Seizure

Epilepsy is one of the most common neurological diseases [1]. In about a third of all patients, seizure freedom is not achieved by anti-seizure medication (ASM) [2, 3]. These patients are referred to as “drug resistant”. Drug resistant epilepsy (DRE) in children is not clearly defined. In early infancy the definition is even more complicated and differs in many aspects from DRE in children and adolescents. Seizures in the neonatal period and first month of life are most frequently caused ...

Infantile spasms belong to the group of epileptic encephalopathies that typically occur in early infancy and are often associated with severe developmental delay. Little is known about whether focal features are part of the syndrome and thus occur independently of etiology, or whether focal features always indicate a cerebral lesion.

Brivaracetam (BRV) is approved as an adjunctive therapy in the treatment of focal seizures, either with or without secondary generalisation, for patients from the age of four [1]. BRV is commercially available in the Netherlands since 2016. LEV and BRV share a similar mechanism of action in seizure reduction. Both target the transmembrane synaptic vesicle protein 2A (SV2A) [2]. However, BRV was found to have a 15- to 30-fold higher affinity and a higher selectivity for the SV2A receptor than ...

The recent paper on eye disorders associated with newer antiseizure drugs is an interesting work [1]. The authors tried to evaluate this association based on the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) using a disproportionality analysis. We agree with the authors on the limited literature of adverse effects of newer antiseizure drugs [1]. Authors concluded that topiramate and lamotrigine were disproportionately associated with serious eye-related adverse events.

Much of what we know about the evolution and development of epilepsy to date has been obtained from observation of the condition post-diagnosis. However, there is a substantial proportion of patients (16-77%) [1–5] who report a history of seizures that occur before their diagnosis is made. This delay to diagnosis, which may range from a few months to many years [1–5], flags a large gap in our knowledge of epilepsy. The identification of underlying factors associated with prior seizures may ...

Kobota and colleagues have expressed concern regarding a potential for bias in our randomised trial testing two modes of virtual epilepsy patient and caregiver education [1]. This is a valid concern as the trial was open labelled and the same investigator administered the intervention and also measured outcomes. Also, there was no blinding as described in the paper.

Dear Sir,

In patients with new-onset seizures, autoimmune limbic encephalitis (LE) is an important differential diagnosis. Consensus criteria for definite autoimmune LE require typical clinical symptoms with subacute onset (working memory deficits, seizures, or psychiatric symptoms), bilateral MRI signs of LE, and either cerebrospinal fluid (CSF) pleocytosis or focal EEG findings of the temporal lobes [1]. Detection of a typical neural autoantibody may compensate for the lack of one of these three criteria.

Cenobamate is a new antiseizure medication (ASM) indicated for the treatment of focal onset (partial-onset) seizures in adults [1]. The summary of product characteristics for Europe specifies the use of cenobamate as adjunctive treatment for focal onset seizures in adults whose epilepsy has not been adequately controlled with at least two ASMS [2]. The efficacy and safety of cenobamate were demonstrated in two double-blind, randomized, placebo-controlled, phase 2 clinical studies (NCT01397968; NCT01866111) in patients with uncontrolled focal seizures who were ...

The corpus callosotomy (CC) was first introduced by Van Wagenen and Herren in 1940 as a palliative procedure to control refractory seizures [1]. Their hypothesis was based on the idea that the corpus callosum as the connecting bridge for interhemispheric spread of epileptic activity. Hence, this procedure is typically used to treat atonic seizures (drop attacks), which are highly refractory, but is also used to prevent generalization of other seizure types and syndromes, especially, Lennox-Gastaut Syndrome (LGS) [2].