Latest & greatest articles for epilepsy

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Top results for epilepsy

61. Generalised seizures

diagnosis, most seizure disorders respond to treatment. The primary treatment complications include lack of efficacy and medication side effects or idiosyncratic reactions. Definition A generalised tonic-clonic seizure is a seizure type as identified by specific clinical and electroencephalographic criteria. International League Against Epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia. 1981 Aug;22(4):489-501. http://www.ncbi.nlm.nih.gov (...) 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

62. Zonisamide add-on therapy for focal epilepsy. Full Text available with Trip Pro

was more successful than placebo at reducing the frequency of seizures by at least 50%. We were unable to identify minimum effective and maximum tolerated doses. The included trials evaluated a maximum stable-dose phase of 18 weeks, so results cannot be used to confirm longer periods of efficacy in seizure control. The results cannot be extrapolated to monotherapy or to people with other seizure types or epilepsy syndromes. (...) Zonisamide add-on therapy for focal epilepsy. The majority of people with epilepsy have a good prognosis, and their seizures can be well controlled with the use of a single antiepileptic agent, but up to 30% develop refractory epilepsy, especially those with focal seizures. In this review, we summarised the evidence from randomised controlled trials (RCT) of zonisamide, used as an add-on treatment for focal epilepsy uncontrolled by one or more concomitant antiepileptic drug. This is an updated

2018 Cochrane

63. Vigabatrin (Kigabeq) - epilepsy in children between 1 month and 7 years of age

Vigabatrin (Kigabeq) - epilepsy in children between 1 month and 7 years of age Kigabeq | European Medicines Agency Search Search Menu Kigabeq vigabatrin Table of contents Authorised This medicine is authorised for use in the European Union. Overview Kigabeq is a medicine for treating epilepsy in children between 1 month and 7 years of age. It is used in the following ways: on its own to treat infantile spasms (West syndrome), a rare epilepsy disorder that starts at a very young age, usually (...) in the first few months of life; together with other medicines to treat partial epilepsy (seizures affecting one part of the brain), including when the seizures spread to other parts of the brain and become more generalised. Kigabeq is only used in partial epilepsy when patients have already tried all other appropriate treatments or cannot use them because of side effects. Kigabeq contains the vigabatrin and is a ‘ ’. This means that it is similar to a ‘reference medicine’ containing the same , but Kigabeq

2018 European Medicines Agency - EPARs

64. Generalised seizures in children

) 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 (...) and Terminology. Epilepsia. 2017 Apr;58(4):512-21. http://www.ncbi.nlm.nih.gov/pubmed/28276062?tool=bestpractice.com Fisher RS, Cross JH, French JA, et al. Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017 Apr;58(4):522-30. http://onlinelibrary.wiley.com/doi/10.1111/epi.13670/full http://www.ncbi.nlm.nih.gov/pubmed/28276060?tool=bestpractice.com The new ILAE classification presents

2018 BMJ Best Practice

65. Validation of a Swahili version of the World Health Organization 5-item well-being index among adults living with HIV and epilepsy in rural coastal Kenya Full Text available with Trip Pro

regression was carried out to assess the association between psychological wellbeing (assessed using Swahili version of WHO-5 well-being index) and having a chronic illness (HIV or epilepsy).The Swahili version of WHO-5 well-being index demonstrated good internal consistency with Cronbach alpha ranges of 0.86-0.88 among the three study groups. The tool had good discriminant validity. A one factor structure of the tool was obtained from confirmatory factor analysis (overall Comparative Fit Index = 1.00 (...) Validation of a Swahili version of the World Health Organization 5-item well-being index among adults living with HIV and epilepsy in rural coastal Kenya The purpose of this study was to evaluate the psychometric properties of the World Health Organization's five item well-being index (WHO-5) when administered to adults living with HIV or epilepsy in a rural setting at the coast of Kenya.A case control study design was conducted among 230 adults aged 18-50 years, who comprised 147 cases (63

2018 Global health research and policy

66. Hypothermia for Neuroprotection in Convulsive Status Epilepticus

Hypothermia for Neuroprotection in Convulsive Status Epilepticus PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2018 PedsCCM Evidence-Based Journal Club

