Seizure

Of the 60 million persons with epilepsy (PWE) worldwide, 80% live in low and middle-income countries (LMICs). Epilepsy care in LMICs including India, is poorly organised, inaccessible to the majority and leaves millions untreated [1]. There are no systems to systematically audit quality or outcomes of epilepsy care that is being provided. Health care facilities and doctors caring for PWE are overwhelmed by patient loads. There is a paucity of resources, including time, that are needed to periodically review quality ...

Therapeutic drug monitoring (TDM) is an established method to improve the quality of antiepileptic drug (AED) therapy. Especially with traditional AEDs such as carbamazepine, phenytoin, or ethosuximide, therapeutic ranges were defined and are still widely used. On the other hand, clinically reliable and useful ranges are still not defined for many new agents, including perampanel (PER) [1].

Epilepsy is the most common chronic neurological disorder with a global estimate of about 70 million cases of lifetime epilepsy (1). More than 80% of people with epilepsy (PWE) live in developing countries (2). The median lifetime epilepsy prevalence has been reported at 15.4 per 1,000 for rural and 10.3 for urban studies in developing countries (1). Epilepsy prevalence in sub-Saharan Africa varies widely from country to country due to different risk factors (3). A meta-analysis found that the global ...

Epilepsy surgery is the most effective treatment option for refractory temporal lobe epilepsy (TLE) with a “good outcome” (i.e., usually seizure- free for at least one year, auras not considered) for about 65% of patients in epilepsy surgery in general [1]. Patients’ decisions in favor of or against surgery are based on a complex trade-off between the chances of seizure-freedom and patients’ subjective expectations [2], on the one hand, and the risks of postoperative cognitive decline [3,4] and further neurological ...

Ryanodine receptor 2 (RYR2) mutation is well-established in the aetiology of an inherited cardiac disorder known as catecholaminergic polymorphic ventricular tachycardia (CPVT). The RYR2 receptor is expressed in cardiomyocytes, and also in the hippocampus. The RYR2 mutation has not been reported as a potential cause of adult-onset genetic generalised epilepsy (GGE).

A variety of psychiatric symptoms are encountered in patients with epilepsy (PWE), which are now widely recognized to have effects more important than seizure frequency and may also be a more powerful determinant of quality of life in that population [1]. There is a large variety of factors associated with psychiatric symptoms in PWE. For effective treatment, it is important to first disentangle the amalgamated complex and focus attention on more potent determinants, while some antiepileptic drugs (AEDs) must be ...

Epilepsy is a frequent neurological disorder with a prevalence of 6.38 per 1,000 persons [1] and approximately 5 million people have been diagnosed with epilepsy worldwide, according to the World Health Organization (WHO). Patients with epilepsy have a three-fold risk for psychiatric comorbidities compared to the general population [2]. Almost 20-22% of patients with epilepsy suffer from depression [2–7], while its prevalence may reach 60% in patients with temporal lobe epilepsy [8,9].

There are many comorbidities in people with epilepsy (PWE), with depression being the most frequent comorbidity. The lifetime prevalence for depression is around 10% in the general population [1] but is estimated at 30% in PWE [2]. A bidirectional relationship between depression and epilepsy was described more than 2000 years ago [3]. Depression may lower the seizure threshold [4]. Many recent epidemiological studies have found that the presence of primary depressive disorder was associated with a three to seven fold ...

Antiepileptic drugs (AEDs), particularly aromatic ones like Carbamazepine (CBZ), Phenytoin (PHT), Phenobarbitone (PB), and Lamotrigine (LTG), are responsible for various cutaneous adverse drug reactions (cADRs). These vary from minor Maculopapular exanthema (MPE) to severe life-threatening reactions like Drug reaction eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), which may develop within few hours to even several weeks after AED initiation.

Nonconvulsive status epilepticus is an important diagnosis to consider when patients present with altered level of consciousness. NCSE has been documented in approximately 8% of comatose patients admitted to ICU without clinical signs of seizure activity [1]. Delay in the diagnosis of NCSE > 24 hours results in increased mortality from 39% to 75% [2]. An EEG is essential for the diagnosis of NCSE.