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  • Epilepsy Currents - Episode 7 - "It’s Current: NAEC Provides Us With the Recipe to Build a Better Epilepsy Center"

    Epilepsy Currents - Episode 7 - "It’s Current: NAEC Provides Us With the Recipe to Build a Better Epilepsy Center"
    2024/08/20
    Join Dr. Bermeo in a conversation with Dr. Susan Arnold, and Dr. Fred Lado, as they discuss the article, "It’s Current: NAEC Provides Us With the Recipe to Build a Better Epilepsy Center". Click here to read the article. This podcast was sponsored by the National Association of Epilepsy Centers (NAEC). 2023 Guidelines for Specialized Epilepsy Centers We’d also like to acknowledge Epilepsy Currents podcast editor Dr. Adriana Bermeo-Ovalle, and contributing editor Dr. Rohit Marawar, and the team at Sage. In episode 7 of the Epilepsy Currents podcast, the discussion focuses on the 2023 Guidelines for Specialized Epilepsy Centers, published by the National Association of Epilepsy Centers (NAEC). Hosted by Dr. Adriana Bermeo, the episode features insights from Dr. Susan Arnold, the senior author of the executive summary of the report, and Dr. Fred Lado, president of the NAEC and the first author of the guidelines. The guidelines aim to set comprehensive standards for epilepsy care, particularly addressing the needs of patients with drug-resistant epilepsy. Brief Summary The 2023 NAEC guidelines for epilepsy care are designed to elevate the standards of care provided at specialized epilepsy centers. These guidelines distinguish between best practices for patient care and accreditation standards, the latter being what centers must meet to receive NAEC accreditation. Developed through an "evidence-informed consensus" process, these guidelines include contributions from a diverse panel, including neurologists, nurses, EEG technologists, social workers, neuropsychologists, patients, and caregivers. This inclusive approach ensures that the guidelines address comprehensive needs across the spectrum of epilepsy care. Key Takeaways Guideline and Accreditation Distinction: Dr. Lado clarified the difference between the NAEC's guidelines and its accreditation process. The guidelines represent consensus on best practices in epilepsy care, while accreditation standards are specific criteria that centers must meet to demonstrate adherence to these practices. This distinction helps centers focus on gradual implementation of the guidelines without immediate pressure for compliance. Inclusive Development Process: Dr. Arnold emphasized that the guidelines were developed through an evidence-informed consensus, incorporating opinions from a broad array of stakeholders, including those directly affected by epilepsy. This method helps ensure that the guidelines are comprehensive and address practical aspects of patient care. Focus on Comprehensive Care: The guidelines have expanded to cover not only inpatient and surgical care but also comprehensive outpatient services, reflecting the realities of where most epilepsy care occurs. This shift acknowledges the importance of accessibility, communication, and specialized services for various patient groups. Resource Considerations: Recognizing the resource-intensive nature of comprehensive epilepsy care, the guidelines provide a framework for centers to gradually adapt to higher standards without abrupt changes. This gradual implementation is intended to ease the burden on centers, allowing them time to secure necessary resources. Future Directions and Improvements: The guidelines are seen as a living document, with the NAEC planning more frequent updates to keep pace with advancements in epilepsy treatment and care. This adaptive approach aims to ensure that the guidelines remain relevant and practical for implementing the latest best practices in epilepsy care. Transcript Adrianna Bermeo-Ovalle, MD (Host): The main purpose that brings our community together is our desire and resolve to offer people living with epilepsy the best alternatives of diagnosis and treatment; the ones that will empower them to live their best possible life. But what does that mean in practical terms? How do we put that intention into clinical practice? The National Association of Epilepsy Centers, NAEC, has taken a careful look at this question. We are delighted to have the opportunity to discuss together the 2023 Guidelines for Specialized Epilepsy Centers that will inform epilepsy care in the present and the future. Welcome to Episode 7 of Epilepsy Currents Podcast. I am your host, Adriana Bermeo. I am the Senior Podcast Editor for Epilepsy Currents, the official journal of the American Epilepsy Society. Let me first welcome Dr. Susan Arnold. Dr. Arnold is Adjunct Professor of Pediatric Neurology at Yale University School of Medicine. She's the Senior Author of the Executive Summary of the Report of the National Association of Epilepsy Centers, entitled Guidelines for Specialized Epilepsy Centers, which was published by the Green Journal Neurology in February of 2024. Dr. Arnold, thank you very much for joining us today. Susan T Arnold, MD: I'm very happy to be here. Host: It is also my pleasure to welcome Dr. Fred Lado. Dr. Lado is the president of the NAEC and professor ...
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    22 分
  • Epilepsy Currents - Episode 6 - " Hiding in Plain Sight—Neighborhood Versus Individual Determinants of Psychological Outcomes in Patients With Epilepsy"

