Seizure : the journal of the British Epilepsy Association
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In people with suspected inflammatory CNS disease, cerebrospinal fluid (CSF) is commonly analyzed. Antibody-associated limbic encephalitis (ab-LE) and anti-NMDAR-encephalitis are recognized as two major syndromes of autoimmune epilepsies. Here, we investigated the diagnostic value of CSF findings in these two entities. ⋯ OCB, and to a lesser extent cell counts in CSF, appear to be helpful additional CSF markers in the diagnostic evaluation of people presenting with a constellation suggestive for GAD-LE, PLE and anti-NMDAR-encephalitis, prompting subsequent analysis of specific antibodies.
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Multicenter Study
Efficacy of intravenous lacosamide as an add-on treatment in refractory status epilepticus: a multicentric prospective study.
Treatment of status epilepticus (SE) has not changed in the last few decades, benzodiazepines plus phenytoin or valproate being the most common treatment. Once this first and second line treatment has failed SE is considered refractory (RSE). This study aimed to assess the efficacy and tolerability of intravenous (iv) lacosamide (LCM) in RSE. ⋯ LCM might be a fast, effective and safe add-on treatment in RSE.
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Some antiepileptic drugs (AEDs) have been reported to aggravate generalized seizures. We have seen three children whose myoclonic seizures increased on starting treatment with Levetiracetam. ⋯ All became seizure-free on withdrawal of levetiracetam with a switch to an alternative antiepileptic drug and this persisted for at least 6 months. This suggests that some children with myoclonic seizures may have an aggravation on starting treatment with levetiracetam but this requires further studies.
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To explore risk perception and medicines information needs in pregnant women with epilepsy (WWE). ⋯ Pregnant WWE were confident in using AEDs through communication with their neurologist, but dose adjustments caused concern. Medicines information to pregnant WWE should focus on empowering the women to control the disease, supporting realistic risk perceptions of AEDs and other necessary medicines. In this article, we outline some medicines information strategies to pregnant WWE.
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Cortico-amygdalohippocampectomy (CAH) has become an important treatment option for patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS); it has resulted in a 60-70% seizure remission rate and significant quality of life (QOL) improvements. Video-electroencephalography (VEEG) monitoring has been widely used in epilepsy centers for pre-surgical evaluation. A major concern in epilepsy surgery is whether to consider CAH treatment in patients with psychosis of epilepsy (POE). This study analyzed the safety and adverse events (AEs) of VEEG monitoring and the post-surgical outcomes of patients with refractory TLE-MTS and POE who underwent CAH. ⋯ These data reinforce that VEEG monitoring is a safe method to evaluate patients with refractory TLE-MTS and POE in epilepsy centers.