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The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on epilepsy or other clinical topics then use Trip today.
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Fenfluramine hydrochloride for the treatment of seizures in Dravet syndrome: a randomised, double-blind, placebo-controlled trial. Dravet syndrome is a rare, treatment-resistant developmental epileptic encephalopathy characterised by multiple types of frequent, disabling seizures. Fenfluramine has been reported to have antiseizure activity in observational studies of photosensitive epilepsy and Dravet syndrome. The aim of the present study was to assess the efficacy and safety of fenfluramine (...) in patients with Dravet syndrome.In this randomised, double-blind, placebo-controlled clinical trial, we enrolled children and young adults with Dravet syndrome. After a 6-week observation period to establish baseline monthly convulsiveseizure frequency (MCSF; convulsiveseizures were defined as hemiclonic, tonic, clonic, tonic-atonic, generalised tonic-clonic, and focal with clearly observable motor signs), patients were randomly assigned through an interactive web response system in a 1:1:1 ratio
with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome, in patients 2 years of age and older . General Contraceptive Considerations Adolescents with seizuredisorders require ongoing education about potential adverse pregnancy outcomes and the most effective contraceptive options. Ideally, education should begin in early adolescence and continue throughout a patient’s reproductive lifespan because antiepileptic drugs, contraceptive needs, and desire for pregnancy may (...) 2011;52:199–211. Article Locations: Cummings LN, Giudice L, Morrell MJ. Ovulatory function in epilepsy. Epilepsia 1995;36:355–9. Article Locations: Tauboll E, Sveberg L, Svalheim S. Interactions between hormones and epilepsy. Seizure 2015;28:3–11. Article Locations: Morrell MJ, Hayes FJ, Sluss PM, Adams JM, Bhatt M, Ozkara C, et al. Hyperandrogenism, ovulatory dysfunction, and polycystic ovary syndrome with valproate versus lamotrigine. Ann Neurol 2008;64:200–11. Article Locations: Joffe H, Cohen LS
are challenged by the new SARS-CoV-2 virus causing corona virus disease 2019 (COVID-19). The virus is causing mainly viral pneumonia and respiratory tract infection. In this statement, we will focus on the impact of COVID-19 on epilepsy. To our knowledge, no publication covering epilepsy, seizures or paroxysmal events has so far been published in relation to COVID-19. However, there are several general aspects to address: During the previous SARS epidemic, some people with epilepsy (PwE) stopped taking (...) their medicine due to isolation, or fear of contracting infection from hospitals, doctors’ offices, pharmacies or surgical procedures. This obviously leads to an increased risk for seizures and status epilepticus with all related complications including injuries, hospital admissions, and potentially sudden unexpected death in people with epilepsy (SUDEP). Hence, patient information is very important and should stress the importance of maintaining concordance with and supply of prescribed medication. COVID-19
will wane over a few days. Nasal decongestant products should be avoided. In some places, herbal products that contain various constituents, such as Ma Huang (ephedra), have been used in treating COVID-19. These products should be avoided in patients with epilepsy as they may interact with ASM and could exacerbate seizures. Patients should always be asked about nonprescription medication and natural product use when taking a medication history. Possible Drugs for Treating COVID-19 Several different (...) Managing Patients with Epilepsy during COVID-19 - Pharmacotherapy-related Recommendations COVID-19 | Pharmacotherapy and Epilepsy | American Epilepsy Society Google Tag Manager | | | You are here » COVID-19 | Pharmacotherapy and Epilepsy COVID-19 | Pharmacotherapy and Epilepsy T his page was last updated April 17, 2020 Managing Patients with Epilepsy during COVID-19 Pharmacotherapy-related Recommendations Prepared by a Task Force of the AES Council on Clinical Activities: Timothy Welty, PharmD
of classifications of seizures: a preliminary study with 28 participants and 48 seizures. Epilepsy Behav. 2005;6(4):607-612. 5. Pellock JM. The classification of childhood seizures and epilepsysyndromes. Neurol Clin. 1990;8(3):619- 632. 6. Scheuer ML, Pedley TA. The evaluation and treatment of seizures. N Engl J Med. 1990;323(21):1468-1474. 7. Engel J, Jr. Report of the ILAE classification core group. Epilepsia. 2006;47(9):1558-1568. 8. Panayiotopoulos CP. Neonatal EpilepticSeizures and Syndromes. Available (...) Boas W, Blume W, et al. Epilepticseizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005;46(4):470-472. 3. Weitemeyer L, Kellinghaus C, Weckesser M, et al. The prognostic value of [F]FDG-PET in nonrefractory partial epilepsy. Epilepsia. 2005;46(10):1654-1660. ACR Appropriateness Criteria ® 9 Seizures — Child 4. Baykan B, Ertas NK, Ertas M, Aktekin B, Saygi S, Gokyigit A. Comparison