    Epilepsy Currents - Episode 6 - " Hiding in Plain Sight—Neighborhood Versus Individual Determinants of Psychological Outcomes in Patients With Epilepsy"
    2024/06/05
    Join Dr. Bermeo in a conversation with Dr. Jarrod E. Dalton, Dr. Bruce Hermann, and Dr. Samuel Terman, as they discuss the article, "Hiding in Plain Sight—Neighborhood Versus Individual Determinants of Psychological Outcomes in Patients With Epilepsy ". Click here to read the article. This podcast was sponsored by the American Epilepsy Society through a grant from the Centers for Disease Control (CDC). These activities are supported by the Centers for Disease Control (CDC) and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1,500,000 with 100% funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor are they an endorsement, by CDC/HHS, or the U.S. Government. We’d also like to acknowledge contributing editor Dr. Rohit Marawar, and the team at Sage. Summary The podcast features a discussion on how environmental conditions, specifically neighborhood deprivation, affect cognitive outcomes and mood in individuals with pharmacoresistant temporal lobe epilepsy. Dr. Hermann & Dr. Dalton's study found that patients living in more deprived areas exhibited significantly lower cognitive performance and increased levels of anxiety and depression compared to those in less deprived areas. Dr. Terman's commentary critically assesses these findings, stressing the importance of considering environmental factors alongside biological ones in understanding and treating epilepsy. Key Takeaways Impact of Neighborhood Deprivation: The study highlighted a strong correlation between increased neighborhood deprivation and poorer cognitive outcomes as well as higher levels of anxiety and depression among epilepsy patients. This suggests that external environmental factors play a crucial role in the health outcomes of individuals with temporal lobe epilepsy.Role of Area Deprivation Index (ADI): The ADI is utilized to quantify neighborhood deprivation, encompassing factors like income, education, and housing conditions. It provided a robust framework for analyzing the socioeconomic conditions impacting patient outcomes, underlining the relevance of broader social determinants in health disparities. Implications for Clinical Practice: These findings underscore the need for clinicians to consider the socioeconomic environment of patients when diagnosing and treating epilepsy. Addressing environmental factors could enhance therapeutic outcomes and improve quality of life for patients.Study Limitations and Future Research: Dr. Terman noted limitations such as the cross-sectional nature of the study, which complicates the ability to infer causation. He advocates for longitudinal studies to better understand how and when neighborhood factors impact patient health, potentially leading to more targeted interventions.Potential for Broader Implications: The discussion extends beyond epilepsy, suggesting that similar environmental influences could be significant across other neurological and psychiatric conditions. Future research might explore how modifications in social policy and urban planning could mitigate these health disparities. [00:00:00] Adriana Bermeo (Host): It is well known that individuals living with epilepsy are at risk of experiencing cognitive decline and psychiatric comorbidities. But did you know that the individual's home address plays a significant role in the cognitive and psychiatric outcomes of people living with temporal lobe epilepsy? [00:00:18] Welcome to episode number six of Epilepsy Currents podcast. Today, we will be talking about the role of environmental factors on cognition and mood of patients with temporal lobe epilepsy. I am your host, Adriana Bermeo. I am the Senior Podcast Editor for Epilepsy Currents, the official journal of the American Epilepsy Society. [00:00:40] I want to first welcome contributing editor, Dr. Samuel Terman, who wrote the commentary, Hiding in Plain Sight--Neighborhood vs. Individual Determinants of Psychological Outcomes in Patients with Epilepsy. This commentary was published on the March 2024 issue of Epilepsy Currents. [00:01:00] Dr. Terman is an Assistant Professor at the University of Michigan. Dr. Terman, welcome to Epilepsy Currents Podcast. [00:01:07] Samuel W. Terman, MD, MS: Thanks so much. Happy to be here. [00:01:09] Host: It is also my pleasure to welcome Dr. Bruce Hermann, who is the Senior Author of the work that inspired this commentary, titled Association of Neighborhood Deprivation with Cognitive and Mood Outcomes in Adults with Pharmacoresistant Temporal Lobe Epilepsy. Their paper was published in Neurology in June 2023. Dr. Hermann is Emeritus professor of Neuropsychology at the University of Wisconsin School of Medicine and Public Health. Welcome, Dr. Hermann. Thank you for being with us. [00:01:39] Bruce Hermann: Thank you, and good afternoon. [00:01:41] Host: We are also joined by Dr. Jarrod Dalton, who is ...
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    30 分
  • Epilepsy Currents - Episode 5 - "More Than Meets the Eye: Human Versus Computer in the Neuroimaging of Temporal Lobe Epilepsy"

