Seizure

Status epilepticus (SE) is defined as an acute “condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures. SE is a condition, which can have long-term consequences including neuronal death, neuronal injury and alteration of neuronal networks, depending on the type and duration of seizures” [1].

Three Chapters of the Commission of the East Mediterranean Affairs (CEMA) of the ILAE conducted a survey to assess the availability of drugs used for the treatment of generalized convulsive status epilepticus (GCSE) across the CEMA countries and to evaluate the treatment choices of adult and pediatric neurologists for the treatment of this condition.

The childhood epilepsy with centrotemporal spikes (CECTS) is self-limited epilepsy of unknown etiology [1,2]. It is the most common focal epilepsy among pediatric epilepsies, and it represents up to 16% of all childhood epilepsy cases [3]. The term benign, previously used for this epileptic syndrome, has been abandoned due to the presence of cognitive deficits and behavioral disorders that negatively impact academic and social competence [4,5,6].

Based on earlier works by Brazier, Penfield, Jasper, and others in the 1940’s to 1970’s [1,2] and clinical observations a network theory of epilepsy was proposed more than 15 years ago [3]. There have been considerable advances made on network studies in epilepsy [4] and in neuroscience in general [5] since that time. While progress has indubitably been made on the use of network measures to understand epilepsy, important aspects of the network theory of epilepsy remain poorly defined. Our ...

Fang and colleagues invesitgated the association of magnesium levels with posterior reversible encephalopathy syndrome in patients with preeclampsia or eclampsia after 20 weeks of gestation or within 6 weeks postpartum [1]. Their results are consistent with previous studies that hypomagnesemia frequently occurs in the acute phase of obstetric posterior reversible encephalopathy syndrome [2]. Due to the retrospective nature of the study, some concerns may arise.

Levetiracetam (LEV) (Keppra, UCB Pharma-SA, Belgium) is a second-generation broad-spectrum antiepileptic drug (AED) with a favourable pharmacokinetic profile. The lack of effect on cytochrome P450 and its minimal protein binding reduce LEV clinically relevant pharmacokinetic interactions. It is a substrate for multiple efflux transporters, including P-glycoprotein (P-gp/ABCB1).[1,2] Therapeutic drug monitoring (TDM) is increasingly recommended in AED-treated patients, though it is not widely practiced for newer AEDs, including LEV.

Seizure detection devices could be invaluable tools for both people with epilepsy, their caregivers, and clinicians. For patients, having a device that could accurately detect seizures and alert caretakers would help relieve the anxiety from the helplessness that seizures can cause. It could also potentially reduce the risk of sudden unexpected death in epilepsy, particularly for those patients with nocturnal seizures who sleep without a bed partner [1]. For clinicians, seizure detection devices can be an important tool because self-reporting ...

The duration of antiepileptic drug (AED) treatment in the management of seizures due to ring enhancing lesions (REL) remains a matter of debate. We undertook a prospective cohort study to look into the seizure patterns and incidence of recurrence in association with two of the most common causes of RELs after gradually stopping AEDs at least 18 months after acheiving seizure control.

SCN1A variants cause a spectrum of epilepsy syndromes from Dravet Syndrome, a severe epileptic encephalopathy of early infancy to the milder disorder of genetic epilepsy with febrile seizures plus (GEFS+). These genetic epilepsies are associated with increased risk of poor outcome including complications of status epilepticus and early mortality. Individualised management of young children known to be at increased risk should be considered, such as around vaccination management.

This position paper is based on a one-day workshop held in Berlin on October 1st, 2018. The executive board of the German Society of Epileptology (German Chapter of the ILAE; HMH, MH, TM, ASB) invited members of the Federal Joint Committee (G-BA) (see acknowledgement), the Institute for Quality and Efficiency in Health Care (IQWiG) (TK; see acknowledgement) as well as representatives of patient organizations (SF, KR) and drug manufacturers (see acknowledgement) to discuss future designs of trials in adults on ...