Epilepsy care cascade, treatment gap and its determinants in rural South Africa

Epilepsy is a common neurologic disorder that currently affects more than 50 million people globally with at least 80% of cases found in low- and middle-income countries (LMICs) [1,2]. Whilst pharmacologic treatment results in seizure freedom in roughly 70% of patients with epilepsy [3], the number of individuals diagnosed with epilepsy and receiving and correctly taking anti-seizure medication (ASM) in LMICs remains low. A 2014 review found that 59% of people with epilepsy in sub-Saharan Africa do not receive any ...

Seguir leyendo →
0

Plant derived versus synthetic cannabidiol: wishes and commitment of epilepsy patients

Medical cannabis (MC) has been used in various medical conditions for centuries. Over the last decades, scientific research has revealed several mechanisms of action of cannabis and its compounds. Of more than 120 known cannabinoids, tetrahydrocannabinol (THC) and cannabidiol (CBD) have been most thoroughly investigated. For CBD, a non-psychoactive cannabinoid, anticonvulsant potential has been shown in different animal models [1] and Class 1 evidence was revealed in severe paediatric epilepsy syndromes (Lennox-Gastaut-Sydrome and Dravet-Syndrome) [2,3].

Seguir leyendo →
0

Adjunctive perampanel and myoclonic and absence seizures: post hoc analysis of data from Study 332 in patients with idiopathic generalized epilepsy

Anti-seizure medications (ASMs) are the primary treatment option for generalized tonic-clonic (GTC; previously primary generalized tonic-clonic) seizures in patients with idiopathic generalized epilepsy (IGE [1,2]). However, clinical data regarding ASM efficacy in this indication are limited and few ASMs are licensed to treat GTC seizures [3]. Other common generalized seizure types that can occur concurrently in patients with IGE and GTC seizures are myoclonic and absence seizures, which may occur in approximately 60% and 40% of patients with GTC seizures, ...

Seguir leyendo →
0

Adherence to mental health care and caregiver-patient relationship after diagnosis of psychogenic non-epileptic seizures: Longitudinal follow-up study

The World Health Organization defines therapeutic adherence as “the extent to which the patient’s behaviour matches the prescriber’s recommendations” [1]. It is therefore a dynamic, complex and multifactorial phenomenon for which patients and healthcare professionals share responsibility. Non-adherence to long-term therapies is a key issue as it concerns around half of all chronically ill patients [1]. Poor adherence severely compromises therapeutic effectiveness and therefore impacts the quality of life of these patients and the economics of health care.

Seguir leyendo →
0

Seizure with CSF lymphocytosis as a presenting feature of COVID-19 in an otherwise healthy young man

A 20-year old previously well man was brought to hospital a seizure. For three days he had complained of myalgia, lethargy and fever. On attempting to get out of bed at home, he had experienced lightheadedness with blurred and double vision and felt his legs were too weak to allow him walk. He then had a generalised tonic-clonic siezure, which lasted one minute. In the wake of the seizure he was confused and aggressive, requiring intravenous midazolam in the emergency ...

Seguir leyendo →
0

Effectiveness of cannabidiol in a prospective cohort of children with drug-resistant epileptic encephalopathy in Argentina

Epileptic encephalopathies (EEs) are severe brain disorders of early age characterized by: (1) aggressive paroxysmal activity on electroencephalography (EEG), (2) seizures that are usually multiform and drug-resistant, (3) cognitive, behavioral and motor deteriorations that may be persistent, and (4) sometimes early death. [1] The concept of “epileptic encephalopathies” refers to the fact that the epileptic activity itself causes progressive cognitive and behavioral deterioration or regression [1,2].

Seguir leyendo →
0

Clinical factors associated with suicide risk independent of depression in persons with epilepsy

Suicide accounts for 1.4% of all deaths worldwide, and was reported to be the 18th leading cause of death in 2016 [1]. In Korea, the estimated total suicide mortality was 24.3 per 100,000 in 2017, which was 2.3 times higher than the global rate [2] and the second highest rate among member states of the Organization for Economic Cooperation and Development [3]. For many years, there were few discussions of suicide as it relates to epilepsy, partly because of concerns ...

Seguir leyendo →
0

Antiseizure medication withdrawal in seizure-free patients with PCDH19-related epilepsy: a multinational cohort survey

PCDH19 (protocadherin-19) was first identified as a cause of epilepsy and intellectual disability in 2008 [1]. Pathogenic variants in PCDH19 are associated with a complex neurodevelopmental syndrome characterized by epilepsy with fever-related clusters, intellectual disability, autism spectrum disorder and behavioral comorbidity [2]. The phenotypic spectrum related to PCDH19 is broadening to include patients with milder phenotype [3].

Seguir leyendo →
0

Comparison of the neurocognitive outcomes in term infants treated with levetiracetam and phenobarbital monotherapy for neonatal clinical seizures

Treatment of neonatal seizures with a proper antiepileptic drug remains a significant clinical problem in medicine [1–3]. There are few evidence-based guidelines for the evaluation and management of neonatal seizures. Available guidelines indicate that phenobarbital (PB) remains the first-line treatment for neonatal seizures [4,5]. Currently, there is no consensus regarding the second-line antiepileptic drugs, such as levetiracetam (LEV), benzodiazepine, fosphenytoin, or lidocaine [6–8]. In the last decade, case series and clinical studies have suggested LEV as a first-line antiepileptic drug ...

Seguir leyendo →
0
Página 2 de 93 12345...»