Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Pharmacogenomics hold the potential to identify variants associated with adverse drug reactions and treatment efficacy of anti-seizure medications. A model-based cost-utility analysis by Gordon and colleagues showed that genetically-guided therapy costs more, yielded higher quality-adjusted life years outcomes, and was considered to be cost-effective compared to usual care. The study provided preliminary evidence on the value of pharmacogenetic testing in patients with drug-resistant epilepsy. However, data input for the model was based on assumptions that need to be empirically tested. ...

Abstract

Objective

Our goal was to determine if animals with a history of epileptic spasms have learning and memory deficits. We also used continuous (24/7) long-term EEG recordings to evaluate the evolution of epileptiform activity in the same animals over time.

Methods

Objective Recognition Memory and Object Location Memory tests were undertaken, as well as a Matching to Place Water Maze test that evaluated working memory. A retrospective analysis was undertaken of long-term video/EEG recordings from rats with epileptic spasms. The frequency and duration ...

Abstract

Objective

Thyroid hormone abnormalities have been linked to antiseizure medications (ASMs). Oxcarbazepine is considered safer than carbamazepine because it induces the hepatic cytochrome P450 metabolic enzymes less than the carbamazepine does. However, limited data exist for the influence of oxcarbazepine on thyroid function in children and adolescents. The objective of this study was to determine the effect of oxcarbazepine on thyroid function in these patients.

Methods

A total of 162 pediatric patients with epilepsy who started oxcarbazepine for the first time between April ...

Abstract

Objective

To evaluate the exploratory time to exceed pre-randomization seizure count (T-PSC) in the determination of efficacy of adjunctive perampanel in participants with primary generalized tonic–clonic (PGTC) seizures in generalized-onset epilepsy.

Methods

In this multicenter, double-blind study (ClinicalTrials.gov identifier: NCT01393743), participants ≥12 years of age with treatment-resistant idiopathic generalized epilepsy were randomized to receive placebo or adjunctive perampanel (≤8 mg/day) across a 17-week double-blind treatment phase (4-week titration; 13-week maintenance). We evaluated the pre-planned exploratory end point of the T-PSC using a Kaplan–Meier analysis. We ...

Abstract

Objective

More than one third of appropriately treated patients with epilepsy have continued seizures despite two or more medication trials, meeting criteria for drug-resistant epilepsy (DRE). Accurate and reliable identification of patients with DRE in observational data would enable large-scale, real-world comparative effectiveness research and improve access to specialized epilepsy care. In the present study, we aim to develop and compare the performance of computable phenotypes for DRE using the Observational Medical Outcomes Partnership (OMOP) Common Data Model.

Methods

We randomly sampled 600 ...

Abstract

Objective

To determine if an ictal EEG recording as part of pre-surgical evaluation of children with a demarcated single unilateral MRI lesion is indispensable for surgical decision making, we investigated the relationship between interictal/ ictal EEG and seizure semiology with seizure-free outcome.

Methods

Data were obtained retrospectively from consecutive patients (≤ 18 years) undergoing epilepsy surgery with a single unilateral MRI lesion at our institution over a 6-year period. Video-telemetry EEG (VT-EEG) was classified as concordant or non-concordant/non-informative in relation to the MRI lesion location. ...

Abstract

Objective

The use of many antiseizure medications (ASMs) is limited due to pharmacoresistance and dose-limiting side effects, suggesting an unmet need for novel therapeutic approaches. The neuropeptide galanin reduces seizures in several preclinical seizure and seizure models but its clinical utility is limited due to rapid metabolism and poor blood-brain barrier penetration. The lead galanin analog 810-2 is systemically bioavailable and reduces seizures when administered alone. Further development of this analog, with the potential for use as an add-on therapy in ...

Abstract

Objective

This study was carried out to determine the effect of intrauterine CBZ exposure on fetal bone development during pregnancy.

Methods

In the study, 24 female pregnancy rats were used: Wistar. Rats were 20 weeks old. They have an average body weight of 150-200 grams. Pregnancy rats were randomly selected and divided (n=6) into control group, low dose CBZ (10 mg/kg/day) group, medium dose CBZ (25 mg/kg/day) group and high dose CBZ (50 mg/kg/day) group. The ossification length (mm) and ossification area (mm2) of ...

Abstract

Objective

To report clinical presentations and outcomes of patients with seizure and myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD).

Methods

We retrospectively reviewed the electronic medical records for clinical and paraclinical features among patients with seizures and MOG-IgG seropositivity.

Results

We identified 213 patients with MOG-IgG seropositivity who fulfilled criteria for MOGAD. Seizures attributed to CNS autoimmunity were observed in 10% of patients (n=23, 19 children, 4 adults). The majority (n=19, 83%) had pediatric disease onset. Focal motor seizures were the most common seizure semiology ...

Abstract

Dravet syndrome (DS) is a rare drug resistant severe developmental and epileptic encephalopathy caused by pathogenic variants in the α subunit of the voltage-gated sodium channel gene SCN1A. Hyperexcitability in DS results from loss of function in inhibitory interneurons. Thus, sodium channel blockers are usually contraindicated in DS patients as they may lead to disease aggravation. Cenobamate (CNB) is a novel anti-seizure-medication (ASM) with promising rates of seizure freedom in patients with focal-onset drug resistant epilepsy. CNB blocks persistent sodium ...