Articles de revues : « Anti-seizure medication »

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Avachat, Charul, Jessica M. Barry, Xintian Lyu, Catherine M. Sherwin et Angela K. Birnbaum. « Management of Anti-Seizure Medications during Pregnancy : Advancements in The Past Decade ». Pharmaceutics 14, n^o 12 (6 décembre 2022) : 2733. http://dx.doi.org/10.3390/pharmaceutics14122733.

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Management of seizures often involves continuous medication use throughout a patient’s life, including when a patient is pregnant. The physiological changes during pregnancy can lead to altered drug exposure to anti-seizure medications, increasing patient response variability. In addition, subtherapeutic anti-seizure medication concentrations in the mother may increase seizure frequency, raising the risk of miscarriage and preterm labor. On the other hand, drug exposure increases can lead to differences in neurodevelopmental outcomes in the developing fetus. Established pregnancy registries provide insight into the teratogenicity potential of anti-seizure medication use. In addition, some anti-seizure medications are associated with an increased risk of major congenital malformations, and their use has declined over the last decade. Although newer anti-seizure medications are thought to have more favorable pharmacokinetics in general, they are not without risk, as they may undergo significant pharmacokinetic changes when an individual becomes pregnant. With known changes in metabolism and kidney function during pregnancy, therapeutic monitoring of drug concentrations helps to determine if and when doses should be changed to maintain similar seizure control as observed pre-pregnancy. This review concentrates on the results from research in the past decade (2010–2022) regarding risks of major congenital malformations, changes in prescribing patterns, and pharmacokinetics of the anti-seizure medications that are prescribed to pregnant patients with epilepsy.

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Holmes, Mark. « Rufinamide : A broad-spectrum anti-seizure medication ». Journal of Pediatric Epilepsy 01, n^o 02 (17 juillet 2015) : 075–76. http://dx.doi.org/10.3233/pep-2012-013.

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Bisi-Onyemaechi, Adaobi I., Ugo N. Chikani, Ndubuisi A. Uwaezuoke, Ann E. Aronu et Ngozi C. Ojinnaka. « Serum folate levels in children on long-term anti-seizure medication in a Nigerian tertiary center—Implications for practice and public health ». Science Progress 104, n^o 4 (octobre 2021) : 003685042110576. http://dx.doi.org/10.1177/00368504211057680.

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Background: Epilepsy is the most common childhood neurological disorder in Nigeria. Treatment of epilepsy is long-term and sometimes lifelong with anti-seizure medications. There are conflicting reports on the effect of anti-seizure medications on serum folate. There is therefore a need to determine the effect of a commonly used anti-seizure medication's on serum folate levels of children. This would provide an evidence-based consideration for folic acid supplementation in children on anti-seizure medication as has been suggested by some studies. Study objectives: To determine whether serum folate levels were lower in children taking long-term carbamazepine or sodium valproate, compared to a control group. Methods: Serum folic acid levels were measured from well-nourished children between the ages of 1–17 years on carbamazepine and sodium valproate monotherapy and their age/sex-matched controls, using spectrophotometry. Results: The mean serum folate levels of patients on carbamazepine (43) and sodium valproate (22) were 0.032 mg/l ± 0.009 and 0.028 mg/l ± 0.008, respectively. The mean folate levels of the controls were 0.046 mg/l ± 0.03 ( p = 0 001). No statistically significant difference was observed between the serum folate levels of children on the two anti-seizure medications, that is, carbamazepine and valproate. Conclusion: The children on treatment with carbamazepine and sodium valproate for more than 6 months had statistically significantly lower serum levels of folic acid compared to the standard reference range and controls. The serum folate levels of children on carbamazepine were not statistically different from those on sodium valproate.

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Watkins, Lance, Máire O’Dwyer et Rohit Shankar. « New anti-seizure medication for elderly epileptic patients ». Expert Opinion on Pharmacotherapy 20, n^o 13 (21 mai 2019) : 1601–8. http://dx.doi.org/10.1080/14656566.2019.1618272.

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Dusabimana, Alfred, Solomon Tsebeni Wafula, Stephen Jada Raimon, Joseph Nelson Siewe Fodjo, Dan Bhwana, Floribert Tepage, Gasim Abd-Elfarag, An Hotterbeekx, Steven Abrams et Robert Colebunders. « Effect of Ivermectin Treatment on the Frequency of Seizures in Persons with Epilepsy Infected with Onchocerca volvulus ». Pathogens 10, n^o 1 (31 décembre 2020) : 21. http://dx.doi.org/10.3390/pathogens10010021.

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A clinical trial performed in the Democratic Republic of Congo (DRC), among persons with epilepsy (PWE) infected with Onchocerca volvulus treated with anti-seizure medication suggested that ivermectin reduces the seizure frequency. We assessed the effect of ivermectin treatment on seizure frequency in PWE with and without anti-seizure medication in three onchocerciasis endemic areas (Maridi, South Sudan; Aketi, DRC; and Mahenge, Tanzania). Pre- and 3–5 months post-ivermectin microfilariae densities in skin snips and seizure frequency were assessed. After ivermectin, the median (IQR) percentage reduction in seizure frequency in the study sites ranged from 73.4% (26.0–90.0) to 100% (50.0–100.0). A negative binomial mixed model showed that ivermectin significantly reduced the seizure frequency, with a larger decrease in PWE with a high baseline seizure frequency. Mediation analysis showed that ivermectin reduced the seizure frequencies indirectly through reduction in microfilariae densities but also that ivermectin may have a direct anti-seizure effect. However, given the short half-life of ivermectin and the fact that ivermectin does not penetrate the healthy brain, such a direct anti-seizure effect is unlikely. A randomized controlled trial assessing the ivermectin effect in people infected with O. volvulus who are also PWE on a stable anti-seizure regimen may be needed to clarify the causal relationship between ivermectin and seizure frequency.

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Zena, Dawit, Abilo Tadesse, Nebiyu Bekele, Samson Yaregal, Nuria Sualih et Edilawit Worku. « Seizure control and its associated factors among epileptic patients at Neurology Clinic, University of Gondar hospital, Northwest Ethiopia ». SAGE Open Medicine 10 (janvier 2022) : 205031212211006. http://dx.doi.org/10.1177/20503121221100612.

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Background: Epilepsy is characterized by two or more unprovoked recurrent seizures, which often respond to available antiseizure medications. However, seizure control among epileptic patients in the developing world is low. Factors determining seizure control among epileptic patients were not evidently explored in the study setting. Objectives: This study aimed to determine the magnitude of uncontrolled seizures and associated factors among epileptic patients at the University of Gondar hospital. Methods: This cross-sectional study was conducted at the University of Gondar hospital, Northwest Ethiopia. A convenience sampling method was used to recruit study subjects. Controlled seizure was defined as seizure freedom for the past 1 year. Logistic regression analysis was used to identify factors associated with seizure control. A p-value < 0.05 was used to declare a significant association. Results: A total of 320 study subjects were included in the study. The mean (±SD) age of patients was 27.5 ± 7.6 years. More than half (182/320, 57%) of epileptic patients had uncontrolled seizures. Five or more pretreatment seizure episodes (adjusted odds ratio = 3.98, 95% confidence interval: 1.81–8.75, p = 0.001), less than 2 years on anti-seizure medications (adjusted odds ratio = 8.64, 95% confidence interval: 3.27–22.85, p < 0.001), taking 2 or more ASMs (adjusted odds ratio = 2.48, 95% confidence interval: 1.23–5.02, p = 0.011), poor adherence to ASMs (adjusted odds ratio = 9.37, 95% confidence interval: 4.04–21.75, p < 0.001), and living at a single trip distance from hospital equaled 1 h or more (adjusted odds ratio = 4.20, 95% confidence interval: 2.11–8.41, p < 0.001) were significantly associated with uncontrolled seizures. Conclusion: The dose of a preferred anti-seizure medication should be optimized before combinations of anti-seizure medications are used. Adherence to anti-seizure medications should be reinforced for better seizure control. Epilepsy care should be integrated into primary health care services in the catchment region.