that exacerbation of seizures, especially from systemic effects of severe COVID-19 infections, will be a major concern. Given this likelihood, all caregivers of patients with epilepsy should take extra care to assist their patients in preventing potential COVID-19 infection. References Theodore WH, Porter RJ. Precipitation of epilepticseizures is influenced by the type of epilepticsyndrome, patient variability, and environmental factors. Epilepsy: 100 Elementary Principles . London: W.B. Saunders Co. Ltd (...) stages of evolution. Realizing both the need for and limitation of current information, this summary provides a focused summary of pertinent clinical diagnostic information about neurological involvement of SARS-CoV-2 virus and COVID-19, especially in relationship to patients with seizures and epilepsy. General issues There are multiple factors which influence frequency of epilepticseizures, including systemic and environmental factors. 1 COVID-19 therefore may exacerbate epilepticseizures from
Vagal nerve stimulation for epilepsy and depression Vagal nerve stimulation for epilepsy and depression | Washington State Health Care Authority Toggle search Toggle navigation Announcement Menu Apple Health Eligibility Manual Search Close menu Search form Search all of HCA Search Health care services and supports Search Billers, providers, & partners Search Employee & retiree benefits Search About HCA Search Vagal nerve stimulation for epilepsy and depression Vagal nerve stimulation (...) for epilepsy and depression Public comment period extended. Public comment on the vagal nerve stimulation draft report has been extended until close of business, March 30, 2020. Submit all comments to: Vagal nerve stimulation (VNS) for epilepsy and depression was first reviewed by the HTA in 2009. In 2013, a review of VNS medical literature was conducted to determine if newly available evidence published since 2008 was likely to change the original coverage determination. The technology was not selected
is a neurological condition characterised by episodes of abnormal electrical activity in the brain (recurrent seizures). The seizures can be focal or generalised. Current treatments Current treatments 2.2 The main treatment for epilepsy is antiepileptic drugs taken to prevent or reduce the occurrence of seizures. However, many people with epilepsy have drug-resistant epilepsy, which is refractory to drug treatment (estimates vary between 20% and 40% of people with epilepsy). They have frequent seizures (...) or neurological deficit, gait disturbance, visual field deficits, cognitive deficit or psychiatric disturbance, and amnestic disorder. 3.4 Patient commentary was sought but none was received. Committee comments Committee comments 3.5 The committee noted that, in adults, the procedure has primarily been used to treat temporal lobe epilepsy. In children it has primarily been used for hypothalamic hamartomas. 3.6 The committee was informed that the procedure is much less invasive than open surgery. MRI-guided
Epilepsy in older people. Globally, as populations age there will be challenges and opportunities to deliver optimal health care to senior citizens. Epilepsy, a condition characterised by spontaneous recurrent seizures, is common in older adults (aged >65 years) and yet has received comparatively little attention in this age group. In this Review, we evaluate the underlying causes of epilepsy in older people, explore difficulties in establishing a diagnosis of epilepsy in this population (...) , discuss appropriate antiseizure medications, and evaluate potential surgical treatment options. We consider cognitive, psychological, and psychosocial comorbidities and the effect that epilepsy might have on an older person's broader social or care network in high-income versus middle-income and low-income countries. We emphasise the need for clinical trials to be more inclusive of older people with epilepsy to help inform therapeutic decision making and discuss whether measures to improve vascular
: The 24 reports identified comprise mostly care programs addressing active convulsiveepilepsy. Phenobarbital has been used most frequently, although other conventional antiseizure medications (ASMs) have also been used, but none of the newer. Tolerability rates in these studies are high, but overall attrition is considerable. Other approaches include updating primary health care providers, reinforcing treatment adherence in clinics, and raising community awareness. In these programs, the coverage (...) of existing treatment gap in the community, epilepsy-related mortality, and comorbidity burden are only fleetingly addressed. None, however, explicitly describe sustainability plans. Conclusions: Cost-free provision, mostly of phenobarbital, has resulted in short-term seizure freedom in roughly half of the people with epilepsy in low- and middle-income countries. Future programs should include a range of ASMs. These should cover apart from seizure control and treatment adherence, primary health care
Cenobamate (Xcopri) - partial onset seizures Drug Approval Package: XCOPRI XCOPRI " /> U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: XCOPRI Company: SK Life Science, Inc. Application Number: 212839 Approval Date: 11/21/2019 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF) FDA Application Review Files (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF
