Efficacy and tolerability of perampanel as a first add-on therapy with different anti-seizure drugs.

Purpose: To investigate the efficacy and tolerability of perampanel (PER) when administered as a first add-on therapy to patients with focal epilepsy or idiopathic generalized epilepsy (IGE) taking one other antiseizure drug (ASD).

Methods: This multicentre, retrospective, one-year observational study collected data from patients (≥12 years) who initiated treatment with PER as first add-on therapy. Patients had to be experiencing inadequate seizure control on ASD monotherapy and tried ≤3 ASD monotherapies before initiating PER.

MONOZEB: Long-term observational study of eslicarbazepine acetate monotherapy.

Aim: The aim of the study was to evaluate the effectiveness and tolerability of eslicarbazepine acetate (ESL) when used as monotherapy for 1 year or more in routine clinical use in patients with focal seizures in epilepsy clinics in Spain.

Methods: This is a retrospective, observational, noninterventional study. Eligible patients were aged ≥18 years, had focal seizures, and started on ESL ≥1 year before database closure.

Perampanel in routine clinical use in idiopathic generalized epilepsy: The 12-month GENERAL study.

Objective: To analyze the effectiveness and tolerability of perampanel across different seizure types in routine clinical care of patients with idiopathic generalized epilepsy (IGE).

Methods: This multicenter, retrospective, 1-year observational study collected data from patient records at 21 specialist epilepsy units in Spain. All patients who were aged ≥12 years, prescribed perampanel before December 2016, and had a confirmed diagnosis of IGE were included.

Effect of lacosamide on depression and anxiety symptoms in patients with focal refractory epilepsy: A prospective multicenter study.

Introduction: Depression is the main psychiatric comorbidity in epilepsy with an estimated prevalence between 20% and 55% and one of the main determinants of quality of life. The aim of this study was to investigate the effect of lacosamide (LCM) on mood and anxiety symptoms in patients with focal onset seizures (FOS). The secondary objective was to evaluate if the potential modifications in variables were related to seizure control or to the intrinsic effect of LCM.

[Quality as management tool. Actions to improve efficiency in neurological care].

Introduction: Quality of care involves meeting the needs and expectations of patients with the lowest consumption of resources and in accordance with scientific knowledge. In this context it is important to know if the changes in medical care procedures based on scientific and technical aspects of the quality positively impacts both efficiency measures and perceived quality.

Methods: Prospective study carried out during the 2000-2006 period at the neurology department of a public hospital with has 1303 beds.

[Importance and factors related to chronic fatigue in multiple sclerosis].

Introduction: The importance of fatigue in multiple sclerosis (MS) is determined by its high frequency and it is an important cause of disability.

Objective: To determine factors that are related to the presence of chronic fatigue in patients with MS.

Patients And Methods: The series comprises patients with MS, consecutively attended in the demyelinizating diseases unit, who met the following criteria: clinically definite MS (RR or SP), MS duration of more than two years, and no relapses during the previous month.

[Sleep disorders in multiple sclerosis].

Introduction: To determine the frequency of sleep disorders in multiple sclerosis (MS) patients and their relation with other manifestations of the disease.

Methods: Selected patients had clinically definite MS (relapsing-remitting and secondary progressive forms) and duration of the disease over two years. They were serially evaluated at the unit of demyelinating diseases of a third level hospital.

[Predicting factors for depression in multiple sclerosis].

Introduction: We assess frequency and intensity of depression in multiple sclerosis (MS) patients, the degree at which it is detected and its relationship to the treatment with beta interferon and other clinical and paraclinical factors.

Methods: The series comprises MS patients, seen in the Demyelinating Disease Unit of a tertiary hospital, who fulfilled the following criteria: clinically defined MS (relapsing-remitting or secondary progressive), disease duration greater than two years and absence of relapses during the month prior to the study. The variables analyzed were detection and assessment of depression with the Hamilton Depression Scale, general demographic data, functional systems, EDSS, ISS, ESS, Pittsburgh Sleep Quality Index, interferon treatment, chronic fatigue and a series of analytical variables.

[Preventive prophylactic treatment in posttraumatic epilepsy].

Posttraumatic epilepsy (PTE) represents about 2 3% of all the etiologies of epilepsy. The so called early seizures , which appear in the first week after the traumatic brain injury (TBI), are related to the severity of the injury; they do not have an strictly epileptic mechanism, but they become a risk factor to the development of PTE. PTE appears in 5% of all the patients suffering from all TBI, and in 15 20% of the patients suffering from a severe TBI.

[Cerebral ischemia and epilepsy].