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Kurup, Deepika, Zachary Davey, Phuong Hoang, Connie Wu, Katherine Werbaneth, Varun Shah, Karen G. Hirsch, Prasanthi Govindarajan et Kimford J. Meador. « Effect of rapid EEG on anti-seizure medication usage ». Epileptic Disorders 24, n^o 5 (1 octobre 2022) : 1–7. http://dx.doi.org/10.1684/epd.2022.1463.

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Sewell, Elizabeth K., Shannon E. G. Hamrick, Ravi M. Patel, Monica Bennett, Veeral N. Tolia et Kaashif A. Ahmad. « Association between anti-seizure medication and outcomes in infants ». Journal of Perinatology 42, n^o 3 (20 octobre 2021) : 359–64. http://dx.doi.org/10.1038/s41372-021-01240-1.

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Abraham, Annette, Javier A. Bustos, Hélène Carabin, Robert de Meijere, Priyadarshi S. Sahu, Vedantam Rajshekhar, Gagandeep Singh et al. « The effectiveness of anti-inflammatory and anti-seizure medication for individuals with single enhancing lesion neurocysticercosis : A meta-analysis and expert group-based consensus recommendations ». PLOS Neglected Tropical Diseases 15, n^o 3 (31 mars 2021) : e0009193. http://dx.doi.org/10.1371/journal.pntd.0009193.

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Single brain enhancing lesions (SEL) are the most common presentation of neurocysticercosis (NCC) observed on neuroimaging in people presenting with epileptic seizures not only on the Indian sub-continent and in travelers returning from cysticercosis-endemic regions, but are also present in other parts of the world. The aim of this study, which consisted of a systematic review (CRD42019087665), a meta-analysis and an expert group consultation, was to reach consensus on the best anti-seizure medication and anti-inflammatory treatment for individuals with SEL NCC. Standard literature review methods were used. The Cochrane risk of bias tool was used and random effects model meta-analyses were performed. The quality of the body of evidence was rated using GRADE tables. The expert committee included 12 gender and geographically balanced members and recommendations were reached by applying the GRADE framework for guideline development. The 1–1.5-year cumulative incidence of seizure recurrence, cyst resolution or calcification following anti-seizure medication (ASM) withdrawal was not statistically different between ASM of 6, 12 or 24 months. In contrast, in persons whose cyst calcified post treatment, longer ASM decreased seizure recurrence. The cumulative incidence ratio (CIR) 1–1.5 years after stopping ASM was 1.79 95% CI: (1.00, 3.20) for patients given 6 versus 24 months treatment. Anti-inflammatory treatment with corticosteroids in patients treated with ASM compared to patients treated with ASM only showed a statistically significant beneficial effect on seizure reduction (CIR 0.44, 95% CI 0.23, 0.85) and cyst resolution (CIR 1.37, 95%CI: 1.07, 1.75). Our results indicate that ASM in patients with SEL NCC whose cysts resolved can be withdrawn, while patients whose cysts calcified seem to benefit from prolonged anti-seizure medication. Additional corticosteroid treatment was found to have a beneficial effect both on seizure reduction and cyst resolution.

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Wilbur, C., C. Sanguansermsri, H. Chable, A. Mihaela, P. Steinbok, A. Singhal et MB Connolly. « Epilepsy surgery in tuberous sclerosis complex : the BC Children’s Hospital experience ». Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 42, S1 (mai 2015) : S14. http://dx.doi.org/10.1017/cjn.2015.88.

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Background: Epilepsy occurs in up to 90% of patients with Tuberous Sclerosis Complex (TSC) and is often refractory to medications. Our objective was to assess the safety and outcome of epilepsy surgery in children with TSC at our institution. Methods: We performed a systematic, retrospective chart review of children with TSC who underwent epilepsy surgery at our institution. Patients were identified through epilepsy and clinical neurophysiology databases. Results: 19 patients (out of 81 with TSC) underwent surgery between 1995-2014. Median age at surgery was 4.2 (Range 1.1-15.6) years, with patients having failed a median 4 (Range 0-10) anti-seizure medications. Surgery comprised corpus callosotomy in 2 and resection of one or more tubers in 17. 2 patients had a subsequent second resection. Minor neurologic deficits occurred after 14% of surgeries. Median follow-up was 2.4 years (Range 0.3 -13.8 years) following surgery . At last follow-up, 47% were seizure free, including 2 patients off anti-seizure medication. Conclusions: Epilepsy surgery is safe and effective in carefully selected TSC patients, with the majority having a good seizure outcome. Children with epilepsy secondary to TSC should be referred for epilepsy surgery assessment.

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Medikonda, Ravi, Kisha Patel, Laura Saleh, Siddhartha Srivastava, Christina Jackson, Aditya Mohan, Pavan Shah et al. « NCOG-25. EFFICACY OF ANTICONVULSANT THERAPY IN GLIOMA PATIENTS ». Neuro-Oncology 22, Supplement_2 (novembre 2020) : ii134. http://dx.doi.org/10.1093/neuonc/noaa215.563.

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Abstract Gliomas account for 30% of primary brain tumors and can frequently present with seizures. There are few guidelines for usage of anticonvulsant therapy in glioma patients. Some clinicians utilize anticonvulsant therapy in all glioma patients as a means of prophylaxis, whereas other clinicians prescribe anticonvulsant therapy only in patients that experience seizures. In this single-institution retrospective cohort study, we evaluate the effect of commonly prescribed anticonvulsant levetiracetam on incidence of post-operative seizures and overall survival in primary glioma patients. 436 patients met the inclusion criteria for this study. 35% of patients presented with a pre-operative seizure and 63% of patients received pre-operative Levetiracetam. The incidence of a seizure within 1 year of tumor resection was 31%. On multivariate logistic regression analysis of patient pre-operative clinical and imaging characteristics, it was found that only a pre-operative seizure (p = 0.02) significantly increased the odds of a post-operative seizure within 1 year of tumor resection. Neither pre-operative levetiracetam (p = 0.31), intra-operative levetiracetam (p = 0.59), or post-operative levetiracetam (p = 0.75) significantly reduced the odds of a post-operative seizure. Using a cox proportional hazards model, pre-operative levetiracetam (p = 0.11), intra-operative levetiracetam (p = 0.34), and post-operative levetiracetam (p = 0.88) do not significantly affect overall survival. Our findings reveal that glioma patients are often prescribed anticonvulsant medication regardless of whether they have had a pre-operative seizure. Most patients also receive anti-convulsant medication in the peri-operative and post-operative setting regardless of whether they have had pre-operative or immediate post-operative seizures. Use of pre-operative or intra-operative levetiracetam as a prophylactic measure does not impact the incidence of post-operative seizures. Furthermore, anti-convulsant therapies do not demonstrate a survival benefit in our study. These results provide a rationale for re-evaluating the use of anti-convulsant medications in glioma patients that do not have seizure symptoms.

