Interleukin-1β in peripheral monocytes is associated with seizure frequency in pediatric drug-resistant epilepsy

2021 ◽  
pp. 577475
Author(s):  
Gaku Yamanaka ◽  
Tomoko Takamatsu ◽  
Shinichiro Morichi ◽  
Takashi Yamazaki ◽  
Izuru Mizoguchi ◽  
...  
Keyword(s):  
Seizure Frequency ◽  
Interleukin 1Β ◽  
Drug Resistant ◽  
Pediatric Drug ◽  
Drug Resistant Epilepsy

Vagus nerve stimulation for drug-resistant epilepsy

2019 ◽  
Vol 20 (3) ◽  
pp. 189-198 ◽  
Author(s):  
Laura Pérez-Carbonell ◽  
Howard Faulkner ◽  
Sean Higgins ◽  
Michalis Koutroumanidis ◽  
Guy Leschziner
Keyword(s):  
Vagus Nerve ◽  
Seizure Frequency ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Therapeutic Option ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
Randomised Controlled

Vagus nerve stimulation (VNS) is a neuromodulatory therapeutic option for drug-resistant epilepsy. In randomised controlled trials, VNS implantation has resulted in over 50% reduction in seizure frequency in 26%–40% of patients within 1 year. Long-term uncontrolled studies suggest better responses to VNS over time; however, the assessment of other potential predictive factors has led to contradictory results. Although initially designed for managing focal seizures, its use has been extended to other forms of drug-resistant epilepsy. In this review, we discuss the evidence supporting the use of VNS, its impact on seizure frequency and quality of life, and common adverse effects of this therapy. We also include practical guidance for the approach to and the management of patients with VNS in situ.

scholarly journals Seizure frequency and social outcome in drug resistant epilepsy patients who do not undergo epilepsy surgery

Seizure ◽  
2011 ◽  
Vol 20 (7) ◽  
pp. 580-582 ◽  
Author(s):  
Mar Carreño ◽  
Juan Luis Becerra ◽  
Joaquín Castillo ◽  
Iratxe Maestro ◽  
Antonio Donaire ◽  
...  
Keyword(s):  
Seizure Frequency ◽  
Epilepsy Surgery ◽  
Drug Resistant ◽  
Social Outcome ◽  
Drug Resistant Epilepsy

The role of targeted gene panel in pediatric drug-resistant epilepsy

2020 ◽  
Vol 106 ◽  
pp. 107003
Author(s):  
Chang-Chun Wu ◽  
Meng-Han Tsai ◽  
Yen-Ju Chu ◽  
Wen-Chin Weng ◽  
Pi-Chuan Fan ◽  
...  
Keyword(s):  
Gene Panel ◽  
Drug Resistant ◽  
Pediatric Drug ◽  
Drug Resistant Epilepsy

scholarly journals Novel Neurotechnological Interventions for Pediatric Drug-Resistant Epilepsy: Physician Perspectives

2020 ◽  
pp. 088307382096693
Author(s):  
Patrick J. McDonald ◽  
Viorica Hrincu ◽  
Mary B. Connolly ◽  
Mark J. Harrison ◽  
George M. Ibrahim ◽  
...  
Keyword(s):  
Decision Making ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Qualitative Content Analysis ◽  
Scientific Evidence ◽  
Clinical Decision ◽  
Drug Resistant ◽  
Ethical Considerations ◽  
Pediatric Drug ◽  
Drug Resistant Epilepsy

This qualitative study investigated factors that guide physicians’ choices for minimally invasive and neuromodulatory interventions as alternatives to conventional surgery or medical management for pediatric drug-resistant epilepsy. North American physicians were recruited to one of 4 focus groups at national conferences. Discussions were analyzed using qualitative content analysis. A pragmatic neuroethics framework was applied to interpret results. Discussions revealed 2 major thematic branches: (1) clinical decision making and (2) ethical considerations. Under clinical decision making, physicians emphasized scientific evidence and patient candidacy when assessing neurotechnologies for patients. Ongoing seizures without intervention was important for safety and neurodevelopment. Under ethical considerations, resource allocation, among other financial considerations for technology adoption, were considerable sources of pressure on decision making. Access to neurotechnology was a salient theme differentiating Canadian and American contexts. When assessing novel neurotechnological interventions for pediatric drug-resistant epilepsy, physicians balance clinical and ethical factors to guide decision making and best practice.