67. Randomized trial of lacosamide versus fosphenytoin for nonconvulsive seizures Full Text available with Trip Pro

Randomized trial of lacosamide versus fosphenytoin for nonconvulsive seizures The optimal treatment of nonconvulsive seizures in critically ill patients is uncertain. We evaluated the comparative effectiveness of the antiseizure drugs lacosamide (LCM) and fosphenytoin (fPHT) in this population.The TRENdS (Treatment of Recurrent Electrographic Nonconvulsive Seizures) study was a noninferiority, prospective, multicenter, randomized treatment trial of patients diagnosed with nonconvulsive seizures (...) (NCSs) by continuous electroencephalography (cEEG). Treatment was randomized to intravenous (IV) LCM 400mg or IV fPHT 20mg phenytoin equivalents/kg. The primary endpoint was absence of electrographic seizures for 24 hours as determined by 1 blinded EEG reviewer. The frequency with which NCS control was achieved in each arm was compared, and the 90% confidence interval (CI) was determined. Noninferiority of LCM to fPHT was to be concluded if the lower bound of the CI for relative risk was >0.8

2018 EvidenceUpdates

68. 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

69. Whole-genome analysis for effective clinical diagnosis and gene discovery in early infantile epileptic encephalopathy Full Text available with Trip Pro

Whole-genome analysis for effective clinical diagnosis and gene discovery in early infantile epileptic encephalopathy Early infantile epileptic encephalopathy (EIEE) is a devastating epilepsy syndrome with onset in the first months of life. Although mutations in more than 50 different genes are known to cause EIEE, current diagnostic yields with gene panel tests or whole-exome sequencing are below 60%. We applied whole-genome analysis (WGA) consisting of whole-genome sequencing

2018 NPJ genomic medicine

70. Sodium valproate versus phenytoin monotherapy for epilepsy: an individual participant data review. Full Text available with Trip Pro

Sodium valproate versus phenytoin monotherapy for epilepsy: an individual participant data review. Epilepsy is a common neurological condition in which abnormal electrical discharges from the brain cause recurrent unprovoked seizures. It is believed that with effective drug treatment up to 70% of individuals with active epilepsy have the potential to become seizure-free, and to go into long-term remission shortly after starting drug therapy with a single antiepileptic drug (...) , and updated in 2013 and 2016.To review the time to treatment failure, remission and first seizure of sodium valproate compared to phenytoin when used as monotherapy in people with focal onset seizures or generalised tonic-clonic seizures (with or without other generalised seizure types).We searched the Cochrane Epilepsy Group's Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, ClinicalTrials.gov and the World Health Organization (WHO) International Clinical

2018 Cochrane

71. Epilepsy

the classification of epileptic seizures and syndromes and when non- epileptic seizures are suspected. Treatment of epilepsy 2016 10. Management of epilepsy in adults with intellectual disability CR203 Browser does not support script. Browser does not support script. Improving the lives of people with mental illness Browser does not support script. CR203. Management of epilepsy in adults with intellectual disability Price: £0.00 Approved: Apr 2017 Published: May 2017 Status: current Number of pages: 49 Review (...) have questions please contact us via jon.brassey@tripdatabase.com Top results for epilepsy 1. Epilepsy Epilepsy - NICE CKS Clinical Knowledge Summaries Share Epilepsy - Summary An epileptic seizure is a transient disturbance of consciousness, behaviour, emotion, motor function, or sensation, due to abnormal electrical activity in the brain. Epilepsy is a disease of the brain defined by any of the following: At least two unprovoked seizures occurring more than 24 hours apart. One unprovoked seizure

2018 Trip Latest and Greatest

72. Phenytoin versus levetiracetam as prophylaxis for postcraniotomy seizure in patients with no history of seizures: systematic review and meta-analysis Full Text available with Trip Pro