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Faulkner, Michele A. « Perampanel for the Control of Drug-Resistant Partial-Onset Seizures in Patients 12 years and Older ». Clinical Medicine Insights : Therapeutics 6 (janvier 2014) : CMT.S11674. http://dx.doi.org/10.4137/cmt.s11674.

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Recent developments in the treatment of seizure disorders have been focused on medications with novel mechanisms of action. One such medication is perampanel, a first-in-class, noncompetitive, α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate (AMPA) receptor antagonist recently approved for the adjunctive treatment of partial seizures in patients 12 years of age and older when other antiepileptic medications have failed. The drug has demonstrated efficacy in several clinical trials, and appears to exert its anti-seizure activity in a dose-dependent manner. The drug has a half-life of approximately 105 hours suggesting the medication might be a logical option for individuals who have difficulty with adherence to medications that require multiple daily doses. Because of changes in serum concentration when enzyme-inducing antiepileptic drugs are employed concurrently, escalations in the initial dose of perampanel are recommended. Adverse events reported with perampanel use tend to be mild to moderate. However, psychiatric side-effects, including hostility and aggressive behavior, have been noted in some patients resulting in the inclusion of a warning on the Food and Drug Administration (FDA) approved labeling.

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Raspin, C., R. Shankar, F. Barion, V. Pollit, J. Murphy, L. Sawyer et V. Danielson. « POSC289 Cost-Effectiveness of Vagus Nerve Stimulation with Anti-Seizure Medication Versus Anti-Seizure Medication Alone in the Management of Drug Resistant Epilepsy in England ». Value in Health 25, n^o 1 (janvier 2022) : S196. http://dx.doi.org/10.1016/j.jval.2021.11.950.

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Sewell, Elizabeth K., Shannon E. G. Hamrick, Ravi M. Patel, Monica Bennett, Veeral N. Tolia et Kaashif A. Ahmad. « Correction to : Association between anti-seizure medication and outcomes in infants ». Journal of Perinatology 42, n^o 3 (16 décembre 2021) : 421. http://dx.doi.org/10.1038/s41372-021-01285-2.

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Sengxeu, Noudy, Chanraksmey Aon, Hanh Dufat, Farid Boumediene, Samleng Chan, Sina Ros, Pierre‐Marie Preux, Voa Ratsimbazafy et Jeremy Jost. « Availability, affordability, and quality of essential anti‐seizure medication in Cambodia ». Epilepsia Open 6, n^o 3 (23 juin 2021) : 548–58. http://dx.doi.org/10.1002/epi4.12514.

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Resnick, Barbara, et Elizabeth Galik. « FACTORS THAT INFLUENCE PSYCHOTROPIC MEDICATION USE ». Innovation in Aging 3, Supplement_1 (novembre 2019) : S558. http://dx.doi.org/10.1093/geroni/igz038.2062.

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Abstract Understanding the factors that influence psychotropic can guide reduction in use of these medications. This study described predictors of psychotropics use among residents with moderate to severe cognitive impairment. This was a secondary data analysis using baseline data from the first 341 residents in the EIT-4-BPSD trial. Predictive measures included demographics, agitation, resistiveness to care, depression, cognition, pain, facility factors and state. Overall 63% (n=211) received at least one psychotropic medication, 16% (n=52) an anti-seizure medication, 23% (n=77) an anxiolytic, 30% (n=99) an antidepressant, 2% (n=8) a sedative hypnotic, 28% (n=93) an antipsychotic medication, and 9% (n=29) an opioid. Model testing explained 9 to 15% of psychotropic medication use. There were high rates of psychotropic medication use and a limited association between demographic factors, behavioral symptoms, and psychotropic medication use. Continued research is needed to explore additional factors associated with psychotropic medication use such as beliefs of providers.

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Marshall, A. D., J. P. Pell, A. Askarieh, J. P. Leach et C. A. Heath. « The influence of demographics and comorbidity on persistence with anti-seizure medication ». Seizure 97 (avril 2022) : 88–93. http://dx.doi.org/10.1016/j.seizure.2022.03.019.

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Russell, Natasha Keerthika, et Gopakumar Hariharan. « EBNEO Commentary : Safety of early discontinuation of anti‐seizure medication in neonates ». Acta Paediatrica 111, n^o 2 (15 décembre 2021) : 449–50. http://dx.doi.org/10.1111/apa.16200.

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Leppik, Ilo, Angela Birnbaum et Silvia Illamola. « Variability of Anti-Seizure Medication Concentrations in Older Adult Nursing Home Residents ». Journal of the American Medical Directors Association 23, n^o 3 (mars 2022) : B21. http://dx.doi.org/10.1016/j.jamda.2022.01.045.

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Deck, Gina M., Christina D. Yarrington et Page B. Pennell. « Factors associated with anti-seizure medication utilization for eclamptic seizures : 1995–2015 ». Epilepsy & ; Behavior 124 (novembre 2021) : 108299. http://dx.doi.org/10.1016/j.yebeh.2021.108299.

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Ernawati, Iin, Wardah Rahmatul Islamiyah et Sumarno. « How to Improve Clinical Outcome of Epileptic Seizure Control Based on Medication Adherence ? A Literature Review ». Open Access Macedonian Journal of Medical Sciences 6, n^o 6 (17 juin 2018) : 1174–79. http://dx.doi.org/10.3889/oamjms.2018.235.

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Anti-Epileptic Drugs (AEDs) are the main therapy for epilepsy to prevent seizures. Non-adherence situation plays an important factor in the failure of seizure control. Such a condition may generate several impacts on clinical, social, and economic aspect. Several methods are used to measure adherence in epilepsy patients, including direct and indirect measurement. The direct measure involves measurement of drug levels in hair or body fluids such as blood and saliva. Whereas, indirect measure involves the non-biological tools, for example, a self-report measure, pill counts, appointment attendance, medication refills, and seizure frequency. Numerous factors may affect adherence in epilepsy patients, such as age, sex, and seizure aetiology, seizure sites, which are categorised as irreversible factors and hardly to be improved. However, there are factors that can be influenced to improve adherence such as patient knowledge, medication, cultural, health care professionals, and national health policies, which are related to treatment and education factor which is associated with behaviour to be likely adherence.

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Batham, Lalima, Lokesh Choudhary, Alka Mishra et Vandana Shrivastava. « Yagya Therapy for Epileptic Seizures : A Case Study ». Interdisciplinary Journal of Yagya Research 1, n^o 2 (31 octobre 2018) : 37–42. http://dx.doi.org/10.36018/ijyr.v1i2.14.

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Epileptic seizure is a neurological condition in which brief to long episodes of vigorous shaking, convulsions, blackouts, fainting, unresponsiveness, jerks, etc. occur in the patients. Current treatment approaches are anti-seizure medicines, which patients are bound to take throughout life. These medications are mostly not able to reverse or eradicate the condition. Vedic literature recommends Yagya as a therapy for mental conditions similar to mania, seizure, etc. Yagya-Therapy provides pulmonary inhalation of medicinal-smoke of multiple herbs (generated through oblation in fire along with chanting of Vedic hymns), which have the potential for seizure treatment. A case study is being reported wherein Yagya-Therapy was prescribed to an epileptic seizure patient. Before the start of Yagya-Therapy, the patient (Male/65 years) had been suffering from epileptic seizures (~8-10 episodes annually) since ~3 years (pre-observation). Subsequently, the patient has been doing Yagya-Therapy since past ~3.5 years, wherein only 2-3 episodes occurred during the first year, that too during sleep only, and after that no seizures have been experienced. All this time, the patient continued to take the allopathic medication that he was taking earlier. Thus, Yagya-Therapy can be an effective treatment option for epileptic seizure patients.