scholarly journals Responsive neurostimulation for treatment of pediatric drug-resistant epilepsy

2018 ◽  
Vol 10 ◽  
pp. 21-24 ◽  
Author(s):  
Nilika S. Singhal ◽  
Adam L. Numis ◽  
Morgan B. Lee ◽  
Edward F. Chang ◽  
Joseph E. Sullivan ◽  
...  
Keyword(s):  
Drug Resistant ◽  
Pediatric Drug ◽  
Drug Resistant Epilepsy

scholarly journals Topiramate Effectiveness as Add-on Therapy in Bulgarian Patients with Drug-resistant Epilepsy

Folia Medica ◽  
2020 ◽  
Vol 62 (4) ◽  
pp. 712-722
Author(s):  
Ekaterina Viteva ◽  
Zahari Zahariev
Keyword(s):  
Adverse Events ◽  
Seizure Frequency ◽  
Dynamic Assessment ◽  
University Hospital ◽  
Drug Resistant ◽  
Seizure Severity ◽  
Impaired Awareness ◽  
Eeg Recordings ◽  
Drug Resistant Epilepsy ◽  
Stable Improvement

Introduction: There are no reliable prospective studies on the effectiveness of topiramate in Bulgarian adult patients with drug-resistant epilepsy. Aim: The aim of the study was to conduct an open, prospective study on various aspects of topiramate (TPM) effectiveness in Bulgarian patients with drug-resistant epilepsy.  Patients and methods: The study included patients with epilepsy who attended the Clinic of Neurology at the University Hospital in Plovdiv, Bulgaria. Patients completed diaries for seizure frequency, seizure severity, and adverse events. There were regular documented visits at 3 or 6 months during the first year of TPM treatment and at 6 months afterwards, with a dynamic assessment of seizure fre-quency, severity, adverse events, and EEG recordings.  Results: TPM was used as an add-on treatment in 120 patients (69 males, mean age 37 years). There was a relatively mild and stable dynamic improvement of seizure severity, a satisfactory seizure frequency reduction in 37% of participants, a stable mean seizure fre-quency reduction (47%) from month 6 to month 24 of treatment and a stable responder rate (48-51%) during the same period. New seizure types (focal with impaired awareness with/without evolution to bilateral tonic-clonic seizures) occurred in 5 patients. There were adverse events (dizziness/vertigo, irritability, speech disturbances, memory impairment, concentration problems, tremor, loss of appe-tite and weight, weakness, numbness, bradypsychia, confusion, visual hallucinations, sleepiness, insomnia, headache, itching, unstable gait, nausea, and vomiting) in 20% of patients.  Conclusions: TPM treatment is associated with low and stable improvement of seizure severity, good and stable improvement of sei-zure frequency, possible worsening of seizure control and appearance of new seizure types, good safety and tolerability.

Efficacy and tolerability of clobazam in adults with drug-refractory epilepsy

2020 ◽  
pp. 10.1212/CPJ.0000000000000992
Author(s):  
Alisha Jamil ◽  
Noah Levinson ◽  
Michael Gelfand ◽  
Chloe E. Hill ◽  
Pouya Khankhanian ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Seizure Frequency ◽  
Retrospective Chart Review ◽  
Adjunctive Treatment ◽  
Drug Resistant ◽  
Before And After ◽  
Initial Cohort ◽  
Epilepsy Classification ◽  
Drug Resistant Epilepsy