    Epilepsy Currents - Episode 5 - "More Than Meets the Eye: Human Versus Computer in the Neuroimaging of Temporal Lobe Epilepsy"
    2024/03/29
    Join Dr. Bermeo in a conversation with Dr. Ezequiel Gleichgerrcht, Dr. Erik Kaestner, and Dr. Peter Widdess Walsh, as they discuss the article, "More Than Meets the Eye: Human Versus Computer in the Neuroimaging of Temporal Lobe Epilepsy". Click here to read the article. This podcast was sponsored by the American Epilepsy Society. We’d also like to acknowledge contributing editor Dr. Rohit Marawar, and the team at Sage Publishing. Summary This fantastic Epilepsy Currents podcast episode delves into a groundbreaking study on the application of artificial intelligence (AI) in differentiating temporal lobe epilepsy from Alzheimer's disease and healthy controls using MRI-based deep learning. The study, co-authored by Dr. Ezequiel Gleichgerrcht and Dr. Erik Kaestner, demonstrated AI's potential to significantly improve the accuracy of neuroimaging analysis in epilepsy. The commentary by Dr. Peter Widdess-Walsh provided a critical examination of these findings, highlighting the practical implications for clinical practice and the limitations of current methodologies. The discussion framed AI not only as a tool for enhancing diagnostic accuracy but also as a means to uncover subtle neurobiological differences between diseases, potentially leading to more personalized treatment approaches. Key Takeaways High Diagnostic Accuracy with AI: The study highlighted showed that AI, specifically convolutional neural networks (CNNs), could differentiate between temporal lobe epilepsy, Alzheimer's disease, and healthy controls with high accuracy. This demonstrates AI's capability to identify nuanced patterns in neuroimaging that may not be visible to the human eye.AI Identifies Subtle Neurological Differences: The inclusion of Alzheimer's disease as a comparative group in the study was strategic to determine if the AI was recognizing temporal lobe epilepsy based on hippocampal atrophy alone or other disease-specific patterns. The findings suggest that AI can discern epilepsy-related patterns beyond the typical markers, indicating a profound potential for AI in understanding complex neurological conditions.Impact on Clinical Practice: Dr. Widdess-Walsh's commentary underscores the importance of these findings for clinical practice. AI's superior detection rate compared to human analysis (90% versus 47%) suggests that AI could significantly augment clinicians' ability to diagnose temporal lobe epilepsy, potentially leading to earlier and more accurate interventions. Limitations and Ethical Considerations: Despite AI's impressive capabilities, the podcast discussion acknowledges limitations, including the current inability of AI systems to interpret scans holistically, consider clinical context, or replace human decision-making. These factors highlight the need for AI to be used as an adjunct tool in clinical practice, enhancing rather than replacing the expertise of healthcare professionals.Future Directions and Challenges: The episode concludes with reflections on the broader implications of AI in neurology, from predicting surgery outcomes to possibly revolutionizing epilepsy care. However, challenges such as external validation, regulatory approval, and integration into clinical workflows must be addressed to fully realize AI's potential in epilepsy diagnosis and treatment. Transcript Adriana Bermeo, MD (Host): Hello and welcome to episode five of Epilepsy Currents podcast. Today, we will be talking about the use of artificial intelligence and machine learning in the study of temporal lobe epilepsy. I am your host, Adriana Bermeo. I am the senior podcast editor for Epilepsy Currents, the official journal of the American Epilepsy Society. Today, I am joined by a team of experts in this very exciting neurodiagnostic arena. I want to first welcome contributing editor, Dr. Peter Widdess-Walsh, who wrote the commentary "More Than Meets the Eye: Human vs. Computer Neuroimaging of Temporal Lobe Epilepsy." This commentary was published on December 2023 issue of Epilepsy Currents. Dr. Widdess-Walsh is a consultant neurologist and Clinical Associate Professor at Beaumont Hospital in Dublin, Ireland. Peter, welcome to Epilepsy Currents podcast. podcast. Peter Widdess-Walsh, MD: Thank you very much, Adriana. I'm delighted to be here. Host: Thank you for being here. It is also my pleasure to welcome Dr. Ezequiel Zeke Gleichgerrcht, who authored the work that inspired this commentary titled, "MRI Based Deep Learning Can Discriminate Between Temporal Lobe Epilepsy, Alzheimer's Disease, and Healthy Controls. Their paper was published in Nature Communications Medicine in 2023. Dr. Gleichgerrcht is an Assistant Professor of Neurology at Emory University. Zeke, welcome. Ezequiel Gleichgerrcht, MD: Thank you. Thanks for having me. Host: We are also joined by Dr. Erik Kaestner, co-author on the original paper and lead author on other related publications addressing the use of artificial intelligence in epilepsy. Dr. Kaestner ...
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    25 分
  • Epilepsy Currents - Episode 4 - "Dobbs vs Jackson - Epilepsy Reproductive Health and Abortion"

