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a diagnosis of epilepsy. C EEG should be used to support the classification of epilepticseizures and epilepsysyndromes when there is clinical doubt. C EEG should be performed in young people with generalised seizures to aid classification and to detect a photoparoxysmal response. B Short-term video-EEG, preferably with suggestion, should be available for the investigation and diagnosis of suspected epilepsy and non-epilepticattackdisorder. C Inpatient video-EEG monitoring and other specialist (...) investigations (including polysomnography with full EEG montages) should be available for patients who present diagnostic difficulties. Diagnosis and management of epilepsy in adults 2 + 1 - 3 2 + 3 2 + 3 4| 11 ? Access to urgent EEG (within 24 hours of request) should be available in all acute medical units for the diagnosis of suspected non-convulsive status epilepticus. 3.5 HAND-HELD VIDEO There is good evidence that epilepticseizures can be distinguished from non-epilepticattackdisorder based
. Status epilepticus presents in several forms: 1) convulsive status epilepticus consisting of repeated generalized tonic–clonic (GTC) seizures with persistent postictal depression of neurologic function between seizures; 2) nonconvulsive status epilepticus where seizures produce a continuous or fluctuating “epileptic twilight” state; and 3) repeated partial seizures manifested as focal motor signs, focal sensory symptoms, or focal impairment of function (e.g., aphasia) not associated with altered (...) and related educational materials depicting the best current medical management of convulsive status epilepticus. The subsequent consensus guideline provided physicians with a consistent, rational approach ( ). Over the past 2 decades, new medical therapies and new clinical trial data have emerged relating directly to the treatment of this most feared type of seizure activity. Coupled with the acceptance of evidence-based rather than consensus-based guidelines, the Epilepsy Foundation in 2004
on the acute pharmacological management of CSE, but some issues regarding supportive care, diagnostic approach and treatment of refractory CSE are discussed. Key Words: Convulsions; Emergency management; Paediatrics; Seizures; Status epilepticus (...) Emergency management of the paediatric patient with generalized convulsive status epilepticus The present guideline paper addresses the emergency management of generalized convulsive status epilepticus (CSE) in children and infants older than one month of age. It replaces the previous statement from 1996, and includes a new treatment algorithm and table of recommended medications, reflecting new evidence and the evolution of clinical practice over the past 15 years. The document focuses
to WWE to prevent postpartum haemorrhage. What is the optimal timing and mode of delivery for WWE based on seizure control? WWE should be reassured that most will have an uncomplicated labour and delivery. The diagnosis of epilepsy per se is not an indication for planned caesarean section or induction of labour. How should women with non-epilepticattackdisorder be counselled in pregnancy and how should their non-epilepticseizures be managed? Inappropriate medical intervention, including AED (...) administration and iatrogenic early delivery, should be avoided when there is a firm diagnosis of non-epilepticattackdisorder. Where required, what dose of antenatal corticosteroids should be given to WWE on enzyme-inducing AEDs? In WWE taking enzyme-inducing AEDs who are at risk of preterm delivery, doubling of the antenatal corticosteroid dose for prophylaxis against respiratory distress syndrome in the newborn is not recommended. Intrapartum care What are the risks and risk factors for seizures
?tool=bestpractice.com The 2006 report by the International League Against Epilepsy Task Force on Classification and Terminology of Epilepsy and EpilepticSyndromes proposed a change in terminology and the omission of the words 'convulsion' and 'convulsive'. They suggested that the term 'febrile convulsions' be replaced by 'febrile seizures'. Fisher RS, Cross JH, French JA, et al. Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE (...) 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
Ketogenic diets for drug-resistant epilepsy. Ketogenic diets (KDs), being high in fat and low in carbohydrates, have been suggested to reduce seizure frequency in people with epilepsy. At present, such diets are mainly recommended for children who continue to have seizures despite treatment with antiepileptic drugs (AEDs) (drug-resistant epilepsy). Recently, there has been interest in less restrictive KDs, including the modified Atkins diet (MAD), and the use of these diets has extended (...) studies; reasons for this being lack of observed efficacy and dietary tolerance.Only one study reported the use of KDs in adults with epilepsy; therefore further research would be of benefit.Other more palatable but related diets, such as the MAD, may have a similar effect on seizure control as the classical KD, but this assumption requires more investigation. For people who have medically intractable epilepsy or people who are not suitable for surgical intervention, KDs remain a valid option; however
