Barriers to Medication Adherence in People Living With Epilepsy.

Background And Objectives: Epilepsy affects approximately 1.2% of the US population, resulting in 3.4 million Americans with active epilepsy.

Early Identification of Candidates for Epilepsy Surgery: A Multicenter, Machine Learning, Prospective Validation Study.

Background And Objectives: Epilepsy surgery is often delayed. We previously developed machine learning (ML) models to identify candidates for resective epilepsy surgery earlier in the disease course. In this study, we report the prospective validation.

Improving self-efficacy in seizure first aid: Developing a seizure first aid certification program in the United States.

Objectives: Seizures and epilepsy are very common neurologic disorders, yet knowledge of how to help a person having a seizure is sorely lacking, increasing the potential for injury and early death for people with seizures. We developed a standardized seizure first aid (SFA) training certification for the general public and evaluated its impact on knowledge and self-efficacy about SFA and program satisfaction.

Methods: The Epilepsy Foundation's SFA certification was developed by a multidisciplinary group of experts, with extensive review, feasibility testing, and analysis of pilot tests from 10 sessions with 177 participants.

Early identification of epilepsy surgery candidates: A multicenter, machine learning study.

Objectives: Epilepsy surgery is underutilized. Automating the identification of potential surgical candidates may facilitate earlier intervention. Our objective was to develop site-specific machine learning (ML) algorithms to identify candidates before they undergo surgery.

Neurology steering board effects change for a major electronic health record vendor.

Neurologists are among the least satisfied physicians with their current electronic health record (EHR), with many known pain points and great opportunities for improved tools and workflows. Improved EHR functionality can have major implications for patient care, physician efficiency, and prevention of burnout. We describe the advocacy of the American Academy of Neurology for improved EHR usability and the resultant formation and subsequent accomplishments of a Neurology Subspecialty Steering Board at 1 major EHR vendor (Epic).

Stimulus-Induced Rhythmic, Periodic, or Ictal Discharges in Coma-Incidence and Interrater Reliability of Continuous EEG After a Standard Stimulation Protocol: A Prospective Study.

Purpose: Stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs) are often seen during continuous electroencephalographic (cEEG) monitoring in coma. Given their uncertain clinical significance, our prospective study evaluated incidence of SIRPIDs in comatose patients in the neuroscience intensive care unit (NSICU) who underwent a standard stimulation protocol and defined interreader reliability for cEEG.

Methods: Of 146 patients prospectively screened who underwent cEEG during a 6-month period, 53 patients were included and 93 patients were excluded.

Spreading depression in continuous electroencephalography of brain trauma.

Objective: Cortical spreading depolarizations are a pathophysiological mechanism and candidate target for advanced monitoring in acute brain injury. Here we investigated manifestations of spreading depolarization in continuous electroencephalography (EEG) as a broadly applicable, noninvasive method for neuromonitoring.

Methods: Eighteen patients requiring surgical treatment of traumatic brain injury were monitored by invasive electrocorticography (ECoG; subdural electrodes) and noninvasive scalp EEG during intensive care.

The incidence of seizures in patients undergoing therapeutic hypothermia after resuscitation from cardiac arrest.

Study Objective: Non-convulsive seizures/status epilepticus occur in approximately 20% of comatose, non-cardiac arrest intensive care unit (ICU) patients, and are associated with increased mortality. The prevalence and clinical significance of seizures in comatose survivors of cardiac arrest undergoing therapeutic hypothermia is not well described.

Methods: At this urban level I trauma center, every patient undergoing therapeutic hypothermia is monitored with continuous video encephalography (cvEEG).

A consensus-based approach to patient safety in epilepsy monitoring units: recommendations for preferred practices.

Patients in an epilepsy monitoring unit (EMU) with video-EEG telemetry have a risk for seizure emergencies, injuries and adverse events, which emphasizes the need for strategies to prevent avoidable harm. An expert consensus process was used to establish recommendations for patient safety in EMUs. Workgroups analyzed literature and expert opinion regarding seizure observation, seizure provocation, acute seizures, and activity/environment.

The Tasmanian Epilepsy Register--a community-based cohort. Background and methodology for patient recruitment from the Australian national prescription database.

Background/aims: Centralized prescription databases may provide an efficient mechanism for recruitment of community-treated disease.

Methods: The Australian federal government agency, the Health Insurance Commission (HIC), invited patients to participate in the Tasmanian Epilepsy Register (TER). Eligible patients included those who received at least one anticonvulsant above a 'reportable' price threshold between July 1, 2001 and June 30, 2002.

Racial/ethnic disparities in the treatment of epilepsy: what do we know? What do we need to know?

We examine current understanding of the minority disadvantage in the clinical management of epilepsy. We performed an online literature search using several keywords (race, ethnicity, epilepsy, treatment, and quality of life) and identified additional literature through cross-referencing/manual search. The search produced 58 items published between 1977 and 2005.

The effect of age and structural lesions on postictal language impairment.

The duration of postictal language dysfunction following a temporal lobe complex partial seizure (TLCPS) is longer when the seizure originates in the dominant hemisphere. However, the effects of older age and the presence of a structural lesion ipsilateral to the area of origin of the seizure remain unknown. Postictal language delay (PILD) was analyzed in relation to age and presence of a structural lesion in 47 patients, 28 with dominant TLCPSs and 19 with nondominant TLCPSs (total 173 seizures).

Assessment of adverse events and quality of life in epilepsy: design of a new community-based trial.

Improving health-related quality of life (HRQOL) has become recognized as an essential component of treating patients with epilepsy. In recent years, several rating scales have been developed that focus on both common adverse effects and various aspects of HRQOL that are more relevant to this patient population. Increasingly, such assessments are being incorporated into clinical trials, as it becomes clear that improvements in overall quality of life are an important feature of drug therapy.

Human blood genomics: distinct profiles for gender, age and neurofibromatosis type 1.

Application of gene expression profiling to human diseases will be limited by availability of tissue samples. It was postulated that germline genetic defects affect blood cells to produce unique expression patterns. This hypothesis was addressed by using a test neurological disease-neurofibromatosis type 1 (NF1), an autosomal dominant genetic disease caused by mutations of the NF1 gene at chromosome 17q11.

Psychopathology and quality of life: psychogenic non-epileptic seizures versus epilepsy.

Background: HRQOL is lower in patients with psychogenic non-epileptic seizures (PNES) than in epilepsy patients. Although psychopathology may reduce HRQOL, it is not known whether patients with PNES and epilepsy are similarly affected. We aimed to compare the relationship between psychopathology and HRQOL in PNES and treatment resistant epilepsy.

Quality of life in psychogenic nonepileptic seizures.

Purpose: Psychogenic nonepileptic seizures (PNESs) are events that alter or seem to alter the neurologic function and, in their appearance, resemble epileptic seizures (ESs). In patients with ESs the psychological and medical aspects of epilepsy greatly influence the health-related quality of life (HRQOL). The relation between these factors and PNESs is not well established.

Levetiracetam: a different approach to the pharmacotherapy of epilepsy.

Objective: To review the pharmacology, pharmacokinetics, efficacy, and adverse effects of levetiracetam in the treatment of epilepsy.

Data Sources: A MEDLINE search restricted to English-language publications was conducted (January 1993-October 2000). Unpublished data provided by the manufacturer and information found in proceedings of professional meetings were also included.