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withdrawal of antiepileptic

Ru-Qian He, Qing-Yi Zeng, Pan Zhu, Yi-Xin Bao, Rong-Yuan Zheng, Hui-Qin Xu
OBJECTIVE: The objective of this study was to estimate the risk of a seizure relapse and the high-risk period of recurrence after antiepileptic drug (AED) withdrawal and to determine the predictive factors for a seizure relapse in adult patients with focal epilepsy who were seizure-free for more than 2years. METHODS: Using the Wenzhou Epilepsy Follow-Up Registry Database, 200 adult patients with focal epilepsy were recruited, who were undergoing follow-up, met the inclusion criteria of this study, were seizure-free for more than 2years, began withdrawing between June 2003 and June 2014, and were followed up prospectively for at least 1year or until a seizure relapse...
October 17, 2016: Epilepsy & Behavior: E&B
Mengqian Wu, Nanya Hao, Dong Zhou
BACKGROUND: Topiramate (TPM) is a broad-spectrum antiepileptic drug used for a variety of clinical conditions, including migraine prophylaxis and mood disorders. Spermatorrhea accompanied by loss of libido severely lowers quality of life for men, but had never been reported as a possible adverse effect of TPM. CASE PRESENTATION: Here, we present a case of a 39-year-old Chinese man who was diagnosed with partial epilepsy and treated with TPM (100 mg/d). Eleven days after initiating TPM treatment, he began to experience spermatorrhea every 2 to 3 days, accompanied by loss of libido, lack of energy, lassitude, irascibility, weakness, poor appetite, frequent urination, and nocturia...
October 14, 2016: Clinical Neuropharmacology
Gerardo Salvato, Pina Scarpa, Stefano Francione, Roberto Mai, Laura Tassi, Elisa Scarano, Giorgio Lo Russo, Gabriella Bottini
It is largely recognized that the mesial temporal lobe and its substructure support declarative long-term memory (LTM). So far, different theories have been suggested, and the organization of declarative verbal LTM in the brain is still a matter of debate. In the current study, we retrospectively selected 151 right-handed patients with temporal lobe epilepsy with and without hippocampal sclerosis, with a homogeneous (seizure-free) clinical outcome. We analyzed verbal memory performance within a normalized scores context, by means of prose recall and word paired-associate learning tasks...
October 10, 2016: Epilepsy & Behavior: E&B
Dieter Schmidt, Matti Sillanpää
PURPOSE: To review the outcome of epilepsy after stopping antiepileptic drugs in remission. RESULTS: Stopping antiepileptic drugs (AEDs) in remission is routinely done in many patients. Although the consequences of an unexpected relapse seizure in the 2 years after stopping AEDs may cause anguish and social issues, the impact on the long term seizure outlook of the epilepsy is minimal, if any. Discontinuation of drug treatment does not seem to affect the long-term prognosis but exposes patients who were seizure-free for years to a transient two-fold risk of seizures for the first 2 years after stopping AEDs...
September 13, 2016: Seizure: the Journal of the British Epilepsy Association
Sheena Derry, Malene Cording, Philip J Wiffen, Simon Law, Tudor Phillips, R Andrew Moore
BACKGROUND: This review updates part of an earlier Cochrane review on 'Pregabalin for acute and chronic pain in adults' (Moore 2009), and considers only fibromyalgia pain.Antiepileptic drugs have been used in pain management since the 1960s. Pregabalin is an antiepileptic drug also used in management of chronic pain conditions, including fibromyalgia. Pain response with pregabalin is associated with major benefits for other symptoms, and improved quality of life and function in people with chronic painful conditions...
September 29, 2016: Cochrane Database of Systematic Reviews
P Vrielynck, P Marique, S Ghariani, F Lienard, V de Borchgrave, K van Rijckevorsel, C Bonnier
OBJECTIVE: Encephalopathy with continuous spike-wave during sleep (CSWS) is a particularly difficult-to-treat childhood epileptic syndrome. This study sought to present the EEG improvement and clinical efficacy of topiramate (TPM), a broad spectrum antiepileptic drug (AED), in a series of 21 children with CSWS encephalopathy. METHODS: We retrospectively reviewed the EEG results and clinical data of children with CSWS followed-up in our institution and treated with TPM...
