A new app seems to help nonneurologist health care workers diagnose seizures as epileptic or nonepileptic, findings from a small study to be presented at the American Academy of Neurology meeting...
The effect of phenobarbitone on cognition in adult patients with new onset epilepsy: A multi-centric prospective study from India - Corrected Proof
The International League Against Epilepsy has revised its definition of epilepsy to include additional criteria for clinical diagnosis, according to a report from the organization published April 14....
Adjunctive use of ezogabine/retigabine with either traditional sodium channel blocking antiepileptic drugs (AEDs) or AEDs with other mechanisms of action: Evaluation of efficacy and tolerability - Corrected Proof
Healthcare professionals need to adopt a wider outlook on the factors underpinning anxiety and depression in epilepsy patients, according to new Australian research.
Carried out by La Trobe University in Victoria, the study looked at data from the 2010 Australian Epilepsy Longitudinal Survey in order to better understand the mechanisms causing mental problems in this group.
Key influencing factors for both anxiety and depression included social aspects of stigma, effectiveness of seizure control and employment status, while the number of different epilepsy drugs also caused anxiety in some cases.
According to the researchers, doctors and caregivers look to be more considerate of factors such as these when looking for the best way to treat and support epilepsy patients affected by mental issues.
The paper observed: “Without this fuller social context, there are limitations on understanding factors that influence anxiety and depression and how to deal with the outcomes.”
Epilepsy patients experiencing signs of depression, meanwhile, are advised that taking regular exercise and improving the quality of their diet could help to alleviate the problem.
Posted by Anne Brown
The importance of offering proper support to those tasked with looking after young epilepsy patients has been underlined by a new study.
Conducted by a team at the Medical University of South Carolina, the research involved conversations with four focus groups of caregivers of young people with epilepsy, in order to better understand their experience of looking after the children.
According to those questioned, caregivers generally have most difficulties with the unpredictability of looking after children with epilepsy, the need for constant vigilance and the lack of a perceived relationship between certain actions and outcomes.
This comes in addition to previous research showing these people often experience greater parenting stress and unanticipated caregiving responsibilities. The study therefore highlighted the need for greater professional support for caregivers.
The researchers said: “Epilepsy healthcare professionals are encouraged to promote patient and family centeredness, provide information on how to access community resources, and work with caregivers to enhance epilepsy self-management skills.”
It is estimated that around one in 240 children under 16 in the UK has epilepsy.
Posted by Steve Long
New research has underlined the potential benefits that a trial of immunotherapy can have in the diagnosis and treatment of patients with suspected autoimmune epilepsy.
Conducted by the College of Medicine at the Mayo Clinic in Rochester, Minnesota, the study saw a team of scientists review the charts of 110 patients seen at the institution’s autoimmune neurology clinic with seizures as a chief complaint.
Out of these, a total of 29 patients with frequent or medically intractable seizures were selected after meeting a number of key inclusion criteria, including the suspicion of autoimmune epilepsy based on the presence of neural autoantibodies, a personal or family history or physical signs of autoimmunity.
The selected patients had also initiated a six to 12-week trial of intravenous methylprednisolone, immune globulin or both. Subjects were defined as having responded to treatment if a 50 per cent or greater reduction in seizure frequency was observed.
According to results published in the journal Neurology, a total of 18 patients, or 62 per cent of the group, responded to therapy, with ten of these becoming seizure-free.
Just over half of this group improved with the first agent, while 43 per cent of those receiving a second agent after not responding to the first subsequently saw improvement.
A favourable response tended to correlate with a shorter interval between symptom onset and treatment initiation. Moreover, of the 13 responders followed for more than six months after initiating long-term oral immunosuppressant therapy, the positive response was sustained in 11 of them, equating to an 85 per cent success rate.
“These retrospective findings justify consideration of a trial of immunotherapy in patients with suspected autoimmune epilepsy,” said the researchers.
This could be an important discovery as it has been noted previously that epilepsy patients are often also affected by autoimmune disorders. A recent JAMA Neurology study analysing US insurance claims data on around 2.5 million people revealed that a diagnosis of epilepsy was nearly four times as common among those with some form of autoimmune disease.
Posted by Anne Brown
Patients affected by a certain type of epilepsy are likely to experience cognitive impairments that are shared by other members of their family, a new study has revealed.
The King’s College London study has investigated the strong genetic component of idiopathic generalised epilepsy (IGE) in order to better understand why patients with this condition often show deficits in a range of frontal lobe functions.
