Objective: To determine the frequency of breakthrough seizures among paediatric patients suffering from epilepsy, and factors related to the precipitation of these seizures.
Methods: The cross-sectional study was conducted from July 1, 2018, to July 1, 2020, at the Combined Military Hospital Lahore and the Military Hospital, Rawalpindi, Pakistan, and comprised children of either gender aged 2-12 years diagnosed with any type of epilepsy presenting at the children outpatient department. Diagnosis of epilepsy was established by either a consultant adult neurophysician or a consultant paediatrician. The presence of breakthrough seizures was assessed by obtaining detailed history from the patient and the primary caregiver. Socio-demographic profile, duration of epilepsy and poly-pharmacy were noted. Data was analysed using SPSS 23.
Results: Of the 450 subjects, 259(57.6%) were boys and 191(42.4%) were girls. The overall mean age was 6.353±4.732 years. The presence of breakthrough seizures was noted in 227(50.4%) subjects. Children with young age, with low family income, and those in need of poly-pharmacy showed significantly higher odds for breakthrough seizures (p<0.05).
Conclusions: The incidence of breakthrough seizures in epileptic children was high despite the anticonvulsant agents that were previously effective in controlling seizures.
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http://dx.doi.org/10.47391/JPMA.2202 | DOI Listing |
Brain
January 2025
Department of Neurosurgery, University of Utah, Salt Lake City, UT 84132, USA.
Brain stimulation has, for many decades, been considered as a potential solution for the unmet needs of the many people living with drug-resistant epilepsy. Clinically, there are several different approaches in use, including vagus nerve stimulation (VNS), deep brain stimulation of the thalamus, and responsive neurostimulation (RNS). Across populations of patients, all deliver reductions in seizure load and SUDEP risk, yet do so variably, and the improvements seem incremental rather than transformative.
View Article and Find Full Text PDFExpert Rev Neurother
January 2025
Department of Paediatrics, Cambridge University Hospitals, Cambridge, UK.
Introduction: The seizures in Lennox-Gastaut syndrome are typically resistant to treatment. Seven antiseizure medications (ASMs) in the US (six in the UK/EU) are licensed for the treatment of seizures in LGS: lamotrigine, topiramate, rufinamide, clobazam, felbamate (not licensed in the UK/EU), cannabidiol and fenfluramine. Other options include neurostimulation, corpus callosotomy and dietary therapies, principally the ketogenic diet and its variants.
View Article and Find Full Text PDFClin Pract Cases Emerg Med
November 2024
Stony Brook Medicine, Department of Emergency Medicine, Stony Brook, New York.
Case Presentation: A 19-year-old male presented for evaluation of breakthrough seizures after inability to refill his medication following recent immigration from Haiti. Previously, the patient had never received neuroimaging due to financial constraints and resource scarcity. Computed tomography and magnetic resonance imaging obtained in the emergency department was significant for large right frontoparietal open-lip schizencephaly with mass effect, a rare congenital neurologic disorder previously undiagnosed in this patient with intractable epilepsy.
View Article and Find Full Text PDFCogn Neurodyn
October 2024
Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072 China.
At present, at least 30% of refractory epilepsy patients in the world cannot be effectively controlled and treated. The suddenness and unpredictability of seizures greatly affect the physical and mental health and even the life safety of patients, and the realization of early prediction of seizures and the adoption of interventions are of great significance to the improvement of patients' quality of life. In this paper, we firstly introduce the design process of EEG-based seizure prediction methods, introduce several databases commonly used in the research, and summarize the commonly used methods in pre-processing, feature extraction, classification and identification, and post-processing.
View Article and Find Full Text PDFSeizure
December 2024
East Carolina University Medical Center, 2100 Stantonsburg Road, Greenville, NC 27834, United States.
Background: To date, it has been assumed that acute seizures which arise in the context of sudden, spontaneous, atraumatic, acute, arterial dissections (SAAADs) are downstream consequences of the dissections driven by syncope or focal brain lesions (FBLs). As this subject has not been formally investigated, likely due to its rarity, we reviewed published case reports (CRs) to examine the veracity of this assumption.
Methods: We included CR describing patients diagnosed with both acute seizures and arterial dissections in order to ascertain the temporal sequence between acute seizures and typical SAAAD symptoms.
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