Valproic acid prescription trends among females of childbearing age in Estonia: A 14-year nationwide prescription database study

Valproic acid (VPA), also known as valproate, is among the most frequently prescribed antiepileptic drugs (AEDs). A major safety issue with VPA is its teratogenicity. Data from several pregnancy registries have consistently shown that the offspring of mothers who use VPA during pregnancy are at greater risk of major congenital malformations [1,2]. Reports have described impaired intellectual and behavioural development in children exposed to VPA in utero [3]. In response to these data, the European Medicines Agency (EMA) strengthened its ...

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Posterior reversible encephalopathy syndrome in preeclampsia and eclampsia: The role of hypomagnesemia

Posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy syndrome (RPLS), is a special type of cerebrovascular disease defined by its clinical and imaging manifestations [1]. The onset of PRES typically occurs acutely or subacutely and involves a variety of nonspecific symptoms, including headaches, visual changes, seizures, consciousness impairment, mental disorders, focal neurologic deficits, nausea, and vomiting [2,3]. MRI is the gold standard for the diagnosis and evaluation of PRES [4], and the imaging features of this condition ...

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Neurocysticercosis in People with Epilepsy in Sub-Saharan Africa: A Systematic Review and Meta-analysis of the Prevalence and Strength of Association

Epilepsy is one of the most common neurological disorders throughout the world [1]. The devastating impact of epilepsy on people with epilepsy and the society at large cannot be overemphasized. Sub-Saharan Africa (SSA) is home to a large proportion of people with epilepsy. The causes of epilepsy in SSA vary with infections of the central nervous system at the forefront of the etiologies [1,2].

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Evaluation of Olfactory and Gustatory Changes in Patients with Mesial Temporal Lobe Epilepsy

The relationship between olfaction, which is one of the chemosenses, and epilepsy has long been of interest to physicians. In the 19th century, olfactory dysfunction was observed in patients with temporal lobe epilepsy. Temporal lobe structures were therefore thought to have a role in olfactory function 1. Various studies since have revealed that the temporal lobe plays an important role in the perception of odors. In particular, the entorhinal cortex, the piriform cortex, and the amygdala are closely related to ...

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LEVETIRACETAM AND CUTANEOUS ADVERSE REACTIONS: A SYSTEMATIC REVIEW OF DESCRIPTIVE STUDIES

Levetiracetam (LEV) was approved in 1999 by the US Food and Drug Administration (FDA) for the treatment of seizure disorders. It is a second-generation antiepileptic drug (AED) with a unique mechanism – it acts by binding to specific sites on the nerve cell surfaces [1]. It inhibits the burst firing without affecting the normal neuronal excitability, suggesting that it selectively prevents the hyper synchronisation of epileptiform burst firing and propagation of seizure activity [2]. The FDA-labelled indications of LEV include ...

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Outcome of status epilepticus and the predictive value of the EMSE and STESS scores: a prospective study

Status epilepticus (SE) is an abnormally prolonged seizure state with a high risk of mortality and functional decline. The short-term case fatality rate is 7.6–33% across all seizure types (1). At hospital discharge, 23–58% of survivors have increased need for help in daily living (2–4). Of intensive care patients with refractory SE, less than half recover to baseline function, 20% die and 30% show new functional deficits (5). Aggressive treatment should be aimed at patients who are at a high ...

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The Exploration of the Spectrum of Motor Manifestations of Anti-LGI1 Encephalitis beyond FBDS

Anti-leucine-rich glioma-inactivated protein 1 (anti-LGI1) encephalitis is a type of autoimmune encephalitis with an antibody targeting neuronal surface antigens [1]. LGI1, which is primarily expressed in the hippocampus and temporal cortex, serves as a component of voltage-gated potassium channel (VGKC) complexes by acting as the ligand for two epilepsy-related proteins, ADAM22 and ADAM23 [2,3], thus epileptic seizures are common symptoms [4–9]. Other paroxysmal events, especially motor events, such as faciobrachial dystonic seizures (FBDS), bizarre behaviors, sleep disorders and so on, ...

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Intubation for Psychogenic Non-Epileptic Attacks: Frequency, Risk Factors, and Impact on Outcome

Psychogenic non-epileptic attacks (PNEA) are defined as paroxysmal movements or abnormal behaviors that resemble epileptic seizures, are not accompanied by epileptiform activity, and are often associated with psychogenic factors. [1,2]. Documented clinical signs of PNEA without accompanying epileptiform activity on video electroencephalography (vEEG) is typically required to definitively confirm the diagnosis of PNEA. [1–3] Approximately 30% of hospitalized patients who undergo elective vEEG monitoring in epilepsy referral centers are diagnosed with PNEA.[4,5] We used the term “psychogenic nonepileptic attacks (PNEA)” ...

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Drug withdrawal in the Epilepsy monitoring unit – The Patsalos Table

Admissions to epilepsy monitoring units (EMUs) are a necessary part of the diagnostic and investigative process of most modern epilepsy centres. Video Telemetry (VT) utilises simultaneous video and EEG to capture episodic events for a variety of indications, including the diagnosis of transient episodes of uncertain nature (especially to distinguish epileptic from non-epileptic attack disorder); the classification of epilepsy syndrome; and pre-surgical evaluation in patients with medically refractory epilepsy [1].

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Safety, tolerability and effectiveness of transition to eslicarbazepine acetate from carbamazepine or oxcarbazepine in clinical practice

Eslicarbazepine acetate (ESL) is a once-daily antiepileptic drug (AED) that is approved for the treatment of focal-onset seizures as monotherapy or adjunctive therapy [1,2]. The efficacy and safety/tolerability of ESL as adjunctive therapy for focal-onset seizures in adults have been established in a series of randomised, double-blind, placebo-controlled, Phase III trials [3–6] and long-term extension studies [7–9]. The efficacy and safety/tolerability of ESL in the monotherapy setting have been established in a randomised, double-blind, active-controlled, Phase III trial, conducted in ...

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