Introduction: We review the characteristics and evolution of epileptic crises (EC) related to non-hemorrhagic ictus. Patients and methods. Since June 1994 we have studied patients with EC both at the time of the ictus (acute symptomatic crises, ASC) and later (remote symptomatic crises RSC).

[Therapeutic benefits of monotherapy with lamotrigine].

Objective: To analyze the overall therapeutic benefit (effect on seizures and quality of life) in 100 patients, aged 14-89 years, treated with lamotrigine (LTG) as primary (25) or secondary (75) monotherapy, followed up for between one and six years.

Patients And Methods: The patients were selected for treatment, under open observation, and not randomized at all. Thirty patients suffered from generalized seizures and 70 from partial crises, with progression to generalized tonic-clonic crises in 36 cases.

[Electro-clinical and neuroimaging studies in epilepsy in elderly patients].

Introduction: Due to the aging population in developed countries, epidemiological studies show an increasing tendency to the prevalence of epilepsy in the elderly.

Patients And Methods: During 54 months, we have studied the electroclinical and neuroimaging features in outpatients older than 60, with active epilepsy. Every patient was interviewed by one of the authors.

[Electroclinical and neuroimaging studies in epilepsy].

Introduction And Material: During 54 months, we have studied the electro-clinical and neuroimaging features in outpatients with active epilepsy. Each patient was interviewed for one of us. Then, we have reviewed the medical records about both the clinical featuring.

[Polyneuropathy caused by vitamin B12 deficiency secondary to chronic atrophic gastritis and giardiasis].

Introduction: In chronic atrophic gastritis atrophy of the stomach glands leads to intrinsic factor deficit, with consequent failure to absorb vitamin B12 and gastric achylia, which predisposes to Giardia infection which in itself leads to depletion of vitamin B12. We describe the case of a patient with peripheral and central nervous system pathology due to lack of vitamin B12 secondary to the combined effect of these two disorders.

Clinical Case: A 54 year old woman consulted us for paraesthesia and weakness of the legs which had been progressive for the previous two years.

[Grouped crises and status epilepticus in complex partial epilepsy].

Introduction: In complex partial crises (CPC) some characteristics of the way in which they occur may be helpful in localizing the focus of origin in the cerebral cortex. Thus, the appearance of any kind of status epilepticus will not predominate depending on the origin of the epileptic focus, but the complex partial state will be rare when the origin is temporal and more frequent when the origin is frontal. The appearance of CPC in a cluster form is, on the other hand, characteristic of crises originating in the frontal lobe.

[Complex partial seizures: the localization value of automatisms].

Introduction: The clinical findings in complex partial crises may help our understanding of the different foci and vias of epileptogenesis.

Material And Methods: We analyse automatisms and findings on EEG and neuroimaging in 151 patients with different types of partial epilepsy, seeking to establish a possible correlation between the type of automatism and cerebral localization.

Results And Conclusions: The relative frequency of automatisms was: oro-alimentary 30%, mimicking 11%, gestures 35%, ambulatory 19% and verbal 13%.

[Multiple sclerosis as a cause of partial complex epilepsy].

Introduction: Although the epileptic seizures (ES) have been described on patients with multiple sclerosis (MS), the causal relationship is not clear. Seizure's prevalence in this illness is low and their apparition concerning the MS course is variable, but more common after MS diagnosis. The predominant crises are generalized or partial with secondary generalization; the partial complex seizures have rarely referred.

[Prognostic value of data from clinical, EEG and neuroimaging assessment in epilepsy with complex partial seizures].

Introduction: The well-known etiology, length of active epilepsy, partial or mixed seizure types and high frequency of seizures before treatment relate with a worst prognosis for seizures control. We have attempted to prove these factors in our study.

Method: We analyzed the electro-clinical characteristics, evolution and etiology of seizures in 151 patient with several type of partial epilepsy.

[Etiology in complex partial epilepsy. II. Correlation between EEG topography and neuroimaging].

Neuro-imaging studies (NI) in patients with complex partial seizures (CPC) demonstrate the epileptogenicity of a more or less localized underlying lesion. Correlation with the topography of the EEG focus permits affirmation of the origin. We analyze anomalies on NI and on the EEG of 151 patients with CPC.

[Etiology in complex partial epilepsy. I. Neuroimaging studies].

With the appearance of MR, a great advance has been made in the study of the aetiology of epilepsy. This technique can show anomalies not detected in CT scans, obtain images of multiple planes, improve the differentiation of cerebral tissues and allow improved visualization of the temporal lobe, making it very useful in the study of patients with complex partial crises (CPC). We studied 151 epileptics with CPC by means of CT scan and MR in all cases; the anomolous topography was the same in all cases, but the diagnosis was not.