Latest & greatest articles for epilepsy

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Top results for epilepsy

1. Fenfluramine hydrochloride for the treatment of seizures in Dravet syndrome: a randomised, double-blind, placebo-controlled trial. (Abstract)

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 convulsive seizure frequency (MCSF; convulsive seizures 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

2020 Lancet

2. Cannabidiol (Epidyolex) - As adjunctive therapy of seizures associated with Lennox?Gastaut syndrome (LGS) in conjunction with clobazam, for patients 2 years of age and older.

estimated using a direct elicitation exercise, where 11 patients with epilepsy and 19 caregivers of patients with epilepsy were asked to value a series of vignettes through the perspective of a patient with Lennox-Gastaut Syndrome using a Visual Analogue Scale (VAS). Although not derived using a ‘choice-based’ approach, the company utilised mean estimates from this exercise in the base case (utilities ranged from 0.75 [‘seizure-free’] to 0.235 [= 3 seizure-free days with more than 110 seizures (...) providing tertiary epilepsy specialist care and when treatment with lamotrigine, rufinamide and topiramate has proved ineffective or not tolerated. 11 The Scottish Intercollegiate Guidelines Network (SIGN) issued publication number 148: diagnosis and management of epilepsy in adults in May 2015 and it was updated in 2018. This makes no specific recommendations on the treatment of Lennox-Gastaut syndrome, but notes that drop attacks in patients with Lennox-Gastaut syndrome may respond to rufinamide. 15

2020 Scottish Medicines Consortium

3. Cannabidiol (Epidyolex) - As adjunctive therapy of seizures associated with  Dravet syndrome (DS) in conjunction with clobazam, for patients 2 years of age and older.

with Dravet syndrome (70% to 80%) have abnormalities in the sodium channel a1 subunit gene (SCN1A). 2 6 Stiripentol 6 is the only other medicine specifically licensed for Dravet syndrome, although sodium valproate and clobazam, licensed for use in epilepsy, 2,7,8 are widely used in Dravet syndrome. Sodium valproate is often used to prevent initial recurrence of convulsive seizures, and benzodiazepines (for example, diazepam, midazolam, clonazepam, or clobazam) are frequently co- administered to limit (...) as follows: ADVICE: following a full submission considered under the orphan process cannabidiol (Epidyolex ® ) is accepted for use within NHSScotland. Indication under review: for use as adjunctive therapy of seizures associated with Dravet syndrome, in conjunction with clobazam, for patients 2 years of age and older. In two phase III, placebo-controlled studies cannabidiol reduced convulsive seizure frequency in the clobazam-treated subgroup of children (aged 2 to 18 years) with Dravet syndrome

2020 Scottish Medicines Consortium

4. Cannabidiol (Epidyolex) in certain severe forms of childhood epilepsy: an option to consider, but liver function must be monitored

with antiepileptic treatment including at least clobazam. How do Prescrire's editors rate this treatment in this situation? Full text (3 pages) available for download by subscribers. Lennox-Gastaut syndrome and Dravet syndrome are severe forms of epilepsy that affect children and infants. Pharmacological treatment is based on combinations of antiepileptic drugs, sometimes including valproic acid and cloba­zam.These combinations frequently fail to fully prevent seizures. An oral solution of cannabidiol (...) , the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight Cannabidiol (Epidyolex°) in certain severe forms of childhood epilepsy: an option to consider, but liver function must be monitored FEATURED REVIEW Cannabidiol (Epidyolex°) has been granted marketing authorisation in the European Union for patients aged 2 years and older with Lennox-Gastaut syndrome or Dravet syndrome, in combination

2020 Prescrire

5. Efficacy of Ketogenic Diet, Modified Atkins Diet, and Low Glycemic Index Therapy Diet Among Children With Drug-Resistant Epilepsy: A Randomized Clinical Trial