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Mahmoud, Madiha Rabie, Hialah Abdalluh Alenazi, Manahel Salem Almutairi, Bayan Sulaiman Alblowi, Osama Gad Abdelaziz, Hager Mohamed Abdelhady et Sherif Gad Abdelaziz. « Measuring of Non-Adherence of Epilepsy Patients to their Medication and its Relationship to their Beliefs about the Disease, and the Frequency of Seizures : A Comparative Study between Epilepsy Patients in Saudi Arabia and Egypt ». Pakistan Journal of Medical and Health Sciences 16, n^o 6 (30 juin 2022) : 479–84. http://dx.doi.org/10.53350/pjmhs22166479.

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Background: Medication adherence and believes are crucial to achieving the desired goal of therapy in epileptic patient. Anti-epileptic drugs (AED) are the primary therapeutic modes for epileptic patients and have been demonstrated to control seizure, which decreases morbidity and mortality associated with epilepsy. Our aim is assessment of patient’s non-adherence to anti-epileptic drugs among Saudis and Egyptians, and evaluation of the association between patient beliefs about the disease and the frequency of seizures. Methodology: A cross-sectional study was carried out using online questionnaire among patients with epilepsy in neurology clinics either in Saudi Arabia (KSA) or Egypt. Medication adherence was assessed using a self-reported questionnaire which was designed by the authors with reference to relevant literature. The questionnaire includes patients’ socio-demographic, types, and causes of epilepsy, causes of poor adherence to antiepileptic drugs and belief of patients about epilepsy. All variables were calculated using frequencies and percentages. Results: The prevalence of non-adherence was high among epileptic Saudi patients (52.3%) compared to Egyptians (36.6%). It was reported that older age, female gender, high educational level, high family income significantly increased the patient adherence to AED, while marital and employment status didn’t. Many factors causing poor adherence were forgetfulness, polypharmacy, medication complexity, feeling bad or better which more pronounced among Saudis than Egyptians. Conclusion: Evaluation of medication adherence and improvement of the belief about the importance of medication and identification of factors affecting adherence to treatment is mandatory to reduce seizure frequency, so we recommend educational programs to enhance the patients’ belief about their medication to improve medication adherence presented by the healthcare providers. Keyword: Anti-epileptic drug, Medication adherence, Patients' beliefs, Saudi Arabia, Egypt.

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Roebber, Jennifer K., Penelope A. Lewis, Vincenzo Crunelli, Miguel Navarrete et Khalid Hamandi. « Effects of Anti-Seizure Medication on Sleep Spindles and Slow Waves in Drug-Resistant Epilepsy ». Brain Sciences 12, n^o 10 (24 septembre 2022) : 1288. http://dx.doi.org/10.3390/brainsci12101288.

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There is a close bidirectional relationship between sleep and epilepsy. Anti-seizure medications (ASM) act to reduce seizure frequency but can also impact sleep; this remains a relatively unexplored field given the importance of sleep on seizure occurrence, memory consolidation, and quality of life. We compared the effect of poly-ASM treatment on a night of sleep compared to an unmedicated night in patients with drug-resistant epilepsy, where ASMs were withdrawn and later restored as part of their pre-surgical evaluation. Within-subject analysis between medicated and unmedicated nights showed ASMs increased spindle (11–16 Hz) power and decreased slow wave (0.1–2 Hz) amplitude. Spindles became less strongly coupled to slow waves in the ASM night compared to no-ASM night, with effects to both the phase and strength of coupling and correlated with slow wave reduction. These effects were not seen in age-matched controls from the same unit where ASMs were not changed between two nights. Overall, we found that ASM polytherapy not only changed specific sleep waveforms, but also the fine interplay of spindle/slow wave coupling. Since these sleep oscillations impact both seizure occurrence and memory consolidation, our findings provide evidence towards a decoupling impact of ASMs on sleep that should be considered in future studies of sleep and memory disruption in people with epilepsy.

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Gesche, Joanna, Helle Hjalgrim, Guido Rubboli et Christoph Patrick Beier. « Risk factors of paradoxical reactions to anti-seizure medication in genetic generalized epilepsy ». Epilepsy Research 170 (février 2021) : 106547. http://dx.doi.org/10.1016/j.eplepsyres.2020.106547.

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Strzelczyk, Adam, et Susanne Schubert-Bast. « A Practical Guide to the Treatment of Dravet Syndrome with Anti-Seizure Medication ». CNS Drugs 36, n^o 3 (14 février 2022) : 217–37. http://dx.doi.org/10.1007/s40263-022-00898-1.

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Lee, Dong Ah, Ho-Joon Lee, Bong Soo Park, Yoo Jin Lee et Kang Min Park. « Can we predict anti-seizure medication response in focal epilepsy using machine learning ? » Clinical Neurology and Neurosurgery 211 (décembre 2021) : 107037. http://dx.doi.org/10.1016/j.clineuro.2021.107037.

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Kerr, Wesley T., Emily A. Janio, Justine M. Le, Jessica M. Hori, Akash B. Patel, Norma L. Gallardo, Janar Bauirjan et al. « Diagnostic delay in psychogenic seizures and the association with anti-seizure medication trials ». Seizure 40 (août 2016) : 123–26. http://dx.doi.org/10.1016/j.seizure.2016.06.015.

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Gesche, Joanna, Helle Hjalgrim, Guido Rubboli et Christoph Patrick Beier. « Risk factors of paradoxical reactions to anti-seizure medication in genetic generalized epilepsy ». Epilepsy Research 170 (février 2021) : 106547. http://dx.doi.org/10.1016/j.eplepsyres.2020.106547.

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Slovin, Susan F., William Clark, Joan Carles, Andrew Krivoshik, Jung Wook Park, Fong Wang et Daniel George. « Seizure rates in enzalutamide (ENZ)-treated men with metastatic castration-resistant prostate cancer (mCRPC) at increased risk of seizure : UPWARD study. » Journal of Clinical Oncology 35, n^o 6_suppl (20 février 2017) : 147. http://dx.doi.org/10.1200/jco.2017.35.6_suppl.147.

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147 Background: ENZ is an androgen receptor inhibitor that improved survival in studies of men with mCRPC. Seizure is a risk of ENZ treatment, and patients (pts) with seizure risk factors were excluded in prior studies. In the TRUVEN report (data on file), pts with mCRPC and potential seizure risk factors, but no ENZ exposure, had a seizure rate of 2.8/100 pt-years. The UPWARD study assessed the seizure risk in ENZ-treated pts with mCRPC who had potential seizure risk factors. Methods: This was a global, multicenter, single-arm, open-label safety study. Enrolled pts had ≥ 1 baseline potential seizure risk factor, including medications lowering seizure threshold, stroke, or prior seizure history. Evaluable pts had ≥ 3 months (ms) of treatment with ENZ or ≥ 1 confirmed seizure in a 4-m treatment period. Exclusion criteria included seizure within the past 12 ms and receipt of anti-epileptic medication. Pts received ENZ (160 mg/day). The primary end point was the proportion of evaluable pts with ≥ 1 confirmed seizure during the 4-m treatment period. Results: A total of423 pts received ENZ; 366 were evaluable. Baseline seizure risk factors were medications lowering seizure threshold (n = 242), brain injury (n = 112), and cerebrovascular accident/transient ischemic attack history (n = 94). Four (1.1%) evaluable pts had ≥ 1 confirmed seizure within 4 ms of ENZ initiation. Four (1.1%) pts had a first seizure after 4 ms. The rate of confirmed seizure was 2.6/100 pt-years. 357 pts (84.4%) experienced ≥ 1 treatment-emergent adverse event (TEAE); 141 (33.3%) had ≥ 1 serious TEAE and 29 (6.9%) had ≥ 1 drug-related serious AE. 38 (9.0%) deaths were reported during treatment/within 30 days of discontinuation; four deaths were considered possibly drug related (cerebral hemorrhage, mCRPC progression, sudden cardiac death, and general deterioration). Conclusions: The incidence of confirmed seizures in the UPWARD study is similar to pts with mCRPC and similar risk factors but no ENZ exposure in the TRUVEN report. ENZ was generally well tolerated, and TEAE data are consistent with its known safety profile. These results suggest that ENZ did not increase the risk of seizures in the UPWARD study. Clinical trial information: NCT01977651.

