scholarly journals Vascular Epilepsy

2021 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Randomised Controlled Trials ◽  
Treatment Options ◽  
Late Complication ◽  
Management Strategies ◽  
Controlled Trials ◽  
Post Stroke ◽  
Sharp Waves ◽  
Randomised Controlled ◽  
Guidelines And Recommendations ◽  
Current Guidelines

Seizures can be a presenting feature of acute stroke. They may complicate its early clinical course or be a late complication or sequel. The incidence of combined “early” and “late” seizures after stroke has been reported to be approximately 10% and the prevalence is of 2-4%. Mechanisms leading to post stroke seizures and chronic epilepsy, in both ischemic and hemorrhagic strokes, are diverse. Focal slowing or diffuse slowing activities, rhythmic slow waves are associated with a low risk of early onset seizures whereas focal spikes, sharp waves, periodic lateralized, or periodic bilateral discharges are associated with a higher risk. There are no randomised controlled trials performed in stroke patients evaluating management strategies for poststroke seizures and epilepsy. Treatment options should be extrapolated from those of epilepsy in general, taking into consideration hepatic and renal function, tolerability, costs, interactions between antiepileptic drugs (AED), interactions with antithrombotic and other treatments. However, randomised controlled trials of AED prophylaxis for acute and remote seizures are essential to improve the evidence level of current guidelines and recommendations for the management of post-stroke seizures

Assessment of Reporting Quality in Randomised Controlled Trials of Acupuncture for Post-Stroke Rehabilitation Using the Consort Statement and Stricta Guidelines

2017 ◽  
Vol 35 (2) ◽  
pp. 100-106 ◽  
Author(s):  
Jingchun Zeng ◽  
Guohua Lin ◽  
Lixia Li ◽  
Liming Lu ◽  
Chuyun Chen ◽  
...  
Keyword(s):  
Stroke Rehabilitation ◽  
Randomised Controlled Trials ◽  
Reporting Quality ◽  
Consort Statement ◽  
Allocation Concealment ◽  
Controlled Trials ◽  
Quality Of Reporting ◽  
Post Stroke ◽  
Randomised Controlled

Objectives To evaluate the completeness of reporting of randomised controlled trials (RCTs) of acupuncture for post-stroke rehabilitation in order to provide information to facilitate transparent and more complete reporting of acupuncture RCTs in this field. Methods Multiple databases were searched from their inception through September 2015. Quality of reporting for included papers was assessed against a subset of criteria adapted from the Consolidated Standards for Reporting Trials (CONSORT) 2010 statement and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) guidelines. Each item was scored 1 if it was reported, or 0 if it was not clearly stated. Descriptive statistical analysis was performed. Cohen's κ-statistics were calculated to assess agreement between the two reviewers. Results A total of 87 RCTs were included in the full text. Based on CONSORT, good reporting was evident for items “Randomised’ in the title or abstract’, ‘Participants’, ‘Statistical methods’, ‘Recruitment’, ‘Baseline data’, and ‘Outcomes and estimation’, with positive rates >80%. However, the quality of reporting for the items ‘Trial design’, ‘Outcomes’, ‘Sample size’, ‘Allocation concealment’, ‘Implementation’, ‘Blinding’, ‘Flow chart’, ‘Intent-to-treat analysis’, and ‘Ancillary analyses’ was very poor with positive rates <10%. Based on STRICTA, the items ‘Number of needle insertions per subject per session’, ‘Responses sought’, and ‘Needle type’ had poor reporting with positive rates <50%. Substantial agreement was observed for most items and good agreement was observed for some items. Conclusions The reporting quality of RCTs in acupuncture for post-stroke rehabilitation is unsatisfactory and needs improvement.

scholarly journals Mindfulness-based interventions for mental well-being among people with multiple sclerosis: a systematic review and meta-analysis of randomised controlled trials

2019 ◽  
Vol 90 (9) ◽  
pp. 1051-1058 ◽  
Author(s):  
Robert Simpson ◽  
Sharon Simpson ◽  
Nitish Ramparsad ◽  
Margaret Lawrence ◽  
Jo Booth ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Treatment Options ◽  
Well Being ◽  
Controlled Trials ◽  
Medical Subject Headings ◽  
Randomised Controlled ◽  
Mental Well Being

