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withdrawal of antiepileptic

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https://www.readbyqxmd.com/read/29076412/efficacy-duration-and-timing-of-withdrawal-of-prophylactic-treatment-with-antiepileptic-drugs-in-neurosurgical-conditions
#1
Daniel R Calnan, Erin D'Agostino, Matthew R Reynolds, Kimon Bekelis
Seizure control is a critical component of care in many neurosurgical conditions. The development of seizures in patients without a previously identified seizure disorder occurs in a significant proportion of traumatic brain injury, subarachnoid hemorrhage, and brain tumor patients. In this literature review and synthesis, we will discuss the incidence of seizures in selected conditions, indications and evidence for the initiation of antiepileptic drugs (AEDs), suggested duration of usage for AEDs, and current AED guidelines by the American Academy of Neurology (AAN), Congress of Neurological Surgeons (CNS), American Academy of Neurological Surgeons (AANS) and international committees...
October 24, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29067682/eslicarbazepine-acetate-add-on-for-drug-resistant-partial-epilepsy
#2
REVIEW
Xian-Chao Chang, Hai Yuan, Yi Wang, Hui-Qin Xu, Wen-Ke Hong, Rong-Yuan Zheng
BACKGROUND: This is an updated version of the Cochrane Review published in the Cochrane Library 2011, Issue 12.The majority of people with epilepsy have a good prognosis, but up to 30% of people continue to have seizures despite several regimens of antiepileptic drugs. In this review, we summarized the current evidence regarding eslicarbazepine acetate (ESL) when used as an add-on treatment for drug-resistant partial epilepsy. OBJECTIVES: To evaluate the efficacy and tolerability of ESL when used as an add-on treatment for people with drug-resistant partial epilepsy...
October 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29033486/topiramate-induced-acute-liver-injury-a-rare-adverse-effect
#3
Archish Khivsara, Jeffrey Pradeep Raj, Divya Hegde, Mangala Rao
Idiosyncratic drug-induced liver injury (DILI) is damage to liver occurring at recommended dose of a drug in contrast to toxic or predictable DILI. Although it is common in first-generation antiepileptic drugs (AEDs), it is rare in newer AEDs such as topiramate. Topiramate commonly causes neurological adverse effects such as psychomotor slowing and somnolence. Hepatotoxicity by topiramate is rare and has been previously reported in combination with other drugs such as valproate and carbamazepine. Here, we report a case of topiramate-induced asymptomatic elevation of liver enzymes in an adult man diagnosed with alcohol dependence syndrome and alcohol withdrawal complicated with seizures...
May 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/28990169/methylphenidate-cognition-and-epilepsy-a-1-month-open-label-trial
#4
Jesse Adams, Valerie Alipio-Jocson, Katherine Inoyama, Victoria Bartlett, Saira Sandhu, Jemima Oso, John J Barry, David W Loring, Kimford J Meador
OBJECTIVE: Cognitive difficulties are common in epilepsy. Beyond reducing seizures and adjusting antiepileptic medications, no well-validated treatment exists in adults. Methylphenidate is used effectively in children with epilepsy and attention-deficit/hyperactivity disorder, but its effects in adults have not been systematically evaluated. We hypothesized that methylphenidate can safely improve cognition in adults with epilepsy. We detail here the open-label follow-up to a double-blind, placebo-controlled, single-dose study...
