Epilepsy is a clinical multiaxial diagnosis.
Epileptic seizure is a transient occurrence of signs/symptoms brought about by abnormal excessive or synchronous neuronal activity in the brain.
It is recommended that all patients having a first seizure be referred as soon as possible to a specialist to ensure accurate and early diagnosis and initiation of treatment appropriate to the needs of the patients.
Stereotactic ablation using magnetic resonance imaging (MRI)–guided laser interstitial thermal therapy (MRg‐LITT) is well tolerated and improves outcomes for patients with extratemporal lobe epilepsy (ETLE), a study has shown. Treatment success is high among patients with lesional epilepsy and favourable seizure‐onset patterns.
For women with drug‐resistant focal epilepsy planning to conceive, undergoing surgery prior to pregnancy is the best option, with outcomes being more favourable than choosing to defer the procedure until after giving birth or opting for pharmacotherapeutic management, a study suggests.
Individuals with late-onset epilepsy appear to exhibit faster declines in global cognition, verbal memory, executive function, and word fluency over time compared with those who do not have the neurological disorder, and some of these declines occur prior to the index seizure, a study has found.
In the treatment of idiopathic generalized epilepsy, switching from valproate to other antiepileptic drugs due to potential childbearing issues may prove detrimental, heightening the risk of poor seizure control, as shown in a recent study.
The anticonvulsant drugs levetiracetam, fosphenytoin and valproate all demonstrate efficacy for benzodiazepine-refractory convulsive status epilepticus, with each drug inducing seizure cessation and improving alertness in most patients and yielding similar safety outcomes, according to data from the Established Status Epilepticus Treatment Trial (ESETT).
Use of lacosamide therapy in the long-term management of adult patients with epilepsy is effective and well tolerated, yielding seizure freedom rates comparable to that achieved with controlled‐release carbamazepine (carbamazepine‐CR), as reported in a recent study.
Three anticonvulsant drugs — levetiracetam, fosphenytoin, and valproate — are equally effective in stopping life-threatening epilepsy seizures in patients who are unresponsive to benzodiazepines, thus providing affirmation for physicians that any of the three drugs can be used for treating status epilepticus, according to results from ESETT*.
A 38-year-old right-handed man had had epilepsy since 2 months of age. There was no relevant family history. Perinatal history was unremarkable. No other risk factors such as central nervous system infection or cerebral trauma were identified. Developmental history did not show major delay. His epilepsy was uncontrolled despite trying valproate, carbamazepine, clobazam, levetiracetam, oxcarbamazepine and perampanel.