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Latest & greatest articles for epilepsy
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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Tiagabine add-on for drug-resistant partial epilepsy. Epilepsy is a common neurological condition, affecting almost 0.5 to 1 per cent of the population. Nearly 30 per cent of people with epilepsy are resistant to currently available drugs. Tiagabine is one of the newer antiepileptic drugs and its effects as an adjunct (add-on) to standard drugs is assessed in this review.To evaluate the effects of add-on treatment with tiagabine upon seizures, side effects, cognition and quality of life (...) for people with drug-resistant localization related seizures.We searched the Cochrane Epilepsy Group trials register (28 March 2002), the Cochrane Controlled Trials Register (Cochrane Library Issue 1, 2002), MEDLINE (1966 to November 2001). In addition, we contacted Sanofi~Synthelabo (makers of tiagabine) and experts in the field to seek any unpublished or ongoing studies.Randomized placebo controlled add-on trials of people of any age with localization related seizures, in which an adequate method
Carbamazepine versus phenytoin monotherapy for epilepsy. Worldwide, carbamazepine and phenytoin are commonly used antiepileptic drugs. This review summarizes evidence from randomized controlled trials in which these two drugs have been compared.To review the best evidence comparing carbamazepine and phenytoin when used as monotherapy in subjects with partial onset seizures, or generalized onset tonic-clonic seizures with or without other generalized seizure types.We searched: (a) the trial (...) register of the Cochrane Epilepsy Group; (b) The Cochrane Controlled Trials Register (Cochrane Library Issue 4, 2001); (c) MEDLINE 1966-2001. In addition we hand searched relevant journals and contacted the pharmaceutical industry and researchers in the field to seek any ongoing or unpublished studies.Randomized controlled trials in children or adults with partial onset seizures or generalized onset tonic-clonic seizures. Trials must have included a comparison of carbamazepine monotherapy
Human epilepsy associated with dysfunction of the brain P/Q-type calcium channel. The genetic basis of most common forms of human paroxysmal disorders of the central nervous system, such as epilepsy, remains unidentified. Several animal models of absence epilepsy, commonly accompanied by ataxia, are caused by mutations in the brain P/Q-type voltage-gated calcium (Ca(2+)) channel. We aimed to determine whether the P/Q-type Ca(2+) channel is associated with both epilepsy and episodic ataxia type (...) 2 in human beings.We identified an 11-year-old boy with a complex phenotype comprising primary generalised epilepsy, episodic and progressive ataxia, and mild learning difficulties. We sequenced the entire coding region of the gene encoding the voltage-gated P/Q-type Ca(2+) channel (CACNA1A) on chromosome 19. We then introduced the newly identified heterozygous mutation into the full-length rabbit cDNA and did detailed electrophysiological expression studies of mutant and wild type Ca(2
Todd, Hughlings Jackson, and the electrical basis of epilepsy. John Hughlings Jackson is widely credited with the first electrical theory of epilepsy (1873), which was confirmed by the experimental studies of Hitzig and Ferrier. His views are summarised in his famous Lumleian lectures to the Royal College of Physicians in 1890. Robert Bentley Todd, however, had earlier developed an electrical theory of epilepsy, which he presented in his own brilliant Lumleian lectures to the Royal College (...) of Physicians in 1849. Todd was influenced by the electrical discoveries of his contemporary, Michael Faraday, and thought of the brain as having battery like properties that led to the sudden discharge of electrical energy (nervous force) in epilepsy. Unlike Hughlings Jackson, Todd was an anatomist and physiologist as well as a physician, and he did his own electrical experiments in rabbits to prove his theory, something Hughlings Jackson, who relied on Ferrier for scientific and experimental support
A pharmacoeconomic analysis of the impact of therapeutic drug monitoring in adult patients with generalized tonic-clonic epilepsy A pharmacoeconomic analysis of the impact of therapeutic drug monitoring in adult patients with generalized tonic-clonic epilepsy A pharmacoeconomic analysis of the impact of therapeutic drug monitoring in adult patients with generalized tonic-clonic epilepsy Rane C T, Dalvi S S, Gogtay N J, Shah P U, Kshirsagar N A Record Status This is a critical abstract (...) of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of therapeutic drug monitoring (TDM) in adult patients with generalised tonic-clonic (GTC) epilepsy. The intervention was intended to enhance the efficacy of anticonvulsant therapy by showing unrecognised under- or over-dosage