October 9, 2017: Epilepsia
https://www.readbyqxmd.com/read/28969235/super-refractory-status-epilepticus-a-therapeutic-challenge-in-paediatrics
#5
Shrikiran Aroor, Kanaparthi Shravan, Suneel C Mundkur, C Jayakrishnan, Sai Sripad Rao
A status epilepticus which persists for 24 hours or more after starting treatment with anaesthesia or has recurred inspite of general anaesthesia is known as Super-Refractory Status Epilepticus (SRSE). It includes cases where status epilepticus recurs on reduction or withdrawal of anaesthesia. SRSE, though infrequently seen, constitutes a medical emergency due to the associated high morbidity and mortality. No clear cut guidelines are available till date for the management of SRSE. Most of the published literature was case reports and expert opinion...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28965335/pregabalin-use-among-users-of-illicit-drugs-a-cross-sectional-survey-in-southern-germany
#6
Brendan J Snellgrove, Tilman Steinert, Susanne Jaeger
BACKGROUND: The antiepileptic drug pregabalin is one of the best-selling pharmaceutical products worldwide. There are increasing concerns about its potential for misuse and dependence especially among patients with former or current substance use disorders (SUDs). OBJECTIVE: Our objective was to clarify the extent and pattern of pregabalin use as well as motives and predictors in this population. METHODS: We conducted a cross-sectional study with patients on a detoxification ward for illicit drugs at the Center for Psychiatry, Südwürttemberg, Ravensburg in southern Germany from August 2012 until July 2013...
October 2017: CNS Drugs
https://www.readbyqxmd.com/read/28940083/efficacy-and-safety-of-antiepileptic-drugs-for-refractory-partial-onset-epilepsy-a-network-meta-analysis
#7
REVIEW
Qingting Hu, Fang Zhang, Wenhui Teng, Fangfang Hao, Jing Zhang, Mingxiao Yin, Naidong Wang
The optimal combination of antiepileptic drugs (AEDs) for the treatment of refractory partial-onset epilepsy is a perpetual point of debate. While several network meta-analyses (NMAs) have been published, conclusions remain controversial, especially since newer AEDs have been introduced. In our review, we included the newer AEDs to evaluate the comparative efficacy and safety of AEDs for the treatment of refractory partial-onset epilepsy. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials (Cochrane Library 2017, Issue 1) from their inception to February 18, 2017...
September 22, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28932875/-severe-cutaneous-drug-reactions-in-children
#8
REVIEW
M Mockenhaupt
Among severe drug reactions in children, besides Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), a specific form of hypersensitivity syndrome which is nowadays known as "drug reaction with eosinophilia and systemic symptoms" (DRESS) has to be mentioned. Whereas SJS/TEN is considered one reaction entity of different severity, DRESS has to be distinguished from SJS/TEN but also from other severe exanthems due to multiorgan involvement. Although SJS/TEN is generally referred to as a drug reaction, only about 75% of all cases are actually caused by medications and in children it is only about 50%...
October 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28891380/stories-of-hell-and-healing-internet-users-construction-of-benzodiazepine-distress-and-withdrawal
#9
Alison M Fixsen, Damien Ridge
Benzodiazepines are a group of drugs used mainly as sedatives, hypnotics, antiepileptics, and muscle relaxants. Consumption is recommended for 2 to 4 weeks only, due to fast onset of dependency and potentially distressing withdrawal symptoms. Few peer-review studies have drawn on the user experiences and language to appreciate firsthand experiences of benzodiazepine withdrawal or discontinuation syndrome. We looked extensively at patient stories of benzodiazepine withdrawal and recovery on Internet support sites and YouTube...
September 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28854405/newer-antiepileptic-drugs-compared-to-levetiracetam-as-adjunctive-treatments-for-uncontrolled-focal-epilepsy-an-indirect-comparison
#10
Li-Na Zhu, Deng Chen, Da Xu, Ge Tan, Hai-Jiao Wang, Ling Liu
PURPOSE: Newer antiepileptic drugs (AEDs), such as Eslicarbazepine (ESL), Lacosamide (LAC), Perampanel (PER) and Brivaracetam (BRV), have been marketed as adjunctive treatments for partial-onset seizures. Our aim was to compare the efficacy and tolerability of newer AEDs with Levetiracetam (LEV), when used as add-on treatments for uncontrolled focal epilepsy. METHOD: We conducted an online database search on PubMed, Embase, Cochrane Online Library and Clinicaltrials...
