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1. Perampanel (Fycompa) - for the adjunctive treatment of partial-onset seizures with or without secondarily generalised seizures in adult and adolescent patients from 12 years of age with epilepsy.

Perampanel (Fycompa) - for the adjunctive treatment of partial-onset seizures with or without secondarily generalised seizures in adult and adolescent patients from 12 years of age with epilepsy. Published 12 August 2019 1 Product update SMC2172 perampanel 0.5mg/mL oral suspension (Fycompa®) Eisai Ltd 5 July 2019 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use (...) in NHSScotland. The advice is summarised as follows: ADVICE: following an abbreviated submission perampanel (Fycompa®) is accepted for restricted use within NHSScotland. Indication under review: for the adjunctive treatment of partial-onset seizures with or without secondarily generalised seizures in adult and adolescent patients from 12 years of age with epilepsy. SMC restriction: use as a second-line adjunctive treatment in patients with refractory partial onset epilepsy who are unable to swallow

2019 Scottish Medicines Consortium

2. Phenytoin versus valproate monotherapy for partial onset seizures and generalised onset tonic-clonic seizures: an individual participant data review. (PubMed)

Phenytoin versus valproate monotherapy for partial onset seizures and generalised onset tonic-clonic seizures: an individual participant data review. Worldwide, phenytoin and valproate are commonly used antiepileptic drugs. It is generally believed that phenytoin is more effective for partial onset seizures, and that valproate is more effective for generalised onset tonic-clonic seizures (with or without other generalised seizure types). This review is one in a series of Cochrane reviews (...) investigating pair-wise monotherapy comparisons. This is the latest updated version of the review first published in 2001 and updated in 2013.To review the time to withdrawal, remission and first seizure of phenytoin compared to valproate when used as monotherapy in people with partial onset seizures or generalised tonic-clonic seizures (with or without other generalised seizure types).We searched the Cochrane Epilepsy Group's Specialised Register (19 May 2015), the Cochrane Central Register of Controlled

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2016 Cochrane

3. Ethosuximide, sodium valproate or lamotrigine for absence seizures in children and adolescents. (PubMed)

Ethosuximide, sodium valproate or lamotrigine for absence seizures in children and adolescents. This is an updated version of the Cochrane Review previously published in 2017.Absence seizures (AS) are brief epileptic seizures which present in childhood and adolescence. Depending on clinical features and electroencephalogram (EEG) findings they are divided into typical, atypical absences, and absences with special features. Typical absences are characterised by sudden loss of awareness (...) and an EEG typically shows generalised spike wave discharges at three cycles per second. Ethosuximide, valproate and lamotrigine are currently used to treat absence seizures. This review aims to determine the best choice of antiepileptic drug for children and adolescents with AS.To review the evidence for the effects of ethosuximide, valproate and lamotrigine as treatments for children and adolescents with absence seizures (AS), when compared with placebo or each other.For the latest update we searched

2019 Cochrane

4. Rufinamide (Inovelon) - treatment of seizures associated with Lennox-Gastaut syndrome

Rufinamide (Inovelon) - treatment of seizures associated with Lennox-Gastaut syndrome Final Appraisal Recommendation Advice No: 0919 – June 2019 Rufinamide (Inovelon ® ) 40 mg/ml oral suspension Limited submission by Eisai Ltd Additional note(s): ? AWMSG considered that rufinamide (Inovelon ® ) satisfied the AWMSG criteria for orphan status. ? This advice incorporates and replaces the existing AWMSG recommendation for rufinamide (Inovelon ® ) as an option for use as adjunctive therapy (...) in the treatment of seizures associated with Lennox-Gastaut syndrome in patients 4 years of age and older where other adjunctive treatments have proved sub-optimal or have not been tolerated (AWTTC reference number 1663, originally published October 2012). In reaching the above recommendation AWMSG has taken account of the appraisal documentation prepared by the AWMSG Secretariat (reference number 991), which includes the AWMSG Secretariat Assessment Report (ASAR), the Preliminary Appraisal Recommendation (PAR

2019 All Wales Medicines Strategy Group

5. Febrile seizure

Febrile seizure Febrile seizure - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Febrile seizure Last reviewed: February 2019 Last updated: January 2019 Summary Febrile seizures are usually self-limiting; an increased risk of developing epilepsy is low except in a small number of cases. Most febrile seizures resolve spontaneously and quickly, and do not require acute or long-term anticonvulsant treatment. Definition (...) The American Academy of Pediatrics announced a standard definition of febrile seizures as a seizure occurring in febrile children between the ages of 6 and 60 months who do not have an intracranial infection, metabolic disturbance, or history of afebrile seizures. Capovilla G, Mastrangelo M, Romeo A, et al. Recommendations for the management of "febrile seizures": Ad Hoc Task Force of LICE Guidelines Commission. Epilepsia. 2009 Jan;50(suppl 1):S2-6. http://onlinelibrary.wiley.com/doi/10.1111/j.1528

