Effect of lamotrigine on cognition in children with epilepsy.

Background: Lamotrigine does not affect cognition in healthy adult volunteers or adult patients with epilepsy, but its effect on cognition in children is uncertain.

Objective: To compare the effect of lamotrigine and placebo on cognition in children with well-controlled or mild epilepsy.

Method: In a double-blind, placebo-controlled, crossover study, 61 children with well-controlled or mild epilepsy were randomly assigned to add-on therapy with either lamotrigine followed by placebo or placebo followed by lamotrigine.

The relationship between the onset of electrographic seizure activity after birth and the time of cerebral injury in utero.

In the fetal lamb model of hypoxic-ischaemic injury, the insult is followed by EEG depression, after which seizures emerge at 7-13 hours. We explored the relationship between the emergence of electrographic seizures and our estimate of the time of the cerebral injury in nine babies who underwent continuous video-EEG monitoring from soon after birth. Babies with prelabour insults had their first seizures before 12 hours of age, whereas those whose insult was peripartum had seizure onset at 18-20 hours of age.

Second-line anticonvulsant treatment of neonatal seizures: a video-EEG monitoring study.

The authors conducted a randomized trial of second-line anticonvulsant treatments for neonates. The response to treatment was assessed using continuous video-EEG because the clinical diagnosis of seizure in neonates is known to be unreliable. Of 27 neonates with EEG-confirmed seizures, 5 were excluded because of protocol violations, and 11 responded to phenobarbitone in a dose of 40 mg/kg as first line.

Non-expert use of the cerebral function monitor for neonatal seizure detection.

Background: The cerebral function monitor (CFM) is widely used to detect neonatal seizures, but there are very few studies comparing it with simultaneous electroencephalography (EEG).

Objective: To determine the accuracy of non-expert use of the CFM and to assess interobserver agreement of CFM seizure detection.

Patients: Babies admitted to the neonatal intensive care unit at King's College Hospital who were at high risk of seizure and had video-EEG monitoring.