1
|
Sculier C, Barcia Aguilar C, Gaspard N, Gaínza-Lein M, Sánchez Fernández I, Amengual-Gual M, Anderson A, Arya R, Burrows BT, Brenton JN, Carpenter JL, Chapman KE, Clark J, Gaillard WD, Glauser TA, Goldstein JL, Goodkin HP, Gorman M, Lai YC, McDonough TL, Mikati MA, Nayak A, Peariso K, Riviello J, Rusie A, Sperberg K, Stredny CM, Tasker RC, Tchapyjnikov D, Vasquez A, Wainwright MS, Wilfong AA, Williams K, Loddenkemper T. Clinical presentation of new onset refractory status epilepticus in children (the pSERG cohort). Epilepsia 2021; 62:1629-1642. [PMID: 34091885 PMCID: PMC8362203 DOI: 10.1111/epi.16950] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 01/14/2023]
Abstract
Objective We aimed to characterize the clinical profile and outcomes of new onset refractory status epilepticus (NORSE) in children, and investigated the relationship between fever onset and status epilepticus (SE). Methods Patients with refractory SE (RSE) between June 1, 2011 and October 1, 2016 were prospectively enrolled in the pSERG (Pediatric Status Epilepticus Research Group) cohort. Cases meeting the definition of NORSE were classified as "NORSE of known etiology" or "NORSE of unknown etiology." Subgroup analysis of NORSE of unknown etiology was completed based on the presence and time of fever occurrence relative to RSE onset: fever at onset (≤24 h), previous fever (2 weeks–24 h), and without fever. Results Of 279 patients with RSE, 46 patients met the criteria for NORSE. The median age was 2.4 years, and 25 (54%) were female. Forty (87%) patients had NORSE of unknown etiology. Nineteen (48%) presented with fever at SE onset, 16 (40%) had a previous fever, and five (12%) had no fever. The patients with preceding fever had more prolonged SE and worse outcomes, and 25% recovered baseline neurological function. The patients with fever at onset were younger and had shorter SE episodes, and 89% recovered baseline function. Significance Among pediatric patients with RSE, 16% met diagnostic criteria for NORSE, including the subcategory of febrile infection‐related epilepsy syndrome (FIRES). Pediatric NORSE cases may also overlap with refractory febrile SE (FSE). FIRES occurs more frequently in older children, the course is usually prolonged, and outcomes are worse, as compared to refractory FSE. Fever occurring more than 24 h before the onset of seizures differentiates a subgroup of NORSE patients with distinctive clinical characteristics and worse outcomes.
Collapse
Affiliation(s)
- Claudine Sculier
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Erasmus Hospital, Free University of Brussels, Brussels, Belgium
| | - Cristina Barcia Aguilar
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Child Neurology, La Paz University Hospital, Autonomous University of Madrid, Madrid, Spain
| | - Nicolas Gaspard
- Department of Neurology, Erasmus Hospital, Free University of Brussels, Brussels, Belgium.,Neurology Department, Comprehensive Epilepsy Center, Yale University School of Medicine, New Haven, CT, USA
| | - Marina Gaínza-Lein
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Faculty of Medicine, Institute of Pediatrics, Austral University of Chile, Valdivia, Chile.,Children's Neuropsychiatry Service, San Borja Arriarán Clinical Hospital, University of Chile, Santiago, Chile
| | - Iván Sánchez Fernández
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Child Neurology, SJD Barcelona Children's Hospital, University of Barcelona, Barcelona, Spain
| | - Marta Amengual-Gual
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Pediatric Neurology Unit, Department of Pediatrics, Son Espases University Hospital, University of the Balearic Islands, Palma, Spain
| | - Anne Anderson
- Section of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Ravindra Arya
- Division of Pediatric Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Brian T Burrows
- Department of Pediatrics, Barrows Neurological Institute, Phoenix Children's Hospital, University of Arizona School of Medicine, Phoenix, AZ, USA.,Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA
| | - James N Brenton
- Department of Neurology and Pediatrics, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Jessica L Carpenter
- Center for Neuroscience, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Kevin E Chapman
- Departments of Pediatrics and Neurology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | - Justice Clark
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - William D Gaillard
- Center for Neuroscience, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Tracy A Glauser
- Division of Pediatric Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Joshua L Goldstein
- Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Northwestern University Feinberg, School of Medicine, Chicago, IL, USA
| | - Howard P Goodkin
- Department of Neurology and Pediatrics, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Mark Gorman
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yi-Chen Lai
- Section of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Tiffani L McDonough
- Division of Neurology and Epilepsy, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mohamad A Mikati
- Division of Pediatric Neurology, Duke University Medical Center, Duke University, Durham, NC, USA
| | - Anuranjita Nayak
- Section of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Katrina Peariso
- Division of Pediatric Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - James Riviello
- Section of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Allison Rusie
- Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Northwestern University Feinberg, School of Medicine, Chicago, IL, USA
| | - Katherine Sperberg