2019 BMJ Best Practice

6. Lacosamide - epilepsy medicine used to treat partial-onset seizures

Lacosamide - epilepsy medicine used to treat partial-onset seizures Official address Domenico Scarlattilaan 6 ? 1083 HS Amsterdam ? The Netherlands An agency of the European Union Address for visits and deliveries Refer to www.ema.europa.eu/how-to-find-us Send us a question Go to www.ema.europa.eu/contact Telephone +31 (0)88 781 6000 © European Medicines Agency, 2019. Reproduction is authorised provided the source is acknowledged. EMA/384569/2019 EMEA/H/C/005243 Lacosamide UCB (lacosamide (...) ) An overview of Lacosamide UCB and why it is authorised in the EU What is Lacosamide UCB and what is it used for? Lacosamide UCB is an epilepsy medicine used to treat partial-onset seizures (epileptic fits starting in one specific part of the brain) in patients with epilepsy aged 4 years or older. It can be used to treat partial-onset seizures with or without secondary generalisation (where the seizure subsequently spreads to other parts of the brain). Lacosamide UCB is given on its own or combined

2019 European Medicines Agency - EPARs

7. Simple febrile seizures in a child. First-choice treatments

Simple febrile seizures in a child. First-choice treatments Prescrire IN ENGLISH - Spotlight ''Simple febrile seizures in a child. First-choice treatments'', 1 February 2019 {1} {1} {1} | | > > > Simple febrile seizures in a child. First-choice treatments Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight Simple febrile seizures in a child. First (...) -choice treatments FEATURED REVIEW Febrile seizures occur in around 3% of children. What are the essential points for healthcare professionals to keep in mind? And what are the warning signs to look out for? Full review (4 pages) available for download by subscribers. A simple febrile seizure is defined as an episode of generalised seizures lasting less than 15 minutes and occurring only once in 24 hours in a child during a febrile episode, without intracranial infection, metabolic disorders

2019 Prescrire

8. Generalised seizures

Generalised seizures Generalised seizures - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Generalised seizures Last reviewed: February 2019 Last updated: October 2018 Summary Common seizure type characterised by loss of consciousness, widespread motor manifestations of tonic contractions followed by clonic jerking movements, and a suppressed level of arousal following the event. May either reflect an underlying (...) generalised-onset epilepsy or focal epilepsy that has secondarily generalised. Magnetic resonance imaging and an electroencephalogram (EEG) are essential tests for properly diagnosing an epilepsy syndrome after a generalised tonic-clonic seizure (GTCS). During a GTCS, the EEG will demonstrate bilateral synchrony in the epileptiform activity. After a GTCS, treatment depends on the type of epilepsy syndrome identified. Generalised-onset epilepsy is treated differently to focal epilepsy. With proper

2018 BMJ Best Practice

9. Lacosamide (Vimpat) - treatment of partial-onset seizures with or without secondary generalisation in children

Lacosamide (Vimpat) - treatment of partial-onset seizures with or without secondary generalisation in children Final Appraisal Recommendation Advice No: 0318 – Feb 2018 Lacosamide (Vimpat ® ) 50 mg, 100 mg, 150 mg, 200 mg film-coated tablets; 10 mg/ml syrup; 10 mg/ml solution for infusion Limited submission by UCB Pharma Ltd. Additional note(s): • Please refer to the Summary of Product Characteristics for the full licensed indication. In reaching the above recommendation AWMSG has taken account (...) Lacosamide (Vimpat ® ) is recommended as an option for use within NHS Wales as adjunctive therapy in the treatment of partial-onset seizures with or without secondary generalisation in children from = 4 years of age to = 15 years of age with epilepsy. Statement of use: No part of this recommendation may be reproduced without the whole recommendation being quoted in full and cited as: All Wales Medicines Strategy Group Final Appraisal Recommendation – 0318: Lacosamide (Vimpat ® ) 50 mg, 100 mg, 150 mg