The effectiveness of specific epilepsy services The effectiveness of specific epilepsy services The effectiveness of specific epilepsy services Meads C, Bradley P, Burls A Authors' objectives To assess the most effective model of care for patients with epilepsy in the UK by evaluating the relative effectiveness and cost-effectiveness of: (1) specialist epilepsy clinics compared with general neurology out- patient clinics; and (2) specialist epilepsy nurses in in-patient, out-patient or GP care (...) compared with 'usual care' without a specialist epilepsy nurse. The two aspects, (1) and (2), comprise two separate systematic reviews with the same inclusion and exclusion criteria and methods, except for the interventions. Searching The following databases were searched from inception to September 1999: MEDLINE, EMBASE, GEARS, PsycLIT, HealthPLAN, Cancerlit, the Cochrane Library, WHO, ECRI, and NHS EED. In addition, the National Research Register and a variety of evidence-based publications were
Topiramate: a review of its use in childhood epilepsy Topiramate: a review of its use in childhood epilepsy Topiramate: a review of its use in childhood epilepsy Ormrod D, McClellan K Authors' objectives To review the use of topiramate in childhood epilepsy. Searching MEDLINE, EMBASE and AdisBase were searched to March 2001. The key terms were stated. The reference lists of published reports were examined and the pharmaceutical company who had developed the drug was contacted for further (...) for inclusion. The included studies used topiramate as an adjunctive therapy to one or more other enzyme-inducing anti-epileptic drugs and as monotherapy. The control interventions, when used, were placebo, carbamazepine or valproic acid. The doses of topiramate are reported in the 'Results' section. Participants included in the review Studies of patients with epilepsy were eligible for inclusion. The included studies were of children with partial seizures, children and adults with generalised tonic-clonic
A randomized, controlled trial of surgery for temporal-lobe epilepsy. Randomized trials of surgery for epilepsy have not been conducted, because of the difficulties involved in designing and implementing feasible studies. The lack of data supporting the therapeutic usefulness of surgery precludes making strong recommendations for patients with epilepsy. We conducted a randomized, controlled trial to assess the efficacy and safety of surgery for temporal-lobe epilepsy.Eighty patients (...) with temporal-lobe epilepsy were randomly assigned to surgery (40 patients) or treatment with antiepileptic drugs for one year (40 patients). Optimal medical therapy and primary outcomes were assessed by epileptologists who were unaware of the patients' treatment assignments. The primary outcome was freedom from seizures that impair awareness of self and surroundings. Secondary outcomes were the frequency and severity of seizures, the quality of life, disability, and death.At one year, the cumulative
Management of newly diagnosed patients with epilepsy: a systematic review of the literature Management of newly diagnosed patients with epilepsy: a systematic review of the literature Management of newly diagnosed patients with epilepsy: a systematic review of the literature Agency for Healthcare Research and Quality Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made (...) for the HTA database. Citation Agency for Healthcare Research and Quality. Management of newly diagnosed patients with epilepsy: a systematic review of the literature. Rockville: Agency for Healthcare Research and Quality (AHRQ). Evidence Report/Technology Assessment No. 39. 2001 Authors' objectives The objective of this evidence report was to systematically review the best available evidence in the published literature regarding health care services pertinent to the diagnosis, treatment, and monitoring
