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.
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*.
Use of topiramate in the treatment of both refractory and super-refractory status epilepticus is safe and well tolerated and leads to SE resolution in a number of patients, according to a recent study.
Use of stiripentol as an adjunctive treatment in patients with different types of refractory epilepsies, including focal onset epilepsy without bilateral tonic‐clonic seizures, has demonstrated long-term efficacy in a prospective observational study.
Measuring heart rate variability (HRV) using a wearable echocardiography (ECG) device shows promise in detecting seizures, including the nonconvulsive episodes, proving to have high sensitivity and low false alarm rate during the night, according to data from a phase II validation study.
Between the two most common invasive monitoring approaches, stereoelectroencephalography (SEEG) leads to fewer surgical resections yet more favourable seizure freedom outcomes in epilepsy patients scheduled to undergo resections compared with subdural electrodes, as reported in a systematic review. Additionally, SEEG is associated with lower morbidity and mortality.
Raving at electronic dance music festivals that commonly use stroboscopic light effects may be risky for individuals who are susceptible to epileptic seizures, with a recent study suggesting that strobe lights carry a threefold increased seizure hazard.
Child-onset epilepsy may negatively affect social outcomes, and individuals who still experience seizure as adults are least likely to start a family and have trouble conceiving, a study from Finland has found.
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa,
08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.