situation. We have made many comparisons of drugs and of routes of administration of drugs in this review; our key findings are as follows:(1) This review provides only low- to very low-quality evidence comparing buccal midazolam with rectal diazepam for the treatment of acute tonic-clonic convulsions (risk ratio (RR) for seizure cessation 1.25, 95% confidence interval (CI) 1.13 to 1.38; 4 trials; 690 children). However, there is uncertainty about the effect and therefore insufficient evidence (...) ; moderate-quality evidence).(3) Intramuscular midazolam also showed a similar rate of seizure cessation to intravenous diazepam (RR 0.97, 95% CI 0.87 to 1.09; 2 trials; 105 children; low-quality evidence).(4) For intravenous routes of administration, lorazepam appears to be as effective as diazepam in stopping acute tonic clonic convulsions: RR 1.04, 95% CI 0.94 to 1.16; 3 trials; 414 children; low-quality evidence. Furthermore, we found no statistically significant or clinically important differences
• 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
the classification of epilepticseizures and syndromes and when non- epilepticseizures 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 firstname.lastname@example.org Top results for epilepsy 1. EpilepsyEpilepsy - NICE CKS Clinical Knowledge Summaries Share Epilepsy - Summary An epilepticseizure 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
% of febrile seizures in children are classified as "complex" and require specific treatment by an emergency medical service as well as hospitalisation in order to investigate the cause. A complex seizure presents at least one of the following features: duration of more than 15 minutes; recurrence within 24 hours; partial seizure , i.e. with convulsions affecting only part of the body, without loss of consciousness; neurological disorder following the seizure. Situations in which there is a risk (...) -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
" neurologic disorders? Neurology. 2007;68(5):326-337. 3. So EL. Classifications and epidemiologic considerations of epilepticseizures and epilepsy. Neuroimaging Clin N Am. 1995;5(4):513-526. 4. Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia. 2010;51(4):676-685. 5. Blume WT, Luders HO, Mizrahi E, Tassinari C, van Emde Boas W, Engel J, Jr. Glossary (...) of descriptive terminology for ictal semiology: report of the ILAE task force on classification and terminology. Epilepsia. 2001;42(9):1212-1218. 6. Kim JH. Pathology of seizuredisorders. Neuroimaging Clin N Am. 1995;5(4):527-545. 7. Jackson GD, Kuzniecky RI. Chapter 79: Structural Neuroimaging. In: Engel J, Pedley TA, eds. Epilepsy: A Comprehensive Textbook. 2 ed. Philadelphia PA: Wolters Kluwer/Lippincott Williams & Wilkins; 2008. 8. Toh KH. Clinical applications of magnetic resonance imaging
Prescribing regular drugs to prevent febrile convulsions risks more harm than benefit Prescribing regular drugs to prevent febrile convulsions risks more harm than benefit Discover Portal Discover Portal Prescribing regular drugs to prevent febrile convulsions risks more harm than benefit Published on 1 August 2017 doi: The benefits of giving anti-epileptic medication to children aged between six months and seven years who have had a convulsion while feverish, do not outweigh the harms. While (...) convulsions are fits that can occur when a young child (aged six months to six years) has a fever. Around 2 to 4% of children will have a febrile convulsion, with a third of those children going on to have another when feverish in the future. Most convulsions last under five minutes and the child may feel sleepy for a while afterwards. Simple febrile convulsions, by definition, are harmless and not a sign of serious brain disease, so can be managed with basic first aid such as putting the child
Sialanar (glycopyrronium) - for treating severe drooling of saliva in children and adolescents (aged 3 years and above) with conditions affecting the nervous system, such as cerebral palsy, epilepsy and neurodegenerative diseases 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact 21 July 2016 EMA/555265/2016 Committee (...) ) regardless the route of dosing. These included mydriasis (all species), tremors, decreased motor activity, clonic and tonic convulsions, respiration failure and death. In rats and mice, absorption of a lethal quantity was not readily accomplished via the oral route. The LD50 values for all species after i.v. dosing was found to be in the range 15-30 mg/kg. Repeat dose toxicity The Applicant only refers to one chronic, oral repeat dose toxicity study in dogs (Dollery, 1998). The applicant summarizes
