Brivaracetam for the treatment of refractory epilepsy in patients with prior exposure to levetiracetam: A retrospective outcome analysis.

Purpose: To determine whether brivaracetam (BRV) provides an evident improvement in treatment efficacy and a reduction in treatment-emergent adverse events (TEAEs) in patients with refractory epilepsy, who previously failed treatment with levetiracetam (LEV).

Design: Retrospective analysis of data extracted from electronic patient files at Epilepsy Centre Kempenhaeghe (Heeze, the Netherlands) from the year 2000 until October 2020.

Methods: The inclusion criteria were met by 407 patients >18 years of age.

Cognitive benefits of the ketogenic diet in patients with epilepsy: A systematic overview.

The ketogenic diet (KD) has been found to be effective in reducing seizures in patients with treatment-refractory epilepsy. Less attention has been paid to additional cognitive benefits of KD. The aim of the present paper was to provide a comprehensive overview of the studies reporting effects on cognition after KD treatment in adults and children with epilepsy.

Chronic antiepileptic drug use and functional network efficiency: A functional magnetic resonance imaging study.

Aim: To increase our insight in the neuronal mechanisms underlying cognitive side-effects of antiepileptic drug (AED) treatment.

Methods: The relation between functional magnetic resonance-acquired brain network measures, AED use, and cognitive function was investigated. Three groups of patients with epilepsy with a different risk profile for developing cognitive side effects were included: A "low risk" category (lamotrigine or levetiracetam, = 16), an "intermediate risk" category (carbamazepine, oxcarbazepine, phenytoin, or valproate, = 34) and a "high risk" category (topiramate, = 5).

Glutamate concentrations vary with antiepileptic drug use and mental slowing.

Objective: Although antiepileptic drugs (AEDs) are effective in suppressing epileptic seizures, they also induce (cognitive) side effects, with mental slowing as a general effect. This study aimed to assess whether concentrations of MR detectable neurotransmitters, glutamate and GABA, are associated with mental slowing in patients with epilepsy taking AEDs.

Methods: Cross-sectional data were collected from patients with localization-related epilepsy using a variety of AEDs from three risk categories, i.

The Cognitive Profile of Ethosuximide in Children.

Introduction: Although ethosuximide is one of the oldest antiepileptic drugs (AEDs), little information is available about the cognitive side effects of ethosuximide.

Objective: The aim of this study was to investigate the cognitive profile of ethosuximide.

Methods: In this cross-sectional study, we used an extensive neuropsychological test battery in patients with epilepsy aged 6-16 years who were treated with monotherapy ethosuximide.

Cognitive and behavioral impact of the ketogenic diet in children and adolescents with refractory epilepsy: A randomized controlled trial.

Purpose: The ketogenic diet (KD) is increasingly used for the treatment of refractory epilepsy in childhood because of the beneficial effect on seizure reduction. The aim of the current study was to objectively assess cognition and aspects of behavior during the first 4months of a randomized controlled study in children and adolescents.

Methods: Participants from a tertiary epilepsy center were randomized to a KD group (intervention) or a care-as-usual (CAU) group (control).

Mental slowing in relation to epilepsy and antiepileptic medication.

Objectives: Slowing of the central information-processing speed (CIPS) is frequently observed in epilepsy as a consequence of epileptic seizures and/or antiepileptic drugs (AEDs). A variety of neuropsychological tests are used to asses this 'mental slowing,' but it is highly questionable whether the different tasks measure the same cognitive process. Also, it remains unspecified to which degree the various tasks are sensitive to seizure- or treatment-related factors, or both.

Metabolic and functional MR biomarkers of antiepileptic drug effectiveness: A review.

As a large number of patients with epilepsy do not respond favorably to antiepileptic drugs (AEDs), a better understanding of treatment failure and the cause of adverse side effects is required. The working mechanisms of AEDs also alter neurotransmitter concentrations and brain activity, which can be measured using MR spectroscopy and functional MR imaging, respectively. This review presents an overview of clinical research of MR spectroscopy and functional MR imaging studies to the effects of AEDs on the brain.

Cognitive effects of lacosamide as adjunctive therapy in refractory epilepsy.

Background: Lacosamide (LCM) is a novel antiepileptic drug (AED) with potential benefit as adjunctive treatment in patients with partial-onset seizures. As yet, limited information on cognitive effects of LCM is available, especially in real-life settings.

Aims: In this open clinical prospective study, the cognitive effects of LCM were evaluated when used as adjunctive antiepileptic therapy in patients with refractory epilepsy.

Changes in the frequency of benign focal spikes accompany changes in central information processing speed: a prospective 2-year follow-up study.

We prospectively examined whether changes in the frequency of benign focal spikes accompany changes in cognition. Twenty-six children with benign focal spikes (19 with Rolandic epilepsy) and learning difficulties were examined with repeated 24-hour EEG recordings, three cognitive tests on central information processing speed (CIPS), and questionnaires on cognition and behavior at baseline, 6months, and 2years. Antiepileptic drug changes were allowed when estimated necessary by the treating physician.

Behavioral side-effects of levetiracetam in children with epilepsy: a systematic review.

Purpose: Children with epilepsy are more likely to have behavioral problems compared to children without epilepsy. Literature suggests that levetiracetam leads to behavioral side-effects in children with epilepsy. The objective of this study is to provide a better overview of the frequency and variety of behavioral side-effects, which can be initiated by levetiracetam therapy in children with epilepsy.

Cognitive side-effects of antiepileptic drugs in children.

Although the causes of cognitive impairment in patients with epilepsy have not been completely elucidated, three factors are clearly involved: the underlying etiology of epilepsy, the effects of seizures or the epileptiform EEG discharges themselves, and the central nervous system effects of antiepileptic drugs (AEDs). All commonly used AEDs have some effect on cognitive function, and the effect may be substantial when crucial functions are involved, such as learning in children. With phenobarbital, there is a high risk for serious cognitive effects impacting attention and memory.

Subgroup classification in patients with psychogenic non-epileptic seizures.

Introduction: In this open non-controlled clinical cohort study, the applicability of a theoretical model for the diagnosis of psychogenic non-epileptic seizures (PNES) was studied in order to define a general psychological profile and to specify possible subgroups.

Methods: Forty PNES patients were assessed with a PNES "test battery" consisting of eleven psychological instruments, e.g.

Cognitive and behavioural findings in children with frontal lobe epilepsy.

Background: Frontal Lobe Epilepsy (FLE) is the second most frequent type of partial epilepsy and its onset is generally in childhood. Though cognitive and behavioural impairments have been described as co-morbid disorders in epilepsy, their extent in FLE, particularly in children, remains unknown.

Aims: In this study, we assess cognitive skills and behaviour in a cohort of paediatric FLE patients.