Does an additional virtual interactive session increase the impact of digital educational material given to epilepsy patients? A randomized controlled trial

Around 50 million people in the world [1] and more than 10 million in India suffer from epilepsy [2]. Treatment outcomes in persons with epilepsy (PwE) can be improved by providing patients and caregivers epilepsy-related education [3]. In most low and middle-income countries like India with extreme shortages of trained personnel for treating PwE [4], patient education is often neglected. Models of educating patients that are both time and cost effective are required. The SARS-CoV2 pandemic and an anticipation of ...

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Aggravation of valproic acid induced thrombocytopenia after the introduction of fenfluramine, a case report

Thrombocytopenia, defined as a platelet count <150 .109/L, is associated with an increased bleeding risk. Drug-induced thrombocytopenia (DIT) is an important cause with an estimated incidence of 10 cases per million people/year. Although the incidence is higher in adults, DIT can also be seen in children. [1] The underlying pathogenetic mechanism of DIT can be diverse encompassing either a reduced platelet production or an increased clearance of platelets into the circulation. The latter is most often immune with an antibody ...

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Sacred Lives – an account of the history, cultural associations and social impact of epilepsy by Ian Bone

This book is excellent at so many levels. Its breadth for a start is impressive. Who knew that, as a result of the eugenics movement, ‘by the mid-1950s a total of 17 states in the USA had prohibited the marriage of people with epilepsy’? Who knew that Napoleon Bonaparte most probably had epilepsy, as well as non-epileptic attacks, that Alfred Lord Tennyson may have had epilepsy, while Alfred Nobel most likely did not. Napoleon was a very good example of ...

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Seizures in myelin oligodendrocyte glycoprotein antibody-associated disorders and related immune factors

MOG was identified in the late 1970s as a central nervous system (CNS) specific protein expressed on the surface of myelin sheath and oligodendrocytes. In pediatric demyelinating diseases, MOG antibodies were first described in 2007 [1], and Mariotto [2] reported that MOG-IgG was detected in up to 40% of pediatric patients with acquired demyelinating syndromes (ADS) of the CNS. MOG antibody-mediated central nervous system demyelinating diseases have a variety of phenotypes, including optic neuritis (ON), myelitis, acute disseminated encephalomyelitis (ADEM), ...

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History of abuse and psychogenic nonepileptic seizures: A systematic review

Psychogenic nonepileptic seizures (PNES) are a subtype of functional neurological disorder (FNDs); disorders of the nervous system with no organic, structural cause but that cause significant symptoms and impairment for the patient [36]. FNDs are distinct from factitious disorders or malingering [12]. PNES’ are categorically separated from epilepsy, which is caused by abnormal and excessive discharge of populations of neurons within the brain, detectable by EEG [31]. PNES patients do not present with this EEG finding, and have different clinical ...

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Sodium channel blockers are effective for benign infantile epilepsy

Benign infantile epilepsy (BIE) is characterized by onset in infancy (with typical development before onset), no underlying disorders, seizure clusters, short seizure duration, and normal interictal electroencephalogram.[1-3] BIE can be familial [3,4] and proline-rich transmembrane protein 2 (PRRT2) gene is a major causal factor.[4,5] The long-term outcome of BIE is favorable, with seizure cessation before 2 years of age [6] and no cognitive or behavioral problems.[7]

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Predictors and prognoses of epilepsy after anti-neuronal antibody-positive autoimmune encephalitis

Autoimmune encephalitis (AIE) is increasingly recognized as a heterogeneous group of conditions associated with anti-neural antibodies (Abs)[1]. These Abs can be classified into two groups according to their epitopes: Abs targeting intracellular neuronal antigens (INAbs); and Abs targeting neural surface antigens (NSAbs)[2]. The initial and common symptoms of AIE include seizures (of several different types), which occur at a high prevalence (50- 90%)[3, 4]. These seizures are reported to respond poorly to routine therapy with antiepileptic drugs (AEDs)[5].

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The Effectiveness of Psychological Interventions for Children and Adolescents with Non-Epileptic Seizures

Non-epileptic seizures (NES) are events that appear similar to epileptic seizures but present without associated epileptic brain activity [38]. In DSM-V and ICD-10 NES is considered to be a subtype of conversion disorder/ functional neurological symptom disorder [2, 51]. A lack of agreement with regard to the most appropriate term to use for NES, means there are a number of synonyms in use, which include pseudoseizures, psychogenic non-epileptic seizures, non-epileptic attack disorder [34] and functional seizures; the latter has been ...

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Impact of antiepileptic drugs on simulated driving in patients with epilepsy

Epilepsy is a common disease, with prevalence ranging from 0.5% to 1.0% in the general population [1,2]. Uncontrolled epileptic seizures have a serious impact on the social activities of affected individuals, such as school achievements and employment [3,4]. Driving license restriction is one of the most frequently noted issues, as that can limit the daily activities of patients with active epilepsy, while acquisition or re-acquisition of a driver’s license has been constantly listed as one of the most highly evaluated ...

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Can machine learning improve randomized clinical trial analysis?

Despite over 24 approved anti-seizure medications, seizure freedom eludes 1 in 3 patients [1]. Meanwhile, new drug development costs have accelerated into billions of dollars. With these factors at play, it is time to re-assess basic assumptions about evaluating randomized clinical trial outcomes. It was recently shown that using “median percentage change” (MPC) [2] increased trial efficiency and lowered cost [3]. Is there a better metric, one that can reduce trial size while maintaining quality, reproducibility, and surveillance for adverse ...

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