Objective: PRIS has been documented in epilepsy patients treated with propofol. But the clinical features associated with the occurrence of PRIS in patients with epilepsy remain incompletely elucidated. This study aimed to investigate the relationship between epilepsy, antiepileptic drugs, and PRIS and draw conclusions about its clinical features.
Methods: Extracted PRIS reports documented in the FAERS (January 2013 to December 2023). Epilepsy patients and non-epilepsy patients were distinguished based on the indication information. We performed multivariate analyses for demography, epilepsy status, and the use of antiepileptic drugs between these two populations. Additionally, we collected all published reports on propofol usage that resulted in PRIS. We focused on the differences in clinical manifestations of PRIS between epilepsy patients and non-epilepsy patients and analyzed them retrospectively.
Results: For 349 PRIS cases in the FAERS database, 94 cases involved epilepsy. Epilepsy was a significant risk factor for PRIS development (ROR = 3.89) and death outcomes (ROR = 1.997). Further analysis of antiepileptic drug regimens revealed that valproic acid was associated with an increased risk of PRIS (ROR = 3.264) and adverse outcomes (ROR = 2.518). For 185 PRIS cases in this review, 49 demonstrated a history of epilepsy. Patients with epilepsy displayed a lower median infusion rate of propofol than those without but a higher median cumulative dose.
Conclusion: When using propofol, epilepsy patients are at high risk of PRIS and are vulnerable to death. Therefore, patients with epilepsy must be closely monitored for safety during treatment, especially when they using valproic acid.
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Seizures, Driver Licensure, and Medical Reporting Update: An AAN Position Statement.
Neurology
April 2025
School of Law, University of Virginia, Charlottesville.
This consensus position statement of the American Academy of Neurology, American Epilepsy Society, and Epilepsy Foundation of America updates prior 1994 and 2007 position statements on seizures, driver licensure, and medical reporting. Key consensus positions include the following: (1) in the United States, national driving standards promulgated through a system such as the Uniform Law Commission would reduce confusion and improve adherence with state driving standards; (2) state licensing criteria for medical conditions should be promulgated by regulations and guidelines based on enabling legislation rather than in statutes themselves and should be developed by medical advisory boards working in collaboration with departments of motor vehicles; (3) licensing criteria should be equitable, nondiscriminatory, objective, and compatible with comparable risks in other populations; (4) a minimum seizure-free interval of 3 months should ordinarily be required before driving in all cases and should be extended in individual cases based on review of favorable and unfavorable features by medical advisory boards; (5) individuals with exclusively provoked seizures attributable to provoking factors that are unlikely to reoccur in the future may not require a seizure-free interval before resuming driving; (6) individuals with previously well-controlled epilepsy who experience seizures due to short-term interruptions of antiseizure medications in the setting of hospitalization or practitioner-directed medication-titration may not require a seizure-free interval before driving once previously effective levels of antiseizure medications have been resumed; (7) patients and practitioners should pause driving during tapering and following discontinuation of an antiseizure medication if another such medication is not introduced; (8) individuals whose cognition or coordination is impaired due to medications used to prevent seizures should refrain from driving; (9) health care practitioners should be allowed but not mandated to report drivers who pose an elevated risk; but (10) neither a decision to report a patient suspected of being at elevated risk nor a decision declining to report a patient suspected of being at elevated risk should be subject to legal liability; (11) nations, states, and municipalities should provide alternative methods of transportation and accommodations for individuals whose driving privileges are restricted due to medical conditions.
View Article and Find Full Text PDFLong-term safety and effectiveness of fenfluramine in children and adults with Dravet syndrome.
Epilepsia
March 2025
University of California San Francisco Weill Institute for Neurosciences, Benioff Children's Hospital, San Francisco, California, USA.
Objective: We analyzed the long-term safety and effectiveness of fenfluramine (FFA) in patients with Dravet syndrome (DS) in an open-label extension (OLE) study after participating in randomized controlled trials (RCTs) or commencing FFA de novo as adults.
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Prognostic value of interictal epileptiform discharges on routine EEG in adults with epilepsy.
Epilepsia
March 2025
Department of Neurosciences, University of Montreal, Montreal, Quebec, Canada.
Objective: To determine whether interictal epileptiform discharges (IEDs) on routine electroencephalography (EEG) predict seizure recurrence in adults with established epilepsy.
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Evaluation of antiseizure medication concentration ranges in blood samples using an automated big data approach.
Epilepsia
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Department of Clinical Biochemistry, Holbæk Hospital, Holbæk, Denmark.
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Neonatal/infantile-onset genetic epilepsies: The utility of genetic testing for molecular etiology-specific diagnosis concerning therapeutic implications.
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Division of Child Neurology, Department of Pediatrics, Ege University Medical Faculty, Izmir, Turkey.
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