The effectiveness of specific epilepsy services The effectiveness of specific epilepsy services The effectiveness of specific epilepsy services Meads C, Bradley P, Burls A Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Meads C, Bradley P, Burls A. The effectiveness of specific epilepsy services. Birmingham: West Midlands Health Technology Assessment (...) Collaboration (WMHTAC). DPHE Report No. 27. 2001 Authors' objectives To summarise the effectiveness of specific epilepsy services. Authors' conclusions Epilepsy clinics - there was no evidence of improvement of seizure frequency or seizure severity when compared to neurology outpatient clinics. There was no information available on quality of life outcomes. Epilepsy clinics were found to be more expensive but no test of statistical significance was available. Epilepsy nurses- there was no evidence
Vagus nerve stimulation for refractory epilepsy Vagus nerve stimulation for refractory epilepsy Vagus nerve stimulation for refractory epilepsy Corabian P, Leggett P Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Corabian P, Leggett P. Vagus nerve stimulation for refractory epilepsy. Edmonton: Alberta Heritage Foundation for Medical (...) Research (AHFMR). AHFMR HTA Report 24. 2001 Authors' objectives This report has been produced in response to a request from Alberta Health an Wellness for an update on the use of vagus nerve stimulation (VNS) for refractory epilepsy. The first section summarizes the findings of the current review of the published literature that has provided evidence on the long-term safety and efficacy/effectiveness of VNS when used for this indication and on the issues related to its use.The second section presents
Psychological treatments for epilepsy. Psychological interventions such as relaxation therapy, cognitive behaviour therapy, EEG bio-feedback and educational interventions have been used alone or in combination in the treatment of epilepsy, to reduce the seizure frequency and improve the quality of life.To assess whether the treatment of epilepsy with psychological methods is effective in reducing seizure frequency and/or leads to a better quality of life.We searched the Cochrane Epilepsy Group (...) , and quality of life.We found three small trials (50 patients) of relaxation therapy. They were of poor methodological quality and a meta-analysis was therefore not undertaken. No study found a significant effect of relaxation therapy on seizure frequency. One trial found cognitive behavioural therapy to be effective in reducing depression, among people with epilepsy with a depressed affect, whilst another did not. One trial of group cognitive therapy found no significant effect on seizure frequency. Two
Levetiracetam add-on for drug-resistant localization related (partial) epilepsy. The majority of patients with epilepsy have a good prognosis and their seizures are well controlled by a single antiepileptic drug. However, up to 30% develop refractory seizures, particularly those with partial seizures. In this review, we summarise the current evidence regarding a new antiepileptic drug, levetiracetam, when used as an add-on treatment for drug-resistant localization related (partial) epilepsy.To (...) evaluate the effects of levetiracetam on seizures, side effects, quality of life and cognition, when used as an add-on treatment for patients with a drug-resistant localization related (partial) epilepsy.We searched the Cochrane Epilepsy Group trials register, the Cochrane Controlled Trials Register (Cochrane Library Issue 2, 2000). In addition, we contacted UCB SA (makers of levetiracetam) and experts in the field to seek any ongoing studies or unpublished studies.Randomized placebo controlled add
Specialist epilepsy nurses for treating epilepsy. Epilepsy is the most common serious neurological condition after stroke, with a 0.5 per cent prevalence, and a two to three per cent life time risk of being given a diagnosis of epilepsy in the developed world. As a result of the perceived deficiencies and suggestions to improve the quality of care offered to people with epilepsy, two models of service provision have been suggested by researchers: specialist epilepsy out-patient clinics (...) (as opposed to the management of patients in general neurology clinics or general medical clinics) and nurse-based liaison services between primary (GP) and secondary/tertiary (hospital based) care.The aim of this review is to overview the evidence from controlled trials investigating the effectiveness of specialist epilepsy nurses compared to routine care.The following databases were searched: The Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 1999), MEDLINE, GEARS, BIDS (EMBASE
