In this multicenter, observational study, the authors assessed the prevalence of neuropsychiatric side effects from medications in subjects with tumor-related epilepsy. Levetiracetam was found to have the highest prevalence of such side effects.
Investigators prospectively analyzed 72-hour continuous electroencephalograms to identify clinical and electroencephalogram risk factors for having seizures and developed a model for “time-dependent” seizure risk. Electrographic seizures occurred in 23% of all patients. The only significant clinical predictors of seizures were presence of coma and prior clinical seizure history.
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.
In this study of 109 consecutive patients with medically refractory neocortical epilepsy without MRI-identifiable lesions who underwent focal resection at a single hospital from 1995 to 2005, almost 60% of patients achieved long-term seizure freedom, with anti-epileptic drugs being withdrawn successfully in about a third of these patients.
In a multicenter trial in France, patients admitted to the ICU from 2011-2015 for convulsive status epilepticus were randomly assigned to receive standard therapy (control group) or hypothermia plus standard therapy (treatment group). The primary outcome measure was an absence of functional impairment at 90 days after seizure onset, as measured by the Glasgow Outcome Scale (score of 5). There was no significant difference in outcomes between the two groups.
The anticonvulsant medication gabapentin, which already is a useful part of strategies to control pain after surgery, also effectively reduces the common complication of postoperative nausea and vomiting, reports a study in Anesthesia & Analgesia.
The authors report the preliminary findings for an implantable ambulatory intracranial recording device for seizure detection in 15 subjects. One of the primary findings was that spike rate significantly changed prior to seizures in nine of 15 subjects. Six of these subjects showed a significant decrease in spiking prior to ictal onset, whereas the remaining three showed a significant increase in spiking and these three subjects had the best seizure prediction results.