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Ntsanwisi, Vongani Titi Raymond, Solomon T. Rataemane et Dali S. Magazi. « Alternative psychosis (forced normalisation) in epilepsy ». South African Journal of Psychiatry 17, n^o 2 (1 juin 2011) : 4. http://dx.doi.org/10.4102/sajpsychiatry.v17i2.281.

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Abstract Forced normalization is a paradoxical relationship between seizure activity and behavioural problems. A 20 year old male with recurrent refractory tonic clonic epilepsy experienced forced normalization, whilst on medication with multiple anti- epileptic drugs (AEDs).(Valproate Sodium, Carbamazepine, and Topiramate). A reduction in the seizure burden correlated with sudden behavioural changes manifesting with aggressive outbursts and violence.. The present case may help clarify the mechanism of forced normalization whilst providing some helpful hints regarding the diagnosis and treatment of symptoms observed in recurrent refractory seizures.

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Han, Ji Yoon, In Goo Lee, Soyoung Shin et Joonhong Park. « Seizure duration may increase thyroid-stimulating hormone levels in children experiencing a seizure ». Journal of International Medical Research 48, n^o 5 (27 novembre 2019) : 030006051988840. http://dx.doi.org/10.1177/0300060519888401.

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Objective Variations in hormone levels are a direct effect of epileptic discharges in both animals and humans, and seizure can affect the hypothalamus–pituitary–thyroid axis. The purpose of this study was to determine which parameters could affect the alternation of thyroid hormones in children experiencing seizure. Methods We retrospectively reviewed the medical records of 181 pediatric patients with seizure and compared three thyroid hormones (serum thyroid-stimulating hormone [TSH], free thyroxine [fT4], and triiodothyronine [T3]) between initial (admission to hospital) and follow-up (2 weeks later) testing. Results Multivariable logistic regression models were used to determine which six parameters (gender, age, seizure accompanying with fever, seizure type, seizure duration, and anti-epileptic drug medication) could help to explain the higher initial TSH levels in pediatric seizure. Only seizure duration in patients with an increase in TSH levels was significantly longer compared with patients with normal TSH at the time of initial testing. Conclusion Neuronal excitability by seizure can cause thyroid hormonal changes, which likely reflects changes in hypothalamic function.

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Das, Ancy M., Lakshmi Ramamoorthy, Sunil k. Narayan et Vaibhav Wadwekar. « Barriers of Drug Adherence among Patients with Epilepsy : in Tertiary Care Hospital, South India ». Journal of Caring Sciences 7, n^o 4 (22 octobre 2018) : 177–81. http://dx.doi.org/10.15171/jcs.2018.027.

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Introduction: Epilepsy is a treatable and curable brain disorder. However major proportion of individuals with this disease in developing countries receives no treatment because of misunderstandings of the public. Other than that, poor adherence to ordered medication is considered the primary cause of drug therapy failure in epilepsy. This study conducted to assess the adherence pattern to antiepileptic regimen, among patients with epilepsy and to identify the clinical and patient-related factors contributing as barriers. Methods: A cross sectional survey design was used in 100 epilepsy patients in an Outpatient unit of tertiary care center. A Convenient sampling technique was used to enroll the patients who meet inclusion criteria. Structured interview with pre-tested questionnaire and eight item Morisky Medication Adherence Scale was used to collect the data. Descriptive and inferential statistics were used for analysis of data. Descriptive statistics (mean, standard deviation, frequency and percentages) were used to describe the clinical and demographic variables of study participants. The determinants of medication adherence were analyzed using Chi-Square test and independent student t- test. The analysis was done with SPSS 20th version. Results: Majority (71%) of patients were not adherent to antiepileptic treatment. Severity of seizure (indicated by the presence of seizure last year), medication frequency and complexity of treatment were found to have significant association with the Anti-Epileptic Drugs (AED) adherence status. Status of adherence is significantly associated with frequency of seizure/year and positive life style. Conclusion: As Medication adherence was observed to be low, services for adherence counseling and health educational interventions in the epilepsy clinics is recommended.

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Roychoudhury, S., M. Esser, J. Buchhalter, L. Bello-Espinosa, H. Zein, A. Howlett, S. Thomas et al. « B.01 Neonatal Neuro-Critical Care (NNCC) program associated with improved short term outcomes in neonates significant Hypoxic Ischemic Encephalopathy (HIE) ». Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 45, s2 (juin 2018) : S12—S11. http://dx.doi.org/10.1017/cjn.2018.89.

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Background: Despite advances in neonatal care, neonates with moderate to severe HIE are at high risk of mortality and morbidity. we report the impact of a dedicated NNCC team on short term mortality and morbidities. Methods: A retrospective cohort study on neonates with moderate to serve HIE between July 1st 2008 and December 31st 2017. primary outcome : a composite of death and/or brain injury on MRI. Secondary outcomes: rate of cooling, length of hospital stay, anti-seizure medication burden, and use of inotropes. A regression analysis was done adjusting for gestational age, birth weight, gender, out-born status, Apgar score at 10 minutes, cord blood pH, and HIE clinical staging Results: 216 neonates were included, 109 before NNCC implementation, and 107 thereafter. NNCC program resulted in reduction in the primary outcome (AOR: 0.28, CI: 0.14-0.54, p<0.001) and brain injury (AOR: 0.28, CI: 0.14-0.55, p<0.001). It decreased average length of stay/infants by 5 days (p=0.03), improved cooling rate (73% compared to 93% , p <0.001), reduced: seizure misdiagnosis (71% compared to 23%, P <0.001), anti-seizure medication burden (P = 0.001), and inotrope use (34% compared to 53%, p=0.004) Conclusions: NNCC program decreased mortality and brain injury , shortened the length of hospital stay and improved care of neonates with significant HIE.

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Xu, Yin, Fang Yang, Zheng Hu, Yan He, Qirui Zhang, Qiang Xu, Yifei Weng et al. « Anti-seizure medication correlated changes of cortical morphology in childhood epilepsy with centrotemporal spikes ». Epilepsy Research 173 (juillet 2021) : 106621. http://dx.doi.org/10.1016/j.eplepsyres.2021.106621.

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Kinney, M. O., V. Chester, S. Tromans, R. T. Alexander, H. Angus-Leppan, M. Bagary, H. Cock et al. « Epilepsy, anti-seizure medication, intellectual disability and challenging behaviour – Everyone’s business, no one’s priority ». Seizure 81 (octobre 2020) : 111–16. http://dx.doi.org/10.1016/j.seizure.2020.07.018.

