include the virus can act as an explosive fuse triggering a devastating cascade of autoimmune, inflammatory and dyscoagulative events, and the subjects fragile for health problems in whom phenomena of pulmonary vasculitis and thromboembolism can result in a severe or fatal outcome.

Published
2021

28. Ictal haemodynamic changes in a patient affected by "subtle" Epilepsia Partialis Continua.

Author

Vaudano AE, Di Bonaventura C, Carni M, Rodionov R, Lapenta L, Casciato S, Fattouch J, Egeo G, Pantano P, Nucciarelli V, Maraviglia B, Prencipe M, Lemieux L, Giallonardo AT, Vaudano, Anna Elisabetta, Di Bonaventura, Carlo, Carni, Marco, Rodionov, Roman, Lapenta, Leonardo, and Casciato, Sara

Abstract

We report on a 64 year-old woman presenting with Epilepsia Partialis Continua (EPC) affecting the left hand since the age of 24 without neurological deficit. Structural MRI showed a region of focal cortical dysplasia (FCD) over the right central gyrus and lesions in the mesial frontal and occipital cortex secondary to perinatal hypoxic injury. Ictal spike haemodynamic mapping using simultaneous EEG-fMRI revealed significant BOLD signal changes prominent in the region of FCD (larger cluster), occipital cortex (global statistical maximum), prefrontal cortex and cerebellum. The cluster over FCD was in good agreement with the result of EEG source analysis. Our findings provide an interesting illustration of the ability of EEG-fMRI to reveal epileptogenic networks confirming the intrinsic epileptogenic properties of dysplastic neurons. [ABSTRACT FROM AUTHOR]

Published
2012
Full Text
View/download PDF

35. The preferential mGlu2/3 receptor antagonist, LY341495, reduces the frequency of spike-wave discharges in the WAG/Rij rat model of absence epilepsy

Author

Ngomba, R. T., Biagioni, F., Casciato, S., Willems-Van Bree, E., Battaglia, G., Bruno, V., Nicoletti, F., Van Luijtelaar, E. L. J. M., Ngomba, R. T., Biagioni, F., Casciato, S., Willems-Van Bree, E., Battaglia, G., Bruno, V., Nicoletti, F., and Van Luijtelaar, E. L. J. M.

Abstract

We examined the expression and function of group-II metabotropic glutamate (mGlu) receptors in an animal model of absence seizures using genetically epileptic WAG/Rij rats, which develop spontaneous non-convulsive seizures after 2–3 months of age. Six-month-old WAG/Rij rats showed an increased expression of mGlu2/3 receptors in the ventrolateral regions of the somatosensory cortex, ventrobasal thalamic nuclei, and hippocampus, but not in the reticular thalamic nucleus and in the corpus striatum, as assessed by immunohistochemistry and Western blotting. In contrast, mGlu2/3 receptor signalling was reduced in slices prepared from the somatosensory cortex of 6-month-old WAG/Rij rats, as assessed by the ability of the agonist, LY379268, to inhibit forskolin-stimulated cAMP formation. None of these changes was found in “pre-symptomatic” 2-month-old WAG/Rij rats. To examine whether pharmacological activation or inhibition of mGlu2/3 receptors affects absence seizures, we recorded spontaneous spike–wave discharges (SWDs) in 6-month-old WAG/Rij rats systemically injected with saline, the mGlu2/3 receptor agonist LY379268 (0.33 or 1 mg/kg, i.p.), or with the preferential mGlu2/3 receptor antagonist, LY341495 (0.33, 1 or 5 mg/kg, i.p.). Injection of 1 mg/kg of LY379268 (1 mg/kg, i.p.) increased the number of SWDs during 3–7 h post-treatment, whereas injection with LY341495 reduced the number of seizures in a dose-dependent manner. It can be concluded that mGlu2/3 receptors are involved in the generation of SWDs and that an upregulation of these receptors in the somatosensory cortex might be involved in the pathogenesis of absence epilepsy.

37. Efficient automated localization of ECoG electrodes in CT images via shape analysis

Author

Roberta Morace, Giancarlo Di Gennaro, Antonio Sarno, Jessica Centracchio, Marcello Bartolo, Sara Casciato, Emilio Andreozzi, Luigi Pavone, Paolo Bifulco, Vincenzo Esposito, Daniele Esposito, Centracchio, J., Sarno, A., Esposito, D., Andreozzi, E., Pavone, L., Di Gennaro, G., Bartolo, M., Esposito, V., Morace, R., Casciato, S., and Bifulco, P.

Subjects
0301 basic medicine, Male, Drug Resistant Epilepsy, Support Vector Machine, Computer science, Electrode, Normal Distribution, computer.software_genre, Pattern Recognition, Automated, 0302 clinical medicine, Retrospective Studie, Voxel, Image Processing, Computer-Assisted, Epilepsy surgery, Electrocorticography, medicine.diagnostic_test, Electroencephalography, General Medicine, Middle Aged, Computer Graphics and Computer-Aided Design, Thresholding, Shape analysis, Computer Science Applications, Electrodes, Implanted, Gaussian Support Vector Machine, CT image processing, Original Article, Female, Computer Vision and Pattern Recognition, Human, Shape analysis (digital geometry), Adult, Similarity (geometry), Biomedical Engineering, Health Informatics, 03 medical and health sciences, Young Adult, medicine, Humans, Radiology, Nuclear Medicine and imaging, Electrodes, Retrospective Studies, Shape analysi, business.industry, Pattern recognition, Electrodes recognition, Support vector machine, 030104 developmental biology, ElectroCorticoGraphy, Surgery, Artificial intelligence, business, Tomography, X-Ray Computed, computer, 030217 neurology & neurosurgery, Software
Abstract

Purpose People with drug-refractory epilepsy are potential candidates for surgery. In many cases, epileptogenic zone localization requires intracranial investigations, e.g., via ElectroCorticoGraphy (ECoG), which uses subdural electrodes to map eloquent areas of large cortical regions. Precise electrodes localization on cortical surface is mandatory to delineate the seizure onset zone. Simple thresholding operations performed on patients’ computed tomography (CT) volumes recognize electrodes but also other metal objects (e.g., wires, stitches), which need to be manually removed. A new automated method based on shape analysis is proposed, which provides substantially improved performances in ECoG electrodes recognition. Methods The proposed method was retrospectively tested on 24 CT volumes of subjects with drug-refractory focal epilepsy, presenting a large number (> 1700) of round platinum electrodes. After CT volume thresholding, six geometric features of voxel clusters (volume, symmetry axes lengths, circularity and cylinder similarity) were used to recognize the actual electrodes among all metal objects via a Gaussian support vector machine (G-SVM). The proposed method was further tested on seven CT volumes from a public repository. Simultaneous recognition of depth and ECoG electrodes was also investigated on three additional CT volumes, containing penetrating depth electrodes. Results The G-SVM provided a 99.74% mean classification accuracy across all 24 single-patient datasets, as well as on the combined dataset. High accuracies were obtained also on the CT volumes from public repository (98.27% across all patients, 99.68% on combined dataset). An overall accuracy of 99.34% was achieved for the recognition of depth and ECoG electrodes. Conclusions The proposed method accomplishes automated ECoG electrodes localization with unprecedented accuracy and can be easily implemented into existing software for preoperative analysis process. The preliminary yet surprisingly good results achieved for the simultaneous depth and ECoG electrodes recognition are encouraging. Ethical approval n°NCT04479410 by “IRCCS Neuromed” (Pozzilli, Italy), 30th July 2020.

