Epilepsy & behavior : E&B
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Epilepsy & behavior : E&B · Apr 2012
Randomized Controlled TrialPregabalin increases slow-wave sleep and may improve attention in patients with partial epilepsy and insomnia.
Insomnia is a common phenomenon particularly in patients with epilepsy. This study was performed to look at the effects of pregabalin, an anticonvulsant known to increase sleep depth and decrease arousals, in patients with insomnia and well-controlled epilepsy. ⋯ Concurrent treatment with pregabalin improves sleep depth in patients with insomnia and epilepsy and improves daytime attention.
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Epilepsy & behavior : E&B · Apr 2012
Low serum leptin level is associated with zonisamide-induced weight loss in overweight female epilepsy patients.
Because iatrogenic obesity may hinder medication compliance, it would be a reasonable approach to consider antiepileptic drugs (AEDs) that promote weight loss in overweight patients. We performed an open-label, observational study to assess the effects of zonisamide on weight in overweight female epilepsy patients. In particular, we studied how the basal serum leptin level is related to changes in the weight of these patients. ⋯ The correlation of the serum leptin level with weight loss was still significant after the effect of the initial weight was adjusted (p=0.042). Our study shows that low serum leptin level is associated with weight loss in overweight female epilepsy patients. This result may be beneficial for selecting AEDs and provide clues for the pathophysiology of zonisamide-induced weight loss.
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Epilepsy & behavior : E&B · Mar 2012
ReviewSCN1A mutations in Dravet syndrome: impact of interneuron dysfunction on neural networks and cognitive outcome.
Dravet syndrome (DS) is a childhood disorder associated with loss-of-function mutations in SCN1A and is characterized by frequent seizures and severe cognitive impairment. Animal studies have revealed new insights into the mechanisms by which mutations in this gene, encoding the type I voltage-gated sodium channel (Na(v)1.1), may lead to seizure activity and cognitive dysfunction. In this review, we further consider the function of fast-spiking GABAergic neurons, one cell type particularly affected by these mutations, in the context of the temporal coordination of neural activity subserving cognitive functions. We hypothesize that disruptions in GABAergic firing may directly contribute to the poor cognitive outcomes in children with DS, and discuss the therapeutic implications of this possibility.
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Epilepsy & behavior : E&B · Mar 2012
Initial EEG predicts outcomes in a trial of levetiracetam vs. fosphenytoin for seizure prevention.
Continuous electroencephalography (cEEG) is increasingly used to detect both clinical and subclinical seizures in patients with traumatic brain injury (TBI) or subarachnoid hemorrhage (SAH). We assess whether EEG findings predict outcomes in TBI/SAH patients enrolled in a levetiracetam (LEV) vs. fosphenytoin (fos-PHT) seizure prevention trial (NCT00618436). This prospective, single-blinded, comparative trial randomized 52 patients with TBI or SAH to receive prophylactic LEV or fos-PHT. ⋯ Severity of generalized slowing tended to be associated with outcomes in both treatment groups (discharge DRS, p=0.042; discharge GOS-E, p=0.026; 3 month DRS, p=0.051). The presence of focal slowing, the presence and frequency of epileptiform discharges and the presence of seizures were not predictive of outcome in either treatment group (all p>0.15). While it has been shown that LEV is associated with better outcome than fos-PHT when used as seizure prophylaxis in brain injury, aside from severity of generalized slowing, electrographic findings of focal slowing, epileptiform discharges, and seizures were not themselves associated with outcomes in patients with TBI or SAH enrolled in a randomized clinical trial.