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Brady, Stacey, Erin Bell, Natalie Courtman et Matthias Le Chevoir. « Nasal dermoid cyst with intracranial extension in a cat ». Journal of Feline Medicine and Surgery Open Reports 5, n^o 1 (janvier 2019) : 205511691982740. http://dx.doi.org/10.1177/2055116919827404.

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Case summary An 11-month-old female neutered Ragdoll cat was presented for focal seizures, aggression and altered behaviour. A diagnosis of a nasal dermoid cyst with intracranial extension was made following MRI, cytology and histopathology. The cyst was surgically excised with a resolution of clinical signs, with the exception of ongoing seizure activity requiring anti-seizure medication. Relevance and novel information To our knowledge, this is the first reported case of a nasal dermoid cyst in a cat, and the first reported case in the veterinary literature of any species with a nasal dermoid cyst presenting with neurological signs.

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Wang, Boya, Orit Kaidar-Person, Deanna Sasaki-Adams, Sivakumar Jaikumar, Matthew Ewend, Zev Nakamura, Ronald Chen et al. « RADI-42. ASSOCIATION BETWEEN TUMOR LOCATION AND TOXICITY OUTCOMES AFTER STEREOTACTIC RADIOSURGERY FOR BRAIN METASTASES ». Neuro-Oncology Advances 1, Supplement_1 (août 2019) : i30. http://dx.doi.org/10.1093/noajnl/vdz014.133.

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Abstract OBJECTIVE: The toxicities associated with stereotactic radiosurgery (SRS) are important factors when considering treatment options and supportive management for patients with brain metastases. We assessed the association between brain metastasis location and rates of toxicity after SRS. METHODS: We conducted a retrospective single-institution review of 170 patients treated with SRS for brain metastases from 2008–2016 with median follow-up of 8.6 months. Typical SRS doses were 18-20Gy in 1 fraction (lesions < 2cm), 18-21Gy in 3 fractions (lesions 2-3cm), and 25-30Gy in 5 fractions (lesions >3cm). Toxicity measures evaluated included radiation necrosis, seizure, and dexamethasone requirement. RESULTS: A total of 221 lesions were treated among frontal (29%), cerebellar (23%), parietal (16%), temporal (15%), occipital (14%), and other (brainstem, thalamus, basal ganglia) (4%) regions. The rate of SRS-related radionecrosis was 4% for all patients and significantly correlated with metastasis volume (increasing from 1% to 7% for lesions ≤1cm3 to >3cm3) and prior whole brain radiotherapy (WBRT) but not with metastasis location or prior resection on multi-variable analysis (P< 0.05). Post-SRS seizure occurred in 9% of all patients but was significantly higher for primary motor cortex and sensory cortex lesions, associated with 52% and 33% seizure rates, respectively (P< 0.05). Of patients who initially presented with seizure and were on anti-epileptic medication during SRS, 53% had no further seizures, while 47% did have post-SRS seizures, nearly all with motor cortex lesions. Only 5% of patients had new-onset seizure after SRS, related to lesion hemorrhage or motor cortex location. Dexamethasone use >3 months post-SRS was higher for motor strip lesions. CONCLUSION: Brain metastasis location in the primary motor cortex was associated with higher rates of post-SRS seizure, including new-onset seizures and breakthrough seizures on anti-epileptic medication during SRS. Rates of radionecrosis were associated with lesion volume and prior WBRT but not with metastasis location.

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Price, Amy. « Antiepileptic Drugs for Preventing Seizures Following Acute Traumatic Brain Injury ». International Journal of User-Driven Healthcare 2, n^o 2 (avril 2012) : 1–5. http://dx.doi.org/10.4018/ijudh.2012040101.

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The work was done to explore the effectiveness of prophylactic antiepileptic drugs for acute traumatic brain injury and assess risk: benefit ratios. The author asked if this intervention helped sort-term survivors avoid seizures after injury and assessed the influence of such medication on death and disability which result in seizures in long term survivors of TBI. Finally, the work assessed the benefits given potential adverse reactions to these drugs. The author found that using anti-epileptic drugs in the early stages after traumatic brain injury does decrease seizures. This review found that anti-epileptic drugs were effective for decreasing seizures in the first week after a TBI. Available pooled data failed to demonstrate reductions in overall mortality, late onset seizures, or the development of persistent vegetative states. However, the conclusions are limited by the scarcity of clear data collected to investigate cognitive/behavioural, neurological, or hematopoietic adverse effects thought to result from the anti seizure medications.

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Zhong, Ning, et Mark Waheed. « Treatment Outcome of Autoimmune Associated Epilepsy (AAE) vs Acute Symptomatic Seizures in Autoimmune Encephalitis (ASSAE)–A Single Center Experience ». Neurology 99, n^o 23 Supplement 2 (5 décembre 2022) : S15.1—S15. http://dx.doi.org/10.1212/01.wnl.0000903144.80173.4c.

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ObjectiveTo assess the seizure treatment outcome in autoimmune encephalitis (AE).BackgroundSeizures due to AE etiology are increasingly recognized. Timely confirmation of autoimmune etiology may lead to improved outcomes by allowing for earlier immunotherapy, which is more effective than anti-seizure medication (ASM). Currently, seizures/epilepsy of autoimmune etiology can be subcategorized as autoimmune associated epilepsy or acute symptomatic seizures in autoimmune encephalitis with varied response to immunotherapy.Design/MethodsThis was a retrospective single center study including patients diagnosed with AE, with a minimum follow-up of 12 months after disease onset in alive cases.Results28 out of 31 patients were analyzed (3 without seizure were excluded). 12 were found to have autoantibodies (Abs) against cell membrane (CM) protein (3 anti-NMDAR, 4 anti-GABAbR, 4 anti-LGI-1, 1 anti-GABAaR); 4 with non-specific Abs (low titer of anti-GAD, VGCC); 11 with no Abs identified; 3 were with intracellular (IC) Abs (MOG, Hu, GFAP). All patients received immunotherapy and ASM treatment. Among the patients with CM-Abs, 10 of the 12 remained seizure free, 7 were successfully weaned off ASM. Among those with nonspecific/no Abs, only 4 of the 15 patients (26.7%) remained seizure free. All 3 patients with intracellular Abs did poorly, and only one patient with anti-MOG-Abs survived with drug resistant epilepsy (DRE). Within the group of CM-Abs, 2 patients (16.7%) with anti-GABAbR-Abs developed DRE, compared to over 70% of patients in group with nonspecific/no Abs or IC-Abs. Upon further investigation of DRE patients, several features were observed: 1) poor response to immunotherapy, 2) sustained abnormal brain MRI T2/FLAIR signal, 3) persistent focal epileptiform features and frequent ictal patterns in EEGs.ConclusionsPatients with CM-Abs likely suffer ASSAE with favorable long-term outcome. Patients without identified auto-Abs or IC-Abs likely develop AAE and consequently develop DRE. Further research focusing on biomarkers predicting AAE and DRE is needed for treatment guidance.

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Hixson-Wallace, Julie A., Beth Barham, Randell K. Miyahara et Charles M. Epstein. « Pharmacist Involvement in a Seizure Clinic ». Journal of Pharmacy Practice 6, n^o 6 (décembre 1993) : 278–82. http://dx.doi.org/10.1177/089719009300600604.