Published
2021

38. Adjunctive Brivaracetam in Older Patients with Focal Seizures: Evidence from the BRIVAracetam add‑on First Italian netwoRk Study (BRIVAFIRST)

Author

Simona Lattanzi, 1, Michele Ascoli, 2, Laura Canafoglia, 3, 4 5, Maria Paola Canevini, Sara Casciato, 6, Emanuele Cerulli Irelli, 7, Valentina Chiesa, 4, Filippo Dainese, 8, Giovanni De Maria, 9, Giuseppe Didato 10, Giancarlo Di Gennaro, 6, Giovanni Falcicchio 11, Martina Fanella, 7, Massimo Gangitano 12, Angela La Neve 11, Oriano Mecarelli, 7, Elisa Montalenti 13, Alessandra Morano, 7, Federico Piazza 14, Chiara Pizzanelli 15, Patrizia Pulitano, 7, Federica Ranzato 16, Eleonora Rosati 17, Laura Tassi 18, Carlo Di Bonaventura, 7, BRIVAFIRST Group Collaborators, Affiliations collapse Collaborators BRIVAFIRST Group: Angela Alicino, Giovanni, Assenza, Federica, Avorio, Valeria, Badioni, Paola, Banfi, Emanuele, Bartolini, Luca Manfredi Basili, Vincenzo, Belcastro, Simone, Beretta, Irene, Berto, Martina, Biggi, Giuseppe, Billo, Giovanni, Boero, Paolo, Bonanni, Jole, Bongiorno, Francesco, Brigo, Emanuele, Caggia, Claudia, Cagnetti, Carmen, Calvello, Edward, Cesnik, Gigliola, Chianale, Domenico, Ciampanelli, Roberta, Ciuffini, Dario, Cocito, Donato, Colella, Margerita, Contento, Cinzia, Costa, Eduardo, Cumbo, Alfredo, D'Aniello, Francesco, Deleo, Jacopo, C DiFrancesco, Roberta Di Giacomo, Alessandra Di Liberto, Elisabetta, Domina, Francesco, Donato, Fedele, Dono, Vania, Durante, Maurizio, Elia, Anna, Estraneo, Giacomo, Evangelista, Maria Teresa Faedda, Ylenia, Failli, Elisa, Fallica, Jinane, Fattouch, Alessandra, Ferrari, Ferreri, Florinda, Giacomo, Fisco, Davide, Fonti, Francesco, Fortunato, Nicoletta, Foschi, Teresa, Francavilla, Rosita, Galli, Sara, Gasparini, Stefano, Gazzina, Anna Teresa Giallonardo, Filippo Sean Giorgi, Loretta, Giuliano, Francesco, Habetswallner, Francesca, Izzi, Kassabian, Benedetta, Lorenzo, Kiferle, Angelo, Labate, Concetta, Luisi, Matteo, Magliani, Giulia, Maira, Luisa, Mari, Daniela, Marino, Addolorata, Mascia, Alessandra, Mazzeo, Stefano, Meletti, Chiara, Milano, Annacarmen, Nilo, Biagio, Orlando, Francesco, Paladin, Maria Grazia Pascarella, Chiara, Pastori, Giada, Pauletto, Alessia, Peretti, Gabriella, Perri, Marianna, Pezzella, Marta, Piccioli, Pietro, Pignatta, Nicola, Pilolli, Francesco, Pisani, Laura Rosa Pisani, Fabio, Placidi, Patrizia, Pollicino, Vittoria, Porcella, Monica, Puligheddu, Stefano, Quadri, Pier Paolo Quarato, Rui, Quintas, Rosaria, Renna, Adriana, Rum, Enrico Michele Salamone, Ersilia, Savastano, Maria, Sessa, David, Stokelj, Elena, Tartara, Mario, Tombini, Gemma, Tumminelli, Anna Elisabetta Vaudano, Ilaria, Viganò, Emanuela, Viglietta, Aglaia, Vignoli, Flavio, Villani, Elena, Zambrelli, Lelia, Zummo, Lattanzi S., Canafoglia L., Canevini M.P., Casciato S., Cerulli Irelli E., Chiesa V., Dainese F., De Maria G., Didato G., Falcicchio G., Fanella M., Ferlazzo E., Gangitano M., Giorgi F.S., La Neve A., Mecarelli O., Montalenti E., Morano A., Piazza F., Pulitano P., Quarato P.P., Ranzato F., Rosati E., Tassi L., and Di Bonaventura C.

Subjects
Antiseizure medication, Epilepsy, Settore MED/26, Pyrrolidinones, Focal seizures, Treatment Outcome, Drug Therapy, Double-Blind Method, Italy, Seizures, Brivaracetam, Combination, Aged, Drug Therapy, Combination, Humans, Retrospective Studies, Anticonvulsants, Pharmacology (medical), Settore MED/26 - Neurologia, Geriatrics and Gerontology
Abstract

BACKGROUND: The management of epilepsy in older adults has become part of daily practice because of an aging population. Older patients with epilepsy represent a distinct and more vulnerable clinical group as compared with younger patients, and they are generally under-represented in randomized placebo-controlled trials. Real-world studies can therefore be a useful complement to characterize the drug's profile. Brivaracetam is a rationally developed compound characterized by high-affinity binding to synaptic vesicle protein 2A and approved as adjunctive therapy for focal seizures in adults with epilepsy. OBJECTIVE: The aim of this study was to assess the 12-month effectiveness and tolerability of adjunctive brivaracetam in older patients (≥65 years of age) with epilepsy treated in a real-world setting. METHODS: The BRIVAFIRST (BRIVAracetam add-on First Italian netwoRk STudy) was a 12-month retrospective multicenter study including adult patients prescribed adjunctive brivaracetam. Effectiveness outcomes included the rates of seizure response (≥50% reduction in baseline seizure frequency), seizure freedom, and treatment discontinuation. Safety and tolerability outcomes included the rate of treatment discontinuation due to adverse events and the incidence of adverse events. Data were compared for patients aged ≥65 years of age ('older') vs those aged

Published
2022

39. Brivaracetam as add-on treatment in patients with post-stroke epilepsy: real-world data from the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST)

