Modified Atkins Diet Versus Levetiracetam for Non-surgical Drug-Resistant Epilepsy in Children: A Randomized Open-Label Study

Epilepsy is among the most frequent neurological disorders in children. Although two-thirds of children with epilepsy (CWE) will attain seizure freedom for more than 3-5 years, nearly 25% eventually develop drug-resistant epilepsy (DRE).[1] Children with DRE are at risk for several comorbidities, including intellectual disability and attention-deficit hyperactivity disorder, and complications, including drug-related adverse effects, injuries, and sudden unexpected death in epilepsy (SUDEP).

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Satisfaction and Seizure Outcomes of Epilepsy Surgery in Tuberous Sclerosis: A Swedish Population-based Long-term Follow-up Study

Tuberous sclerosis complex (TSC), a rare genetic disease, involves excessive cell growth, which leads to benign tumors in several organs, including the central nervous system [1]. These cerebral hamartomas or tubers are potential substrates for neuronal hyperexcitability that induces epileptic seizures. Approximately 70-90% of patients with TSC develop epilepsy—often difficult to control with drug treatment [2–4]. Pharmaco-resistant epilepsy is twice as common as in the general epilepsy population [5].

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Carer’s perceptions of paediatric epilepsy services with and without epilepsy specialist nurses: A thematic analysis

Childhood epilepsy is a common neurological disorder of variable aetiology affecting approximately 0.5-1% of children[1]. For caregivers, management of their child’s epilepsy not only involves managing seizures within the context of home, education and leisure activities, but also administering medication, seeking clinical intervention when appropriate, and often negotiating cognitive, mental health and neurodevelopmental comorbidities[2–5]. Depending on clinical and family circumstances, caring for a child with epilepsy can involve detrimental changes to carer employment, finances, sleep and mental health[3-4, 6-7].

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Childhood vs. Juvenile Absence Epilepsy: How to make a diagnosis

The International League Against Epilepsy (ILAE) Task Force on Nosology and Definitions has recently provided a position statement on the definition of the idiopathic generalized epilepsy (IGE) Syndromes[1]. They have included four syndromes in their definition: childhood absence epilepsy (CAE), juvenile absence epilepsy (JAE), juvenile myoclonic epilepsy (JME), and epilepsy with generalized tonic-clonic seizures (GTCS) alone[1]. In their definition of IGEs, seizure types include one or a combination of the following types: absences, myoclonic seizures, GTCS, and myoclonic-tonic- clonic seizures.

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Diffusion-weighted imaging hyperintensity of the striatum or “striatum sign’’ in convulsive status epilepticus

Prior studies have identified the important role of cerebral magnetic resonance imaging (MRI) in providing information on ictal and peri-ictal phases in patients with epilepsy [1, 2]. The main MRI sequences used in diagnosing patients with epilepsy include arterial spin labeling (ASL) and diffusion-weighted imaging (DWI) [2]. The diagnostic findings include hyperintense abnormalities on DWI and hyperperfusion on ASL observed in the focal cortex or the thalamus (otherwise called the “pulvinar sign”) or splenium in patients with focal status epilepticus ...

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Utility of serum lactate on differential diagnosis of seizure-like activity: A systematic review and meta-analysis

Transient loss of consciousness (TLOC) has a diverse etiology with a lifetime prevalence of 50% [1]. Differential diagnosis includes syncope, orthostatic hypotension, seizures, psychogenic non-epileptic seizures (PNES), and cardiac arrhythmias [2]. Unfortunately, diagnosis of the underlying cause can be a challenge in the emergency department (ED), where there is a 20-30% misdiagnosis rate for TLOC [3,4,5] with most epileptic seizures wrongly diagnosed as syncope [6]. Overall, syncope accounts for 76% of cases of TLOC [7,8], whereas seizures account for 1% ...

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Effects of cenobamate on cognitive performance of epilepsy patients

Cenobamate (CNB) is a new antiseizure medication (ASM) that has been approved by the US Food and Drug Administration in November 2019, and in March 2021 by the European Medicines Agency for the adjunctive treatment of focal onset seizures in adults. CNB is a novel tetrazole-derived carbamate compound with one chiral center. Dual, complementary mechanisms of action may contribute to its antiseizure activity. CNB has been shown to reduce neuronal excitability by enhancing the fast and slow inactivation of sodium ...

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Performance of a pediatric adaptation of the RITE2 and APE2 scores in children with autoimmune epilepsy: P-RITE2 and P-APE2 scores.

A substantial proportion of new-onset cryptogenic epilepsies have been attributed to a probable autoimmune cause, especially in adolescents and adults [1,2]. As timely immunotherapy can bring a dramatic improvement in achieving seizure control in these patients and most of them do not respond to conventional antiseizure medication (ASM) regimen, early suspicion and timely identification are important in clinical practice [3]. In the pediatric population, definite autoimmune encephalitis in which neural-specific autoantibodies are positive in high titers in plasma or cerebrospinal ...

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Brivaracetam add-on treatment in pediatric patients with severe drug-resistant epilepsy: Italian real-world evidence.

Brivaracetam (BRV) is a recently released antiepileptic drug (AED), currently approved as adjunctive therapy for focal seizures in patients aged 4 years and older in the European Union, and as monotherapy and adjunctive therapy in patients aged 4 years and older in the United States (US) [1,2]. BRV is a 2S)-2-[(4R)-2-oxo-4-propylpyrrolidin-1-yl] butanamide, with four different diastereomers, with high-affinity binding to SV2A [3,4]. This mechanism of action partially mirrors that of levetiracetam (LEV), a previously discovered and widely used AED.

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Caregiver reported seizure precipitants and measures to prevent seizures in children with Dravet syndrome

Dravet syndrome (DS) is a severe developmental and epileptic encephalopathy1, characterized by multiple intractable seizure types and frequent episodes of status epilepticus (SE). Seizures usually start in the first year of life2. DS is usually caused by dominant pathogenic variants in the Sodium voltage-gated channel alpha subunit 1 (SCN1A) gene3. Most affected individuals meet the criteria for intellectual disability and behavioral problems are common4. The incidence has been calculated to 1 per 15,500 live births in a prospective study5.

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