Seizure : the journal of the British Epilepsy Association
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Comparative Study
A population audit of first clinic attendance with suspected epilepsy.
To assess the quality of clinical care at first clinic attendance in children with suspected epilepsy from a defined geographical population. ⋯ A managed clinical network for children with epilepsy in Nottingham and the surrounding Trent region is currently being discussed which will consider alternative models of care for children with epilepsy. A revision of the BPNA audit tool has been produced with the BPNA Audit group and is available for other centres via the BPNA website's 'clinical toolbox' (http://www.bpna.org.uk/audit).
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In Genetic Absence Epilepsy Rats from Strasbourg (GAERS), age-related absence seizures start to appear from postnatal day (PN) 30 concomitant with 'spike and wave discharges' (SWDs) appearing on cortical EEG recordings. The aim of this study was to investigate the effect of early chronic levetiracetam (LEV) treatment on the development of SWDs in young and adult GAERS. ⋯ In this study, chronic LEV administration induced a reduction in epileptiform events in young GAERS. This effect persisted to some extent after treatment cessation (PN 61-PN 64), which might indicate a slowing down of epileptogenic processes. However, at the age of 4 months all animals revealed a similar expression of epileptiform discharges.
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Febrile seizures are the commonest convulsive event in children younger than 5 years of age (incidence of 2-5%). Electroencephalography (EEG) is not indicated in the work up of simple febrile seizures. Information about its role in the assessment of complex febrile seizures (CFSs) is unclear and EEGs are frequently ordered. This study was designed to assess utility of clinical variables at presentation in predicting the likelihood of an abnormal EEG. ⋯ Clinical variables at presentation can be used to screen children with CFS for whom an EEG is considered. This may lead to better use of resources. Whether abnormal EEG translates to future recurrences or epilepsy needs a prospective study.
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We investigated the diagnostic performance of 18F-FDG PET and ictal (99m)Tc-HMPAO SPET in pediatric temporal lobe epilepsy (TLE). Twenty-one pediatric TLE patients were enrolled in this study. Their diagnoses were confirmed by histology and post-surgical outcome (Engel class I or II). ⋯ As is found in adult TLE, PET and ictal SPET efficiently localized epileptogenic zones in pediatric TLE. SPM analysis of PET or ictal SPET could be used as an aid to visual assessment. Moreover, SISCOM was equal visual assessment of ictal SPET images in terms of lesion localizations.
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To investigate whether patients presenting after a first seizure to an Accident and Emergency (A&E) department were being managed according to consensus recommendations. ⋯ All patients presenting after a first seizure should be directly referred to a neurology clinic from the A&E department. The currently proposed target time to specialist review is unrealistic without significant resource improvements. The provision of diagnostic guidelines and telephone advice by the neurology team prior to discharge from A&E may avoid unnecessary investigation.