October 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28831924/management-of-antiepileptic-treatment-after-epilepsy-surgery-practices-and-problems
#11
Guido Rubboli, Anne Sabers, Peter Uldall, Kristina Malmgren
BACKGROUND: Although epilepsy surgery is a recognized treatment option for drug-resistant epilepsies since several decades, the management of antiepileptic drugs (AEDs) after successful surgery still remains one of the most difficult and unsolved therapeutic challenges. Indeed, no systematic controlled trials have been specifically conducted so far and no consensus or standardized guidelines regarding postsurgical drug discontinuation policy and procedures are available. METHODS: In this paper, we aim to provide an updated overview on the the present knowledge on this topic, which is based mainly on retrospective studies reporting practices used in individual centers...
August 22, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28829985/follow-up-study-of-idiopathic-generalized-epilepsy-with-associated-absence-seizure-and-myoclonic-epilepsy-of-infancy
#12
Vincenzo Belcastro, Lucio Giordano, Dario Pruna, Cinzia Peruzzi, Susanna Casellato, Salvatore Barca, Giorgia Carlone, Pasquale Striano, Alberto Verrotti
We evaluated the long-term prognosis of patients featuring the association of absences and myoclonic epilepsy of infancy. Our cohort consisted of 10 male subjects with mean age at seizure onset of 29 months. Follow-up data included seizure outcome and EEG findings. All individuals received antiepileptic drugs (AEDs) as monotherapy (6 patients) or polytherapy (4 patients) for a mean period of 24 months. Over a 30-60 month evaluation period (mean: 43 months), all patients were seizure-free. Follow-up data after withdrawal of antiepileptic therapy were obtained for a mean period of 22 months...
August 14, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28827041/epilepsy-and-sleep-disorders-improve-in-adolescents-and-adults-with-angelman-syndrome-a-multicenter-study-on-46-patients
#13
Chiara Sueri, Edoardo Ferlazzo, Maurizio Elia, Paolo Bonanni, Giovanna Randazzo, Sara Gasparini, Tiziana D'Agostino, Antonino R Sapone, Michele Ascoli, Marina A Bellavia, Vittoria Cianci, Antonio Gambardella, Angelo Labate, Umberto Aguglia
OBJECTIVE: Actual knowledge on evolution of Angelman syndrome (AS) relies on questionnaire-based cohort studies, phone interviews, or small retrospective cohort studies focused on specific clinical-genetic features. These reports provide conflicting results. The aim of this study was to assess the long-term outcome of epilepsy, sleep disorders, and EEG in a vast series of AS subjects. METHODS: We collected patients with genetically confirmed AS, aged ≥14years, followed in three tertiary epilepsy Centers or attending the meetings of the Italian Organization for AS (OrSA)...
August 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28816832/reversible-splenial-lesion-syndrome-after-intravenous-immunoglobulin-treatment-for-guillain-barre-syndrome
#14
Elif Uygur Kucukseymen, Burcu Yuksel, Fatma Genc, Eylem Ozaydin Goksu, Sevim Yildiz, Yasemin Bicer Gomceli
Reversible corpus callosum splenial (CCS) lesions have been described in patients with varied etiologies. The most common causes of previously reported reversible focal lesions of the CCS are viral encephalitis, antiepileptic drug toxicity/withdrawal, and metabolic disorders. Intravenous immunoglobulin (IVIG) therapy is used for different immune-mediated diseases. It is generally safe, and serious adverse reactions are uncommon. We presented a rare case of disturbed consciousness with reversible CCS lesions after IVIG therapy for Guillain-Barre syndrome in an adult woman...
September 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28799513/ketogenic-diets-in-the-treatment-of-epilepsy
#15
Maurizio Elia, Joerg Klepper, Baerbel Leiendecker, Hans Hartmann
BACKGROUND: Although a larger number of antiepileptic drugs became available in the last decades, epilepsy remains drug-resistant in approximately a third of patients. Ketogenic diet (KD), first proposed at the beginning of the last century, is complex and has anticonvulsant effects, yet not completely understood. Over the last decades, different types of ketogenic diets (KDs) have been developed, namely classical KD and modified Atkins diet (MAD). They offer an effective alternative for children and adults with drug-resistant epilepsies...
