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Treatment of epilepsy for people with Alzheimer's disease. Any type of seizure can be observed in Alzheimer's disease (AD). Antiepileptic drugs seem to prevent the recurrence of epilepticseizures in most people with AD. There are pharmacological and non-pharmacological treatments for epilepsy in people with AD. There are no current systematic reviews to evaluate the efficacy and tolerability of these treatments; this review aims to review those different modalities. This is an updated version (...) - ), ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP). In an effort to identify further published, unpublished and ongoing trials, we searched ongoing trials registers, reference lists and relevant conference proceedings, and contacted authors and pharmaceutical companies.We included randomized and quasi-randomized controlled trials investigating treatment for epilepsy in people with AD, with the outcomes of proportion of participants with seizure freedom or proportion
Nomograms to predict naming decline after temporal lobe surgery in adults with epilepsy To develop and externally validate models to predict the probability of postoperative naming decline in adults following temporal lobe epilepsy surgery using easily accessible preoperative clinical predictors.In this retrospective, prediction model development study, multivariable models were developed in a cohort of 719 patients who underwent temporal lobe epilepsy surgery at Cleveland Clinic and externally (...) validated in a cohort of 138 patients who underwent temporal lobe surgery at one of 3 epilepsy surgery centers in the United States (Columbia University Medical Center, Emory University School of Medicine, University of Washington School of Medicine).The development cohort was 54% female with an average age at surgery of 36 years (SD 12). Twenty-six percent of this cohort experienced clinically relevant postoperative naming decline. The model included 5 variables: side of surgery, age at epilepsy onset
Acetaminophen and Febrile Seizure Recurrences During the Same Fever Episode To confirm the safety of using acetaminophen for febrile seizures (FSs) and to assess its efficacy in preventing FS recurrence during the same fever episode.In this single-center, prospective, open, randomized controlled study, we included children and infants (age range: 6-60 months) with FSs who visited our hospital between May 1, 2015, and April 30, 2017. The effectiveness of acetaminophen was examined by comparing (...) the recurrence rates of patients in whom rectal acetaminophen (10 mg/kg) was administered every 6 hours until 24 hours after the first convulsion (if the fever remained >38.0°C) to the rates of patients in whom no antipyretics were administered. No placebo was administered to controls. The primary outcome measure was FS recurrence during the same fever episode.We evaluated 423 patients; of these, 219 were in the rectal acetaminophen group, and 204 were in the no antipyretics group. In the univariate analysis
) on its use in NHSScotland. The advice is summarised as follows: ADVICE: following an abbreviated submission brivaracetam (Briviact ® ) is accepted for restricted use within NHSScotland. Indication under review: Adjunctive therapy in the treatment of partial-onset seizures with or without secondary generalisation in children from 4 years to =15 years of age with epilepsy. SMC restriction: for use in patients with refractory epilepsy and treatment should be initiated by physicians who have appropriate (...) experience in the treatment of epilepsy. SMC has previously accepted brivaracetam for restricted use as adjunctive therapy in the treatment of partial-onset seizures with or without secondary generalisation in adult and adolescent patients from 16 years of age with epilepsy. 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 and was arrived at after evaluation of the evidence
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
, Shinnar S, Gloss D, et al. Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the Guideline Committee of the American Epilepsy Society. Epilepsy Curr. 2016;16:48-61. 10. ShorvonS.Clinicaltrialsinacute repetitive seizures and status epilepticus. EpilepticDisord. 2012;14:138-147. 11. Morimoto K, Fahnestock M, Racine RJ. Kindling and status epilepticus models of epilepsy:rewiring the brain.ProgNeurobiol. 2004;73:1-60. 12. MeierkordH,BoonP,EngelsenB (...) midazolam and intravenous diazepam sedation for procedures and seizures. Indian J Pediatr. 2006;73:975-978. 4. Arya R, Gulati S, Kabra M, et al. Intranasal versus intravenous lorazepam for control of acute seizures in children: a randomized open-label study. Epilepsia. 2011;52:788-793. 5. Thakker A, Shanbag P. A randomized controlled trial of intranasal-midazolam versus intravenous-diazepam for acute childhood seizures. J Neurol. 2013;260:470-474. ofstatusepilepticus,ageofpatients, number of patients
