Seizure

The outpatient services at the Epilepsy Unit in the Western Infirmary, Glasgow, Scotland was set up in September 1982. From the outset patient data were collected prospectively. A focused approach to patients with newly diagnosed epilepsy was developed and a series of 4 analyses have been undertaken over the intervening years, with results from the latest still being written up for publication. A total of 16 published papers have described patient outcomes over the years, focusing on response to different ...

Newly diagnosed epilepsy is estimated at 47 per 100,000 person-years [1]. One study on 5,000 people with epilepsy (PWE) from 15 European countries reported that 96% of PWE were prescribed antiepileptic drugs (AEDs), among whom 88% reported at least one side effect (e.g. tiredness, memory problems, difficulty in concentrating or thinking clearly, nervousness and agitation, etc.) and 31% had changed their AEDs at least once in the last year because of side effects[2]. In addition, a diagnosis of epilepsy can ...

The concern for sudden unexpected death in epilepsy (SUDEP) and the need for better seizure control in persons with epilepsy (PWE) have led to the implementation of seizure detection devices (SDD). Timely identification of seizures may lead to decreased SUDEP risk [1] and a reduction in the potential for seizure related injury and status epilepticus. Accurate detection of seizures and creation of alarms should improve monitoring of treatment efficacy, as patient reporting is not completely reliable [2–4].

Systemic autoimmune diseases (SAD) have gained notoriety as being a risk factor for epilepsy. Conversely, recent studies have reported that epilepsy increases the risk of systemic autoimmune diseases [1,2]. Based on the emerging data, one may speculate that there is an underlying biological mechanism, such as pro-inflammatory conditions and antibodies, which links epilepsy and SAD [2,3]. Numerous studies have focused on clarifying this association, as it could help elucidate the different roles of auto-Abs and inflammation in epileptogenesis.

We read with the interest the letter to the editor submitted by Simon Borghs and his colleagues about their methodological concerns about our work and their disagreement with our conclusions [1]. We always welcome different points of view. However, we would like to stress two points. Firstly, as stated in our paper, our work was conducted in strict accordance with Cochrane Review Methods (www.cochrane-handbook.org) and the PRISMA statement (preferred reporting items for systematic reviews and meta-analyses) [1,2].

We read with interest the meta-analysis and indirect comparison of levetiracetam and brivaracetam recently presented by Zhang et al. (Seizure 2016;39:28–33) [1]. We would like to raise two points in response. Firstly, some methodological elements common to indirect comparisons have not been addressed in the published work. Secondly, the use of network meta-analyses of clinical trials to produce valid evidence of the comparative efficacy and safety of antiepileptic drugs (AEDs) has previously been called into question, which was not discussed ...