Computation of antiepileptic drug retention rates in the presence of a competing risk

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].

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Quality of life and correlating factors in children, adolescents with epilepsy, and their caregivers: A cross-sectional multicenter study from Germany

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 ...

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A study of perfusion changes with Insula Epilepsy using SPECT

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.

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MEF2C-related epilepsy: Delineating the phenotypic spectrum from a novel mutation and literature review

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].

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Risk factors for the development of seizures after cranioplasty in patients that sustained traumatic brain injury: a systematic review

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 ...

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Reply to ‘Computation of antiepileptic drug retention rates in the presence of a competing risk’

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 ...

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Familial Adult Myoclonic Epilepsy: a new expansion repeats disorder

The first description of a family showing tremulous movement associated with myoclonic jerks and generalized seizures was provided by Uyama and colleagues in 1985 [1]. In this description, no other neurological nor neuroradiological abnormalities were identified and all the patients showed a cortical reflex myoclonus as demonstrated by the electrophysiological assessment. Subsequently, four additional unrelated families, including a total of 27 individuals, with similar symptoms were described [2].

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Novel variants and phenotypes widen the phenotypic spectrum of GABRG2-related disorders

Next-generation sequencing (NGS) has made genetic testing of patients with epileptic encephalopathies easier – novel variants are discovered and new phenotypes described. Variants in the same gene – even the same variant – can cause different types of epilepsy and neurodevelopmental disorders. Our aim was to identify the genetic causes of epileptic encephalopathies in paediatric patients with complex phenotypes.

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Short burst Clobazam dosing at discharge from VEEG evaluation reduces re-presentation with seizures

Video electroencephalogram (VEEG) is a non-invasive investigation for patients presenting with recurrent seizures. It is a crucial tool when determining whether seizures are epileptic in nature, classifying the subtype of epilepsy and determining suitability for surgery [1]. Patients are typically admitted to an epilepsy monitoring unit (EMU) for VEEG assessment and anti-epileptic medications (AEDs) are reduced or ceased in order to increase the likelihood of recording a seizure during the observation period [1].

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