. doi: 10.1001/jamapediatrics.2020.2282. Online ahead of print. Efficacy of Ketogenic Diet, Modified Atkins Diet, and Low Glycemic Index Therapy Diet Among Children With Drug-Resistant Epilepsy: A Randomized Clinical Trial , , , , , , , , , , Affiliations Expand Affiliations 1 Center of Excellence & Advanced Research on Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. 2 Department of Pediatrics, All (...) Among Children With Drug-Resistant Epilepsy: A Randomized Clinical Trial Vishal Sondhi et al. JAMA Pediatr . 2020 . Show details Display options Display options Format JAMA Pediatr Actions . 2020 Aug 3;e202282. doi: 10.1001/jamapediatrics.2020.2282. Online ahead of print. Authors , , , , , , , , , , Affiliations 1 Center of Excellence & Advanced Research on Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi

2020 EvidenceUpdates

6. Deep brain stimulation for refractory epilepsy in adults

of 52 2 The condition, current treatments and The condition, current treatments and procedure procedure The condition The condition 2.1 Epilepsy is a neurological condition characterised by episodes of abnormal electrical activity in the brain which cause recurrent seizures. The seizures can be focal or generalised. Current treatments Current treatments 2.2 The main treatment for epilepsy is anti-epileptic drugs taken to prevent or reduce the occurrence of seizures. However, many people have drug (...) epilepsy. 1.5 Further research should describe patient selection and clearly define the target area of the brain. Outcomes should include reduction in seizure frequency and improvement in the epilepsy seizure outcome scale, quality of life, reduction in concomitant medication and hospital admissions. Deep brain stimulation for refractory epilepsy in adults (IPG678) © NICE 2020. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2

2020 National Institute for Health and Clinical Excellence - Interventional Procedures

7. Does screening for adverse effects improve health outcomes in epilepsy? A randomized trial

of Biomedical and Neuromotor Sciences, University of Bologna, Italy. PMID: 32601123 DOI: Item in Clipboard Full-text links Cite Abstract Objective: To determine whether systematic screening for adverse effects of antiepileptic drugs (AEDs) reduces toxicity burden and improves health-related quality of life in patients with epilepsy. Methods: Consecutive patients with uncontrolled seizures aged ≥16 years and a high Adverse Event Profile (AEP) score were randomized to 2 groups and followed up for 18 months (...) MP, De Sarro G, Fattore C, Galimberti CA, Gatti G, La Neve A, Muscas G, Specchio LM, Striano S, Perucca E; SOPHIE Study Group. Luoni C, et al. Epilepsia. 2011 Dec;52(12):2181-91. doi: 10.1111/j.1528-1167.2011.03325.x. Epilepsia. 2011. PMID: 22136077 Clinical Trial. Micoulaud-Franchi JA, Bartolomei F, Duncan R, McGonigal A. Micoulaud-Franchi JA, et al. Epilepsy Behav. 2017 Oct;75:18-24. doi: 10.1016/j.yebeh.2017.07.016. Epub 2017 Aug 15. Epilepsy Behav. 2017. PMID: 28818810 LeBlanc EL, Patnode CD

2020 EvidenceUpdates

8. Keeping people with epilepsy safe during the COVID-19 pandemic

, impaired immune function due to underlying conditions or drug treatment, and older age, particularly when associated with frailty. People with epilepsy may also have any of these conditions. Because autoimmune disorders are associated with an increased risk of epilepsy and are often treated with immunosuppressive therapies, this is a concern for some people with epilepsy. Individuals with tuberous sclerosis complex, which is often accompanied by epileptic seizures, may have reduced lung function (...) and may also be treated with immune therapy. For certain epilepsy syndromes such as Dravet syndrome, as well as for other epilepsies where seizures are triggered by fever or illness, there may be a risk of worsening in a person with fever due to COVID-19. To date, case reports of worsening have not come forward, which is reassuring. Children are less likely to have severe respiratory illnesses (0.9% 0–14 years in China, 1.5% affected were younger than 20 years in Italy ). c. Are there medications

2020 American Epilepsy Society

9. Randomized phase 2 study of adjunctive cenobamate in patients with uncontrolled focal seizures Full Text available with Trip Pro

