Seizures
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Cannabidiol: Does It Help in Drug-resistant Epileptic Encephalopathies?
In this double-blind, placebo-controlled trial, the authors investigated the efficacy of adjunctive cannabidiol in a population of severe developmental epileptic encephalopathies and found some efficacy.
What Are the Early Predictors for Post-traumatic Epilepsy After Injury?
Following traumatic brain injury, early (first five days after injury) epileptiform abnormalities on EEG were seen more commonly in patients with subsequent post-traumatic epilepsy (PTE), compared to controls, and were found to be a significant and independent predictor of PTE. The presence of subdural hemorrhage was the only other independent predictor of PTE.
Phenytoin as a Second-line Treatment for Status Epilepticus: What’s the Evidence?
In this systematic review, the evidence supporting the use of intravenous phenytoin for convulsive status epilepticus was analyzed critically and did not demonstrate strong evidence to support its use as a preferred second-line agent.
Pitfalls in the Treatment of Seizures Associated With Brain Tumors
In this multicenter, observational study, the authors assessed the prevalence of neuropsychiatric side effects from medications in subjects with tumor-related epilepsy. Levetiracetam was found to have the highest prevalence of such side effects.
Risk Factors for Seizures in Critically Ill Patients Monitored by Continuous EEG
Investigators prospectively analyzed 72-hour continuous electroencephalograms to identify clinical and electroencephalogram risk factors for having seizures and developed a model for “time-dependent” seizure risk. Electrographic seizures occurred in 23% of all patients. The only significant clinical predictors of seizures were presence of coma and prior clinical seizure history.
Randomized Trial of Cannabidiol for Medically Refractory Seizures in Dravet Syndrome
In a double-blind study, 120 children and young adults with the Dravet syndrome and medically refractory seizures were assigned randomly to receive either cannabidiol or placebo, as well as their usual antiepileptic drugs/therapies. The primary finding was a significant decrease in convulsive seizure frequency during the 14-week treatment period for patients receiving cannabidiol compared to those receiving placebo.
Outcomes After Surgical Treatment of Nonlesional Neocortical Epilepsy
In this study of 109 consecutive patients with medically refractory neocortical epilepsy without MRI-identifiable lesions who underwent focal resection at a single hospital from 1995 to 2005, almost 60% of patients achieved long-term seizure freedom, with anti-epileptic drugs being withdrawn successfully in about a third of these patients.
Does Therapeutic Hypothermia Improve Functional Outcomes After Convulsive Status Epilepticus?
In a multicenter trial in France, patients admitted to the ICU from 2011-2015 for convulsive status epilepticus were randomly assigned to receive standard therapy (control group) or hypothermia plus standard therapy (treatment group). The primary outcome measure was an absence of functional impairment at 90 days after seizure onset, as measured by the Glasgow Outcome Scale (score of 5). There was no significant difference in outcomes between the two groups.
Relationship Between Spikes and Seizures Using an Implantable Intracranial Detection Device
The authors report the preliminary findings for an implantable ambulatory intracranial recording device for seizure detection in 15 subjects. One of the primary findings was that spike rate significantly changed prior to seizures in nine of 15 subjects. Six of these subjects showed a significant decrease in spiking prior to ictal onset, whereas the remaining three showed a significant increase in spiking and these three subjects had the best seizure prediction results.
Potential Imaging Biomarkers of SUDEP: Can We Predict Sudden Death in Epilepsy?
The authors retrospectively conducted a voxel-based analysis of T1 MRI scans to compare gray matter volumes in 12 cases of sudden unexpected death in epilepsy (SUDEP) acquired at a median of 2 years before death with patients at high or low risk for SUDEP and with healthy controls, and demonstrated significant anatomical differences between the groups.