TABLE 2.
Epilepsy Features of the Patient Cohort
| Case | Epilepsy Type; Age at Onset | Seizure Frequency | Antiseizure Medication; Outcome | Sodium Channel Blocker | Brain MRI | EEG/sEEG |
|---|---|---|---|---|---|---|
| 1 a | SHE; 7 yr | NA | Low dosage of CBZ (recurrence after withdrawal); good outcome | Yes | Negative (1.5T) | Interictal EEG: normal |
| 2 a | SHE; 12 yr | 4–10 sz/yr | TPM + LTG, CBZ added at 44, sz‐free for 8 mo before SUDEP | Yes | Negative | EEG: bifrontal epileptic activity |
| 3 | SHE; 5 yr | Several sz/night several days per week | CBZ, LEV | Yes | Negative (1.5T) | Interictal EEG: normal; sEEG: right insula onset |
| 4 | SHE; 4 yr | 1 nocturnal convulsive sz/month | CLB, OXC, PER; drug‐resistant | Yes | Negative | Ictal EEG: right frontocentral seizure |
| 5 | FLE (operated at 18 yr: FCD 1); 3 yr | 1 nocturnal convulsive sz/month | LAC, CLB; drug‐resistant | Yes | Negative (1.5T) | sEEG: right frontobasal and insular onset |
| 6 | FLE; 8 yr | Monthly to weekly nocturnal focal frontal sz | OXC, LTG, VPA, PER; drug‐resistant | Yes | Negative (1.5T) | EEG: frontal epileptic activity |
| 7 | FLE (left frontal lobectomy, sz recurrence afterward); 11 yr | 2 clusters of 2 focal to bilateral tonic–clonic sz/month | VPA, LTG, PHE, rescue protocol with midazolam after the first sz; drug‐resistant | Yes | Negative (3T) | EEG: left frontal lobe epilepsy; sEEG: left orbitofrontal lobe epilepsy |
| 8 | Focal epilepsy, localization unclear, 7 yr | 2–4 focal to bilateral tonic–clonic sz/month, almost all arising from sleep | LTG, TPM | Yes | Negative (3T) | EEG (3 days VT): focal epilepsy, localization unclear (most likely left frontotemporal) |
| 9 | Focal epilepsy, left neocortical temporal onset; 4 yr | 1–2 focal sz with or without impaired awareness every 2 weeks, rare focal to bilateral tonic–clonic sz | LEV, VPA, clobazam | No | Negative (3T) | EEG (VT): neocortical focal epilepsy, possible left lateral temporal region |
| 10 | FTE, lateralization unclear; 1 yr | Brief blank spells 2–3 times per week; no focal to bilateral tonic–clonic sz | VPA, LAC | Yes | Negative (3T) | EEG (VT): interictal epileptiform discharges from both temporal regions |
| 11 | FTE; 7 yr | No clear sz, but frequent syncopal episodes (most likely of autonomic origin) | LTG | Yes | Mild cerebellar atrophy, small right parafalcine meningioma (3T) | EEG: bitemporal interictal epileptiform activity, more prominent on the left |
| 12 | Focal epilepsy, left parietal onset; surgically resected FCD type 2; 7 yr | sz‐free after lesionectomy | LAC, PER, TPM, clobazam | Yes | Left parietal FCD (3T) | Presurgical VT: ictal bradycardia down to 42 bpm |
| 13 | Focal epilepsy, left hemispheric onset; 11 yr | 3–7 sz/week (30–40% focal to bilateral tonic–clonic sz; others: focal impaired awareness sz) | OXC, TPM, rescue protocol with lorazepam and CLB | Yes | Negative (3T) | VT: focal epilepsy, left hemispheric onset, localization unclear |
| 14 | Focal epilepsy; 10 yr | sz‐free for 3 yr | LEV, LTG, CBZ | Yes | Negative (3T) | 24‐h ambulatory EEG (23 yr): normal |
| 15 | FTE, 27 yr | sz‐free for the past 2 yr | BRV, ZNS, pregabalin | No | Negative (3T) | 24‐h ambulatory EEG: left temporal slow, no clear interictal epileptiform abnormalities |
| 16 a | Focal epilepsy; 7 yr | 1 unprovoked nocturnal convulsive sz every 2–3 mo (but issues with medication compliance) | OXC | Yes | Negative | 24 h ambulatory EEG: bihemispheric cortical dysfunction, suggestive of multifocal irritative regions |
a
Succumbed to SUDEP.
bpm = beats per minute; BRV = brivaracetam; CBZ = carbamazepine; CLB = clonazepam; EEG = electroencephalogram; FCD = focal cortical dysplasia; FLE = frontal lobe epilepsy; FTE = focal temporal epilepsy; LAC = lacosamide; LEV = levetiracetam; LTG = lamotrigine; MRI, magnetic resonance imaging; NA = not available; OXC = oxcarbazepine; PER = perampanel; PHE = phenytoin; sEEG = stereotaxic EEG; SHE = sleep‐related hypermotor epilepsy; SUDEP = sudden unexpected death in epilepsy; sz = seizure(s); TPM = topiramate; VPA = valproate; VT = video telemetry; ZNS = zonisamide.