- Center for Neuroscience, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Coral M Stredny
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert C Tasker
- Department of Neurology, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Dmitry Tchapyjnikov
- Division of Neurology and Epilepsy, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alejandra Vasquez
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Child and Adolescent Neurology, Mayo Clinic, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Mark S Wainwright
- Division of Pediatric Neurology, Department of Neurology, University of Washington, Seattle, WA, USA
| | - Angus A Wilfong
- Division of Pediatric Neurology, Department of Child Health, Phoenix Children's Hospital, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Korwyn Williams
- Division of Pediatric Neurology, Department of Child Health, Phoenix Children's Hospital, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Tobias Loddenkemper
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|
14
|
Gaspard N, Foreman BP, Alvarez V, Cabrera Kang C, Probasco JC, Jongeling AC, Meyers E, Espinera A, Haas KF, Schmitt SE, Gerard EE, Gofton T, Kaplan PW, Lee JW, Legros B, Szaflarski JP, Westover BM, LaRoche SM, Hirsch LJ. New-onset refractory status epilepticus: Etiology, clinical features, and outcome. Neurology 2015; 85:1604-13. [PMID: 26296517 DOI: 10.1212/wnl.0000000000001940] [Citation(s) in RCA: 281] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 07/06/2015] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES The aims of this study were to determine the etiology, clinical features, and predictors of outcome of new-onset refractory status epilepticus. METHODS Retrospective review of patients with refractory status epilepticus without etiology identified within 48 hours of admission between January 1, 2008, and December 31, 2013, in 13 academic medical centers. The primary outcome measure was poor functional outcome at discharge (defined as a score >3 on the modified Rankin Scale). RESULTS Of 130 cases, 67 (52%) remained cryptogenic. The most common identified etiologies were autoimmune (19%) and paraneoplastic (18%) encephalitis. Full data were available in 125 cases (62 cryptogenic). Poor outcome occurred in 77 of 125 cases (62%), and 28 (22%) died. Predictors of poor outcome included duration of status epilepticus, use of anesthetics, and medical complications. Among the 63 patients with available follow-up data (median 9 months), functional status improved in 36 (57%); 79% had good or fair outcome at last follow-up, but epilepsy developed in 37% with most survivors (92%) remaining on antiseizure medications. Immune therapies were used less frequently in cryptogenic cases, despite a comparable prevalence of inflammatory CSF changes. CONCLUSIONS Autoimmune encephalitis is the most commonly identified cause of new-onset refractory status epilepticus, but half remain cryptogenic. Outcome at discharge is poor but improves during follow-up. Epilepsy develops in most cases. The role of anesthetics and immune therapies warrants further investigation.
Collapse
Affiliation(s)
- Nicolas Gaspard
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston.
| | - Brandon P Foreman
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Vincent Alvarez
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Christian Cabrera Kang
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - John C Probasco
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Amy C Jongeling
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Emma Meyers
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Alyssa Espinera
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Kevin F Haas
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Sarah E Schmitt
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Elizabeth E Gerard
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Teneille Gofton
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Peter W Kaplan
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Jong W Lee
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Benjamin Legros
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Jerzy P Szaflarski
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Brandon M Westover
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Suzette M LaRoche
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | - Lawrence J Hirsch
- From the Yale University School of Medicine (N.G., L.J.H.), Department of Neurology, Division of Epilepsy and Clinical Neurophysiology and Comprehensive Epilepsy Center, New Haven, CT; Université Libre de Bruxelles-Hôpital Erasme (N.G., B.L.), Brussels, Belgium; University of Cincinnati Department of Neurology and Rehabilitation Medicine (B.P.F.), OH; Department of Neurology (V.A.), Hôpital de Sion; Department of Clinical Neurosciences (V.A.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Department of Neurology (V.A., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston MA; Emory University School of Medicine (C.C.K., S.M.L.), Atlanta, GA; Johns Hopkins Bayview Medical Center (J.C.P., P.W.K.), Department of Neurology, and Johns Hopkins University School of Medicine, Baltimore MD; Department of Neurology (A.C.J., E.M.), Columbia University, New York, NY; Vanderbilt University Medical Center (K.F.H.), Nashville, TN; Hospital of the University of Pennsylvania (S.E.S.), Philadelphia; Feinberg School of Medicine (A.E., E.E.G.), Northwestern University, Chicago, IL; University of Western Ontario (T.G.), Canada; University of Alabama at Birmingham (J.P.S.); and Department of Neurology (B.M.W.), Massachusetts General Hospital, Boston
| | | |
Collapse
|