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The role of the clinical pharmacist in ambulatory care settings has expanded in the last several years. Various types of clinical pharmacy services in ambulatory clinics have been reported in the literature. This article seeks to describe the involvement of clinical pharmacists as primary-care givers in an outpatient neurology-seizure clinic of the Veterans Affairs Medical Center in Atlanta, GA. The Neurology-Seizure clinical pharmacy services are provided by faculty, residents, and students from Mercer University Southern School of Pharmacy. The faculty members have been granted clinical privileges to practice in the ambulatory clinics in order to function with authority to perform such duties as giving medication renewals, and writing in the medical chart. In the clinic itself, the pharmacist is responsible for providing a medication profile, an initial interview with the patient, a minor neurological examination, presentation of the patient to the attending neurologist, writing of a SOAP (subjective, objective, assessment and plan) note, an end-of-appointment consultation, completion of a clinic flow sheet, maintenance of the clinic record, follow-up phone calls relating the results of anti-epileptic drug levels, and monthly quality assurance summaries. Clinical pharmacist-supervised primary care outpatient clinics can be rewarding endeavors. Through close patient contact and interaction with attending physicians, pharmacists can greatly assist with pharmaceutical care and provide expert drug management of seizure patients.

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Fujimoto, Ayataka, Hideo Enoki, Keisuke Hatano, Keishiro Sato et Tohru Okanishi. « Earlier Age at Surgery for Brain Cavernous Angioma-Related Epilepsy May Achieve Complete Seizure Freedom without Aid of Anti-Seizure Medication ». Brain Sciences 12, n^o 3 (18 mars 2022) : 403. http://dx.doi.org/10.3390/brainsci12030403.

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Background: The present study hypothesized that some factors may distinguish between patients with a brain cavernous angioma (BCA), who were free from anti-seizure medication (ASM), and patients who still required ASMs postoperatively. The purpose of the study was thus to identify factors associated with ceasing ASMs for patients with drug-resistant epilepsy secondary to BCA, who underwent BCA removal surgery. Methods: We divided patients into those with drug-resistant epilepsy secondary to BCA who achieved complete seizure freedom without ASMs a year after surgery (No-ASM group) (International League Against Epilepsy (ILAE) classification class I with no epileptiform discharges), and others (ASM group) (ILAE classification ≤ II and/or epileptiform discharges). We statistically compared groups in terms of: (1) age at operation; (2) history of epilepsy; (3) size of BCA; and (4) location of BCA. Results: Overall, a year after the surgery, the No-ASM group comprised 12 patients (48%), and the ASM group comprised 13 patients (52%). In both multi- and univariate logistic regression analyses, age at BCA removal surgery correlated significantly with the No-ASM group (p = 0.043, p = 0.019), but history of epilepsy did not (p = 0.581, p = 0.585). Conclusions: Earlier age at surgery for patients with drug-resistant epilepsy is encouraged to achieve complete seizure freedom without the need for ASMs when the cause of epilepsy is BCA.

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Rasker, Johannes J., Frederick Wolfe, Ewa G. Klaver-Krol, Machiel J. Zwarts et Peter M. ten Klooster. « The relation of fibromyalgia and fibromyalgia symptoms to self-reported seizures ». PLOS ONE 16, n^o 2 (4 février 2021) : e0246051. http://dx.doi.org/10.1371/journal.pone.0246051.

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Objective Several epidemiological and clinical reports associate fibromyalgia (FM) with seizure disorders, and clinical studies associate FM diagnosis with psychogenic non-epileptic seizures. However, these associations rely on self-reports of being diagnosed with FM or unstandardized clinical diagnosis in combination with small samples. We investigated the association of FM and self-reported seizures using a large rheumatic disease databank and the current established self-reported, symptom-based FM diagnostic criteria. Methods We selected a random observation from 11,378 subjects with rheumatoid arthritis (RA), 2,390 (21.0%) of whom satisfied 2016 revised criteria for FM. Patients were inquired about the presence of any kind of seizures in the previous 6 months, anti-epileptic medications, and patient-reported symptoms and outcomes. Results Seizures were reported by 89 RA patients who met FM criteria (FM+) and by 97 patients who did not (FM-), resulting in an age- and sex-adjusted seizure prevalence of 3.74 (95% CI 2.95 to 4.53) per 100 FM+ subjects and 1.08 (95% CI 0.87 to 1.30) in FM- subjects. The seizure odds ratio of FM+ to FM- cases was 3.54 (95% CI 2.65 to 4.74). Seizures were associated to a very similar degree with symptom reporting (somatic symptom count and comorbidity index) as to FM diagnosis variables. RA patients reporting seizures also reported worse pain, quality of life, and functional status. Seizure patients treated with anti-seizure medication had worse outcomes and more comorbidities than seizure patients with no seizure drugs. Conclusions We found a significant and similar association of both FM diagnostic variables and FM-related symptom variables, including the number of symptoms and comorbidities, with self-reported seizures in people with RA. The observed association was similar to those found in previous studies of symptoms variables and seizures and does not suggest a unique role for fibromyalgia diagnosis. Rather, it suggests that multi-symptom comorbidity is linked to seizures in a complex and not yet clearly understood way. As the current study relied on self-reported seizures and was not able to distinguish between epileptic and psychogenic nonepileptic seizures, future studies are needed to replicate the findings using both validated FM criteria assessments and clinically verified diagnoses of epileptic and psychogenic seizures.

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Liu, Wen, Elizabeth Galik et Barbara Resnick. « FACTORS ASSOCIATED WITH EATING PERFORMANCE IN NURSING HOME RESIDENTS WITH DEMENTIA AND MULTIPLE COMORBIDITIES ». Innovation in Aging 6, Supplement_1 (1 novembre 2022) : 271–72. http://dx.doi.org/10.1093/geroni/igac059.1076.

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Abstract Eating performance is the functional ability to get food and drink into the mouth. Nursing home residents with dementia commonly experience compromised eating performance and subsequent nutritional consequences. Resident characteristics including cognition, physical capacity, and functional ability are associated with eating performance. This study aimed to test the association between functional ability, behavioral symptoms, psychotropic medication use, and comorbidities and eating performance. This was a secondary analysis using baseline data from two randomized controlled trials testing the impact of Function Focused Care on function and behavioral symptoms between 2014-2020. A total of 889 residents with moderate-to-severe dementia (mean age 86.58 years, 72% female, 70% white, 69.5% severe dementia) from 67 nursing homes in two states were recruited. Eating performance (dependent variable) was measured using the single self-feeding item on the Barthel Index. Independent variables included functional ability (Barthel Index total score excluding self-feeding item score), behavioral symptoms (agitation, depression, resistiveness to care), and psychotropic medication use (anti-depression, sedative, anti-psychotics, anti-seizure, anti-anxiety), and comorbidities. Residents had on average 5 documented comorbidities (SD=3.06, range=0-12) and were on approximately 1 psychotropic medication (range=0-5, SD=1.24). Thirty-eight percent of residents were dependent in eating performance. Functional ability (OR=1.052, 95% CI=1.043,1.061, p<.001), depression(OR=.931, 95% CI=.887,.978, p=.004), and anti-anxiety medication use(OR=.632, 95% CI=.409, .978, p=.039) were associated with eating performance. Findings supported better functional ability, lower depression, and less anti-anxiety medication use were associated with better eating performance. Targeted efforts including maintaining functional ability, minimizing anti-anxiety medication use, and managing depression are encouraged to support eating performance.

