Innovations In Clinical Neuroscience

Current Trends in Epilepsy 2015

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

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Current Trends in Epilepsy Management [December 2015] 13 INTRACTABLE EPILEPSY A prospective long-term study of external trigeminal nerve stimulation for drug-resistant epilepsy Soss J, Heck C, Murray D, et al. Epilepsy Behav. 2015 Jan;42:44-7. Summary: In this study, investigators report the long-term safety and efficacy of external trigeminal nerve stimulation (eTNS), an emerging noninvasive therapy for drug-resistant epilepsy (DRE), after completion of a phase II, randomized, controlled, clinical trial for drug- resistant epilepsy (DRE). Subjects who completed the phase II randomized controlled trial of eTNS for DRE were offered long-term follow-up for 1 year. Thirty-five of 50 subjects continued in the long-term study. The authors found that eTNS stimulation was well tolerated, with no serious device- related adverse events occurring through 12 months of long-term treatment, and conclude that eTNS is a safe and promising long-term treatment for DRE. * PMID: 25499162 Mindfulness-based therapy for drug-resistant epilepsy: an assessor-blinded randomized trial Tang V, Poon WS, Kwan P. Neurology. 2015 Sep 29;85(13):1100–7. Summary: Here, the investigators examined the effectiveness of mindfulness-based therapy (MT) and social support (SS) in patients with drug- r esistant epilepsy. Sixty patients with drug-resistant epilepsy were randomly allocated to MT or SS (30 per group), with each group receiving 4 biweekly intervention sessions. The primary outcome was the change in the total score of the Patient- Weighted Quality of Life in Epilepsy Inventory (QOLIE-31-P). Investigators found that following intervention, mindfulness therapy was associated with greater benefits than SS alone in quality of life, mood, seizure frequency, and verbal memory. * PMID: 26333801 CURRENT STATE OF EPILEPSY The economic impact of epilepsy: a systematic review. Allers K, Essue BM, Hackett ML, et al. BMC Neurol. 2015 Nov 25;15(1):245. Summary: In this systematic review, the authors sought to determine the economic impact of epilepsy and the factors associated with costs to individuals and health systems. The authors found that total costs associated with epilepsy varied significantly in relation to the duration and severity of the condition, response to treatment, and healthcare setting. Future research is required to examine the role of different models of care and insurance programs in protecting against economic hardship for this condition, particularly in low and middle income settings. * PMCID: PMC4660784 The current state of epilepsy guidelines: a systematic review. Sauro KM, Wiebe S, Dunkley C, et al. Epilepsia. 2015 Dec 10. Epub ahead of print. Summary: The International League Against Epilepsy (ILAE) Epilepsy Guidelines Task Force, composed of 14 international members, conducted a systematic review of the literature (1985–2014) to examine e xisting guidelines on epilepsy management. The review was conducted using six electronic databases and a broad search strategy without initial limits to language or study design. Six gray literature databases (e.g., American Academy of Neurology [AAN], ILAE) were also searched to minimize publication bias. The Task Force found that 29% of the guidelines (that met the inclusion criteria) did not specify the target age groups, 27% were focused on adults, 22% included only children, and 6% specifically addressed issues related to women with epilepsy. Guidelines included in the review were most often aimed at guiding clinical practice for status epilepticus, first seizure, drug- resistant epilepsy, and febrile seizures Most of the guidelines were therapeutic or diagnostic in nature. The quality of the guidelines using a 1 to 7 point scale (7=highest) varied and was moderate overall (mean=4.99±1.05 [SD]). * PubMed PMID: 26659723 PERSONALIZED MEDICINE AND EPILEPSY Personalized medicine approaches in epilepsy. Walker LE, Mirza N, Yip VL, et al. J Intern Med. 2015 Feb;277(2):218-34. Review. Summary: In this review article, the authors review the role of neuroinflammation in the pathophysiology of resistant epilepsy. The authors also review their research on HLA-A*31:01 as a potential risk marker for all phenotypes of carbamazepine-induced hypersensitivity with applicability in European and other populations. The authors explore the currently available key stratification approaches to address the therapeutic challenges in epilepsy. * PMID: 25338670. Journal Watch Highlights of Noteworthy Published Studies, Reviews, and Case Reports Click * at the end of each synopsis to access the abstract on Pubmed.

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