August 9, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28799510/safety-profile-of-the-newest-antiepileptic-drugs-a-curated-literature-review
#16
Caterina Palleria, Giuseppe Cozza, Rajeshree Khengar, Vincenzo Libri, Giovambattista De Sarro
BACKGROUND: Despite the introduction of new antiepileptic drugs (AEDs), the quality of life and therapeutic response for patients with epilepsy remain unsatisfactory. In addition, whilst several antiepileptic drugs (AEDs) have been approved and consequently marketed in recent years, little is known about their long-term safety and tolerability. Availability of the newest AEDs, characterized by improved pharmacokinetic profiles, has positively impacted the treatment approach for patients with partial seizures in clinical practice...
August 9, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28770976/non-steroidal-anti-inflammatory-drugs-nsaids-for-chronic-non-cancer-pain-in-children-and-adolescents
#17
REVIEW
Christopher Eccleston, Tess E Cooper, Emma Fisher, Brian Anderson, Nick Mr Wilkinson
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past pain was largely dismissed and was frequently left untreated, views on children's pain have changed over time, and relief of pain is now seen as important...
August 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28763466/risk-factors-for-seizure-reoccurrence-after-withdrawal-from-antiepileptic-drugs-in-individuals-who-have-been-seizure-free-for-over-2-years
#18
XingHua Tang, Peimin Yu, Ding Ding, Yan Ge, Yunbo Shi, Ping Wang, Guoxing Zhu, Zhen Hong
PURPOSE: To observe risk factors for recurrence after withdrawal from antiepileptic drugs. METHODS: We assessed 1282 patients with a definite diagnosis of epilepsy. RESULTS: In total, 292 patients between 14 and 80 years of age were grouped according to risk factors for recurrence. Of these individuals, 119 discontinued AED(s) and relapsed. The relapse rate was 34.4 per 100 person-years. We used a Cox regression for multivariate analysis to investigate the influence of the following on seizure recurrence: receiving more than one type of AED (HR = 2...
2017: PloS One
https://www.readbyqxmd.com/read/28753046/levetiracetam-in-toxic-seizures
#19
Ted Lee, Brandon J Warrick, Preeyaporn Sarangarm, Robert L Alunday, Silas Bussmann, Susan C Smolinske, Steven A Seifert
BACKGROUND/OBJECTIVES: The use of levetiracetam (LEV) in the management of drug-induced seizures has not been systematically investigated. Repetitive and continuous seizures that do not respond to benzodiazepines require second line therapy. Levetiracetam has a unique receptor binding site, rapid absorption, no known cardiac effects at therapeutic doses, and is theoretically a good candidate for use in drug-induced seizures. We evaluate the safety of LEV and its association with seizure cessation in this retrospective chart review of patients who received LEV as a control agent in drug-induced seizures...
July 28, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28744867/antiepileptic-drug-discontinuation-by-people-with-epilepsy-in-the-general-population
#20
Giorgia Giussani, Elisa Bianchi, Valentina Canelli, Giuseppe Erba, Carlotta Franchi, Alessandro Nobili, Josemir W Sander, Ettore Beghi
OBJECTIVE: Rate, reasons, and predictors of antiepileptic drug (AED) discontinuation were investigated in a well-defined cohort of people with epilepsy to verify efficacy and tolerability of treatment up to 20 years from treatment initiation. METHODS: The history of AED usage in children and adults with epilepsy registered with 123 family physicians in an area of Northern Italy between 2000 and 2008 was recorded. Cumulative probabilities of AED withdrawal for specific reasons were estimated using cumulative incidence functions...
September 2017: Epilepsia
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