Author

Simona Lattanzi, Laura Canafoglia, Maria Paola Canevini, Sara Casciato, Emanuele Cerulli Irelli, Valentina Chiesa, Filippo Dainese, Giovanni De Maria, Giuseppe Didato, Giancarlo Di Gennaro, Giovanni Falcicchio, Martina Fanella, Edoardo Ferlazzo, Massimo Gangitano, Angela La Neve, Oriano Mecarelli, Elisa Montalenti, Alessandra Morano, Federico Piazza, Chiara Pizzanelli, Patrizia Pulitano, Federica Ranzato, Eleonora Rosati, Laura Tassi, Carlo Di Bonaventura, Angela Alicino, Michele Ascoli, Giovanni Assenza, Federica Avorio, Valeria Badioni, Paola Banfi, Emanuele Bartolini, Luca Manfredi Basili, Vincenzo Belcastro, Simone Beretta, Irene Berto, Martina Biggi, Giuseppe Billo, Giovanni Boero, Paolo Bonanni, Jole Bongorno, Francesco Brigo, Emanuele Caggia, Claudia Cagnetti, Carmen Calvello, Edward Cesnik, Gigliola Chianale, Domenico Ciampanelli, Roberta Ciuffini, Dario Cocito, Donato Colella, Margerita Contento, Cinzia Costa, Eduardo Cumbo, Alfredo D'Aniello, Francesco Deleo, Jacopo C DiFrancesco, Roberta Di Giacomo, Alessandra Di Liberto, Elisabetta Domina, Fedele Dono, Vania Durante, Maurizio Elia, Anna Estraneo, Giacomo Evangelista, Maria Teresa Faedda, Ylenia Failli, Elisa Fallica, Jinane Fattouch, Alessandra Ferrari, Florinda Ferreri, Giacomo Fisco, Davide Fonti, Francesco Fortunato, Nicoletta Foschi, Teresa Francavilla, Rosita Galli, Stefano Gazzina, Anna Teresa Giallonardo, Filippo Sean Giorgi, Loretta Giuliano, Francesco Habetswallner, Francesca Izzi, Benedetta Kassabian, Angelo Labate, Concetta Luisi, Matteo Magliani, Giulia Maira, Luisa Mari, Daniela Marino, Addolorata Mascia, Alessandra Mazzeo, Chiara Milano, Stefano Meletti, Annacarmen Nilo, Biagio Orlando, Francesco Paladin, Maria Grazia Pascarella, Chiara Pastori, Giada Pauletto, Alessia Peretti, Gabriella Perri, Marianna Pezzella, Marta Piccioli, Pietro Pignatta, Nicola Pilolli, Francesco Pisani, Laura Rosa Pisani, Fabio Placidi, Patrizia Pollicino, Vittoria Porcella, Silvia Pradella, Monica Puligheddu, Stefano Quadri, Pier Paolo Quarato, Rui Quintas, Rosaria Renna, Giada Ricciardo Rizzo, Adriana Rum, Enrico Michele Salamone, Ersilia Savastano, Maria Sessa, David Stokelj, Elena Tartara, Mario Tombini, Gemma Tumminelli, Anna Elisabetta Vaudano, Maria Ventura, Ilaria Viganò, Emanuela Viglietta, Aglaia Vignoli, Flavio Villani, Elena Zambrelli, Lelia Zummo, Lattanzi S., Canafoglia L., Canevini M.P., Casciato S., Cerulli Irelli E., Chiesa V., Dainese F., De Maria G., Didato G., Di Gennaro G., Falcicchio G., Fanella M., Ferlazzo E., Gangitano M., La Neve A., Mecarelli O., Montalenti E., Morano A., Piazza F., Pizzanelli C., Pulitano P., Ranzato F., Rosati E., Tassi L., Di Bonaventura C., Alicino A., Ascoli M., Assenza G., Avorio F., Badioni V., Banfi P., Bartolini E., Basili L.M., Belcastro V., Beretta S., Berto I., Biggi M., Billo G., Boero G., Bonanni P., Bongiorno J., Brigo F., Caggia E., Cagnetti C., Calvello C., Cesnik E., Chianale G., Ciampanelli D., Ciuffini R., Cocito D., Colella D., Contento M., Costa C., Cumbo E., D'Aniello A., Deleo F., DiFrancesco J.C., Di Giacomo R., Di Liberto A., Domina E., Dono F., Durante V., Elia M., Estraneo A., Evangelista G., Faedda M.T., Failli Y., Fallica E., Fattouch J., Ferrari A., Ferreri F., Fisco G., Fonti D., Fortunato F., Foschi N., Francavilla T., Galli R., Gazzina S., Giallonardo A.T., Giorgi F.S., Giuliano L., Habetswallner F., Izzi F., Kassabian B., Labate A., Luisi C., Magliani M., Maira G., Mari L., Marino D., Mascia A., Mazzeo A., Milano C., Meletti S., Nilo A., Orlando B., Paladin F., Pascarella M.G., Pastori C., Pauletto G., Peretti A., Perri G., Pezzella M., Piccioli M., Pignatta P., Pilolli N., Pisani F., Pisani L.R., Placidi F., Pollicino P., Porcella V., Pradella S., Puligheddu M., Quadri S., Quarato P.P., Quintas R., Renna R., Rizzo G.R., Rum A., Salamone E.M., Savastano E., Sessa M., Stokelj D., Tartara E., Tombini M., Tumminelli G., Vaudano A.E., Ventura M., Vigano I., Viglietta E., Vignoli A., Villani F., Zambrelli E., and Zummo L.

Subjects
Adult, Antiseizure medication, Brivaracetam, Cerebrovascular diseases, Focal seizures, Stroke, Settore MED/26, Antiseizure medication, Brivaracetam, Focal seizures, Stroke, Cerebrovascular diseases, Double-Blind Method, Drug Therapy, Seizures, Humans, Aged, Retrospective Studies, Epilepsy, General Medicine, Middle Aged, Pyrrolidinones, Treatment Outcome, Neurology, Italy, Combination, Anticonvulsants, Drug Therapy, Combination, Neurology (clinical)
Abstract

Objective: Post-stroke epilepsy (PSE) is one of the most common causes of acquired epilepsy and accounts for about 10-15% of all newly diagnosed epilepsy cases. However, evidence about the clinical profile of antiseizure medications in the PSE setting is currently limited. Brivaracetam (BRV) is a rationally developed compound characterized by high-affinity binding to synaptic vesicle protein 2A. The aim of this study was to assess the 12-month effectiveness and tolerability of adjunctive BRV in patients with PSE treated in a real-world setting. Methods: This was a subgroup analysis of patients with PSE included in the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST). The BRIVAFIRST was a 12-month retrospective, multicentre study including adult patients prescribed adjunctive BRV. Effectiveness outcomes included the rates of seizure response (≥50% reduction in baseline seizure frequency), seizure‐freedom, and treatment discontinuation. Safety and tolerability outcomes included the rate of treatment discontinuation due to adverse events (AEs) and the incidence of AEs. Results: Patients with PSE included in the BRIVAFIRST were 75 and had a median age of 57 (interquartile range, 42-66) years. The median daily doses of BRV at 3, 6, and 12 months from starting treatment were 100 (100-150) mg, 125 (100-200) mg and 100 (100-200) mg, respectively. At 12 months, 32 (42.7%) patients had a reduction in their baseline seizure frequency by at least 50%, and the seizure freedom rates was 26/75 (34.7%). During the 1-year study period, 10 (13.3%) patients discontinued BRV. The reasons of treatment withdrawal were insufficient efficacy in 6 (8.0%) patients and poor tolerability in 4 (5.3%) patients. Adverse events were reported by 13 (20.3%) patients and were rated as mild in 84.6% and moderate in 15.4% of cases. Significance: Adjunctive BRV was efficacious and generally well-tolerated when used in patients with PSE in clinical practice. Adjunctive BRV can be a suitable therapeutic option for patients with PSE.

