Seizure : the journal of the British Epilepsy Association
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Multicenter Study
Validation of a phone app for epilepsy diagnosis in India and Nepal.
Untreated epilepsy is a major global public health problem with more than 20 million people not being treated for an easily treatable disease. In part this is due to a lack of trained doctors. There are many more non-medical health workers than doctors and they could have an important role in diagnosis and treatment of epilepsy if they had some tools. We have previously described such a tool to distinguish epileptic episodes from other causes of altered consciousness and here present its validation in three new populations. ⋯ A tool presented as a phone app can be used by non-medical health workers to identify episodes as epileptic or not with good accuracy. It needs to be evaluated more widely but has the potential to play a part in reducing the epilepsy treatment gap.
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Cardiac asystole is known to cause clinical manifestations mimicking seizures. The recognition of this uncommon phenomenon is important to expedite appropriate clinical intervention and avoid unnecessary morbidity as well as potential mortality. ⋯ Cardiac asystole can be associated with features closely mimicking seizures. Recurrent episodes of cardiac asystole can be stereotypical in a given patient. There are some diagnostic clues in semiology.
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Convulsive status epilepticus (CSE) is a common neurologic emergency in elderly people. The current study elaborates the clinical characteristics and outcome of CSE in elderly patients. ⋯ Less than one-third of elderly patients with CSE progressed to RSE. Vascular aetiology, the leading cause of generalized CSE in elderly, was not associated with progression to RSE and mortality. Acute symptomatic aetiology was associated with high mortality.
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Anti-NMDAR-encephalitis is a recently described form of autoimmune encephalitis. Here, we characterize CSF changes in Chinese patients with anti-NMDAR encephalitis, and explore the relationship between CSF findings and disease outcome. ⋯ The sensitivity of NMDA receptor antibody testing is higher in CSF compared to serum. Other CSF abnormalities are present in some patients with Anti-NMDAR-encephalitis, however these changes do not appear to affect prognosis.
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Multicenter Study
Long-term efficacy and safety of lacosamide monotherapy in the treatment of partial-onset seizures: A multicenter evaluation.
The goal of this study is to report the efficacy and tolerability of lacosamide (LCM) monotherapy, as first-line and conversion regimens, in the treatment of patients with partial-onset seizures. ⋯ In our series more than two-thirds of the patients remained seizure-free on LCM monotherapy. Side effects were generally mild and led to discontinuation in only 3/66 (4.5%) patients. Our experience suggests that LCM monotherapy, either as first-line or after conversion, may be a valuable option for patients with focal epilepsy.