Epilepsy & behavior : E&B
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Epilepsy & behavior : E&B · Jan 2018
Randomized Controlled TrialHuman abuse potential of brivaracetam in healthy recreational central nervous system depressant users.
Brivaracetam is a new antiepileptic drug indicated for adjunctive treatment of focal seizures in adults at a dose of 50-200mg/day taken in two equal doses. The objective of this study was to evaluate the abuse potential of brivaracetam compared with alprazolam (positive control), placebo, and levetiracetam. ⋯ This study in healthy recreational CNS depressant users showed that single doses of brivaracetam 50mg (therapeutic single dose) had lower sedative, positive, and negative drug effects than alprazolam, while brivaracetam 200 and 1000mg (supratherapeutic single doses) were more similar to alprazolam. The subjective profile of brivaracetam appeared to be similar to that of levetiracetam, but further evaluation using a range of levetiracetam doses would be needed to confirm similar abuse potential.
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Epilepsy & behavior : E&B · Jan 2018
Randomized Controlled TrialMozart's music in children with drug-refractory epileptic encephalopathies: Comparison of two protocols.
In this prospective, randomized, open label study, we compared the effect on seizure recurrence and quality-of-life parameters, of two different protocols of music therapy in children and adolescents with refractory epileptic encephalopathies. Nine out of 19 patients (13 males and 6 females, aged between 1 and 24years) were randomized to listen to Mozart's sonata in D major for two pianos K448 for 2h/day for 2weeks; other 10 children were randomized on a set of Mozart's compositions. In group 1 (K448), 2/9 children (22.2%) had a ≥75% seizure decrease; two patients had less than 50% seizure reduction, and the other five were unchanged. ⋯ An overall more significant behavioral improvement including less irritability and tearfulness, reduced self-/heteroaggression, a better daytime vigilance, and nighttime sleep quality, was also reported in children from group 2. In conclusion, the present study seems to confirm that music therapy may be an additional, nonpharmacological, effective treatment for patients with refractory epileptic seizures in childhood. The Mozart's set of different compositions can be better accepted and effective than the K448.
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Epilepsy & behavior : E&B · Jan 2018
IDH1 and IDH2 mutations in postoperative diffuse glioma-associated epilepsy.
Isocitrate dehydrogenase 1 and 2 mutations (IDH1/2) have an established association with preoperative seizures in patients with grades II-IV diffuse gliomas. Here, we examined if IDH1/2 mutations are a biomarker of postoperative seizure frequency. ⋯ In patients with supratentorial diffuse gliomas, IDH1-R132H mutations are associated with a more severe phenotype of postoperative epilepsy. These findings support further research into IDH mutations, and the potential for an antiepileptic therapeutic effect of their inhibitors, in patients with glioma-associated epilepsy.
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Epilepsy & behavior : E&B · Dec 2017
Long-term forgetting in temporal lobe epilepsy: Is this phenomenon a norm?
This research investigated forgetting rates of patients with temporal lobe epilepsy (TLE) at brief and longer intervals. ⋯ These findings suggest that forgetting patterns in patients with TLE may be heterogeneous, and the presence of accelerated long-term forgetting is not universal.
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Epilepsy & behavior : E&B · Dec 2017
Understanding variability in driving recommendations for patients with seizures.
There is lack of consensus regarding driving restrictions for patients with epilepsy. Regulations vary by state. New York State (NYS) recommends driving restrictions for one year in a person with an episode of loss of consciousness (LOC), with physician discretion. Often, providers make recommendations to permit their patients to drive after a shorter seizure-free period than proposed guidelines. The prevalence and reasons behind more lenient recommendations have not been elucidated. ⋯ We found that many neurologists' recommendations for limiting driving for patients with seizure-related episodes are shorter than those recommended by NYS. Furthermore, as there are no specific guidelines for questionable epileptic scenarios and seizures occurring nocturnally or without LOC, this appears to contribute to substantial variability in the duration of recommended driving restrictions. This opens a broad discussion about approaches towards advising driving limitations in order to protect public and patient safety while maintaining patient autonomy.