Epilepsy

The staff neurologist at Cleveland Clinic’s Mellen Center for MS shared her insight into the use of telemedicine in an outpatient setting across a number of subspecialties in neurology and how it can supplement care going forward.

A new analysis of NASR data suggests that the risk for sudden unexpected death in epilepsy exists across a broad range of epilepsies, including those patients who are seizure-free, have never had tonic-clonic seizures, or those diagnosed with a benign epilepsy syndrome.

The neurology resident at the University of California San Francisco spoke about the role that seizure diaries can play in a patient’s peace of mind, as well as in the understanding of that patient’s response to a given treatment.

After receiving a refusal to file letter and undergoing a Type A meeting with the FDA, Zogenix has announced that it plans to resubmit an NDA for fenfluramine (Fintepla) for the treatment of seizures associated with Dravet syndrome in Q3 of 2019.

This patient had febrile seizures as a child but experienced no further events until the recent episode on an airplane. How would you proceed?

Neurology News Network for the week ending June 29, 2019.

A lot of hype and hope surround this treatment class, making reasonable expectations difficult to form for practitioners and patients alike.

Patients whose EEG changes were monitored prior to onset of clinical seizures and who were given preventive therapy demonstrated a lower risk of epilepsy overall, especially drug-refractory.

A trio of predictors may help inform which patients may be candidates for resective surgery, as well as improve the postsurgical consideration for re-operation on those who experience disabling seizure recurrence.

The professor of neurology at Cleveland Clinic’s epilepsy center discussed how algorithms can better influence the personalization of medicine, not just in the field of epilepsy, but in medicine as a whole.

Data suggest that rufinamide is capable of aiding in the control and reduction of seizures, as well as the possible achievement of seizure-freedom in pediatric patients with genetic/metabolic, hypoxic-ischemic, structural, and other intractable epilepsies.

The chief of neurology at Sree Chitra Tirunal Institute for Medical Sciences and Technology spoke about how to reassure patients with epilepsy who are planning for pregnancy and how to make treatment decisions with pregnant patients.

Investigators compared an intermittent low glycemic index therapy diet, a version of the ketogenic diet, to a daily version in pediatric patients with drug-refractory epilepsy.

Several poster presentations at IEC 2019 suggest that the incidence of comorbid sleep disorders in people with epilepsy is higher than estimated and have a detrimental impact on quality of life and social adjustment.

Patients with CLN2 disease have shown a maintained treatment benefit, high rate of response, and lowering rates of seizure occurrence over 3 years in an ongoing extension trial.

The professor of epilepsy and medical education at St. George’s University Hospital London spoke about the number of challenges plaguing epileptologists when treating patients who present with possible status epilepticus in the hospital.

The section chief of neurology at Nationwide Children's Hospital spoke about the role of wearable technology in pediatric epilepsy, an area that has the potential to make a major impact on treatment.

The GW Pharmaceuticals cannabidiol formulation, marketed as Epidiolex, did not show any evidence of clinically relevant drug-drug interactions when co-administered in patients with epilepsy.

While 65% of patients indicated that they no longer have epilepsy, only a quarter of the study population were actually completely free of seizures postoperatively.

The professor of neurology at Cleveland Clinic’s epilepsy center spoke about the limitations of individual physicians in making clinical decisions, and how utilizing algorithm data can help improve epilepsy interventions.

Overall, myoclonic and absence seizures worsened in 1.2% and 15.9% more patients in the placebo group, respectively, than those given perampanel. The reductions in seizure frequency and the increases in seizure-free days were also greater with the noncompetitive AMPA receptor antagonist.

An assessment of 230 poststroke patients determined that neurorehabilitation outcomes and length of stay did not differ between those with poststroke epileptic seizures and those without.

Over 57% of patients who received intranasal midazolam were responders, with status epilepticus ceasing within an average of 5:05 minutes.

Preliminary results from the 4 mg maintenance period of the FREEDOM study, the first in which perampanel has been examined as monotherapy, were presented at the 2019 International Epilepsy Congress in Bangkok.

In a retrospective study, 51.7% of patients achieved seizure freedom while receiving lacosamide, with seizure freedom rates going as high 88.9% for those who were administered the drug as monotherapy.

Findings from SANAD II have suggested that levetiracetam is inferior to valproate in time to 12-month and 24-month remission in patients with generalized or unclassified epilepsy.

Abeona Therapeutics is currently planning a phase 1/2 clinical trial to evaluate ABO-202 in Batten disease.

Neurology News Network for the week ending June 15, 2019.

Almost 25% more of the patients with focal drug-resistant epilepsy who successfully underwent cortical stimulation to induce electroclinical seizures experienced good outcomes versus poor, suggesting the method’s ability to identify the epileptic generator as reliably as spontaneous seizures.

The Task Force sought to improve the employment of MRI’s capabilities in the treatment of epilepsy, which the authors noted “are variable worldwide and may not harness the full potential of recent technological advances for the benefit of people with epilepsy.”