Published
2022

40. Sustained seizure freedom with adjunctive brivaracetam in patients with focal onset seizures

Author

Simona Lattanzi, 1, Michele Ascoli, 2, Laura Canafoglia, 3, 4 5, Maria Paola Canevini, Sara Casciato, 6, Emanuele Cerulli Irelli, 7, Valentina Chiesa, 4, Filippo Dainese, 8, Giovanni De Maria, 9, Giuseppe Didato 10, Giancarlo Di Gennaro, 6, Giovanni Falcicchio 11, Martina Fanella, 7, Massimo Gangitano 12, Angela La Neve 11, Oriano Mecarelli, 7, Elisa Montalenti 13, Alessandra Morano, 7, Federico Piazza 14, Chiara Pizzanelli 15, Patrizia Pulitano, 7, Federica Ranzato 16, Eleonora Rosati 17, Laura Tassi 18, Carlo Di Bonaventura, 7, BRIVAFIRST Group Collaborators, Affiliations collapse Collaborators BRIVAFIRST Group: Angela Alicino, Giovanni, Assenza, Federica, Avorio, Valeria, Badioni, Paola, Banfi, Emanuele, Bartolini, Luca Manfredi Basili, Vincenzo, Belcastro, Simone, Beretta, Irene, Berto, Martina, Biggi, Giuseppe, Billo, Giovanni, Boero, Paolo, Bonanni, Jole, Bongiorno, Francesco, Brigo, Emanuele, Caggia, Claudia, Cagnetti, Carmen, Calvello, Edward, Cesnik, Gigliola, Chianale, Domenico, Ciampanelli, Roberta, Ciuffini, Dario, Cocito, Donato, Colella, Margerita, Contento, Cinzia, Costa, Eduardo, Cumbo, Alfredo, D'Aniello, Francesco, Deleo, Jacopo, C DiFrancesco, Roberta Di Giacomo, Alessandra Di Liberto, Elisabetta, Domina, Francesco, Donato, Fedele, Dono, Vania, Durante, Maurizio, Elia, Anna, Estraneo, Giacomo, Evangelista, Maria Teresa Faedda, Ylenia, Failli, Elisa, Fallica, Jinane, Fattouch, Alessandra, Ferrari, Ferreri, Florinda, Giacomo, Fisco, Davide, Fonti, Francesco, Fortunato, Nicoletta, Foschi, Teresa, Francavilla, Rosita, Galli, Sara, Gasparini, Stefano, Gazzina, Anna Teresa Giallonardo, Filippo Sean Giorgi, Loretta, Giuliano, Francesco, Habetswallner, Francesca, Izzi, Kassabian, Benedetta, Lorenzo, Kiferle, Angelo, Labate, Concetta, Luisi, Matteo, Magliani, Giulia, Maira, Luisa, Mari, Daniela, Marino, Addolorata, Mascia, Alessandra, Mazzeo, Stefano, Meletti, Chiara, Milano, Annacarmen, Nilo, Biagio, Orlando, Francesco, Paladin, Maria Grazia Pascarella, Chiara, Pastori, Giada, Pauletto, Alessia, Peretti, Gabriella, Perri, Marianna, Pezzella, Marta, Piccioli, Pietro, Pignatta, Nicola, Pilolli, Francesco, Pisani, Laura Rosa Pisani, Fabio, Placidi, Patrizia, Pollicino, Vittoria, Porcella, Monica, Puligheddu, Stefano, Quadri, Pier Paolo Quarato, Rui, Quintas, Rosaria, Renna, Adriana, Rum, Enrico Michele Salamone, Ersilia, Savastano, Maria, Sessa, David, Stokelj, Elena, Tartara, Mario, Tombini, Gemma, Tumminelli, Anna Elisabetta Vaudano, Ilaria, Viganò, Emanuela, Viglietta, Aglaia, Vignoli, Flavio, Villani, Elena, Zambrelli, Lelia, Zummo, Lattanzi S., Ascoli M., Canafoglia L., Paola Canevini M., Casciato S., Cerulli Irelli E., Chiesa V., Dainese F., De Maria G., Didato G., Di Gennaro G., Falcicchio G., Fanella M., Gangitano M., La Neve A., Mecarelli O., Montalenti E., Morano A., Piazza F., Pizzanelli C., Pulitano P., Ranzato F., Rosati E., Tassi L., and Di Bonaventura C.

Subjects
Adult, Freedom, focal seizures, Epilepsies, Settore MED/26, Double-Blind Method, Drug Therapy, antiseizure medication, brivaracetam, seizure freedom, sodium channel blockers, Drug Therapy, Combination, Humans, Middle Aged, Pyrrolidinones, Seizures, Treatment Outcome, Anticonvulsants, Epilepsies, Partial, anti-seizure medication, epilepsy, Neurology, Combination, Neurology (clinical), Partial
Abstract

The maintenance of seizure control over time is a clinical priority in patients with epilepsy. The aim of this study was to assess the sustained seizure frequency reduction with adjunctive brivaracetam (BRV) in real-world practice. Patients with focal epilepsy prescribed add-on BRV were identified. Study outcomes included sustained seizure freedom and sustained seizure response, defined as a 100% and a ≥50% reduction in baseline seizure frequency that continued without interruption and without BRV withdrawal through the 12-month follow-up. Nine hundred ninety-four patients with a median age of 45 (interquartile range = 32-56) years were included. During the 1-year study period, sustained seizure freedom was achieved by 142 (14.3%) patients, of whom 72 (50.7%) were seizure-free from Day 1 of BRV treatment. Sustained seizure freedom was maintained for ≥6, ≥9, and 12months by 14.3%, 11.9%, and 7.2% of patients from the study cohort. Sustained seizure response was reached by 383 (38.5%) patients; 236 of 383 (61.6%) achieved sustained ≥50% reduction in seizure frequency by Day 1, 94 of 383 (24.5%) by Month 4, and 53 of 383 (13.8%) by Month 7 up to Month 12. Adjunctive BRV was associated with sustained seizure frequency reduction from the first day of treatment in a subset of patients with uncontrolled focal epilepsy.

Published
2022

41. The surgical treatment of epilepsy

Author

Carmen Barba, Luca De Palma, Giampaolo Vatti, Alessandro Consales, Sofia Asioli, Massimo Cossu, Giancarlo Di Gennaro, Flavio Villani, Sara Casciato, Carlo Efisio Marras, Gabriella Colicchio, Massimo Caulo, Alessandra Morano, Nelia Zamponi, Laura Tassi, Consales A., Casciato S., Asioli S., Barba C., Caulo M., Colicchio G., Cossu M., de Palma L., Morano A., Vatti G., Villani F., Zamponi N., Tassi L., Di Gennaro G., and Marras C.E.