. The dossier was sent to IQWiG on 30 November 2017. Research question The aim of the present report was to assess the added benefit of perampanel as adjunctive therapy for primary generalized tonic-clonic seizures in adults and adolescents aged 12 years and older with idiopathic generalized epilepsy in comparison with the appropriate comparator therapy (ACT). The ACT specified by the G-BA is shown in Table 2. Table 2: Research question of the benefit assessment of perampanel Research question Subindication (...) ACT a 1 Adjunctive therapy for primary generalized tonic- clonic seizures in adults and adolescents aged 12 years and older with idiopathic generalized epilepsy an individual antiepileptic adjunctive therapy, if medically indicated and if no pharmacoresistance/intolerance and contraindications are known yet, with one of the following drugs: lamotrigine, levetiracetam, valproic acid b , topiramate, clobazam Treatment is to be chosen by the doctor depending on the basic and prior therapy/therapies
Subpial transection surgery for epilepsy. Nearly 30% of patients with epilepsy continue to have seizures despite using several antiepileptic drugs (AEDs). Such patients are regarded as having refractory, or uncontrolled, epilepsy. While there is no universally accepted definition of uncontrolled, or medically refractory, epilepsy, for the purposes of this review we will consider seizures as drug resistant if they have failed to respond to a minimum of two AEDs. Specialists consider that early (...) surgical intervention may prevent seizures at a younger age, which in turn may improve the intellectual and social status of children. Many types of surgery are available for treating refractory epilepsy; one such procedure is known as subpial transection.To assess the effects of subpial transection for focal-onset seizures and generalised tonic-clonic seizures in children and adults.For the latest update we searched the following databases on 7 August 2018: the Cochrane Register of Studies (CRS Web
diagnosis, most seizuredisorders 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 epilepticseizures. 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 epilepsysyndrome 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 epilepsysyndrome identified. Generalised-onset epilepsy is treated differently to focal epilepsy. With proper
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 epilepsydisorder 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
) of epilepsy and the epilepsysyndrome 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 epilepsysyndrome 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
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
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
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
Whole-genome analysis for effective clinical diagnosis and gene discovery in early infantile epileptic encephalopathy Early infantile epileptic encephalopathy (EIEE) is a devastating epilepsysyndrome 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
among epileptic patients in sub-Saharan Africa. Methods A systematic desk review and electronic web-based search of PubMed, Google Scholar, EMBASE, PsycINFO and the World Health Organization’s Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) identified peer-reviewed research studies and doctoral dissertations on the prevalence of depression among patients with epilepsy using pre-defined quality and inclusion criteria. Relevant data were (...) eligible for inclusion the final analysis. The pooled estimate of prevalence of depression among patients with epilepsy was 32.71 (95% CI: 25.50 - 39.91). Regional sub-group analysis found that the pooled prevalence in East Africa was 34.52 (95% CI: 23.53 - 45.51) and 29.69 (95% CI: 22.7 - 36.68) in Southern and West Africa. The odds of depression among epileptic patients receiving polytherapy were 2.65 higher than in those receiving monotherapy (95% CI: 1.49 - 4.71, I 2 =79.1%, p < 0.05). Conclusion
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 email@example.com 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
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
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
as monotherapy, and how does their efficacy and tolerability compare with those of older antiepileptic drugs (AEDs)? • Clobazam (CLB) • Lacosamide • Perampanel • Topiramate (TPM) • Eslicarbazepine • Lamotrigine (LTG) • Pregabalin (PGB) • Vigabatrin (VGB • Felbamate (FBM) • Levetiracetam (LEV) • Rufinamide • Zonisamide (ZNS) • Gabapentin (GBP) • Oxcarbazepine (OXC) • Tiagabine Recommendations for monotherapy in adults with new-onset epilepsy with focal epilepsy or unclassified tonic-clonic seizures Level (...) profile precludes VGB use as first-line therapy. Level C PGB use at 150 mg/d is possibly less efficacious than LTG use at 100 mg/d. Level U Evidence is insufficient to consider GBP , OXC, or TPM instead of CBZ. Level U Evidence is insufficient to consider TPM instead of phenytoin in urgent treatment of new-onset or recurrent focal epilepsy, unclassified generalized tonic-clonic (GTC) seizures, or generalized epilepsy (GE) presenting with GTC seizures. Level U Data are lacking to support or refute use