Actions Cite Share Permalink Copy Page navigation Neurology Actions . 2020 Jun 2;94(22):e2311-e2322. doi: 10.1212/WNL.0000000000009530. Epub 2020 May 14. Randomized phase 2 study of adjunctive cenobamate in patients with uncontrolled focal seizures , , , , , , , , , Affiliations Expand Affiliations 1 From the Neuroscience Institute (S.S.C), Banner-University Medical Center, University of Arizona, Phoenix; NYU Langone Comprehensive Epilepsy Center (J.A.F.), New York; NZOZ Vito-Med (J.K.), Gliwice (...) Randomized phase 2 study of adjunctive cenobamate in patients with uncontrolled focal seizures Randomized phase 2 study of adjunctive cenobamate in patients with uncontrolled focal seizures - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health National Library of Medicine National Center for Biotechnology

2020 EvidenceUpdates

10. Gynecologic Management of Adolescents and Young Women With Seizure Disorders

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 seizure disorders 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

2020 American College of Obstetricians and Gynecologists

11. Covid-19: Epilepsy

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

2020 European Academy of Neurology

12. Managing Patients with Epilepsy during COVID-19 - Pharmacotherapy-related Recommendations

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

2020 American Epilepsy Society

13. Seizures-Child

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 epilepsy syndromes. 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 Epileptic Seizures and Syndromes. Available (...) Boas W, Blume W, et al. Epileptic seizures 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

2020 American College of Radiology

14. COVID-19 in Patients with Seizures and Epilepsy: Interpretation of Relevant Knowledge of Presenting Signs and Symptoms Full Text available with Trip Pro

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 epileptic seizures is influenced by the type of epileptic syndrome, 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 epileptic seizures, including systemic and environmental factors. 1 COVID-19 therefore may exacerbate epileptic seizures from

2020 American Epilepsy Society

15. Vagal nerve stimulation for epilepsy and depression

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

2020 Washington Health Care Authority

16. MRI-guided laser interstitial thermal therapy for drug-resistant epilepsy

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

2020 National Institute for Health and Clinical Excellence - Interventional Procedures

17. Epilepsy in older people. (Abstract)

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

2020 Lancet

18. Models of community-based primary care for epilepsy in low- and middle-income countries

: The 24 reports identified comprise mostly care programs addressing active convulsive epilepsy. 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

2020 EvidenceUpdates

19. Cannabidiol with clobazam for treating seizures associated with Lennox–Gastaut syndrome

–Gastaut syndrome treatment pathway is consistent with NICE's clinical guideline on epilepsies: diagnosis and management. The guideline recommends starting treatment with sodium valproate and, if seizures are not adequately controlled, adding lamotrigine. They added that they would consider trying other antiepileptic drugs if sodium valproate and lamotrigine together do not adequately control seizures. The committee was aware that the marketing authorisation for cannabidiol is for use as an adjuvant (...) Cannabidiol with clobazam for treating seizures associated with Lennox–Gastaut syndrome Cannabidiol with clobazam for treating seizures associated with Lennox–Gastaut syndrome T echnology appraisal guidance Published: 18 December 2019 www.nice.org.uk/guidance/ta615 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guidance represent the view of NICE

2020 National Institute for Health and Clinical Excellence - Technology Appraisals

20. Cannabidiol with clobazam for treating seizures associated with Dravet syndrome

having fewer nights with seizures, when there is a higher risk of sudden unexpected death in epilepsy. The patient and carer expert considered that reducing the duration of convulsive seizures and the frequency of other seizure types would improve the quality of life of people with Dravet syndrome. The committee concluded that there is an unmet need for treatments that reduce the number and duration of convulsive seizures, and that patients and their carers would value a new treatment option (...) convulsive seizures were less likely to die from epilepsy-related causes, and people taking cannabidiol were more likely to be free from convulsive seizures. The company used an Cannabidiol with clobazam for treating seizures associated with Dravet syndrome (TA614) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 16 of 25observational study of people with epilepsy (Trinka et al. 2013) to model a 58% reduction in risk

2020 National Institute for Health and Clinical Excellence - Technology Appraisals