Subjects
medicine.medical_specialty, Referral, Dermatology, Commission, Neurosurgical Procedure, Palliative surgery, Neurosurgical Procedures, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Resource (project management), Epilepsy surgery, medicine, Humans, 030212 general & internal medicine, Surgical treatment, Referral and Consultation, Drug-resistant, Neuromodulation, Patient Selection, Neurosciences, General Medicine, Pre-surgical evaluation, medicine.disease, Psychiatry and Mental health, Neurology (clinical), Neurosurgery, Medical emergency, Psychology, Surgically remediable syndrome, 030217 neurology & neurosurgery, Human
Abstract

In 2009, the Commission for Epilepsy Surgery of the Italian League Against Epilepsy (LICE) conducted an overview about the techniques used for the pre-surgical evaluation and the surgical treatment of epilepsies. The recognition that, in selected cases, surgery can be considered the first-line approach, suggested that the experience gained by the main Italian referral centers should be pooled in order to provide a handy source of reference. In light of the progress made over these past years, some parts of that first report have accordingly been updated. The present revision aims to harmonize the general principles regulating the patient selection and the pre-surgical work-up, as well as to expand the use of epilepsy surgery, that still represents an underutilized resource, regrettably. The objective of this contribution is drawing up a methodological framework within which to integrate the experiences of each group in this complex and dynamic sector of the neurosciences.

Published
2020

42. Antidepressant effect of vagal nerve stimulation in epilepsy patients: a systematic review

Author

Giovanni Assenza, Stefano Meletti, Loretta Giuliano, Roberto Michelucci, Ettore Beghi, Mario Tombini, Vincenzo Di Lazzaro, Lorenzo Ricci, Francesca Bisulli, Amedeo Bianchi, Umberto Aguglia, Vincenzo Belcastro, Fabrizio A. de Falco, Angelo Labate, Pasquale Striano, Francesco Pisani, Paolo Tinuper, Annapia Verri, Anna Teresa Giallonardo, Sara Gasparini, Silvana Franceschetti, Sara Casciato, Barbara Mostacci, Giancarlo Di Gennaro, Edoardo Ferlazzo, Alessandra Morano, Vincenzo Pizza, Angela La Neve, Flavio Villani, Paolo Benna, Gaetano Zaccara, Carlo Di Bonaventura, Giuliano Avanzini, Jacopo Lanzone, Adriana Magaudda, Ferdinando Sartucci, Vittoria Cianci, Assenza G., Tombini M., Lanzone J., Ricci L., Di Lazzaro V., Casciato S., Morano A., Giallonardo A.T., Di Bonaventura C., Beghi E., Ferlazzo E., Gasparini S., Giuliano L., Pisani F., Benna P., Bisulli F., De Falco F.A., Franceschetti S., La Neve A., Meletti S., Mostacci B., Sartucci F., Striano P., Villani F., Aguglia U., Avanzini G., Belcastro V., Bianchi A., Cianci V., Labate A., Magaudda A., Michelucci R., Verri A., Zaccara G., Pizza V., Tinuper P., and Di Gennaro G.

Subjects
medicine.medical_specialty, Vagus Nerve Stimulation, Vagal nerve, MEDLINE, Drug-resistant epilepsy, Stimulation, Dermatology, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Depression, Systematic review, Vagal nerve stimulation, Depression (differential diagnoses), business.industry, General Medicine, medicine.disease, Comorbidity, Antidepressive Agents, Palliative Therapy, Psychiatry and Mental health, Treatment Outcome, Quality of Life, Antidepressant, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Background: Vagal nerve stimulation (VNS) is an effective palliative therapy in drug-resistant epileptic patients and is also approved as a therapy for treatment-resistant depression. Depression is a frequent comorbidity in epilepsy and it affects the quality of life of patients more than the seizure frequency itself. The aim of this systematic review is to analyze the available literature about the VNS effect on depressive symptoms in epileptic patients. Material and methods: A comprehensive search of PubMed, Medline, Scopus, and Google Scholar was performed, and results were included up to January 2020. All studies concerning depressive symptom assessment in epileptic patients treated with VNS were included. Results: Nine studies were included because they fulfilled inclusion criteria. Six out of nine papers reported a positive effect of VNS on depressive symptoms. Eight out of nine studies did not find any correlation between seizure reduction and depressive symptom amelioration, as induced by VNS. Clinical scales for depression, drug regimens, and age of patients were broadly different among the examined studies. Conclusions: Reviewed studies strongly suggest that VNS ameliorates depressive symptoms in drug-resistant epileptic patients and that the VNS effect on depression is uncorrelated to seizure response. However, more rigorous studies addressing this issue are encouraged.

Published
2020

43. HCN ion channels and accessory proteins in epilepsy: genetic analysis of a large cohort of patients and review of the literature

Author

Andrea Barbuti, Laura Canafoglia, Francesca Ragona, Roberta Solazzi, Silvana Franceschetti, Raffaella Milanesi, Elena Freri, Giancarlo Di Gennaro, Anna Binda, Jacopo C. DiFrancesco, Antonio Gambardella, Tiziana Granata, Sara Casciato, Angelo Labate, Dario DiFrancesco, Cinzia Costa, Ilaria Rivolta, Barbara Castellotti, Cinzia Gellera, Franco Taroni, Carlo Ferrarese, Ludovico D'Incerti, Stefania Magri, Difrancesco, J, Castellotti, B, Milanesi, R, Ragona, F, Freri, E, Canafoglia, L, Franceschetti, S, Ferrarese, C, Magri, S, Taroni, F, Costa, C, Labate, A, Gambardella, A, Solazzi, R, Binda, A, Rivolta, I, Di Gennaro, G, Casciato, S, D'Incerti, L, Barbuti, A, Difrancesco, D, Granata, T, and Gellera, C

Subjects
0301 basic medicine, Male, Accessory protein, Potassium Channels, Caveolin 3, Cytoplasmic and Nuclear, Receptors, Cytoplasmic and Nuclear, Disease, medicine.disease_cause, Filamin, Bioinformatics, Cohort Studies, Epilepsy, 0302 clinical medicine, Receptors, Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels, education.field_of_study, Mutation, medicine.diagnostic_test, Genetic, HCN, Ion channel, Cadherins, Carrier Proteins, Electroencephalography, Family Health, Female, Filamins, Genetic Testing, Humans, Membrane Proteins, Nerve Tissue Proteins, Potassium Channels, Voltage-Gated, Voltage-Gated, Phenotype, Neurology, Population, Biology, 03 medical and health sciences, medicine, education, Adaptor Proteins, Signal Transducing, Genetic testing, medicine.disease, 030104 developmental biology, Membrane protein, Neurology (clinical), Guanylate Kinases, 030217 neurology & neurosurgery
Abstract

