1,721,300 research outputs found
Lacosamide monotherapy for newly diagnosed epilepsy
No full textRefers to: Michel Baulac, Felix Rosenow, Manuel Toledo, Kiyohito Terada, Ting Li, Marc De Backer, Konrad J Werhahn, Melissa Brock Efficacy, safety, and tolerability of lacosamide monotherapy versus controlled-release carbamazepine in patients with newly diagnosed epilepsy: a phase 3, randomised, double-blind, non-inferiority trial The Lancet Neurology, Volume 16, Issue 1, January 2017, Pages 43-5
Psychogenic nonepileptic seizures: We know what they are not. But do we know what they are?
No full text[no abstract available
Nonconvulsive status epilepticus: the diagnostic dilemma.
No full textNonconvulsive status epilepticus (NCSE) represents a diagnostic dilemma, and so far several different definitions and diagnostic criteria have been proposed in the literature order to address and try to solve the diagnostic problems related to this condition. NCSE is practically diagnosed as an enduring epileptic condition with reduced or altered consciousness, but without major convulsive movements together with epileptiform discharges on EEG. The diagnosis of NCSE is therefore electro-clinical, and diagnostic criteria for this epileptic condition should take into account both clinical and EEG features. Based on a comprehensive search of the literature, this brief review critically appraises the electro-clinical diagnostic criteria for NCSE present in the Literature, with particular emphasis on EEG features encountered in NCSE
New anti-epileptic drugs: overcoming the limits of randomised controlled trials.
No full textThis commentary focuses on the designs of randomised controlled trials of new anti-epileptic drugs as treatment for focal epilepsy. Limits of these trials, with particular focus on placebo-controlled designs, are discussed and strategies to overcoming them proposed. To date there are only few head-to-head comparison trials between new anti-epileptic drugs. Ideally, direct head-to-head comparisons of new anti-epileptic drugs should be available in order to get the whole picture of each treatment, but usually randomised controlled trials have not such a direct-comparison design. Multiple-treatment meta-analysis may represent a promising way of overcoming this limit, providing information on ranking efficacy of new anti-epileptic drugs, thus allowing to answer several relevant questions regarding daily practice and decision-making. Although not free from concerns, also historical design trials might have several advantages in that all patients receive a promising anti-epileptic drug at dose(s) that are expected to be fully effective and eliminate the need for a parallel group on suboptimal treatment or placebo. All these strategies aimed to overcome the lack of head-to-head comparisons can't anyway be considered as a substitute for properly conducted direct-comparison randomised trials, which remain the most relevant source of data to inform clinical decisions
Selecting the appropriate pharmacotherapy for epilepsy in patients with Alzheimer's disease
No full text[no abstract available
EEG features of nonconvulsive status epilepticus.
No full textNonconvulsive status epilepticus (NCSE) is diagnosed in practice as an enduring epileptic condition with reduced or altered consciousness, but without major convulsive movements, and epileptiform discharges on EEG. In this article, an illustrative and paradigmatic case is presented with a focus on the main EEG features which should be considered when there is clinical suspicion of NCSE. Some clinical and neurophysiological tips are also provided in order to effectively differentiate between NCSE and other conditions. The clinical suspicion of NCSE may be supported by EEG recordings showing rhythmic and dynamic epileptiform activity. However, although a definitive diagnosis of NCSE cannot be made without EEG-based evidence, the “ultimate diagnosis” of NCSE relies on both neurophysiological and clinical features
Diagnosing epileptic seizures in patients with Alzheimer's disease and deciding on the appropriate treatment plan
No full textIntroduction: Alzheimer's disease (AD) is the predominant cause of dementia and a significant contributor to morbidity among the elderly. Patients diagnosed with AD face an increased risk of epileptic seizures. Areas covered: Herein, the authors review the challenges in the diagnosis of seizures in patients with AD, the risks of seizures related to medications used in AD and the pharmacological treatment of seizures in AD. The authors also provide the reader with their expert opinion on the subject matter and future perspectives. Expert opinion: Healthcare professionals should maintain a vigilant approach to suspecting seizures in AD patients. Acute symptomatic seizures triggered by metabolic disturbances, infections, toxins, or drug-related factors often have a low risk of recurrence. In such cases, addressing the underlying cause may suffice without initiating antiseizure medications (ASMs). However, unprovoked seizures in certain AD patients carry a higher risk of recurrence over time, warranting the use of ASMs. Although data is limited, both lamotrigine and levetiracetam appear to be reasonable choices for controlling seizures in elderly AD patients. Decisions should be informed by the best available evidence, the treating physician's clinical experience, and the patient's preferences
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