Prognostic implications of persistent interictal epileptiform discharges on antiseizure medication withdrawal in patients with epilepsy in five-year remission

Antiseizure medication (ASM) therapy remains the main treatment of epilepsy at present, with 65%–85% of patients with epilepsy becoming seizure-free after receiving appropriate medication treatment[1]. Up to 88% of patients suffer from one or more ASM adverse effects, such as memory impairment and depressed mood[2], resulting in decreased quality of life. Consequently, ASM discontinuation may be considered in patients with epilepsy, whose seizures have been completely controlled for a prolonged remission period, typically two to five years without interictal epileptiform ...

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Heart rate variability alterations in Dravet Syndrome: the role of status epilepticus and a possible association with mortality risk

Dravet syndrome (DS) is a developmental and epileptic encephalopathy, characterized by epilepsy, cognitive decline, behavior disorders and motor impairment [1], caused by a mutation in SCN1A in almost all the patients. SCN1A encodes the α1 subunit of the voltage-gated sodium channel (Nav1.1) and its loss of function determines a dysfunction of GABAergic interneurons with consequent impairment of inhibitory pathways [2]. The mortality in DS is very high, not only compared to healthy controls but also to other patients with drug-resistant ...

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Therapeutic drug monitoring of newer generation antiseizure medications at the point of treatment failure

Therapeutic drug monitoring (TDM) of older generation antiseizure medications (ASMs) such as phenytoin, carbamazepine, phenobarbital or valproate has been widely used since 1960 and the relationship between plasma ASM levels and a clinical effect was well established for some of these agents [1]. Pharmacokinetic characteristics such as non-linear metabolism or drug-drug interactions support the use of TDM for this type of medication. Prescription of older agents however, is decreasing in favor of newer generation ASMs (i.e.

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Experiences of stigma in people with epilepsy: A meta-synthesis of qualitative evidence

Epilepsy is a chronic condition characterised by risk of unprovoked seizures, which has multifaceted implications for the lives of individuals.[1] People with epilepsy (PWE) experience related cognitive, emotional and psychological difficulties,[2] including anxiety, depression and low self-esteem, as well as problems with family functioning.[3] PWE also experience social and legal restrictions with possible implications for their welfare, not least in relation to driving[4] and employment.[5]

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Predicting the Occurrence of Thrombocytopenia from Free Vaproate Levels: A Prospective Study

The likelihood of valproate (VPA) induced thrombocytopenia increases with higher VPA levels. In critically ill patients, the biological active free VPA level cannot be predicted from the total serum level. In this study, we evaluated the relationship between trough free VPA serum levels and concomitant platelet counts and assessed risk factors for the development of thrombocytopenia with the aim of generating a formula specifying the probabilities of developing thrombocytopenia based on trough free serum VPA levels.

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Epilepsy mortality in Wales during COVID-19

: The COVID-19 pandemic has increased mortality worldwide and those with chronic conditions may have been disproportionally affected. However, it is unknown whether the pandemic has changed mortality rates for people with epilepsy. We aimed to compare mortality rates in people with epilepsy in Wales during the pandemic with pre-pandemic rates.

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High Dose Cannabidiol (CBD) in the Treatment of New-Onset Refractory Status Epilepticus (NORSE)

New-Onset Refractory Status Epilepticus (NORSE) is a clinical presentation, not a specific diagnosis, in a patient without active epilepsy or other preexisting relevant neurological disorder, with new onset of refractory status epilepticus without a clear acute or active structural, toxic or metabolic cause [1]. Febrile Infection-Related Epilepsy Syndrome (FIRES) is a subcategory of NORSE, applicable for all ages, that requires a prior febrile infection starting between 2 weeks and 24 hours prior to onset of refractory status epilepticus, with or ...

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High rates of early remission pattern in adult-onset compared with earlier-onset idiopathic generalized epilepsy: a long-term follow-up study

Idiopathic generalized epilepsy (IGE) is a common form of epilepsy accounting for almost 20% of patients attending epilepsy outpatient clinics.[1] Four distinct IGE syndromes have been recognized by the International League Against Epilepsy (ILAE). These syndromes present with consistent clinical overlap and share genetic causative factors, suggesting a common pathophysiological background.[2]

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Sudden Unexpected Death in Epilepsy: A Pilot Study on Neurologists’ Knowledge and Experience in the Eastern Mediterranean Region

Epilepsy is one of the most common neurological disorders in the world, affecting approximately 0.6-1% of the global population [1]. In the Eastern Mediterranean Region (EMR), which includes a range of twenty-two low to high-income countries, it is estimated that 4.7 million people have the disorder (2), indicating that epilepsy is a major public health concern in this part of the world as well. It is estimated that in low and middle-income countries (LMICs), the mortality rate in people with ...

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