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 (...) is limited and mixed. The authors aimed to collate the available evidence on the efficacy and tolerability of levetiracetam monotherapy and compare it with that of the classic AED, phenytoin, for DSC.METHODSPubMed, Embase, Web of Science, and the Cochrane Library were searched for studies that compared levetiracetam with phenytoin for DSC prevention. Inclusion criteria were adult patients with no history of epilepsy who underwent craniotomy with prophylactic usage of phenytoin, a comparator group

2018 EvidenceUpdates

73. Clobazam monotherapy for focal or generalized seizures. Full Text available with Trip Pro

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 (...) and safety of clobazam as monotherapy in people with new-onset focal or generalized seizures.For the latest update we searched the following databases on 19 March 2018: the Cochrane Register of Studies (CRS Web), which includes the Cochrane Epilepsy Group Specialized Register and the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid, 1946- ), BIOSIS Previews (1969- ), ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform (ICTRP

2018 Cochrane

74. Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and th Full Text available with Trip Pro

literature (January 2003-November 2015), classify pertinent studies according to the therapeutic rating scheme, and link recommendations to evidence strength.Several second-generation AEDs are effective for new-onset focal epilepsy. Data are lacking on efficacy in new-onset generalized tonic-clonic seizures, juvenile myoclonic epilepsy, or juvenile absence epilepsy, and on efficacy of third-generation AEDs in new-onset epilepsy.Lamotrigine (LTG) should (Level B) and levetiracetam (LEV) and zonisamide (...) (ZNS) may (Level C) be considered in decreasing seizure frequency in adults with new-onset focal epilepsy. LTG should (Level B) and gabapentin (GBP) may (Level C) be considered in decreasing seizure frequency in patients ≥60 years of age with new-onset focal epilepsy. Unless there are compelling adverse effect-related concerns, ethosuximide or valproic acid should be considered before LTG to decrease seizure frequency in treating absence seizures in childhood absence epilepsy (level B). No high

2018 EvidenceUpdates

75. Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs II: Treatment-resistant epilepsy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the Full Text available with Trip Pro

to November 2015), classify pertinent studies according to the therapeutic rating scheme, and link recommendations to evidence strength.Forty-two articles were included.The following are established as effective to reduce seizure frequency (Level A): immediate-release pregabalin and perampanel for TR adult focal epilepsy (TRAFE); vigabatrin for TRAFE (not first-line treatment); rufinamide for Lennox-Gastaut syndrome (LGS) (add-on therapy). The following should be considered to decrease seizure frequency (...) ). The text presents Level C recommendations. AED selection depends on seizure/syndrome type, patient age, concomitant medications, and AED tolerability, safety, and efficacy. This evidence-based assessment informs AED prescription guidelines for TR epilepsy and indicates seizure types and syndromes needing more evidence. A recent Food and Drug Administration (FDA) strategy allows extrapolation of efficacy across populations; therefore, for focal epilepsy, eslicarbazepine and lacosamide (oral only

2018 EvidenceUpdates

76. Cognitive-behavioural therapy does not meaningfully reduce depression in most people with epilepsy: a systematic review of clinically reliable improvement Full Text available with Trip Pro

Cognitive-behavioural therapy does not meaningfully reduce depression in most people with epilepsy: a systematic review of clinically reliable improvement Psychological treatment is recommended for depression and anxiety in those with epilepsy. This review used standardised criteria to evaluate, for the first time, the clinical relevance of any symptom change these treatments afford patients. Databases were searched until March 2017 for relevant trials in adults. Trial quality was assessed (...) randomised to CBT. The extent of gain was though low-the depressive symptoms of most participants (66.9%) receiving CBT were 'unchanged' and 2.7% 'reliably deteriorated'. Only 30.4% made a 'reliable improvement. This compares with 10.2% of participants in the control arms who 'reliably improved' without intervention. The effect of the treatments on secondary outcome measures, including anxiety, was also low. Existing CBT treatments appear to have limited benefit for depression symptoms in epilepsy

2018 EvidenceUpdates

77. Systematic review and network meta-analysis of resective surgery for mesial temporal lobe epilepsy Full Text available with Trip Pro