ObjectiveImpairment of mental well-being (anxiety, depression, stress) is common among people with multiple sclerosis (PwMS). Treatment options are limited, particularly for anxiety. The aim of this study was to update our previous systematic review (2014) and evaluate via meta-analysis the efficacy of mindfulness-based interventions (MBIs) for improving mental well-being in PwMS.MethodsSystematic searches for eligible randomised controlled trials (RCTs) were carried out in seven major databases (November 2017, July 2018), using medical subject headings and key words. Studies were screened, data extracted, quality appraised and analysed by two independent reviewers, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Mental well-being was the primary outcome. Random effects model meta-analysis was performed, with effect size reported as standardised mean difference (SMD).ResultsTwelve RCTs including 744 PwMS were eligible for inclusion in the systematic review, eight had data extractable for meta-analysis; n=635. Ethnicity, socioeconomic status, comorbidity and disability were inconsistently reported. MBIs varied from manualised to tailored versions, lasting 6–9 weeks, delivered individually and via groups, both in person and online. Overall SMD for mental well-being (eight studies) was 0.40 (0.28–0.53), p<0.01, I2=28%; against active comparators only (three studies) SMD was 0.17 (0.01–0.32), p<0.05, I2 =0%. Only three adverse events were reported.ConclusionsMBIs are effective at improving mental well-being in PwMS. More research is needed regarding optimal delivery method, cost-effectiveness and comparative-effectiveness.PROSPERO registration numberCRD42018093171.

scholarly journals Dysphagia treatment post stroke: a systematic review of randomised controlled trials

2008 ◽  
Vol 37 (3) ◽  
pp. 258-264 ◽  
Author(s):  
Norine Foley ◽  
Robert Teasell ◽  
Katherine Salter ◽  
Elizabeth Kruger ◽  
Rosemary Martino
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Post Stroke ◽  
Dysphagia Treatment ◽  
Randomised Controlled

scholarly journals European Stroke Organisation guidelines for the management of post-stroke seizures and epilepsy

2017 ◽  
Vol 2 (2) ◽  
pp. 103-115 ◽  
Author(s):  
Martin Holtkamp ◽  
Ettore Beghi ◽  
Felix Benninger ◽  
Reetta Kälviäinen ◽  
Rodrigo Rocamora ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Antiepileptic Drugs ◽  
Observational Studies ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Unprovoked Seizure ◽  
Post Stroke ◽  
Symptomatic Seizures ◽  
Randomised Controlled ◽  
Acute Symptomatic Seizures

Background Following stroke, acute symptomatic seizures (manifestation within seven days) and epilepsy, i.e. occurrence of at least one unprovoked seizure (manifestation after more than seven days), are reported in 3–6% and up to 12% of patients, respectively. Incidence of acute symptomatic seizures is higher in intracranial haemorrhage (10–16%) than in ischaemic stroke (2–4%). Acute symptomatic seizures and unprovoked seizure may be associated with unfavourable functional outcome and increased mortality. In view of the clinical relevance, the European Stroke Organisation has issued evidence-based guidelines on the management of post-stroke seizures and epilepsy. Method A writing committee of six clinicians and researchers from five European countries and Israel identified seven questions relating to prevention of (further) post-stroke seizures and epilepsy and to amelioration of functional outcome and prevention of mortality. Recommendations are based on findings in randomised controlled trials and observational studies using the grading of recommendations assessment, development and evaluation approach. Results In the absence of adequately powered randomised controlled trials, evidence for all recommendations is very low. Based on findings in observational studies, some weak recommendations have been made. In most instances, we suggest not to administer antiepileptic drugs. Due to high incidence of seizure recurrence after one post-stroke unprovoked seizure, secondary antiepileptic drugs prophylaxis needs to be considered. Conclusion Due to very low evidence, these guidelines only give some weak recommendations on prevention of occurrence and recurrence of post-stroke acute symptomatic seizures and unprovoked seizure. Adequately powered randomised controlled trials are required to assess interventions for post-stroke seizure management.

scholarly journals Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials

2002 ◽  
Vol 249 (3) ◽  
pp. 272-280 ◽  
Author(s):  
Annette A. M. Gerritsen ◽  
Marc C. T. F. M. de Krom ◽  
Margaretha A. Struijs ◽  
Rob J. P. M. Scholten ◽  
Henrica C. W. de Vet ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Conservative Treatment ◽  
Carpal Tunnel ◽  
Randomised Controlled Trials ◽  
Treatment Options ◽  
Controlled Trials ◽  
Tunnel Syndrome ◽  
Randomised Controlled
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