Epileptic patients with major depression were randomized to either cognitive behavioral therapy (CBT) or sertraline. Depression and related secondary health outcomes were analyzed in both groups. Sertraline and CBT were found to be equally efficacious with improvement in mood in just over one-half of the patients.
Epilepsy surgery is one of the treatment modalities for intractable pharmacoresistent epilepsy. For seizure freedom to be achieved, the epileptogenic zone (EZ) must be resected successfully. Stereoelectroencephalography is one of the invasive intracranial EEG recording techniques used for EZ localization. The technological advancements in the past two decades have made this procedure safer, more accurate, and easier to perform and therefore more readily available.
These authors analyzed data from a long-standing prospective cohort to study changes in prescribing habits and pregnancy outcomes following restriction on the use of valproic acid in women of child-bearing potential. Declining use of valproate and carbamazepine was associated with a decline in teratogenesis.
Juvenile myoclonic epilepsy (JME) is a common form of generalized epilepsy. Although the prognosis of JME is not clear, it is assumed to have a good response to treatment. The authors of this meta-analysis found a higher than expected prevalence of refractoriness in JME, which will affect how neurologists counsel patients with JME.
In a review of 377 magnetoencephalography (MEG) studies in epilepsy patients undergoing presurgical workup, 44 patients were found to have one or more seizures during routine recordings, lasting up to a mean of 51.2 minutes. Ictal MEG provided unique localizing data in about one-third of patients. For patients with frequent seizures or reliably induced seizures, MEG may be a useful supplemental tool for medically refractory epilepsy patients undergoing presurgical evaluation.
In this double-blind, placebo-controlled trial, the authors investigated the efficacy of adjunctive cannabidiol in a population of severe developmental epileptic encephalopathies and found some efficacy.
In a double-blind study, 120 children and young adults with the Dravet syndrome and medically refractory seizures were assigned randomly to receive either cannabidiol or placebo, as well as their usual antiepileptic drugs/therapies. The primary finding was a significant decrease in convulsive seizure frequency during the 14-week treatment period for patients receiving cannabidiol compared to those receiving placebo.
Seizures are a common complaint in both children and adults presenting to the emergency department. Seizures may stop prior to physician evaluation, may be ongoing upon presentation, or may occur after the patient is brought to the ED. Patients may be experiencing a seizure for the first time in their lives or may be suffering from chronic epilepsy.