    Epilepsy Currents - Episode 4 - "Dobbs vs Jackson - Epilepsy Reproductive Health and Abortion"
    2023/10/23
    Join Dr. Bermeo in a conversation with Dr. Page Pennell and Dr. Alison Pack as they discuss the article, "Dobbs Versus Jackson: Epilepsy, Reproductive Health, and Abortion". Click here to read the article. This podcast was sponsored by the American Epilepsy Society. We’d also like to acknowledge contributing editor Dr. Rohit Marawar, and the team at Sage Publishing. Summary: In this episode of the Epilepsy Currents podcast, Dr. Adriana Bermeo discusses the Supreme Court's decision on Dobbs v Jackson and its implications for people living with epilepsy. She is joined by Dr. Allison Pack, a professor of neurology at Columbia University, and Dr. Page Pennell, the chair of the Department of Neurology at the University of Pittsburgh School of Medicine. They discuss the key points and historical significance of the Roe v. Wade and Dobbs v Jackson rulings, the current state-by-state variation of abortion access in the United States, and the impact on women and people of childbearing age living with epilepsy. They also address the importance of contraception, the risks of anti-seizure medications during pregnancy, and the need for evidence-based care and advocacy for patients. Resources such as the Guttmacher Institute and the National Abortion Federation Hotline are mentioned for further information and support.   5 Key Takeaways: 1. The Supreme Court's decision on Dobbs v Jackson has significant consequences for persons living with epilepsy and their access to abortion. 2. The current state-by-state variation of abortion access in the United States is complex and can range from very restrictive to most protective. 3. Planned pregnancies are crucial for individuals with epilepsy to optimize outcomes for both the individual and the developing fetus. 4. Effective contraception is important for individuals with epilepsy, and options such as long-acting reversible contraception (IUDs) and birth control pills should be considered. 5. Neurologists and epilepsy specialists should advocate for their patients' rights and women's rights, ensuring that medical decisions are made by qualified practitioners based on evidence and with respect for the individual patient. Resources such as the Guttmacher Institute and the National Abortion Federation Hotline can provide information and support.     Transcript Dr. Adriana Bermeo (00:05): Hello and welcome to episode four of Epilepsy Currents podcast. I am your host, Adriana Bermeo. I am the senior podcast editor for Epilepsy Currents, the official journal of the American Epilepsy Society. It is my pleasure to welcome today's guest to talk about the Supreme Court's decision on Dobbs v Jackson and its consequences for persons living with epilepsy. We have two very special guests to help us understand the implications of this ruling on reproductive health and access to abortion for people living with epilepsy of childbearing potential. First, I want to welcome Dr. Pack, senior author of a commentary titled Dobbs versus Jackson Epilepsy Reproductive Health and Abortion, published online first in the May, 2023 issue of Epilepsy Currents. Dr. Pack is a professor of neurology at Columbia University. She's the Chief division of Epilepsy and sleep at New York Presbyterian, Columbia University Medical Center. I also want to especially welcome Dr. Page Pennell, who's the Henry B. Hickman Professor of Neurology and chair of the Department of Neurology at the University of Pittsburgh School of Medicine. Dr. Pennell is a global expert on the management of pregnancy-related issues in epilepsy, and she's also a past president of the American Epilepsy Society. Dr. Pack, let me start with you. Most of our listeners are familiar with Roe versus Wade and Dobbs versus Jackson Supreme Court rulings, but could you give us a quick refresher on the key points and historical significance of these two landmark cases? Dr. Allison Pack (01:43): Thank you very much, Adriana, and it's a pleasure to be here today and I want to thank the American Epilepsy Society for supporting this discussion as we go through our discussion today. Today we will be referring to persons with epilepsy of childbearing potential. Please recognize that we are aware that not all individuals who seek pregnancy or become pregnant identify as a woman. So I'm going to go through right now the court rulings ruling Roe v. Wade was enacted in 1973. In this ruling, the court ruled that the Constitution of the United States generally protected a right to abortion. This ruling was reaffirmed in 1992 in the ruling Planned Parenthood of Southeastern Pennsylvania versus Casey. Dobbs v Jackson was enacted on June 24th, 2022. With this ruling, the Constitution does not confer a right to abortion. Essentially, Roe v. Wade and Planned Parenthood of Southeastern Pennsylvania versus Casey were overturned. The authority to regulate abortion went back to the state and the constitutional right to abortion was eliminated. Dr. Adriana ...
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    25 分
  • Epilepsy Currents – Episode 3 "Keto Is Not Just for Kids: A Randomized Trial of a Modified Atkins Diet for Adolescents and Adults With Anti-Seizure Medication Resistant Epilepsy"