2018 All Wales Medicines Strategy Group

10. Generalised seizures in children

Generalised seizures in children Generalised seizures in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Generalised seizures in children Last reviewed: February 2019 Last updated: September 2018 Summary Seizures may occur as a stand-alone event or may recur (epilepsy). Aetiology can be structural, genetic, infectious, metabolic, immune, or unknown. An attempt should be made to identify the type(s (...) ) of epilepsy and the epilepsy syndrome by recognising a pattern of seizure types, clinical features, and EEG characteristics. Detailed history is of paramount importance in the diagnosis, as key diagnostic factors lie in the history as opposed to ancillary investigations. Main treatment options will depend on the epilepsy syndrome and include anticonvulsants, a ketogenic diet, vagus nerve stimulation, and surgery as well as consideration of lifestyle factors. Definition With the revised and updated

2018 BMJ Best Practice

11. Febrile seizure

Febrile seizure Febrile seizure - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Febrile seizure Last reviewed: February 2019 Last updated: January 2019 Summary Febrile seizures are usually self-limiting; an increased risk of developing epilepsy is low except in a small number of cases. Most febrile seizures resolve spontaneously and quickly, and do not require acute or long-term anticonvulsant treatment. Definition (...) The American Academy of Pediatrics announced a standard definition of febrile seizures as a seizure occurring in febrile children between the ages of 6 and 60 months who do not have an intracranial infection, metabolic disturbance, or history of afebrile seizures. Capovilla G, Mastrangelo M, Romeo A, et al. Recommendations for the management of "febrile seizures": Ad Hoc Task Force of LICE Guidelines Commission. Epilepsia. 2009 Jan;50(suppl 1):S2-6. http://onlinelibrary.wiley.com/doi/10.1111/j.1528

2018 BMJ Best Practice

12. Focal seizures

Focal seizures Focal seizures - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Focal seizures Last reviewed: February 2019 Last updated: June 2018 Summary Electrical and clinical manifestations of seizures that arise from one portion of the brain. May evolve to bilateral tonic-clonic seizures. Underlying structural brain abnormalities are known to cause a localised epileptiform focus, but idiopathic cases may occur (...) . History taking is the most important aspect of diagnosis. Supportive tests, although helpful, need not be abnormal for a diagnosis of focal seizures. Monotherapy with antiepileptic medication is the preferred treatment. When polytherapy is required, this should be approached rationally, by considering the combination of different mechanisms of action and different adverse-event profiles. Patients with 2 failed monotherapy trials followed by a failed trial of polytherapy are considered to have

2018 BMJ Best Practice

13. Generalised seizures

Generalised seizures Generalised seizures - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Generalised seizures Last reviewed: February 2019 Last updated: October 2018 Summary Common seizure type characterised by loss of consciousness, widespread motor manifestations of tonic contractions followed by clonic jerking movements, and a suppressed level of arousal following the event. May either reflect an underlying (...) generalised-onset epilepsy or focal epilepsy that has secondarily generalised. Magnetic resonance imaging and an electroencephalogram (EEG) are essential tests for properly diagnosing an epilepsy syndrome after a generalised tonic-clonic seizure (GTCS). During a GTCS, the EEG will demonstrate bilateral synchrony in the epileptiform activity. After a GTCS, treatment depends on the type of epilepsy syndrome identified. Generalised-onset epilepsy is treated differently to focal epilepsy. With proper

2018 BMJ Best Practice

14. Absence seizures

Absence seizures Absence seizures - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Absence seizures Last reviewed: February 2019 Last updated: June 2018 Summary Typical absence seizure: behavioural arrest or staring, lasting 5 to 10 seconds, interrupting otherwise normal activity. Can be hyperventilation-induced. Atypical absence seizures: less distinct beginning and end, not usually precipitated by hyperventilation (...) . EEG is the definitive test. Determining the exact nature of their seizures is the key to the appropriate treatment and prognosis. Most typical absence seizures are medically responsive, and childhood absence epilepsy (CAE) tends to remit by adulthood. Typical absence seizures in CAE, juvenile absence epilepsy (JAE), and juvenile myoclonic epilepsy (JME) are treated with ethosuximide, valproate, or lamotrigine as first-line therapies. Atypical absence seizures tend to be medically refractory

2018 BMJ Best Practice

15. Overview of seizure disorder

Overview of seizure disorder Overview of seizure disorder - Summary of relevant conditions | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Overview of seizure disorder Last reviewed: February 2019 Last updated: June 2018 Important updates 27 Oct 2017 Revised operational classification of seizure types and epilepsies by the International League Against Epilepsy (ILAE) What’s new? The classification has been revised. Seizures are divided into those (...) of focal, generalised, unknown onset, with sub-categories of motor, non-motor, with retained or impaired awareness for focal seizures. Levels of classification to aid the diagnosis include seizure type, epilepsy type (focal, generalised, combined generalized and focal, unknown) and epilepsy syndrome. Introduction A seizure is defined as "a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain". Fisher RS, Acevedo C, Arzimanoglou A, et al

