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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
Cleveland Clinic Journal of Medicine (CCJM)
This 1-Minute Consult reviews the bedside workup of delirium and possible stroke and reviews the cases for – and against – imaging.
Geriatrics May 2nd 2023
MDLinx
An Idaho man received $13.5 million after a nearby hospital missed his stroke diagnosis by more than 12 hours. The jury’s finding that the emergency physician engaged in “reckless misconduct” allowed this case to exceed the usual Idaho cap on judgments for cases of this nature of $400,000.00.
All Specialties April 18th 2023
Practical Neurology
The transition from hospital to home post-stroke is fraught with challenges for ensuring the continuation of appropriate care and managing the risk of rehospitalization. This review and recommendation details the potential disruptions to care and provides practical advice for preventing and managing the same.
Hospital Medicine February 22nd 2023
Infectious Disease Special Edition (IDSE)
Reports on the Vaccine Safety Datalink flagged the need to investigate a potential increased risk those 65 years of age and older, for ischemic stroke in the first 21 days after receiving the bivalent Pfizer-BioNTech booster. FDA has parallel monitoring systems to confirm or fail to validate a safety signal. In this case, those other systems did not confirm the Vaccine Safety Datalink flag.
Allergy & Immunology January 24th 2023
JAMA Network
The risk of symptomatic intracranial hemorrhage was lower among the 832 patients receiving direct oral anticoagulant treatment in this cohort study involving 33,207 patients with ischemic stroke who received intravenous thrombolysis at 64 centers in Europe, Asia, Australia, and New Zealand when compared to controls who received no anticoagulation. This outcome held true across subgroups and various selection methodologies.
Cardiology January 18th 2023