Sudden unexpected death in epilepsy: a review of incidence and risk factors.

Sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. However, SUDEP is rare in patients with new onset epilepsy and in patients in remission. Incidence is about 0.

Cause-specific mortality in epilepsy.

Epilepsy is associated with a two- to three-fold increase in mortality. Studies of cause-specific mortality show that deaths may be classified into those that are directly or indirectly related to epilepsy, those that are related to the underlying pathology giving rise to epilepsy, and those that are unrelated to both epilepsy and its causes. Overall, direct epilepsy related deaths are infrequent.

Cerebral damage in epilepsy: a population-based longitudinal quantitative MRI study.

Purpose: Whether cerebral damage results from epileptic seizures remains a contentious issue. We report on the first longitudinal community-based quantitative magnetic resonance imaging (MRI) study to investigate the effect of seizures on the hippocampus, cerebellum, and neocortex.

Methods: One hundred seventy-nine patients with epilepsy (66 temporal lobe epilepsy, 51 extratemporal partial epilepsy, and 62 generalized epilepsy) and 90 control subjects underwent two MRI brain scans 3.

Psychiatric adverse events in patients with epilepsy and learning disabilities taking levetiracetam.

Purpose: To investigate the prevalence and psychopathological features of psychiatric adverse events (PAEs) in patients with learning disabilities (LD) in therapy with levetiracetam (LEV).

Method: From a population of 517 consecutively patients with epilepsy started on LEV, we identified 118 patients with epilepsy and LD.

Results: Fifteen patients (12.

The role of hippocampal sclerosis in topiramate-related depression and cognitive deficits in people with epilepsy.

Purpose: To clarify the role of hippocampal sclerosis (HS) in developing psychiatric and cognitive adverse events during therapy with topiramate (TPM) in patients with temporal lobe epilepsy (TLE).

Methods: We analyzed the data of 70 patients with TLE and HS and 128 patients with cryptogenic TLE matched for age, sex, starting dose, and titration schedule of TPM. They were selected from the first consecutive 431 patients started on TPM between 1995 and 1999.

Topiramate and psychiatric adverse events in patients with epilepsy.

Purpose: The aim of this study was to determine the prevalence of psychiatric adverse events (PAEs) in patients with epilepsy treated with topiramate (TPM). Classification, relation to TPM dosing, and outcome were evaluated to identify a patient profile at risk of developing PAEs.

Methods: We evaluated the data of the first consecutive and prospectively collected patients in therapy with TPM.

Topiramate and word-finding difficulties in patients with epilepsy.

Objective: To evaluate the prevalence of word-finding difficulties as a treatment-emergent adverse event in patients with epilepsy taking topiramate and to identify a clinical phenotype at risk.

Methods: The authors investigated the relationship of word-finding difficulties to topiramate titration schedule, seizure frequency and pattern, and EEG and neuroradiologic findings in 431 consecutively and prospectively collected patients taking topiramate.

Results: Thirty-one patients (7.

Progressive neocortical damage in epilepsy.

Our objective was to determine the pattern and extent of generalized and focal neocortical atrophy that develops in patients with epilepsy and the factors associated with such changes. As part of a prospective, longitudinal follow-up study of 122 patients with chronic epilepsy, 68 newly diagnosed patients, and 90 controls, serial magnetic resonance imaging scans were obtained 3.5 years apart.

Talampanel, a new antiepileptic drug: single- and multiple-dose pharmacokinetics and initial 1-week experience in patients with chronic intractable epilepsy.

Purpose: Talampanel (LY300164), a potent and selective alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA)-receptor antagonist, is a potential new antiepileptic drug (AED). This study examines the single- and multiple-dose pharmacokinetics, safety, and tolerability of talampanel in patients with intractable epilepsy and assesses the potential for pharmacokinetic interaction.

Methods: Eleven of 14 patients entered into the study completed.

Evidence for sustained efficacy of levetiracetam as add-on epilepsy therapy.

Purpose: To evaluate the long-term clinical usefulness of levetiracetam (LEV, Keppra((R))(1)) as add-on therapy in patients with refractory epilepsy.

Methods: Data for all 1422 patients with refractory epilepsy treated with LEV during the development program were analyzed for changes in seizure frequency per week, seizure freedom, and adverse events.

Results: Median percent reduction from baseline in seizure frequency per week over the whole treatment period was 39.

The structural consequences of newly diagnosed seizures.

Intractable epilepsy may be associated with widespread structural cerebral damage. We determined whether structural damage occurs to the hippocampus, cerebellum and neocortex in the first few years following a diagnosis of seizures. Sixty-eight patients over the age of 14 years with newly diagnosed seizures and 90 matched controls underwent serial magnetic resonance imaging (MRI) brain scans 3.

Sulthiame in adults with refractory epilepsy and learning disability: an open trial.

This prospective uncontrolled open study explored the efficacy and long-term tolerability of sulthiame (STM) in 52 patients with refractory epilepsy and learning disability. Thirty-six patients completed a 14-weeks trial period with STM and 22 patients achieved a seizure reduction>50% of which three became seizure-free. Twenty-six patients continued taking STM for now up to 120 weeks, one continued to be seizure-free, whilst five patients stopped STM during this period.

Carbamazepine toxicity during combination therapy with levetiracetam: a pharmacodynamic interaction.

Levetiracetam is a novel antiepileptic drug with an unknown mechanism of action. To-date levetiracetam is not known to be associated with any clinically significant pharmacokinetic interaction. Similarly, levetiracetam has not been associated with any pharmacodynamic interactions.