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Epilepsy Currents
Dive into the intriguing findings from the PEACH trial on prophylactic levetiracetam for seizure prevention in intracerebral haemorrhage patients. The PEACH trial aimed to test prophylactic levetiracetam for seizure prevention in acute intracerebral haemorrhage (ICH) patients. Early seizures within seven days of stroke onset occur in almost 30% of patients. However, current guidelines lack strategies to manage this issue. Despite being prematurely stopped, the trial showed promise. In this double-blind, randomised, placebo-controlled trial, 50 patients received either levetiracetam or a placebo. Clinical or electrographic seizures were seen in 16% of levetiracetam patients and 43% of placebo patients within 72 hours. Interestingly, these seizures were only electrographic. Adverse events included headaches and pain, but no treatment-related deaths were reported. The findings suggest levetiracetam may prevent acute seizures in ICH patients, but larger studies are needed. Acute seizures can lead to increased morbidity and mortality. The trial found fewer seizures within 72 hours of study inclusion in the levetiracetam group. This is promising, but more research is required. This study opens avenues for further investigation. It raises questions about early detection of interictal epileptiform activity and the need for prophylactic levetiracetam. It also underscores the need to understand which factors influence seizure […]
Internal Medicine May 23rd 2023
Based on previously found and published population pharmacokinetic models, Monte Carlo simulation was used to investigate corrective dosing regimens. The delayed time, predetermined dose interval, and half-life of the antiseizure medicine were strongly linked with the suggested treatment regimens. Additionally, there were differences between the best treatment plans for adult and pediatric patients. The treatment plans may also be influenced by renal function and concurrent medications that affect the antiseizure drug’s clearance. A user-defined module with all parameters that could be configured flexibly by the user was also established in order to provide tailored remedial regimens for the delayed or missing dose. Both of these tools are web-based dashboards.
Neurology May 2nd 2023
It is generally agreed that sudden unexpected death in epilepsy could be averted if the patient could be rapidly ventilated following the seizure. Diaphragmatic pacing is a surgical intervention used in spinal cord injury, sleep apnea, and similar causes of ventilatory failure. In this mouse model, all of the animals receiving the intervention survived, compared with death in most of the animals in the control arm of the study.
Neurology April 3rd 2023
A chart review of 81 million individuals yielded two matched groups of more than 150,000 patients each: one with COVID and the other with influenza. In these populations, the risk of seizures and epilepsy was higher in the COVID group. The HR of epilepsy after COVID compared with influenza was highest in individuals who were not hospitalized and in those under the age of 16.
In this study of 243 adolescent and adult patients, addition of Modified Atkins Diet (MAD) to standard drug therapy netted seizure reduction of >50% in 26% of patients in the intervention arm versus 2.5% in the control group.
Family Medicine/General Practice March 14th 2023
Mayo Clinic Labs
It wasn’t carpal tunnel. It wasn’t just anxiety, and Ed wasn’t having a stroke. Even after a complete neurological assessment, it wasn’t “mild cognitive impairment.” For months, Ed’s life was plagued with psychiatric and movement disorders that puzzled his wife and his physicians. Read the narrative about how Ed was finally diagnosed, what happened next, and where he is now.
Neurology January 10th 2023