{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:33:23Z","timestamp":1761824003384,"version":"3.37.3"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,6,14]],"date-time":"2018-06-14T00:00:00Z","timestamp":1528934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>There is little detailed phenotypic characterization of bilateral hippocampal sclerosis (<jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content>). We therefore conducted a multicenter review of people with pharmacoresistant epilepsy and bilateral <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content> to better determine their clinical characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Databases from 11 <jats:styled-content style=\"fixed-case\">EPIGEN<\/jats:styled-content> centers were searched. For identified cases, clinicians reviewed the medical notes, imaging, and electroencephalographic (<jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>), video\u2010<jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>, and neuropsychometric data. Data were irretrievably anonymized, and a single database was populated to capture all phenotypic information. These data were compared with phenotyped cases of unilateral <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content> from the same centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 96 patients with pharmacoresistant epilepsy and bilateral <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content> were identified (43 female, 53 male; age range = 8\u201080\u00a0years). Twenty\u2010five percent had experienced febrile convulsions, and 27% of patients had experienced status epilepticus. The mean number of previously tried antiepileptic drugs was 5.32, and the average number of currently prescribed medications was 2.99; 44.8% of patients had cognitive difficulties, and 47.9% had psychiatric comorbidity; 35.4% (34\/96) of patients continued with long\u2010term medical therapy alone, another 4 being seizure\u2010free on medication. Sixteen patients proceeded to, or were awaiting, neurostimulation, and 11 underwent surgical resection. One patient was rendered seizure\u2010free postresection, with an improvement in seizures for 3 other cases. By comparison, of 201 patients with unilateral <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content>, a significantly higher number (44.3%) had febrile convulsions and only 11.4% had experienced status epilepticus. Importantly, 41.8% (84\/201) of patients with unilateral <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content> had focal aware seizures, whereas such seizures were less frequently observed in people with bilateral <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content>, and were never observed exclusively (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002; Fisher's exact test).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>The current work describes the phenotypic spectrum of people with pharmacoresistant epilepsy and bilateral <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content>, highlights salient clinical differences from patients with unilateral <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content>, and provides a large platform from which to develop further studies, both epidemiological and genomic, to better understand etiopathogenesis and optimal treatment regimes in this condition.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.14436","type":"journal-article","created":{"date-parts":[[2018,6,14]],"date-time":"2018-06-14T09:10:27Z","timestamp":1528967427000},"page":"1410-1420","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The phenotype of bilateral hippocampal sclerosis and its management in \u201creal life\u201d clinical settings"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8948-4763","authenticated-orcid":false,"given":"Arjune","family":"Sen","sequence":"first","affiliation":[{"name":"Oxford Epilepsy Research Group National Institute for Health Research Biomedical Research Centre Nuffield Department of Clinical Neuroscience John Radcliffe Hospital Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6199-1870","authenticated-orcid":false,"given":"Patricia","family":"Dugan","sequence":"additional","affiliation":[{"name":"Department of Neurology New York University Langone Medical Center New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7855-7066","authenticated-orcid":false,"given":"Piero","family":"Perucca","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Neurology Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia"},{"name":"Departments of Neuroscience and Neurology Central Clinical School Alfred Hospital Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Costello","sequence":"additional","affiliation":[{"name":"Department of Neurology Cork University Hospital Wilton, Cork Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyunmi","family":"Choi","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center Neurological Institute of New York New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Bazil","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center Neurological Institute of New York New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rod","family":"Radtke","sequence":"additional","affiliation":[{"name":"Department of Neurology Duke University School of Medicine Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Andrade","sequence":"additional","affiliation":[{"name":"Toronto Western Hospital Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal","family":"Depondt","sequence":"additional","affiliation":[{"name":"Department of Neurology H\u00f4pital Erasme Universit\u00e9 Libre de Bruxelles Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sinead","family":"Heavin","sequence":"additional","affiliation":[{"name":"FutureNeuro Research Centre Royal College of Surgeons in Ireland Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5181-0925","authenticated-orcid":false,"given":"Jane","family":"Adcock","sequence":"additional","affiliation":[{"name":"Oxford Epilepsy Research Group National Institute for Health Research Biomedical Research Centre Nuffield Department of Clinical Neuroscience John Radcliffe Hospital Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4396-5657","authenticated-orcid":false,"given":"W. Owen","family":"Pickrell","sequence":"additional","affiliation":[{"name":"Neurology Research Group Institute of Life Science Swansea University Medical School Swansea UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4606-7783","authenticated-orcid":false,"given":"Ronan N.","family":"McGinty","sequence":"additional","affiliation":[{"name":"Oxford Epilepsy Research Group National Institute for Health Research Biomedical Research Centre Nuffield Department of Clinical Neuroscience John Radcliffe Hospital Oxford UK"},{"name":"Department of Neurology Cork University Hospital Wilton, Cork Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7161-6385","authenticated-orcid":false,"given":"F\u00e1bio","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Toronto Western Hospital Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Wales Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark I.","family":"Rees","sequence":"additional","affiliation":[{"name":"Neurology Research Group Institute of Life Science Swansea University Medical School Swansea UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7310-276X","authenticated-orcid":false,"given":"Patrick","family":"Kwan","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Neurology Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia"},{"name":"Departments of Neuroscience and Neurology Central Clinical School Alfred Hospital Monash University Melbourne Victoria Australia"},{"name":"Department of Medicine and Therapeutics Chinese University of Hong Kong Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terence J.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Neurology Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia"},{"name":"Departments of Neuroscience and Neurology Central Clinical School Alfred Hospital Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Institute for Genomic Medicine Columbia University Medical Center New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norman","family":"Delanty","sequence":"additional","affiliation":[{"name":"FutureNeuro Research Centre Royal College of Surgeons in Ireland Dublin Ireland"},{"name":"Department of Neurology Beaumont Hospital Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,6,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200108023450501"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70109-1"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurpsyc.1958.02340050003001"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2008.12.023"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.20.1.11"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn726"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.40.12.1869"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.09.006"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2013.02.003"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410410109"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1550059416653900"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/120.10.1865"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1995.tb01634.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2007.123406"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1997.tb01144.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181b99a07"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1996.tb00578.x"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8249(200002)47:2<195::AID-ANA9>3.0.CO;2-2"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198702263160901"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1535-7597.2003.03401.x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.69.6.733"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awt233"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2005.61104.x"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2003.015354"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181eee3f0"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410400314"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410420608"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.7.JNS132037"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13010"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.1.JNS131592"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awr209"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fepi.14436","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.14436","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T00:20:31Z","timestamp":1694910031000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.14436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,14]]},"references-count":31,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1111\/epi.14436"],"URL":"https:\/\/doi.org\/10.1111\/epi.14436","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"type":"print","value":"0013-9580"},{"type":"electronic","value":"1528-1167"}],"subject":[],"published":{"date-parts":[[2018,6,14]]},"assertion":[{"value":"2018-05-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-06-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}