Epilepsy clinics versus general neurology or medical clinics. Epilepsy is the most common serious neurological condition after stroke, with a 0.5 per cent prevalence, and a two to three per cent life time risk of being given a diagnosis of epilepsy in the developed world. As a result of perceived deficiencies of the quality of care offered to people with epilepsy, two models of service provision have been suggested by researchers: specialist epilepsy out-patient clinics (as opposed (...) to the management of patients in general neurology clinics or general medical clinics) and nurse-based liaison services between primary (GP) and secondary/tertiary (hospital based) care.The aim of this review was to overview the evidence from controlled trials investigating the effectiveness of specialist epilepsy clinics compared to routine care. A second similar review investigating the effectiveness of specialist epilepsy nurses is also underway.We searched the Cochrane Epilepsy Group trials register
Calcium antagonists as an add-on therapy for drug-resistant epilepsy. As up to 30% of patients with epilepsy do not have their seizures controlled with current treatments, there have been continuous attempts to find new antiepileptic drugs based on increasing knowledge of cellular and molecular biology involved in the genesis of epilepsy and seizures. Calcium has been established to play a major role in seizure occurrence, thus, calcium antagonists that can alter the effects of calcium on brain (...) cells have been investigated for effect on epileptic seizures.To evaluate the effects of calcium antagonists on seizures, side effects, quality of life and cognition, when used as an add-on therapy for patients with drug-resistant epilepsy.We searched MEDLINE from 1966 to 2000 and the Cochrane Epilepsy Group trials register, the Cochrane Controlled Trials Register (The Cochrane Library Issue 1, 2001).Randomized placebo-controlled add-on trials of any calcium antagonists in patients with drug
Early versus late antiepileptic drug withdrawal for people with epilepsy in remission. Antiepileptic drugs ( AEDs) are used to prevent seizures but are associated with both short and long term adverse effects. When epilepsy is in remission, it may be in the patient's best interest to discontinue medication. However, the optimal timing of AED discontinuation is not known.To quantify seizure relapse risk after early (less than two seizure free years) versus late (more than two seizure free years (...) ) AED withdrawal in adult and pediatric epilepsy patients. To assess which variables modify the risk of seizure recurrence.We searched the Cochrane Epilepsy Group trials register, the Cochrane Controlled trials register (Cochrane Library Issue 4, 2000), MEDLINE (January 1996 to January 2001), EMBASE, Index Medicus, CINAHL, as well as hand-searching of journals.Randomized controlled trials that evaluate withdrawal of AEDs after varying periods of seizure remission in adult and pediatric epilepsy
Cost minimization analysis of antiepileptic drugs in newly diagnosed epilepsy in 12 European countries Cost minimization analysis of antiepileptic drugs in newly diagnosed epilepsy in 12 European countries Cost minimization analysis of antiepileptic drugs in newly diagnosed epilepsy in 12 European countries Heaney D C, Shorvon S D, Sander J W, Boon P, Komarek V, Marusic P, Dravet C, Peerucca E, Majkowski J, Lopes Llima J, Arroyo S, Tomson T, Ried S, van Donselaar C, Eskazan E, Peeters P, Carita (...) P, Tjong-a-Hung I, Myon E, Taieb C Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Different drugs for epilepsy were evaluated. Lamotrigine (LTG) was compared with older anti-epilepsy drugs (AEDs), in particular carbamazepine
Ketogenic diet for the treatment of refractory epilepsy in children: a systematic review of efficacy Ketogenic diet for the treatment of refractory epilepsy in children: a systematic review of efficacy Ketogenic diet for the treatment of refractory epilepsy in children: a systematic review of efficacy Lefevre F, Aronson N Authors' objectives To systematically review and synthesise the available evidence on the efficacy of the ketogenic diet, in reducing seizure frequency for children (...) with refractory epilepsy. Searching MEDLINE was searched using the keywords 'epilepsy/therapy', 'ketogenic diet', 'dietary therapy' and 'epilepsy'. The World Wide Web (via the Alta Vista search engine) and the Cochrane Controlled Trials Register on the Cochrane Library were also searched using the term 'ketogenic diet'. Current Contents, and the bibliographies of recent review articles and relevant primary research reports, were reviewed for additional citations. The review was limited to those studies