IGE is the term used to describe forms of epilepsy that do not have any readily apparent causes and are not associated with structural brain abnormalities, meaning that a better understanding of their underlying genetic foundations is essential.
For this new study, 36 patients with IGE were examined using a series of neuropsychological tests sensitive to frontal lobe dysfunction, including assessments of executive function, nonverbal reasoning, verbal generativity, response inhibition, attention and working memory. 38 of their first-degree relatives and 40 healthy controls also underwent these tests.
Previous studies have hinted that unaffected siblings of people with IGE may share some of their cognitive deficits, suggesting these may be genetically determined endophenotypes – a discovery that would increase general understanding of the pathophysiology of these types of epilepsy.
Results published in the journal Epilepsia revealed not only that patients with IGE tended to experience deficits in nonverbal reasoning, verbal generativity, attention, and working memory, but also that their relatives exhibited a parallel profile, with significant impairments in these tasks.
Though the IGE patients tended to show greater deficits in these tasks than their relatives, this nevertheless indicates that these problems stem from the same underlying genetic cause.
The paper concluded: “This study shows that measures of nonverbal reasoning, verbal generativity, sustained attention and working memory are endophenotypes of IGE and offer the potential for aiding molecular genetic studies and elucidating the pathophysiology of IGE.
“Patients tended to demonstrate greater impairment in these tasks, possibly because of a greater genetic contribution and/or disease-related factors.”
Posted by Anne Brown
Structural changes in the temporal lobe and piriform cortex in frontal lobe epilepsy - Corrected Proof
Outcome of intracranial electroencephalography monitoring and surgery in magnetic resonance imaging-negative temporal lobe epilepsy - Corrected Proof
LAS VEGAS – The treatment window for generalized, convulsive status epilepticus has been compressed in recent years, something that’s important for hospitalists to know, according to Dr. Andrew...
Parents of children with epilepsy and pervasive developmental disorders (PDDs) could soon see a new treatment option become available.
A new study from Japan’s University of Yamanashi has demonstrated the potential benefits that treatment with the drug levetiracetam can deliver for younger patients affected by these conditions.
Published in the European Journal of Paediatric Neurology, the study investigated the relationship between behavioural problems, the location of electroencephalogram (EEG) paroxysmal abnormalities and levetiracetam therapy among this patient group.
A total of 12 children were involved in the trial, which saw the subjects receive levetiracetam with an initial dose of ten mg/kg/day for the first week, followed by increments of five mg/kg/day every week. The dosage was then adjusted up to a maximum of 60 mg/kg/day.
EEG recordings were performed every three months, with the researchers counting the frequency of seizures and EEG paroxysmal abnormalities, while instances of panic/aggressive behaviours were scored.
It was found that 66.7 per cent of the patients saw reductions in the number of seizures and paroxysmal abnormalities they experienced during the trial period, while 75 per cent of them saw an easing of their behavioural problems.
The researchers concluded: “The present data indicated the usefulness of LEV in reducing behavioural problems related to the reduction of seizures and frontal spikes in PDD for some, but not all, of the patients.
“Thus, levetiracetam represents an important addition to treatment for PDD children with epilepsy presenting with frontal EEG paroxysms.”
Epilepsy is particularly common in youngsters who have developmental disabilities, with approximately 30 per cent of children with epilepsy having another form of development disorder. The presence of both conditions presents its own unique challenges in terms of treatment and symptom management, meaning research into new therapy options represents an important area of scientific understanding.
Posted by Steve Long
A new study has demonstrated the potential benefits of a technique called transcranial magnetic stimulation (TMS) in the treatment and diagnosis of epilepsy.
The Aristotle University of Thessaloniki-led research reviewed a number of recent papers showing how TMS can be used to track distinct changes in brain activity patterns associated with the condition.
TMS involves the use of magnetic fields to stimulate nerve cells in the brain, an approach that is sometimes applied to improve symptoms of depression. However, these recent studies have suggested it could be utilised to monitor the effect that traditional and new epilepsy medicines have on the brain, in order to gauge their efficacy.
Moreover, it has also shown promise in predicting patients response to therapy and to treat the disease itself, with the newer technique of TMS-electroencephalography demonstrating particularly strong promise.
The study concluded: “TMS has provided important insight into the pathophysiological substrate of human epilepsies and emerges as a valuable tool with diagnostic, prognostic and therapeutic potential.”
Posted by Bob Jones