Cannabidiol reduces seizures and associated behavioral comorbidities in a range of animal seizure and epilepsy models

Summary

Objective

Epilepsy is a progressive neurological disease characterized by recurrent seizures and behavioral comorbidities. We investigated the antiseizure effect of cannabidiol (CBD) in a battery of acute seizure models. Additionally, we defined the disease‐modifying potential of chronic oral administration of CBD on associated comorbidities in the reduced intensity status epilepticus–spontaneous recurrent seizures (RISE‐SRS) model of temporal lobe epilepsy (TLE).

Methods

We evaluated the acute antiseizure effect of CBD in the maximal electroshock seizure, 6‐Hz psychomotor seizure, and pentylenetetrazol acute seizure tests, as well ...

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Localization yield and seizure outcome in patients undergoing bilateral SEEG exploration

Summary

Objective

We aimed to determine the rates and predictors of resection and seizure freedom after bilateral stereo‐electroencephalography (SEEG) implantation.

Methods

We reviewed 184 patients who underwent bilateral SEEG implantation (2009‐2015). Noninvasive and invasive evaluation findings were collected. Outcomes of interest included subsequent resection and seizure freedom. Statistical analyses employed multivariable logistic regression and proportional hazard modeling. Preoperative and postoperative seizure frequency, severity, and quality of life scales were also compared.

Results

Following bilateral SEEG implantation, 106 of 184 patients (58%) underwent resection. Single seizure type ...

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Illness severity scoring in status epilepticus—When STESS meets APACHE II, SAPS II, and SOFA

Summary

Objective

To characterize a critically ill cohort with status epilepticus (SE) by the illness severity scoring systems SAPS II (Simplified Acute Physiology Score II), APACHE II (Acute Physiology and Chronic Health Evaluation II), and SOFA (Sequential Organ Failure Assessment), and to compare their performance with the STESS (Status Epilepticus Severity Score) for outcome prediction.

Methods

The prospective cohort study was carried out at the University Hospital Basel, a Swiss tertiary academic medical care center. Consecutive adult SE patients hospitalized in the intensive care ...

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Do neurologists agree in diagnosing drug resistance in adults with focal epilepsy?

Summary

Objective

To evaluate interrater agreement in categorizing treatment outcomes and drug responsiveness status according to the International League Against Epilepsy (ILAE) definition of drug‐resistant epilepsy.

Methods

A total of 1053 adults with focal epilepsy considered by the investigators to meet ILAE criteria for drug resistance were enrolled consecutively at 43 centers and followed up prospectively for 18‐34 months. Treatment outcomes for all antiepileptic drugs (AEDs) used up to enrollment (retrospective assessment), and on an AED newly introduced at enrollment, were categorized by individual investigators ...

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Long‐term cannabidiol treatment in patients with Dravet syndrome: An open‐label extension trial

Summary

Objective

Add‐on cannabidiol (CBD) significantly reduced seizures associated with Dravet syndrome (DS) in a randomized, double‐blind, placebo‐controlled trial: GWPCARE1 Part B (NCT02091375). Patients who completed GWPCARE1 Part A (NCT02091206) or Part B, or a second placebo‐controlled trial, GWPCARE2 (NCT02224703), were invited to enroll in a long‐term open‐label extension trial, GWPCARE5 (NCT02224573). We present an interim analysis of the safety, efficacy, and patient‐reported outcomes from GWPCARE5.

Methods

Patients received a pharmaceutical formulation of highly purified CBD in oral solution (100 mg/mL), titrated from 2.5 ...

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Differences in pediatric and adult epilepsy surgery: A comparison at one center from 1990 to 2014

Summary

Objective

Surgical volumes at large epilepsy centers are decreasing. Pediatric cohorts, however, show a trend toward more resections and superior outcome. Differences in pediatric and adult epilepsy surgery were investigated in our cohort.

Methods

The Bethel database between 1990 and 2014 was retrospectively analyzed.

Results

A total of 1916 adults and 1300 children underwent presurgical workup. The most common etiologies were medial temporal sclerosis (35.4%) in adults, and focal cortical dysplasias (21.1%) and diffuse hemispheric pathologies (14.7%) in children. Only 1.4% of the total cohort ...

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Postictal clinical and electroencephalographic activity following intracranially recorded bilateral tonic–clonic seizures

Summary

Objective

The dynamics of the postictal period, which may demonstrate such dramatic clinical phenomena as focal neurological deficits, prolonged coma and immobility, and even sudden death, are poorly understood. We sought to classify and characterize postictal phases of bilateral tonic–clonic seizures based on electroencephalographic (EEG) criteria and associated clinical features.

Methods

We performed a detailed electroclinical evaluation of the postictal period in a series of 31 bilateral tonic–clonic seizures in 16 patients undergoing epilepsy surgery evaluations for focal pharmacoresistant epilepsy with intracranial electrodes ...

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Infections and risk of epilepsy in children and young adults: A nationwide study

Summary

Objective

The development of epilepsy has been linked to infections of the central nervous system, but recently also to infections and inflammation outside of the central nervous system. Thus we investigated the association between infections and the risk of subsequent epilepsy.

Methods

This was a Danish nationwide population‐based cohort study comprising a total of 1 938 555 individuals born between 1982 and 2012. Individuals were followed from birth until December 31, 2012, death, disappearance, emigration, or epilepsy diagnosis, whichever came first (28 512 ...

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Medical health care utilization cost of patients presenting with psychogenic nonepileptic seizures

Summary

Objective

To investigate the health care utilization cost of patients presenting with psychogenic nonepileptic seizures (PNES) to a tertiary hospital in Australia.

Methods

This is a retrospective analysis of adult patients with PNES based on video‐electroencephalographic confirmation over a 5‐year period. We used an itemized list to collect detailed health care utilization data. The items included emergency room visits, hospital ward admissions, intensive care unit (ICU) admissions, outpatient neurology clinic visits, medical interventions, Code Blue and Medical Emergency Team calls for seizures, medications, ...

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