Prophylactic drug management for febrile seizures in children. Febrile seizures occurring in a child older than one month during an episode of fever affect 2% to 4% of children in Great Britain and the United States and recur in 30%. Rapid-acting antiepileptics and antipyretics given during subsequent fever episodes have been used to avoid the adverse effects of continuous antiepileptic drugs.To evaluate primarily the effectiveness and safety of antiepileptic and antipyretic drugs used (...) prophylactically to treat children with febrile seizures; but also to evaluate any other drug intervention where there was a sound biological rationale for its use.We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2016, Issue 7); MEDLINE (1966 to July 2016); Embase (1966 to July 2016); Database of Abstracts of Reviews of Effectiveness (DARE) (July 2016). We imposed no language restrictions. We also contacted researchers in the field to identify continuing
) seizures occurring more than 24 hours apart One unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after 2 unprovoked seizures, occurring over the next 10 years Diagnosis of an epilepsysyndrome. Epilepticseizures may be classified as focal, generalised, or unknown onset, with subcategories of motor, non-motor (absence), with retained or impaired awareness for focal seizures. Fisher RS, Cross JH, French JA, et al. Operational (...) intervention. EEG shows bisynchronous epileptiform activity in both cerebral hemispheres. Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia. 2010;51:676-685. http://www.ncbi.nlm.nih.gov/pubmed/20196795?tool=bestpractice.com GTCS occur in many different types of epilepsy. Anti-epileptic agents are the primary treatment for all types. Bergey GK. Evidence
Ketogenic diet and other dietary treatments for epilepsy. The ketogenic diet (KD), being high in fat and low in carbohydrates, has been suggested to reduce seizure frequency. It is currently used mainly for children who continue to have seizures despite treatment with antiepileptic drugs. Recently, there has been interest in less restrictive KDs including the modified Atkins diet (MAD) and the use of these diets has extended into adult practice.To review the evidence for efficacy (...) seizure freedom rates of up to 10% and seizure reduction rates of up to 60%. One study compared the MAD to a 4 : 1 KD, but did not report rates of seizure freedom or seizure reduction.Adverse effects were fairly consistent across different dietary interventions. The most commonly reported adverse effects were gastrointestinal syndromes. It was common that adverse effects were the reason for participants dropping out of trials. Other reasons for drop-out included lack of efficacy and non-acceptance
First-ever convulsiveseizures in children presenting to the emergency department: risk factors for seizure recurrence and diagnosis of epilepsy. Aetiologies of first-ever convulsiveseizures may be diverse, not all leading to recurrence or epilepsy diagnosis. We aimed to describe the epidemiology of first-ever convulsiveseizures in children, investigating risk factors for recurrence and epilepsy diagnosis.This was a retrospective study of children presenting with a first-ever convulsive (...) to the PED with first-ever convulsiveseizures represent a heterogeneous group. The identification of prognostic factors for recurrence and epilepsy diagnosis may help provide tailored counselling and follow-up.Seizures were 'unprovoked' in 19.4% and 'provoked' in 80.6% of children presenting to the emergency department. At 4-year follow-up, 37.9% relapsed, and 13.6% received a diagnosis of epilepsy. 'Unprovoked' first seizure, family history of febrile seizures, and pre-existing neurological conditions
16 years, who were admitted to the hospital with primary or secondary codes "epilepsy", "fits" or "status epilepticus". Patients who were subsequently considered to be suffering from non-epilepticattacks were excluded from the study. Setting The setting was secondary care. The economic study was carried out in London, UK. Dates to which data relate Cases of CSE were retrospectively identified over two 18-month periods (1 October 95 - 31 March 97 and 1 June 97 to 3 November 98), either side (...) 2002; 95(4): 225-231 Other publications of related interest Leppik IE, Derivan AT, Homan RW, et al. Double-blind study of lorazepam and diazepam in status epilepticus. JAMA 1983;249:1452-4. Appleton R, Sweeney A, Choonara I, et al. Lorazepam versus diazepam in the acute treatment of epilepticseizures and status epilepticus. Developmental Medicine and Child Neurology 1995;37:682-8. Scott RC, Besag FM, Neville BG. Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood