Seizure : the journal of the British Epilepsy Association
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Since 1990, sixteen new antiepileptic drugs (AEDs) have been introduced. Most of these new AEDs have only been insufficiently studied with respect to women-specific aspects such as endogenous sex hormones, hormonal contraception, pregnancy, breastfeeding, or menopause. This is of concern because it has been shown for some of the new AEDs that these factors may have a clinically significant impact on their pharmacokinetics and seizure control. ⋯ Little to nothing is known about zonisamide, retigabine/ezogabine, lacosamide, perampanel and the other new AEDs. Nevertheless, many small studies and case series have been published on new AEDs and women-specific aspects. This review gives an overview on what is known today.
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Most epilepsy surgery candidates are young adults. Outcome reports after epilepsy surgery in patients ≥50 years are few and varying. The aim of this study was to describe patient characteristics of older compared to younger adults and analyse seizure, complication and vocational outcomes in a large population-based series. ⋯ 12% of adults in the Swedish series were ≥50 years at epilepsy surgery. Seizure outcome was as good for older as for younger adults, and there was no difference in the occurrence of major complications. This constitutes important information in the presurgical counselling process.
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There has been little research on the accessibility and quality of primary care services for epilepsy and emergency hospital admissions for epilepsy. ⋯ Patient access to primary care appointments and percentage of patients who have been recorded as seizure free for 12 months were associated with lower admission rates. However the effect sizes are small relative to that of population deprivation.
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Febrile convulsion (FC) and Tourette syndrome (TS) are both common neurological disorders in infants and children. Both disorders share clinical similarities, such as paroxysmal symptoms with normal neurodevelopment and expected remission over time. This population-based study investigated the association between FC with TS during childhood neurodevelopment. ⋯ FC may increase the risk of subsequent TS occurrence in children. Children who had frequent medical visits for FC were particularly vulnerable.
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To determine the rate of cerebrospinal fluid (CSF) pleocytosis among children presenting with status epilepticus (SE) without proven central nervous system infection. ⋯ CSF pleocytosis is relatively uncommon among children with prolonged seizures, even in the presence of peripheral leukocytosis. Therefore, all children with CSF pleocytosis after status epilepticus need comprehensive evaluation for central nervous system infection.