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Anti-seizure drug may reduce alcohol consumption

Medical News Today - 3 hours 54 min ago
Researchers from Boston University School of Medicine (BUSM) have discovered that the anti-seizure drug ezogabine, reduced alcohol consumption in an experimental model.
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Lorazepam not superior to diazepam in pediatric status epilepticus

Clinical Neurology News - Tue, 04/22/2014 - 16:00

The efficacy and safety of lorazepam were not superior to diazepam in a clinical trial of pediatric status epilepticus, investigators reported online April 22 in JAMA.

Both drugs effectively halted...

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Commonly available blood-pressure medication prevents epilepsy after severe brain injury

Science Daily - Tue, 04/22/2014 - 10:01
A team of neuroscientists has shown in rats that a drug commonly prescribed for hypertension can nearly eliminate the epilepsy that often follows severe head injury. The drug blocks a receptor on astrocytes, preventing a cascade of signals that lead to inflammation and neuron damage. The experiments also prove that epilepsy results from temporary breaks in the blood-brain barrier following head trauma.
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An Ingredient of Pot May Help People with Epilepsy

Scientific American: Epilepsy - Tue, 04/22/2014 - 07:30
A new marijuana-derived drug may treat epileptic children, without the high

-- Read more on ScientificAmerican.com
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Discovery may lead to improvements in drugs that act on the sodium channel to treat a range of cardiac and pain conditions

Medical News Today - Tue, 04/22/2014 - 03:00
Sodium channels are implicated in many serious conditions such as heart disease, epilepsy and pain, making them an important potential target for drug therapies.
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Hemodynamic changes during posterior epilepsies: An EEG-fNIRS study - Corrected Proof

Epilepsy Research Journal - Mon, 04/21/2014 - 00:00
Highlights: Summary: Posterior epilepsies are mainly characterized clinically by visual symptoms. Functional near-infrared spectroscopy (fNIRS) is an emerging non-invasive imaging technique that has the potential to monitor hemodynamic changes during epileptic activity. Combined with electroencephalography (EEG), 9 patients with posterior epilepsies were recorded using EEG-fNIRS with large sampling (19 EEG electrodes and over 100 fNIRS channels). Spikes and seizures were carefully marked on EEG traces, and convolved with a standard hemodynamic response function for general linear model (GLM) analysis. GLM results for seizures (in 3 patients) and spikes (7 patients) were broadly sensitive to the epileptic focus in 7/9 patients, and specific in 5/9 patients with fNIRS deoxyhemoglobin responses lateralized to the correct lobe, and to plausible locations within the occipital or parietal lobes. This work provides evidence that EEG-fNIRS is a sensitive technique for monitoring posterior epileptic activity.
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Default mode network hypometabolism in epileptic encephalopathies with CSWS - Corrected Proof

Epilepsy Research Journal - Mon, 04/21/2014 - 00:00
Highlights: Summary: Previous studies investigating cerebral metabolic changes associated with continuous spike-waves during sleep (CSWS) compared the metabolism of children with CSWS with that of healthy adults, precluding any assessment in brain areas showing physiologic age-related metabolic changes. Here, we investigated the metabolic and connectivity changes characterizing the acute phase of CSWS activity by comparing awake brain metabolism of children with CSWS with that of pediatric pseudo-controls.Positron emission tomography using [18F]-fluorodeoxyglucose (FDG-PET) was performed in 17 awake children with cryptogenic CSWS (5 girls, age: 5–11 years). Voxel-based analyses identified significant metabolic changes in CSWS patients compared with 18 pediatric pseudo-controls (12 girls, age: 6–11 years, non-CSWS focal cryptogenic epilepsy with normal FDG-PET). CSWS-induced changes in the contribution of brain areas displaying metabolic changes to the level of metabolic activity in other brain areas were investigated using pathophysiological interaction.Hypermetabolism in perisylvian regions bilaterally and hypometabolism in lateral and mesial prefrontal cortex, precuneus, posterior cingulate cortex and parahippocampal gyri characterized the acute phase of CSWS (p<0.05 FWE). No change in thalamic metabolism was disclosed. Altered functional connectivity was found between hyper- and hypometabolic regions in CSWS patients compared with pediatric pseudo-controls.This study demonstrates hypometabolism in key nodes of the default mode network (DMN) in awake patients with CSWS, in relation with a possible phenomenon of sustained remote inhibition from the epileptic foci. This hypometabolism might account for some of the acquired cognitive or behavioral features of CSWS epileptic encephalopathies. This study failed to find any evidence of thalamic metabolic changes, which supports the primary involvement of the cortex in CSWS genesis.
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Antiepileptic drugs ‘can be safely discontinued following successful surgery’

Epilepsy Research - Thu, 04/17/2014 - 13:23

New research has underlined the safety of discontinuing treatment with antiepileptic drugs (AEDs) among patients who have successfully undergone epilepsy surgery.