Systematic review and network meta-analysis of resective surgery for mesial temporal lobe epilepsy To evaluate the effectiveness of anterior temporal lobectomy (ATL) versus selective amygdalohippocampectomy (SAH) on seizure-free outcome in patients with temporal lobe epilepsy, using both direct and indirect evidence from the literature.MEDLINE, Embase and Cochrane databases were searched for original research articles and systematic reviews comparing ATL versus SAH, and ATL or SAH versus (...) medical management (MM). The outcome was seizure freedom at 12 months of follow-up or longer. Direct pairwise meta-analyses were conducted, followed by a random-effect Bayesian network meta-analysis (NMA) combining direct and indirect evidence.Twenty-eight articles were included (18 compared ATL vs SAH, 1 compared ATL vs SAH vs MM, 8 compared ATL vs MM, and 1 compared SAH vs MM). Direct pairwise meta-analyses showed no significant differences in seizure-free outcome of ATL versus SAH (OR 1.14, 95% CI

2018 EvidenceUpdates

78. Lamotrigine versus carbamazepine monotherapy for epilepsy: an individual participant data review. Full Text available with Trip Pro

Lamotrigine versus carbamazepine monotherapy for epilepsy: an individual participant data review. This is an updated version of the original Cochrane Review published in Issue 11, 2006 of the Cochrane Database of Systematic Reviews.Epilepsy is a common neurological condition in which abnormal electrical discharges from the brain cause recurrent unprovoked seizures. It is believed that with effective drug treatment up to 70% of individuals with active epilepsy have the potential to become (...) and secondarily generalised) or generalised onset tonic-clonic seizures (with or without other generalised seizure types).We conducted the first searches for this review in 1997. For the most recent update, we searched the Cochrane Epilepsy Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online (CRSO), MEDLINE, Clinical Trials.gov and the WHO International Clinical Trials Registry Platform on 26 February 2018, without language

2018 Cochrane

79. Eslicarbazepine acetate (Zebinix) - treatment of partial-onset seizures, with or without secondary generalisation, in adults with newly diagnosed epilepsy

Eslicarbazepine acetate (Zebinix) - treatment of partial-onset seizures, with or without secondary generalisation, in adults with newly diagnosed epilepsy Non Submission eslicarbazepine acetate 200mg and 800mg tablets (Zebinix ® ) SMC2090 Eisai Ltd 4 May 2018 ADVICE: in the absence of a submission from the holder of the marketing authorisation eslicarbazepine acetate (Zebinix ® ) is not recommended for use within NHS Scotland. Indication under review: As monotherapy in the treatment of partial (...) -onset seizures, with or without secondary generalisation, in adults with newly diagnosed epilepsy. The holder of the marketing authorisation has not made a submission to SMC regarding this product in this setting. As a result we cannot recommend its use within NHSScotland. Advice context: No part of this advice may be used without the whole of the advice being quoted in full. This advice represents the view of the Scottish Medicines Consortium. It is provided to inform the considerations of Area

2018 Scottish Medicines Consortium

80. Everolimus (Votubia) - Adjunctive treatment of patients aged two years and older whose refractory partial-onset seizures, with or without secondary generalisation, are associated with tuberous sclerosis complex (TSC)

experience frequent seizures which are likely to have a severely negative impact on their physical and mental health. Many patients have neurodevelopmental problems and learning disabilities and uncontrolled epilepsy is thought to be a major contributing and exacerbating factor. • There is unmet need in the treatment of TSC-related epilepsy. Anti-epileptic medications are used as first-line treatment however it is estimated that approximately 60% of patients have seizures that are uncontrolled (...) TSC manifestations and neuropsychiatric comorbidities £41,134 Deterministic (one-way) sensitivity analysis (with PAS) Parameter ‘Lower’ value ICER ‘Upper’ value ICER Distribution of patients in epilepsy control categories – everolimus plus BSC £73,475 £22.768 % whose seizure type was secondary generalised: convulsive at 66 weeks - BSC (mean) £49,194 £9,458 Prevalence of SEGA in the 14-18 years of age group £30,784 Dominant Adverse event discontinuation - everolimus plus BSC £44,558 £15,983 % whose

2018 Scottish Medicines Consortium