2018 BMJ Best Practice

16. Generalised seizures in children

Generalised seizures in children Generalised seizures in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Generalised seizures in children Last reviewed: February 2019 Last updated: September 2018 Summary Seizures may occur as a stand-alone event or may recur (epilepsy). Aetiology can be structural, genetic, infectious, metabolic, immune, or unknown. An attempt should be made to identify the type(s (...) ) of epilepsy and the epilepsy syndrome by recognising a pattern of seizure types, clinical features, and EEG characteristics. Detailed history is of paramount importance in the diagnosis, as key diagnostic factors lie in the history as opposed to ancillary investigations. Main treatment options will depend on the epilepsy syndrome and include anticonvulsants, a ketogenic diet, vagus nerve stimulation, and surgery as well as consideration of lifestyle factors. Definition With the revised and updated

2018 BMJ Best Practice

17. Antiepileptic drugs as prophylaxis for postcraniotomy seizures. (PubMed)

Antiepileptic drugs as prophylaxis for postcraniotomy seizures. This is an updated version of the Cochrane Review previously published in Issue 3, 2015.The incidence of seizures following supratentorial craniotomy for non-traumatic pathology has been estimated to be between 15% to 20%; however, the risk of experiencing a seizure appears to vary from 3% to 92% over a five-year period. Postoperative seizures can precipitate the development of epilepsy; seizures are most likely to occur within (...) the first month of cranial surgery. The use of antiepileptic drugs (AEDs) administered pre- or postoperatively to prevent seizures following cranial surgery has been investigated in a number of randomised controlled trials (RCTs).To determine the efficacy and safety of AEDs when used prophylactically in people undergoing craniotomy and to examine which AEDs are most effective.For the latest update we searched the following databases on 26 June 2017: Cochrane Epilepsy Group Specialized Register

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2018 Cochrane

18. Clobazam monotherapy for focal or generalized seizures. (PubMed)

Clobazam monotherapy for focal or generalized seizures. This is an updated version of the original Cochrane Review published in Issue 10, 2014. There is a need to expand monotherapy options available to a clinician for the treatment of new focal or generalized seizures. A Cochrane systematic review for clobazam monotherapy is expected to define its place in the treatment of new-onset or untreated seizures and highlight gaps in evidence.To evaluate the efficacy, effectiveness, tolerability (...) ). There were no language restrictions.Randomized or quasi-randomized controlled trials comparing clobazam monotherapy versus placebo or other anti-seizure medication in people with two or more unprovoked seizures or single acute symptomatic seizure requiring short-term continuous anti-seizure medication, were eligible for inclusion.Primary outcome measure was time on allocated treatment (retention time), reflecting both efficacy and tolerability. Secondary outcomes included short- and long-term

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2018 Cochrane

19. Phenytoin versus levetiracetam as prophylaxis for postcraniotomy seizure in patients with no history of seizures: systematic review and meta-analysis

Phenytoin versus levetiracetam as prophylaxis for postcraniotomy seizure in patients with no history of seizures: systematic review and meta-analysis OBJECTIVEDe novo seizure following craniotomy (DSC) for nontraumatic pathology may adversely affect medical and neurological outcomes in patients with no history of seizures who have undergone craniotomies. Antiepileptic drugs (AEDs) are commonly used prophylactically in patients undergoing craniotomy; however, evidence supporting this practice (...) with levetiracetam treatment as the main treatment difference between the two groups, and availability of data on the numbers of patients and seizures for each group. Patients with brain injury and previous seizure history were excluded. DSC occurrence and adverse drug reaction (ADR) were evaluated. Seizure occurrence was calculated using the Peto odds ratio (POR), which is the relative effect estimation method of choice for binary data with rare events.RESULTSData from 7 studies involving 803 patients were

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2018 EvidenceUpdates

20. Stiripentol (Diacomit) - To treat seizures associated with Dravet syndrome in patients 2 years of age and older taking clobazam

Stiripentol (Diacomit) - To treat seizures associated with Dravet syndrome in patients 2 years of age and older taking clobazam Drug Approval Package: Diacomit (stiripentol) U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: Diacomit (stiripentol) Company: Biocodex SA Application Number: 206709 & 207223 Approval Date: 08/20/2018 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval

2018 FDA - Drug Approval Package

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