    Epilepsy Currents – Episode 3 "Keto Is Not Just for Kids: A Randomized Trial of a Modified Atkins Diet for Adolescents and Adults With Anti-Seizure Medication Resistant Epilepsy"
    2023/06/20
    Join Dr. Bermeo in a conversation with Dr. Mackenzie Cervenka and Dr. Manjari Tripathi as they discuss the article, " Keto is Not Just for Kids: A Randomized Trial of a Modified Atkins Diet for Adolescents and Adults With Anti-Seizure Medication Resistant Epilepsy ". Click here to read the article. This podcast was sponsored by the American Epilepsy Society. We’d also like to acknowledge contributing editor Dr. Rohit Marawar, and the team at Sage Publishing.   Five Key Takeaways:   Effectiveness of Modified Atkins Diet (MAD): The research conducted by Dr. Manjari Tripathi found that 26% of the people who supplemented their drug therapy with the MAD experienced a more than 50% reduction in seizure frequency compared to only 2.5% of people who used only drug therapy. Importantly, some patients even became seizure-free. Improved Quality of Life: Along with a significant decrease in seizures, patients following the MAD also reported improved quality of life and behavior. Difference in Adherence Between Adolescents and Adults: The study found that adults were more likely to adhere to the diet than adolescents, possibly due to a combination of food preferences and possible differences in gut microbiota. Potential Long-Term Effects of Ketogenic Diets: While ketogenic diets can be effective in managing epilepsy, there are potential long-term side effects to consider, such as vitamin and mineral deficiencies, bone loss, risk of nephrolithiasis (kidney stones), and hyperlipidemia (high levels of lipids in the blood), which may lead to cardiovascular and cerebrovascular diseases. Approach to Weaning off the Diet: Dr. Mackenzie Cervenka suggests that weaning off the diet should be considered in a similar manner to removing anti-seizure medication. The decision should be made considering the side effects and the overall burden of the therapy on the patient. Abrupt discontinuation of the diet can result in an increase in seizures, hence the diet should be gradually reduced. Dr. Adriana Bermeo (00:06): Hello, and welcome to episode three of Epilepsy Currents podcast. I am your host, Adriana Bermeo. I am the senior podcast editor for Epilepsy Currents, the official journal of the American Epilepsy Society. It is my pleasure to welcome today's guest to talk about the use of ketogenic diets in the treatment of refractory epilepsy in adolescents and adults. First, I want to welcome our contributing editor for epilepsy current, Dr. Mackenzie Cervenka, who wrote a commentary titled "Keto Is Not Just For Kids: a randomized trial of a modified Atkins diets for adolescents and adults with anti-seizure medication resistant epilepsy". This was published online first in the March, 2023 issue of Epilepsy Currents. Dr. Cervenka is Professor of Neurology at John Hopkins School of Medicine. She's the medical director of the Adult Epilepsy Diet Center and the Adult Epilepsy Monitoring Unit. She developed the John Hopkins Adult Epilepsy Dietary Center in 2010 and has treated nearly 450 adults with epilepsy using ketogenic diet. Dr.Cervenka, welcome to Epilepsy Currents podcast. Dr. Mackenzie Cervenka (01:16): Thank you so much Dr. Bermeo for inviting me as a guest today at the Epilepsy Currents Podcast. Dr. Adriana Bermeo (01:22): It's a pleasure to have you. I also want to specially welcome Dr. Manjari Tripathi, who is the senior author of the publication that inspired this commentary titled "Safety, efficacy, and Tolerability of Modified Atkins Diet in Persons with Drug-Resistant Epilepsy." This was published in Neurology in March of 2023. Dr. Tripathi is a professor of neurology and epilepsy at the All India Institute of Medical Sciences, where she serves as director of the Epilepsy, Behavioral Neurology, and Sleep Medicine Programs. Dr. Tripathi, it's a pleasure to have you. Dr. Manjari Tripathi (01:57): Hi. Thank you. Great being here. Dr. Adriana Bermeo (02:00): Dr. Cervenka, I want to start with you. Our listeners may or may not be familiar with the concept of ketogenic diets for the treatment of epilepsy in adults particularly, but they may not know that there are different options for treatment. Can you please give us an overview of the principles of these dietary treatments and tell us what options can we can offer to our patients Dr. Mackenzie Cervenka (02:21): In our field? We refer to ketogenic diets for epilepsy actually as ketogenic diet therapies. And we do this to distinguish them from ketogenic diets that we typically hear about being used for weight loss or for other purposes, and that are not necessarily recommended or monitored by clinicians or treating teams. Technically, a ketogenic diet therapy is any dietary manipulation that can produce a state of nutritional ketosis, and that is a state where the body metabolizes fatty acids into ketone bodies. Those are beta hydroxybutyrate, acetoacetate, and acetone. There are a whole variety of ketogenic diet therapies, and these include what ...
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    27 分
  • Epilepsy Currents – Episode 2 “SUDEP Risk Counseling: What We Don’t Do in the Shadows”