Safety and efficacy of adjunctive cenobamate (YKP3089) in patients with uncontrolled focal seizures: a multicentre, double-blind, randomised, placebo-controlled, dose-response trial More than a third of patients with epilepsy are treatment resistant, and thus new, more effective therapies to achieve seizure freedom are needed. Cenobamate (YKP3089), an investigational antiepileptic drug, has shown broad-spectrum anticonvulsant activity in preclinical studies and seizure models. We aimed (...) to evaluate the safety, efficacy, and tolerability of adjunctive cenobamate in patients with uncontrolled focal (partial)-onset epilepsy.We did a multicentre, double-blind, randomised, placebo-controlled, dose-response study at 107 epilepsy and neurology centres in 16 countries. Adult patients (aged 18-70 years) with focal seizures despite treatment with 1-3 antiepileptic drugs were randomly assigned (1:1:1:1) via an interactive web response system, by block sizes of 4 within each country, to adjuvant
Evaluation of Long-term Risk of Epilepsy, Psychiatric Disorders, and Mortality Among Children With Recurrent Febrile Seizures: A National Cohort Study in Denmark Febrile seizures occur in 2% to 5% of children between the ages of 3 months and 5 years. Many affected children experience recurrent febrile seizures. However, little is known about the association between recurrent febrile seizures and subsequent prognosis.To estimate the risk of recurrent febrile seizures and whether (...) there is an association over long-term follow-up between recurrent febrile seizures and epilepsy, psychiatric disorders, and death in a large, nationwide, population-based cohort in Denmark.This population-based cohort study evaluated data from all singleton children born in Denmark between January 1, 1977, and December 31, 2011, who were identified through the Danish Civil Registration System. Children born in Denmark who were alive and residing in Denmark at age 3 months were included (N = 2 103 232). The study
Levetiracetam is a useful alternative to phenytoin for epilepticseizures in children. The studyLyttle MD, Rainford NEA, Gamble C, et al. Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial. Lancet 2019;393:2125-34.This trial was funded by the NIHR Health Technology Assessment Programme (project number 12/127/134).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content (...) /signal-000790/levetiracetam-vs-phenytoin-in-stopping-childrens-prolonged-epileptic-seizures.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
• A range of genetic disorders causing epilepsysyndromes e.g. early onset epileptic encephalopathy; Ohtahara syndrome Developmental/ congenital • Abnormality of brain development 8 Queensland Clinical Guideline: Neonatal seizures Refer to online version, destroy printed copies after use Page 11 of 32 2.3 Presentation Neonatal seizures evolve over time. The peak incidence occurs between 12 and 24 hours of age but the time of onset is dependent on aetiology and treatment. Often the seizures cease by 72 (...) maintenance treatment for genetic and metabolic disorders usually lifelong 42,57 • Treatment usually continued if there is known progress to epilepsy (e.g. structural brain malformations and neonatal epilepsysyndromes) Queensland Clinical Guideline: Neonatal seizures Refer to online version, destroy printed copies after use Page 20 of 32 6.1 Anti-epileptic drugs 6.1.1 Phenobarbital Table 14. Phenobarbital Phenobarbital* Dose and administration • First line treatment • May be diluted to 10 mg/mL in 0.9
with another episode of CRACKCast. Today, we will be covering the topic of seizures. This content is exceedingly important, as approximately 10% of adults will experience at least one seizure. Additionally, 3% of all persons will be diagnosed with epilepsy, thus further reinforcing the importance of knowing this content. Today, we will go about diving into the nitty gritty of seizuredisorders, giving you the knowledge to differentiate between neurogenic seizures, psychogenic seizures, and seizure mimics (...) psychogenic seizures when the patient is mid-episode is impossible. Additionally, anywhere from 5-50% of all patients with psychogenic non-epilepticseizures ALSO HAVE EPILEPSY, further complicating treatment, investigation, and disposition of these patients. There are features classically described in the literature that can help you differentiate between psychogenic and neurogenic seizures, and we have listed them in the table below. Just remember, it is not always as clear cut as we would like
) 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 (epilepticfits 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 (...) does Lacosamide UCB work? The active substance in Lacosamide UCB, lacosamide, is an epilepsy medicine. Epilepsy is caused by excessive electrical activity in the brain. The exact way in which lacosamide works is still unclear but it seems to reduce the activity of sodium channels (pores on the surface of nerve cells) that allow electrical impulses to be transmitted between nerve cells. This action may prevent abnormal electrical activity in the brain, reducing the chance of an epilepticfit. What