Controversies on the network theory of epilepsy: Debates held during the ICTALS 2019 conference

Based on earlier works by Brazier, Penfield, Jasper, and others in the 1940’s to 1970’s [1,2] and clinical observations a network theory of epilepsy was proposed more than 15 years ago [3]. There have been considerable advances made on network studies in epilepsy [4] and in neuroscience in general [5] since that time. While progress has indubitably been made on the use of network measures to understand epilepsy, important aspects of the network theory of epilepsy remain poorly defined. Our ...

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Comment on “Posterior reversible encephalopathy syndrome in preeclampsia and eclampsia: The role of hypomagnesemia”

Fang and colleagues invesitgated the association of magnesium levels with posterior reversible encephalopathy syndrome in patients with preeclampsia or eclampsia after 20 weeks of gestation or within 6 weeks postpartum [1]. Their results are consistent with previous studies that hypomagnesemia frequently occurs in the acute phase of obstetric posterior reversible encephalopathy syndrome [2]. Due to the retrospective nature of the study, some concerns may arise.

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Correlation of Levetiracetam Concentration in Peripheral Blood Mononuclear Cells with Clinical Efficacy: A Sensitive Monitoring Biomarker in Patients with Epilepsy

Levetiracetam (LEV) (Keppra, UCB Pharma-SA, Belgium) is a second-generation broad-spectrum antiepileptic drug (AED) with a favourable pharmacokinetic profile. The lack of effect on cytochrome P450 and its minimal protein binding reduce LEV clinically relevant pharmacokinetic interactions. It is a substrate for multiple efflux transporters, including P-glycoprotein (P-gp/ABCB1).[1,2] Therapeutic drug monitoring (TDM) is increasingly recommended in AED-treated patients, though it is not widely practiced for newer AEDs, including LEV.

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Sounds of Seizures

Seizure detection devices could be invaluable tools for both people with epilepsy, their caregivers, and clinicians. For patients, having a device that could accurately detect seizures and alert caretakers would help relieve the anxiety from the helplessness that seizures can cause. It could also potentially reduce the risk of sudden unexpected death in epilepsy, particularly for those patients with nocturnal seizures who sleep without a bed partner [1]. For clinicians, seizure detection devices can be an important tool because self-reporting ...

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Neurocysticercosis or tuberculoma – Which one has more epileptic potential?

The duration of antiepileptic drug (AED) treatment in the management of seizures due to ring enhancing lesions (REL) remains a matter of debate. We undertook a prospective cohort study to look into the seizure patterns and incidence of recurrence in association with two of the most common causes of RELs after gradually stopping AEDs at least 18 months after acheiving seizure control.

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Vaccination management in an asymptomatic child with a novel SCN1A variant and family history of status epilepticus following vaccination: a case report on a potential new direction in personalised medicine

SCN1A variants cause a spectrum of epilepsy syndromes from Dravet Syndrome, a severe epileptic encephalopathy of early infancy to the milder disorder of genetic epilepsy with febrile seizures plus (GEFS+). These genetic epilepsies are associated with increased risk of poor outcome including complications of status epilepticus and early mortality. Individualised management of young children known to be at increased risk should be considered, such as around vaccination management.

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Position paper of a German interdisciplinary round table on future designs of trials on adjunctive treatment with antiseizure drugs

This position paper is based on a one-day workshop held in Berlin on October 1st, 2018. The executive board of the German Society of Epileptology (German Chapter of the ILAE; HMH, MH, TM, ASB) invited members of the Federal Joint Committee (G-BA) (see acknowledgement), the Institute for Quality and Efficiency in Health Care (IQWiG) (TK; see acknowledgement) as well as representatives of patient organizations (SF, KR) and drug manufacturers (see acknowledgement) to discuss future designs of trials in adults on ...

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Levetiracetam versus phenytoin for the treatment of established status epilepticus: A systematic review and meta-analysis of randomized controlled trials

Convulsive status epilepticus is the second most common neurologic emergency, with an annual incidence of 10–40 cases per 100,000 people.[1,2] Morbidity and mortality are considerable, and thus, timely termination of convulsive status epilepticus is the primary goal of management to avoid these risks.[3–5] Benzodiazepines, typically lorazepam or diazepam, are used as first-line therapy for status epilepticus.[6–8] After benzodiazepines failed to terminate convulsive status epilepticus in about 40–60% of patients, phenytoin has traditionally been used as a second-stage treatment since the ...

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Effect of intensive self-management education on seizure frequency and quality of life in epilepsy patients with prodromes or precipitating factors

Epilepsy is one of the most common neurological disorders. The unpredictable nature of epileptic seizure attacks may lead to accidental injuries, which can have a negative impact on the quality of life for patients and their caregivers, while also contributing considerably to the burden of the disease. In addition, psychological factors may also have a negative impact on quality of life in PWE 1.

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