September 8, 2016: European Journal of Paediatric Neurology: EJPN
Nilesh Kurwale, Kanwaljeet Garg, Amit Arora, Poodipedi Sarat Chandra, Manjari Tripathi
Valproic acid (VPA) has been associated with coagulation factors deficiency, platelet dysfunction and hemorrhagic complications. We investigated 169 patients with drug resistant epilepsy (DRE), who underwent surgery, to look for clinical implications of VPA associated bleeding problems. All patients had normal preoperative coagulation profile. VPA was a part of polytherapy in 54% of patients (Group A), however 46% patients were not on VPA (Group B). The groups were comparable with mean age of 17.3±10.3years...
September 4, 2016: Epilepsy Research
Harpreet S Sidhu, Akshay Sadhotra
Antiepileptic drugs (AEDs) are extensively used worldwide to treat a wide range of disorders other than epilepsy, such as neuropathic pain, migraine, and bipolar disorder. Due to this situation more than 20 new third-generation AEDs have been introduced in the market recently. The future design of new AEDs must also have potential to help in the non-epileptic disorders. The wide acceptance of second generation AEDs for the management of various non-epileptic disorders has caused the emergence of generics in the market...
2016: Frontiers in Pharmacology
Garima Shukla, Priya Agarwal, Rajesh Sagar, Mamta Sood, Aditya Gupta, Ashish Suri, Ajay Garg
Surgery is an established and increasingly utilized treatment option in medically refractory temporal lobe epilepsy. Many psychiatric problems are known to complicate in the postoperative period. Most studies have a follow-up period of less than 24 months. We report the cases of three patients who developed severe psychiatric problems in the late postoperative period after successful temporal lobectomy for refractory epilepsy - Psychosis, major depression with psychosis, and severe anxiety disorder, respectively...
July 2016: Annals of Indian Academy of Neurology
Gudrun Gröppel, Christian Dorfer, Anastasia Dressler, Angelika Mühlebner, Barbara Porsche, Johann A Hainfellner, Thomas Czech, Martha Feucht
AIM: To study the effect of hemispherotomy on electrical status epilepticus in sleep (ESES) and language development. METHOD: Children with a confirmed diagnosis of ESES prior to surgery and a minimum of 24 months of developmental follow-up data were compared with age-matched controls without ESES. Language quotients (LQs) were calculated before and after surgery. RESULTS: Eleven patients (five females, six males) and 21 controls (11 females, 10 males) were included...
August 25, 2016: Developmental Medicine and Child Neurology
Bernd Pohlmann-Eden, Anthony G Marson, Matthias Noack-Rink, Francisco Ramirez, Azita Tofighy, Konrad J Werhahn, Imane Wild, Eugen Trinka
BACKGROUND: Few clinical trials have evaluated the efficacy and tolerability of antiepileptic drugs (AEDs) as initial monotherapy for elderly patients. METHODS: This post-hoc subgroup analysis of data from an unblinded, randomized, 52-week superiority study (KOMET) compared the effectiveness of levetiracetam (LEV) with extended-release sodium valproate (VPA-ER) and controlled-release carbamazepine (CBZ-CR) as monotherapy in patients aged ≥ 60 years with newly diagnosed epilepsy...
2016: BMC Neurology
Francesco Brigo, Eugen Trinka, Nicola Luigi Bragazzi, Raffaele Nardone, Alberto Milan, Elisabetta Grillo
OBJECTIVE: Eslicarbazepine acetate (ESL) and lacosamide (LCM) have recently emerged as add-on treatments in patients with focal epilepsy experiencing seizures despite adequate monotherapy. Both drugs enhance slow inactivation of voltage-gated sodium channels. To date no randomized controlled trial (RCT) has directly compared ESL with LCM as add-on treatments for focal epilepsy. Our aim was to indirectly compare the efficacy of ESL and LCM used as add-on treatments in patients with focal epilepsy using common reference-based indirect comparison meta-analysis...
August 11, 2016: Epilepsy Research
David G Vossler, Robert T Wechsler, Paulette Williams, William Byrnes, Sheila Therriault
OBJECTIVE: To assess long-term use and safety of lacosamide (LCM) ≤800 mg/day monotherapy in patients with partial-onset seizures (POS) enrolled previously in a historical-controlled, conversion-to-monotherapy study (SP902; NCT00520741). METHODS: Patients completing or exiting SP902 with LCM as monotherapy or as adjunctive therapy were eligible to enter this 2-year open-label extension (OLE) trial (SP904; NCT00530855) at a starting dose ±100 mg/day of their final SP902 dose...