    Epilepsy Currents – Episode 2 “SUDEP Risk Counseling: What We Don’t Do in the Shadows”
    2023/03/24

    Join Dr. Bermeo in a conversation with Dr. Erik St Louis and Dr. Eugen Trinka as they discuss the article, "SUDEP Risk Counseling: What We Don’t Do in the Shadows ".

    Click here to read the article.

    This podcast was sponsored by the Danny Did Foundation.
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    30 分
  • Epilepsy Currents - Episode 1 “RNS—It Never Gets Old”

    Epilepsy Currents - Episode 1 “RNS—It Never Gets Old”
    2022/08/26

    Join Dr. Bermeo in a conversation with Dr. Christopher Todd Anderson and Dr. Dileep Nair as they discuss the article, "RNS—It Never Gets Old".

    Click here to read the article.

    This podcast was sponsored by the American Epilepsy Society.
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    30 分
  • Epilepsy Currents Podcast Introduction with Dr. Bermeo

    Epilepsy Currents Podcast Introduction with Dr. Bermeo
    2022/04/26

    Join Dr. Bermeo in a conversation with our contributing editors and the original authors of the literature shaping the field of epilepsy.

    Epilepsy Currents Podcast will bring you all the features you know and love about the Journal in an innovative format you can take with you wherever you go.
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    2 分