Carried out by researchers at the University of Saskatchewan in Canada, the meta-analysis aimed to establish a consensus regarding the management of AEDs after successful epilepsy surgery, as none previously existed.

Collating the most relevant evidence in this topic, the team identified 257 abstracts and eventually selected 16 papers for consideration, describing outcomes in 1,456 patients who discontinued AEDs and 685 patients who did not.

Results published in the medical journal Epilepsy Research revealed that the odds of experiencing seizure recurrence after AED discontinuation was 0.39 times lower in patients who ceased treatment after undergoing surgery.

A minority of patients who were seizure-free after surgery had recurrence after discontinuation, but recurrence tended to be higher for those without AED withdrawal.

It was also noted that patients who did experience seizure recurrence after discontinuation found the problem relatively easy to bring back under control after restarting their programme of medication.

Differences in the success of this strategy were attributed to specific attributes of the selected population where discontinuation was attempted, with young patients with lesional temporal epilepsy shown to be good candidates. This suggests that doctors need to be selective when choosing when to apply this principle.

The researchers concluded: “The discontinuation of medications should be done in good candidates and the decision should be individualised taking into account clinical, electrographical, imaging and histopathological variables.”

Around two thirds of epileptic seizures can be successfully treated and controlled through the appropriate use of AEDs, though they do not help every patient in the long term. For those who are unable to benefit from drug therapy, surgery can be a preferable option.

Surgical interventions can be performed on both adults and children and are utilised when a physical cause for the epilepsy can be found in a specific area of the brain.

Posted by Bob Jones

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Antiepileptic drugs ‘can be safely discontinued following successful surgery’

Epilepsy Research - Thu, 04/17/2014 - 13:23

New research has underlined the safety of discontinuing treatment with antiepileptic drugs (AEDs) among patients who have successfully undergone epilepsy surgery.

Carried out by researchers at the University of Saskatchewan in Canada, the meta-analysis aimed to establish a consensus regarding the management of AEDs after successful epilepsy surgery, as none previously existed.

Collating the most relevant evidence in this topic, the team identified 257 abstracts and eventually selected 16 papers for consideration, describing outcomes in 1,456 patients who discontinued AEDs and 685 patients who did not.

Results published in the medical journal Epilepsy Research revealed that the odds of experiencing seizure recurrence after AED discontinuation was 0.39 times lower in patients who ceased treatment after undergoing surgery.

A minority of patients who were seizure-free after surgery had recurrence after discontinuation, but recurrence tended to be higher for those without AED withdrawal.

It was also noted that patients who did experience seizure recurrence after discontinuation found the problem relatively easy to bring back under control after restarting their programme of medication.

Differences in the success of this strategy were attributed to specific attributes of the selected population where discontinuation was attempted, with young patients with lesional temporal epilepsy shown to be good candidates. This suggests that doctors need to be selective when choosing when to apply this principle.

The researchers concluded: "The discontinuation of medications should be done in good candidates and the decision should be individualised taking into account clinical, electrographical, imaging and histopathological variables."

Around two thirds of epileptic seizures can be successfully treated and controlled through the appropriate use of AEDs, though they do not help every patient in the long term. For those who are unable to benefit from drug therapy, surgery can be a preferable option.

Surgical interventions can be performed on both adults and children and are utilised when a physical cause for the epilepsy can be found in a specific area of the brain.

Posted by Bob Jones

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Improved accuracy in diagnosis for epilepsy with new clinical definition

Medical News Today - Wed, 04/16/2014 - 03:00
An expert task force has created a new definition for epilepsy that refines the scope of patients diagnosed with this brain disease.
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Evidence-Based Apps: Is it possible to diagnose epileptic seizure digitally?

Clinical Neurology News - Tue, 04/15/2014 - 14:00

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...