October 2016: Epilepsia
Ziyi Chen, Ana Lusicic, Terence J O'Brien, Dennis Velakoulis, Sophia J Adams, Patrick Kwan
Antiepileptic drug treatment can induce psychosis in some patients. However, there are no agreed definitions or diagnostic criteria for antiepileptic drug-induced psychotic disorder in the classification systems of either epileptology or psychiatry. In this study we investigated the clinical spectrum of antiepileptic drug-induced psychotic disorder in patients with epilepsy. The medical records of all patients with epilepsy who were diagnosed by a neuropsychiatrist as having a psychotic disorder at the Royal Melbourne Hospital from January 1993 to June 2015 were reviewed...
August 8, 2016: Brain: a Journal of Neurology
Mehmet Satar, Kadir Ortaköylü, İnci Batun, Hacer Y Yıldızdaş, Ferda Özlü, Hüsnü Demir, Ali Kemal Topaloğlu
The usage of drugs during pregnancy affect the fetus and the newborn. In this report, we present findings from a newborn baby, whose mother was epileptic, and was under the treatment of valproic acid and carbamazepine during pregnancy. We have found symptoms of withdrawal syndrome, hyponatremia and feeding problem, which was most probably related to exposure to the mentioned drugs. We have also diagnosed hypomagnesaemia and atrial septal defect 4 milimeters in diameter. There are already many reports about the side effects of valproic acid and carbamazepine usage during pregnancy...
June 2016: Türk Pediatri Arşivi
Johan A F Koekkoek, Linda Dirven, Martin J B Taphoorn
INTRODUCTION: The withdrawal of antiepileptic drugs (AEDs) in World Health Organization (WHO) grade II-III glioma patients with epilepsy is controversial, as the presence of a symptomatic lesion is often related to an increased risk of seizure relapse. However, some glioma patients may achieve long-term seizure freedom after antitumor treatment, raising questions about the necessity to continue AEDs, particularly when patients experience serious drug side effects. AREAS COVERED: In this review, we show the evidence in the literature from 1990-2016 for AED withdrawal in glioma patients...
August 2, 2016: Expert Review of Neurotherapeutics
Philipp Dammann, Karsten Wrede, Ramazan Jabbarli, Salome Neuschulte, Katja Menzler, Yuan Zhu, Neriman Özkan, Oliver Müller, Michael Forsting, Felix Rosenow, Ulrich Sure
OBJECTIVE The aim of this study was to determine seizure outcome, functional outcome, and the withdrawal of antiepileptic drugs (AEDs) after conservative or surgical treatment of patients with new-onset cavernoma-related epilepsy (CRE). METHODS The authors conducted a retrospective comparative observational study of 79 consecutive patients, each with a single sporadic cerebral cavernous malformation (CCM) and new-onset CRE. RESULTS Forty-one patients underwent initial surgery (IS), and 38 patients underwent initial conservative (IC) treatment...
July 1, 2016: Journal of Neurosurgery
Firas Fahoum, Nurit Omer, Svetlana Kipervasser, Tal Bar-Adon, Miri Neufeld
The yield of monitoring patients at an epilepsy monitoring unit (EMU) depends on the recording of paroxysmal events in a timely fashion, however, increasing the risk of safety adverse events (AEs). We aimed to retrospectively study the frequency and risk factors for AE occurrences in all consecutive admissions to an adult EMU in a tertiary medical center. We also compared our findings with published data from other centers. Between January 2011 and June 2014, there were 524 consecutive admissions to the adult EMU at the Tel Aviv Sourasky Medical Center...
August 2016: Epilepsy & Behavior: E&B
Paweł Kubik, Martyna Stanios, Ewelina Iwan, Alicja Kubik
UNLABELLED: Neurofeedback (EEG biofeedback, NF) is one of the methods of non-pharmacological instrumental therapy. In the treatment of epilepsy it is considered as a complementary method, reducing the number of seizures. The aim of this study was to investigate the effect of NF on the incidence of clinical attacks and bioelectrical activity of the brain in children with epilepsy with partial seizures and secondarily generalized seizures. MATERIAL AND METHODS: The study involved a group of 78 children with partial seizures, additionally 30 of them had second-ry generalized seizures...
2016: Przegla̧d Lekarski
Sridharan Ramaratnam, Mariangela Panebianco, Anthony G Marson
BACKGROUND: This is an updated version of the Cochrane review published in The Cochrane Library 2010, Issue 1.Epilepsy is a common neurological disorder, affecting almost 0.5% to 1% of the population. For nearly 30% of these people, their epilepsy is refractory to currently available drugs. Pharmacological treatment remains the first choice to control epilepsy. Lamotrigine is one of the newer antiepileptic drugs and is the topic of this review. Lamotrigine in combination with other antiepileptic drugs (add-on) can reduce seizures, but with some adverse effects...
2016: Cochrane Database of Systematic Reviews
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