Seizure

Valproic acid (VPA) is the most commonly administered first-generation antiepileptic drug (AED) and is also useful for a variety of other diseases, including bipolar disorder (BD) [1,2], migraine headache (MA) [3–5] and neuropathic pain [6,7]. The side effects of antiepileptic drugs are often the main factors restricting treatment and drug retention for patients with epilepsy [8,9]. The clinical utility of VPA may be hindered by its adverse drug reactions (ADRs), such as tremors, weight gain, hair loss, gastrointestinal disturbances, heartburn, ...

Approximately 70 million people currently live with epilepsy worldwide [1]. The availability and accessibility of antiepileptic drugs has been an issue for developing countries. In Asia, the treatment gap has ranged from 28% to as high as 98% [2]. For those who received antiepileptic drugs, there were about one-third of patients who still continue to have seizures [3]. Patients with drug-resistant epilepsy are potential candidates for surgery especially those with surgically remediable syndrome, such as mesial temporal sclerosis or focal ...

Vagus nerve stimulation (VNS) is well established in the treatment of epilepsy and disorders of depression. The prevalence of depression is high in patients with epilepsy, but still it remains unclear how patients with a comorbidity of epilepsy and symptoms of depression respond to VNS.

A thorough study has been carried out by Larsson et al. [1] based on nation-wide registers, which provides valuable information on the long-term retention rates of the most often prescribed antiepileptic drugs (AEDs) in post-stroke epilepsy. Computation of the retention rates was estimated by using the Kaplan-Meier (KM) methodology. The authors excluded a priori patients who died during the first two months after stroke, while patients who died during the study period (>2 months post-stroke) were censored [1].

Epilepsy is a common, chronic neurological disease with a clinical hallmark of recurrent seizures that places a major burden on patients, their caregivers, and society [1–3]. Moreover, disease-specific restrictions on self-sufficiency, mobility, career choice, family planning, and other social aspects as well as frequent epilepsy-related accidents and injuries have been shown to be associated with a reduced quality of life (QoL) and increased depression scores [4–7]. QoL is a complex and multidimensional construct representing the general “well-being” of individuals by ...

The non-invasive localisation of insular lobe epilepsy (ILE) continues to pose a challenge. The suggestion of insular cortex involvement is often based upon recognition of the described clinical semiology[1–4]. Non-invasive neurophysiological investigation is often non-localising and at times discordant to the hypothesis of insular lobe involvement [5]. With these difficulties, many cases progress to intracranial EEG evaluation to achieve a surgical solution.

The publisher regrets that there are some missing commas in some figures appearing in the abstract, the text and Table 1. This has now been corrected in the article. The errors were only made in an “ahead of print” version of the PDF and corrected prior to final publication.

MEF2C haploinsufficiency has been described in the literature over the past decade, with the majority of patients harbouring 5q14.3 microdeletions (MIM# 613443, mental retardation, stereotypic movements, epilepsy, and/or cerebral malformations) [1]. These patients typically present with severely impaired expressive language, gross motor delay and epilepsy.2 The phenotype may resemble Rett’s syndrome in some cases, with stereotypic behaviour, particularly hand flapping, but no microcephaly or neuroregression [3].

Traumatic brain injury (TBI) is a common neurosurgical presentation, with a variable clinical phenotype depending on the severity and anatomy of injury [1, 2]. A proportion of TBI patients develop uncontrollable raised intracranial pressure (ICP). In this group, an increasingly common surgical management option is decompressive craniectomy (DC), involving the removal of a bone flap to allow the brain to swell while relieving ICP [3, 4]. The removed flap may be stored in an abdominal pouch or a specialised refrigeration ...

We are very grateful for the comments of van der Meer et al. on our paper describing retention rates of the first prescribed antiepileptic drugs (AEDs) in a large cohort of patients with poststroke epilepsy [1]. We decided to use Kaplan Meier (KM) analysis for several reasons. Firstly, the basic assumption of a KM analysis, that censoring (because of death) is independent of the outcome (discontinuation of an AED) seems reasonable. Secondly, one of the benefits of a KM analysis ...