ObjectivesTo evaluate the effectiveness and tolerability of clobazam as an adjunctive treatment for adults with drug-resistant epilepsy.MethodsWe performed a single-center, retrospective chart review of patients ≥18 years of age with drug-resistant epilepsy who started clobazam between 2010 and 2018. Included patients had outpatient visits both before and ≥1 month after clobazam initiation. Epilepsy classification, seizure frequency before and after clobazam, duration of clobazam treatment, and adverse effects were analyzed.ResultsA total of 417 patients met inclusion criteria. Mean age was 37.5 years, and 54% of patients were female. Patients were on a mean of 2.4 antiepileptic drugs at time of initiation of clobazam. Epilepsy types were focal (56.8%), Lennox-Gastaut syndrome (LGS) (21.1%), generalized (15.1%), and unclassified (7.0%). At the first follow-up visit ≥1 month after clobazam initiation, 50.3% of patients had >50% reduction in seizure frequency, and 20.5% were seizure-free. Of the initial cohort, 17.1% were followed >1 year and were seizure-free at last follow-up. Response rates did not differ between different epilepsy classifications. Fifty-one percent of patients experienced ≥1 side effect, most commonly lethargy/fatigue (30.7%) or mood changes (10.8%). A total of 178 (42.6%) patients discontinued clobazam, most commonly due to adverse effects (55%).ConclusionsClobazam is effective and safe as a long-term adjunctive therapy for adults with drug-resistant epilepsy; efficacy in off-label use is similar to that in LGS.Classification of evidenceThis study provides Class IV evidence that clobazam is an effective treatment for adults with drug-resistant epilepsy, independent of epilepsy classification.

scholarly journals Serum level of C-reactive protein and interleukin-6 in children with drug-resistant epilepsy

2018 ◽  
Vol 16 ◽  
pp. 205873921880816 ◽  
Author(s):  
Mohamed M Elwan ◽  
Nirmeen A Kishk ◽  
Rasha A El-Kapany ◽  
Ibrahim E Al-Ahmer ◽  
Ahmed Elkady
Keyword(s):  
Seizure Frequency ◽  
Interleukin 6 ◽  
Age Of Onset ◽  
Serum Levels ◽  
Control Group ◽  
Drug Resistant ◽  
C Reactive Protein ◽  
Mri Findings ◽  
Reactive Protein ◽  
Drug Resistant Epilepsy

There is increasing evidence that chronic inflammation affects the pathophysiology of epilepsy, especially the drug-resistant type. Drug-resistant epilepsy is a challenging condition, because of the difficulties in its management, and its unclear epileptogenesis. This study is looking at C-reactive protein (CRP) and interleukin-6 (IL-6) levels in those with drug-resistant epilepsy and the correlation of these levels with seizure frequency. Hence, 40 children with drug-resistant epilepsy were included in this study and compared with 20 healthy volunteers (as a control group). Participants were aged between 5 and 15 years. Patients were divided into two subgroups, those with daily seizures (Group A1) and those with monthly seizures (Group A2). Serum levels of CRP and IL-6 were measured in all participants. The clinical characteristics, electroencephalography, and magnetic resonance imaging (MRI) findings were then compared. CRP levels were significantly higher in Group A1, at 21.88–93.29 mg/L than both Group A2 and the control group, at 3.02–40.37 mg/L and 2.23–13.18 mg/L, P < 0.01 and P < 0.001, respectively. The IL-6 levels were also significantly higher in Group A1, at 153.60–597.80 ng/L than in both Group A2 and the control group, at 97.40–232.50 ng/L and 12.00–96.30 ng/L, P < 0.01 and P < 0.001, respectively. Significantly higher levels of CRP and IL-6 were associated with earlier age of onset ( P < 0.01), seizure frequency ( P < 0.05), and the frequency of status epilepticus ( P < 0.01). Moreover, frequent-generalized motor seizures are correlated with elevated CRP and IL-6 levels. As a result, this systemic inflammatory reaction in children may contribute to drug-resistant seizure and potentially could be used as biomarkers to be correlated with disease severity and prognosis.

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