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The effect of phenobarbitone on cognition in adult patients with new onset epilepsy: A multi-centric prospective study from India - Corrected Proof

Epilepsy Research Journal - Tue, 04/15/2014 - 00:00
Highlights: Summary: Objective: In view of the conflicting results of cognitive and behavioral consequences of PB, the present study was planned to analyze its efficacy, serial neuropsychological functions and its impact on psychosocial functioning in adults with epilepsy while on phenobarbitone (PB).Methodology: This prospective multi-centric study carried out across 4 centers in India included 75 adult patients of ≥18 years (M:F=52:23; age: 27.3±8.5 years) with epilepsy who were prescribed phenobarbitone and underwent serial standardized neuropsychological assessment (NIMHANS battery for adults) at baseline, 1 month, 3 months, 6 months and 12 months. The demographic, seizure details and outcome measures were recorded.Results: Of the 75 patients, 63 had completed clinical and neuropsychological assessment, i.e. visit 1 (baseline), visit 4 (6 months) and visit 5 (12 months). There was no deterioration rather an improvement during the follow visits in all the neuropsychological functions. The results indicate that 16 neuropsychological variables changed significantly, viz. mental speed (p<0.001), sustained attention (p<0.001), focused attention (p<0.002), planning (p<0.001), concept formation (p<0.05), set shifting (p<0.001), verbal learning (p<0.0001), verbal memory (p<0.0001), visual memory (p<0.0001) and intelligence (p<0.001). The scales measuring the outcome of psychosocial functioning significantly changed during follow up included happiness (p<0.002), Impact of Epilepsy on patient's life (p<0.02), A–B Neuropsychological Assessment (p<0.015), HADS anxiety (p<0.001) and emotional disorder (p<0.006). There was a significant reduction in seizure severity as measured by Liverpool Seizure Severity Scale (p<0.002) and seizure freedom was maintained.Conclusions: This study demonstrated that phenobarbitone is effective, well tolerated AED and do not have cognitive impairment over one year. There was variable but distinct improvement in cognition and psychosocial functioning, and effective seizure control could be one of the factor for it.
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New clinical definition for epilepsy improves diagnosis accuracy

Science Daily - Mon, 04/14/2014 - 09:19
An expert task force has created a new definition for epilepsy that refines the scope of patients diagnosed with this brain disease. The study provides a greater level of detail to diagnose epilepsy by including individuals with two unprovoked seizures, and those with one unprovoked seizure and other factors that increase risk of seizure recurrence.
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Young people with epilepsy at significantly more risk of injury

Science Daily - Mon, 04/14/2014 - 09:19
Children and young adults with epilepsy are more likely to suffer broken bones, burns and poisonings compared to those without the neurological disorder, new research has found. The results, taken in tandem with previous research findings, highlight the need for further research into whether young people with the condition are at greater risk from an overdose, accidental or intentional, of their epilepsy drugs or other medication.
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Young people with epilepsy significantly more at risk of injury

Medical News Today - Mon, 04/14/2014 - 03:00
Children and young adults with epilepsy are more likely to suffer broken bones, burns and poisonings compared to those without the neurological disorder, new research has found.
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Epilepsy diagnosis may be improved by new clinical definition

Medical News Today - Mon, 04/14/2014 - 03:00
Nine years after redefining the diagnosis criteria for epilepsy, the International League Against Epilepsy have published a new, updated version of their clinical definition.
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Clinical definition of epilepsy broadened by new criteria

Clinical Neurology News - Mon, 04/14/2014 - 00:01

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....

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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

Epilepsy Research Journal - Mon, 04/14/2014 - 00:00
Highlights: Summary: Integrated data from three double-blind, randomized, placebo-controlled trials were analyzed to evaluate the efficacy and tolerability of ezogabine (EZG; US adopted name)/retigabine (RTG; international non-proprietary name) when used in combination with ≥1 sodium channel blocking antiepileptic drug (AED), ≥1 non-sodium channel blocking AED, or ≥1 AED from both the sodium channel and non-sodium channel mechanistic groups. Efficacy and tolerability appeared to be similar across all three groups of patients.
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New study highlights factors behind anxiety and depression in epilepsy patients

Epilepsy Research - Fri, 04/11/2014 - 13:12

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

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Caregivers for children with epilepsy ‘need greater support’

Epilepsy Research - Fri, 04/11/2014 - 13:12

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

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