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Vajda, Frank J. E., Terence J. O'Brien, Janet E. Graham, Alison A. Hitchcock, Cecilie M. Lander et Mervyn J. Eadie. « The contribution of non-drug factors to fetal malformation in anti-seizure-medication-treated pregnancy ». Epilepsy & ; Behavior 118 (mai 2021) : 107941. http://dx.doi.org/10.1016/j.yebeh.2021.107941.

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Ahmed, Quazi Mamtaz Uddin, et Md Nazmul Hasan. « A 30-Year-Old Male Patient of Miliary Tuberculosis Presented with Pancytopenia and Intracerebral Haemorrhage Mimicking Brain Tumor in MRI ». Bangladesh Medical Journal 49, n^o 1 (19 janvier 2021) : 51–54. http://dx.doi.org/10.3329/bmj.v49i1.52590.

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Unlike to fever, pancytopenia is a rare hematological manifestations of tuberculosis and intracranial haemorrhage as well. Here we report a case of disseminated tuberculosis presented with pancytopenia and intracranial haemorrhage. The patient presented with prolonged pyrexia, weight loss and subsequently unconsciousness and convulsion. After the diagnosis of tuberculosis with pancytopenia and intracerebral haemorrhage flowed by convulsion, he was treated with category-1 standard anti-tubercular therapy and anticonvulsant. After completion of the anti-tubercular drug his fever completely subsided and gained weight and pancytopenia was improved. But he is still on anti-convulsant medication with good control of seizure. Bangladesh Med J. 2020 Jan; 49 (1): 51-54

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Crook, Cara, Seth A. Margolis, Jennifer Davis, Jeffrey S. Gonzalez, Arthur C. Grant et Luba Nakhutina. « A-167 The Role of Epilepsy Knowledge and Treatment Beliefs in Medication Self-Management Among Diverse People with Epilepsy ». Archives of Clinical Neuropsychology 37, n^o 6 (17 août 2022) : 1322. http://dx.doi.org/10.1093/arclin/acac060.167.

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Abstract Objective: Research into medication adherence remains limited among ethnically diverse people with epilepsy (PWE). We characterized self-reported reasons for suboptimal adherence in this population. Next, we sought to replicate a previously established link between negative medication beliefs and worse adherence. Finally, we explored whether epilepsy knowledge moderates the beliefs-adherence relationship. Method: Sixty-three PWE (Age=42.1±13.2; Education=12.6±2.4 years; 60% female; 79% Black; 19% Hispanic/Latinx; 5% Mixed Race) completed the Beliefs about Medicines Questionnaire (BMQ), Epilepsy Knowledge Profile (EKP), and Epilepsy Self-Management Scale’s (ESMS) Medication Management subscale with nonadherent practices endorsed “sometimes, most of the time, or always” considered “suboptimal.” Results: The four most prevalent suboptimal adherence practices were endorsed by 20-34% of participants and included not taking anti-seizure medications the same time every day, forgetting doses, not requesting refills before running out, and spreading out doses when running out. A considerable number of participants agreed/strongly agreed that medications were overused by prescribers (45.2%), that their medications concerned them (24.2%) or were harmful (19.4%). Epilepsy knowledge was fair (EKP=70.4%±9.5% correct). Harm and overuse beliefs were negatively correlated with adherence (r’s=-0.27 and -0.32 with p’s=.035 and .013, respectively). Epilepsy knowledge was unrelated to beliefs or adherence and did not moderate their relationship. Harm/overuse beliefs were combined (α=0.78) and their significant relationship with adherence (r=-0.34, p=.008) was unchanged after controlling for epilepsy knowledge (pr=-0.31, p=.017). Conclusions: In these diverse PWE, the most prevalent reasons for suboptimal medication adherence are behaviorally-mediated and may be modifiable. However, interventions addressing negative medication beliefs may be necessary to effect change over knowledge-based psychoeducation alone.

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Drishya Dev, Rakhi Krishna, Mahima Bharathi, Neethu C M, Alex Baby Paul et Priya Vijayakumar. « Pattern of usage of psychotropic agents in geriatric patients in a teritiary care hospital ». International Journal of Research in Pharmaceutical Sciences 12, n^o 1 (13 janvier 2021) : 631–35. http://dx.doi.org/10.26452/ijrps.v12i1.4145.

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Psychotropic medications are used in the treatment of chronic psychotic disorders like anxiety, depression, insomnia, bipolar disorders, cognitive impairment, seizure, loss of consciousness, altered sensorium, delirium etc. The objective of this study is to describe the pattern of use of psychotropic medications in patients presenting to geriatrics department, to compare the pattern of usage of psychotropic medication at the time of admission versus at the time of discharge and to find out the dose optimization pattern in elderly patients. Observational retrospective study, conducted in the department of geriatrics. The sample size calculated for the study was 35. The study was carried out through AHIS and by reviewing case files. The data were collected on specially designed data collection forms. Consumption of the psychotropic drugs was the highest within 71-80 years of age group, of which 49.15% of patients fall in this age group. All of the patients prescribed with psychotropic medications had insomnia (26.70%), followed by anxiety (20.30%), seizure (20.30%) and depression (16.90%). Among the 2nd generation anti psychotropics, quetiapine was the most frequently prescribed drug (54.24%). Benzodiazepines were the preferred antidepressants (36%) followed by SSRIs. Sixty two percent of the patients continued the same dose prescribed from the outside hospital and a dose increment was done for 37.5% of the patients. The incidence of usage of psychotropic medications were found to be more with females. Atypical antipsychotic drugs were the most commonly used ones. Current evidence shows no superiority for atypical antipsychotics over haloperidol.

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Stritzelberger, Jenny, Johannes D. Lang, Tamara M. Mueller, Caroline Reindl, Vivien Westermayer, Karel Kostev et Hajo M. Hamer. « Anti-seizure medication is not associated with an increased risk to develop cancer in epilepsy patients ». Journal of Neurology 268, n^o 6 (23 janvier 2021) : 2185–91. http://dx.doi.org/10.1007/s00415-020-10379-4.

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Abstract Objective Whether anti-seizure medication (ASM) increases the risk for cancer has been debated for decades. While for some ASM, a carcinoma-promoting effect has been suspected, carcinoma-protective effects have been shown for other ASM. However, the issue remains unresolved as data from preclinical and clinical studies have been inconsistent and contradictory. Methods We collected anonymous patient data from practice neurologists throughout Germany between 2009 and 2018 using the IMS Disease Analyzer database (QuintilesIMS, Frankfurt, Germany). People with epilepsy (PWE) with an initial cancer diagnosis and antiepileptic therapy prior to the index date were 1:1 matched with a control group of PWE without cancer according to age, gender, index year, Charlson Comorbidity Index, and treating physician. For both groups, the risk to develop cancer under treatment with different ASMs was analyzed using three different models (ever use vs. never use (I), effect per one (II) and per five therapy years (III). Results A total of 3152 PWE were included (each group, n = 1,576; age = 67.3 ± 14.0 years). The risk to develop cancer was not significantly elevated for any ASM. Carbamazepine was associated with a decreased cancer risk (OR Model I: 0.699, p < .0001, OR Model II: 0.952, p = .4878, OR Model III: 0.758, p < .0004). Significance Our findings suggest that ASM use does not increase the risk of cancer in epilepsy patients.

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Houben, Eline, Rachael J. Benson, Eric A. P. Steegers et Ron M. C. Herings. « Twenty-year trends in the use of anti-seizure medication among pregnant women in the Netherlands ». Epilepsy & ; Behavior 127 (février 2022) : 108549. http://dx.doi.org/10.1016/j.yebeh.2021.108549.

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