The Hyperpolarization-activated Cyclic Nucleotide-gated (HCN) channels are highly expressed in the Central Nervous Systems, where they are responsible for the I h current. Together with specific accessory proteins, these channels finely regulate neuronal excitability and discharge activity. In the last few years, a substantial body of evidence has been gathered showing that modifications of I h can play an important role in the pathogenesis of epilepsy. However, the extent to which HCN dysfunction is spread among the epileptic population is still unknown. The aim of this work is to evaluate the impact of genetic mutations potentially affecting the HCN channels’ activity, using a NGS approach. We screened a large cohort of patients with epilepsy of unknown etiology for mutations in HCN1, HCN2 and HCN4 and in genes coding for accessory proteins (MiRP1, Filamin A, Caveolin-3, TRIP8b, Tamalin, S-SCAM and Mint2). We confirmed the presence of specific mutations of HCN genes affecting channel function and predisposing to the development of the disease. We also found several previously unreported additional genetic variants, whose contribution to the phenotype remains to be clarified. According to these results and data from literature, alteration of HCN1 channel function seems to play a major role in epilepsy, but also dysfunctional HCN2 and HCN4 channels can predispose to the development of the disease. Our findings suggest that inclusion of the genetic screening of HCN channels in diagnostic procedures of epileptic patients should be recommended. This would help pave the way for a better understanding of the role played by I h dysfunction in the pathogenesis of epilepsy.

Published
2019

44. Epilepsy, cerebral calcifications, and gluten-related disorders: Are anti-transglutaminase 6 antibodies the missing link?

Author

Sara Casciato, Edoardo Ferlazzo, Antonietta Coppola, Giuseppe Genovese, Chiara Sueri, Vittoria Cianci, Vito Sofia, Leonilda Bilo, Anna Teresa Giallonardo, Sara Gasparini, Tullio Messana, Giuseppe Gobbi, Marika Monoriti, Carlo Di Bonaventura, Serena Polidoro, Umberto Aguglia, Luciano Arcudi, Salvatore Striano, Loretta Giuliano, Paola Sarica, Ferlazzo, E., Polidoro, S., Gobbi, G., Gasparini, S., Sueri, C., Cianci, V., Sofia, V., Giuliano, L., Giallonardo, A. T., Di Bonaventura, C., Casciato, S., Messana, T., Coppola, A., Striano, S., Bilo, L., Monoriti, M., Genovese, G., Sarica, P., Arcudi, L., and Aguglia, U.

Subjects
Male, Tissue transglutaminase, Autoantigens, Gastroenterology, Coeliac disease, Epilepsy, 0302 clinical medicine, Brain Diseases, biology, Brain Disease, Calcinosis, Brain, General Medicine, Middle Aged, Seizure, Autoantibodie, Diet, Gluten, Seizures, Transglutaminases, Neurology, Biomarker (medicine), Calcinosi, Female, medicine.symptom, Human, Adult, medicine.medical_specialty, Ataxia, Cerebral calcification, 03 medical and health sciences, Refractory, Autoantigen, Internal medicine, medicine, Humans, Autoantibodies, Cross-Sectional Studie, business.industry, medicine.disease, Transglutaminase, Celiac Disease, Cross-Sectional Studies, biology.protein, Etiology, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Purpose Gluten-related disorders (GRDs) are a group of immune-mediated diseases often associated to neurologic manifestations. Epilepsies with cerebral calcifications, with or without coeliac disease (CD), are rare neurological disorders characterized by childhood-onset focal seizures, often refractory to antiepileptic drugs. Transglutaminase 6 antibodies (anti-TG6) have been considered a biomarker for gluten-related ataxia and neuropathy, but their prevalence in epilepsies with cerebral calcifications is unknown. The aim of this study is to evaluate anti-TG6 prevalence in patients with epilepsies and cerebral calcifications. Method this was a cross-sectional study conducted at five Italian epilepsy centres. The following groups were included. Group 1: nine patients with CD, posterior cerebral calcifications and epilepsy (CEC); group 2: nine patients with epilepsy and posterior cerebral calcifications, without CD; group 3: twenty patients with focal epilepsy of unknown etiology; group 4: twenty-two healthy controls (HC). All subjects were tested for serological evidence of anti-TG6 IgA and IgG. Differences among groups were analysed using χ ² test. Results anti-TG6 were present in 1/9 subjects (11%) of group 1, 2/9 subjects (22%) of group 2, 0/20 subjects in group 3, 3/22 (13.6%) of HC. No significant difference was found among the 4 groups. Conclusions Anti-TG6 do not seem to be associated to epilepsies with cerebral calcifications.

Published
2019

45. Temporal lobe epilepsy surgery in children and adults: A multicenter study

Author

Barba, Carmen, Cossu, Massimo, Guerrini, Renzo, Di Gennaro, Giancarlo, Villani, Flavio, De Palma, Luca, Grisotto, Laura, Consales, Alessandro, Battaglia, Domenica, Zamponi, Nelia, d’Orio, Piergiorgio, Revay, Martina, Rizzi, Michele, Casciato, Sara, Esposito, Vincenzo, Quarato, Pier Paolo, Di Giacomo, Roberta, Didato, Giuseppe, Pastori, Chiara, Pavia, Giusy Carfi, Pellacani, Simona, Matta, Giulia, Pacetti, Mattia, Tamburrini, Gianpiero, Cesaroni, Elisabetta, Colicchio, Gabriella, Vatti, Giampaolo, Asioli, Sofia, Caulo, Massimo, Marras, Carlo Efisio, Tassi, Laura, D’Aniello, Alfredo, Morace, Roberta, De Curtis, Marco, Deleo, Francesca, Giordano, Flavio, De Benedictis, Alessandro, Prato, Giulia, Perulli, Marco, Barba C., Cossu M., Guerrini R., Di Gennaro G., Villani F., De Palma L., Grisotto L., Consales A., Battaglia D., Zamponi N., d'Orio P., Revay M., Rizzi M., Casciato S., Esposito V., Quarato P.P., Di Giacomo R., Didato G., Pastori C., Carfi Pavia G., Pellacani S., Matta G., Pacetti M., Tamburrini G., Cesaroni E., Colicchio G., Vatti G., Asioli S., Caulo M., Marras C.E., and Tassi L.

Subjects
0301 basic medicine, Male, Electroencephalography, Neuropsychological Tests, Hippocampus, Neurosurgical Procedures, Epilepsy, 0302 clinical medicine, Postoperative Complications, Cognition, Epilepsy surgery, Child, seizure outcome, medicine.diagnostic_test, Age Factors, Prognosis, Temporal Lobe, Malformations of Cortical Development, Neurology, Child, Preschool, epilepsy surgery, Anticonvulsants, Female, Adult, medicine.medical_specialty, Referral, Adolescent, Temporal lobe, 03 medical and health sciences, Young Adult, Settore MED/39 - NEUROPSICHIATRIA INFANTILE, children, Internal medicine, Early Medical Intervention, medicine, Humans, Preschool, Retrospective Studies, Hippocampal sclerosis, Sclerosis, business.industry, Magnetic resonance imaging, Odds ratio, cognitive outcome, medicine.disease, 030104 developmental biology, Epilepsy, Temporal Lobe, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Objective: To assess seizure and cognitive outcomes and their predictors in children (

Full Text
View/download PDF

46. Distinguishing seizures in autoimmune limbic encephalitis from mesial temporal lobe epilepsy with hippocampal sclerosis: Clues of a temporal plus network.

Author

Morano A, Cerulli Irelli E, Fortunato F, Casciato S, Panzini C, Milano C, Versace S, Orlando B, Iorio R, Tinelli E, Ruffolo G, Pizzanelli C, Vogrig A, Quarato P, Giallonardo AT, Di Gennaro G, Gambardella A, and Di Bonaventura C

Abstract

Objective: Diagnosing autoimmune limbic encephalitis (ALE) in adults with new-onset seizures can be challenging, especially when seizures represent the predominant manifestation and MRI findings are not straightforward. By comparison with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), this study aimed to identify ictal electro-clinical features that might help clinicians recognize ALE-related seizures., Methods: This retrospective, multi-centre study analysed the ictal semiology and EEG correlate of 116 video-EEG-captured seizures in 40 ALE patients and 45 ones recorded in 21 MTLE-HS subjects. The proportion of patients presenting each clinical feature on at least one occasion was compared between the study groups. Latent class analysis (LCA) was also performed., Results: Ictal features were overall more numerous in ALE than in MTLE-HS (33 vs 22), and LCA confirmed the intrinsic variability of ALE-related seizures. Hyperventilation served as a trigger only in ALE (4/40). Awareness impairment (p = 0.032), limb dystonic posturing (p = 0.009) and manual automatisms (p < 0.001) were significantly less common in ALE cases. Conversely, piloerection was observed only in ALE subjects, although it did not reach statistical significance (p = 0.289), as was the case for déjà-vu (p = 0.084), and sensory symptoms (p = 0.079). Regarding EEG, the type of ictal pattern differed significantly (p = 0.007)., Significance: This study shows that, despite the wide overlap with MTLE-HS, some ictal electro-clinical features could help clinicians suspect the autoimmune origin of adult-onset seizures. Moreover, autoimmune limbic seizures apparently shared similarities with 'temporal plus' epilepsy, which could partly account for the poor surgical outcomes and provide an interesting conceptual framework for future research., Competing Interests: Declaration of competing interest On behalf of all authors, the corresponding author states that there is no conflict of interest., (Copyright © 2024. Published by Elsevier B.V.)

Published
2024
Full Text
View/download PDF

47. Lamotrigine vs levetiracetam in female patients of childbearing age with juvenile absence epilepsy: A Bayesian reanalysis.

Author

Cerulli Irelli E, Cocchi E, Gesche J, Peña-Ceballos J, Caraballo RH, Lattanzi S, Strigaro G, Orlando B, Moloney PB, Catania C, Ferlazzo E, Pascarella A, Casciato S, Pizzanelli C, Milano C, Giuliano L, Viola V, Mostacci B, Fortunato F, Pulitano P, Rosati E, Perulli M, Delanty N, Di Gennaro G, Gambardella A, Labate A, Operto FF, Giallonardo AT, Baykan B, Beier CP, and Di Bonaventura C

Subjects
Humans, Female, Retrospective Studies, Adult, Young Adult, Adolescent, Treatment Outcome, Proportional Hazards Models, Levetiracetam therapeutic use, Lamotrigine therapeutic use, Bayes Theorem, Anticonvulsants therapeutic use, Epilepsy, Absence drug therapy
Abstract

Objective: Women of childbearing age with juvenile absence epilepsy (JAE) face treatment challenges due to limited access to safe and effective anti-seizure medications (ASMs). In a previous study we compared the effectiveness of levetiracetam (LEV) and lamotrigine (LTG) in women with idiopathic generalized epilepsy (IGE), highlighting a superiority of LEV in juvenile myoclonic epilepsy. In this study, we specifically reanalyzed, through a Bayesian approach and by expanding the previously published cohort, the comparative effectiveness of these ASMs as initial monotherapy in JAE., Methods: We conducted a multicenter, retrospective, comparative effectiveness study on women of childbearing age diagnosed with JAE and prescribed LEV or LTG as the initial ASM. Inverse probability treatment weighting (IPTW) Bayesian Cox proportional hazard models were employed to evaluate treatment failure (TF) due to ineffectiveness and ASM retention. The patients' center of provenance and year of prescription were considered as random effect factors. Posterior probabilities and relative log-risk distribution were computed, and the distribution of posterior draws was analyzed to assess the evidence supporting LTG superiority over LEV., Results: Of 123 patients, those treated with LTG (n = 67) demonstrated lower TF and higher ASM retention than those treated with LEV (n = 56), with the IPTW-weighted Bayesian Cox proportional hazards model showing a 99.2% posterior probability of LTG being superior on TF and a 99.5% probability on ASM retention. Additional analyses on ≥50% and ≥75% seizure reduction through IPTW-weighted Bayesian logistic regression largely confirmed these findings, whereas the two ASMs did not show evident differences in terms of seizure freedom. The two ASMs showed comparable safety profiles, with only a minority of patients discontinuing treatment due to side effects., Significance: Bayesian reanalysis supports LTG as first-line monotherapy for JAE in women of childbearing age, emphasizing the importance of individualized treatment strategies in women with IGE. This study underscores the value of Bayesian methods in refining clinical research and treatment decisions., (© 2024 International League Against Epilepsy.)

Published
2024
Full Text
View/download PDF

48. Prognostic value of scalp EEG ictal patterns in epilepsy surgery of hippocampal sclerosis.

Author

Di Gennaro G, Romigi A, Quarato PP, Mascia A, D'Aniello A, Panzini C, Casciato S, Grammaldo L, Centonze D, and Esposito V

Subjects
Humans, Male, Female, Adult, Retrospective Studies, Prognosis, Young Adult, Middle Aged, Scalp, Adolescent, Treatment Outcome, Hippocampal Sclerosis, Electroencephalography methods, Sclerosis, Hippocampus surgery, Hippocampus physiopathology, Hippocampus pathology, Epilepsy, Temporal Lobe surgery, Epilepsy, Temporal Lobe physiopathology, Epilepsy, Temporal Lobe diagnosis
Abstract

Background: Temporal lobe epilepsy associated with hippocampal sclerosis (TLE-HS) is a surgically treatable epileptic syndrome. While the core of pre-surgical evaluations rely on video-EEG, recent studies question the necessity of recorded seizures denying a possible role of ictal EEG in surgical decision. This study aims to retrospectively assess the prognostic value of EEG ictal patterns in TLE-HS, in order to identify which patients need further investigations before offering surgery., Methods: We included TLE-HS patients who underwent surgery with at least one captured seizure during non-invasive pre-surgical video-EEG recordings. They were classified in "mesial" and "lateral/mixed", according to the ictal EEG patterns, defined by the frequency of the discharge (mesial ≥ 5 Hz, lateral < 5 Hz). Seizure outcome was assessed by Engel's Class. Statistical analyses were performed to evaluate associations between EEG patterns and post-surgical outcomes., Results: Sixty-nine exhibited a mesial pattern, forty- two displayed lateral/mixed patterns. Mesial pattern group had a significantly higher rate of postsurgical seizure freedom (82.7% vs. 28.6%). Gender, age of onset, age at surgery, duration of epilepsy, seizure frequency, and lateralization did not influence the outcome. Mesial pattern significantly correlated with favorable outcomes (p < 0.001), suggesting its potential predictive value., Conclusion: This retrospective study proposes ictal EEG patterns as possible predictors of postoperative prognosis in TLE-HS. A mesial pattern correlates with better outcomes, indicating a potentially more circumscribed epileptogenic zone. Patients with lateral/mixed patterns may benefit from additional investigations to delineate the epileptogenic zone. Further studies are warranted to validate and extend these findings., (© 2024. Fondazione Società Italiana di Neurologia.)

Published
2024
Full Text
View/download PDF

49. Long-term outcomes and adaptive behavior in adult patients with Lennox-Gastaut syndrome.

Author

Cerulli Irelli E, Petrungaro A, Pastorino GMG, Mazzeo A, Morano A, Casciato S, Salati E, Operto FF, Giallonardo AT, Di Gennaro G, and Di Bonaventura C

Subjects
Humans, Male, Adult, Female, Cross-Sectional Studies, Young Adult, Anticonvulsants therapeutic use, Electroencephalography, Middle Aged, Adolescent, Activities of Daily Living, Lennox Gastaut Syndrome drug therapy, Adaptation, Psychological
Abstract

Objective: Lennox-Gastaut syndrome (LGS) is a severe form of epilepsy characterized by difficult-to-control seizures and cognitive dysfunction. Previous studies mainly focused on pediatric populations, and little is known about the long-term cognitive outcome in adult patients with LGS. The objective of this study was to investigate the long-term functional and adaptive behavior in adult patients with LGS., Methods: This cross-sectional study enrolled adult patients diagnosed with LGS according to the recently published International League Against Epilepsy (ILAE) diagnostic criteria. The adaptive behavior of participants was assessed using the Vineland Adaptive Behavior Scales, Survey Interview, Second Edition (VABS-II). Demographic, clinical, electroencephalography (EEG), and antiseizure medication (ASM) data were also collected at different timepoints, to investigate their association with VABS-II scores., Results: The study included 38 adult patients with LGS. A low score on the Adaptive Behavior Composite Scale was found in all patients. When considering single VABS-II domains, particularly low scores were found in daily living skills and socialization, whereas slightly higher performances were observed in communication. An earlier age at LGS diagnosis was identified as the most significant predictor of worse adaptive outcomes in adult life. At the time of study evaluation, high seizure frequency, higher EEG background slowing, and multifocal EEG epileptiform abnormalities were significantly associated with lower VABS-II raw scores. Furthermore, in an exploratory correlation analysis with ASM regimen at the study visit, treatment with cannabidiol was associated with higher adaptive behavior scores, whereas benzodiazepine intake correlated with lower scores., Significance: This study provides relevant insights into the long-term challenges faced by adults with Lennox-Gastaut syndrome (LGS), highlighting significant impairments in adaptive behavior as well as the associated clinical and electroencephalography features. Additionally, this study provides a more specific neuropsychological profile in adults with LGS and underscores the importance of comprehensive care approaches that go beyond seizure control in this population., Plain Language Summary: This study examined adults with Lennox-Gastaut syndrome (LGS), a severe type of epilepsy, to understand their long-term abilities to perform daily tasks and adapt socially. We found that these adults have significant difficulties with daily living and social skills, although not all areas were equally affected. They performed somewhat better in communication, particularly in understanding others (receptive communication). Importantly, the younger the age at which LGS was diagnosed, the worse their outcomes were as adults. This study highlights the need for research and treatment approaches that focus not only on controlling seizures but also on improving daily life skills., (© 2024 The Author(s). Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)

Published
2024
Full Text
View/download PDF

50. Predictors of Seizure Recurrence in Women With Idiopathic Generalized Epilepsy Who Switch From Valproate to Another Medication.

Author

Cerulli Irelli E, Cocchi E, Morano A, Gesche J, Caraballo RH, Lattanzi S, Strigaro G, Rosati E, Catania C, Ferlazzo E, Casciato S, Di Gennaro G, Pizzanelli C, Giuliano L, Viola V, Mostacci B, Pignatta P, Fortunato F, Pulitano P, Panzini C, Gambardella A, Atalar AÇ, Labate A, Operto FF, Giallonardo AT, Baykan BB, Beier CP, and Di Bonaventura C

Subjects
Humans, Female, Retrospective Studies, Anticonvulsants therapeutic use, Seizures drug therapy, Levetiracetam therapeutic use, Lamotrigine therapeutic use, Immunoglobulin E therapeutic use, Valproic Acid therapeutic use, Epilepsy, Generalized drug therapy
Abstract

Background and Objectives: To investigate the predictors of seizure recurrence in women of childbearing age with idiopathic generalized epilepsy (IGE) who switched from valproate (VPA) to alternative antiseizure medications (ASMs) and compare the effectiveness of levetiracetam (LEV) and lamotrigine (LTG) as VPA alternatives after switch., Methods: This multicenter retrospective study included women of childbearing age diagnosed with IGE from 16 epilepsy centers. Study outcomes included worsening or recurrence of generalized tonic-clonic seizure (GTCS) at 12 months and 24 months after the switch from VPA to an alternative ASM. The comparative effectiveness of LEV and LTG as alternative ASM following VPA discontinuation was assessed through inverse probability treatment-weighted (IPTW) Cox regression analysis., Results: We included 426 women with IGE, with a median (interquartile range) age at VPA switch of 24 (19-30) years and a median VPA dosage of 750 (500-1,000) mg/d. The most common reason for VPA switch was teratogenicity concern in 249 women (58.6%), and the most common ASM used in place of VPA was LEV in 197 (46.2%) cases, followed by LTG in 140 (32.9%). GTCS worsening/recurrence occurred in 105 (24.6%) and 139 (32.6%) women at 12 and 24 months, respectively. Catamenial worsening of seizures, higher VPA dosage during switch, multiple seizure types, and shorter duration of GTCS freedom before switch were independent predictors of GTCS recurrence or worsening at 12 months according to mixed multivariable logistic regression analysis. After internal-external validation through 16 independent cohorts, the model showed an area under the curve of 0.71 (95% CI 0.64-0.77). In the subgroup of 337 women who switched to LEV or LTG, IPTW Cox regression analysis showed that LEV was associated with a reduced risk of GTCS worsening or recurrence compared with LTG (adjusted hazard ratio 0.59, 95% CI 0.40-0.87, p = 0.008) during the 24-month follow-up., Discussion: Our findings can have practical implications for optimizing counselling and treatment choices in women of childbearing age with IGE and may help clinicians in making informed treatment decisions in this special population of patients., Classification of Evidence: This study provides Class III evidence that for women with IGE switching from VPA, LEV was associated with a reduced risk of GTCS worsening or recurrence compared with LTG.

Published
2024
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results