Wednesday 2 April 2014

Epilepsy

Evidence Based Reports

Phenytoin versus valproate monotherapy for partial onset seizures and generalised onset tonic-clonic seizures. (2013) [Cochrane Library] NEW

Gabapentin add-on for drug-resistant partial epilepsy. (2013) [Cochrane Library] NEW

Melatonin as add-on treatment for epilepsy. (2012) [Cochrane Library] NEW

Vigabatrin versus carbamazepine monotherapy for epilepsy. (2012) [Cochrane Library] NEW

Subpial transection surgery for epilepsy. (2013) [Cochrane Library] NEW

Absence seizures in children. (2013) [Clinical Evidence] NEW Log-in required

Epilepsy (generalised)(2012) [Clinical evidence] NEW Log-in required

Partial-onset seizures in epilepsy: perampanel as adjunctive treatment (2012) [NICE] NEW

Acupuncture for epilepsy (2011)[Cochrane]

Intravenous immunoglobulins for epilepsy (2011)[Cochrane]

Felbamate as an add-on therapy for refractory epilepsy (2011)[Cochrane]

Immediate-release versus controlled-release carbamazepine in the treatment of epilepsy (2011)[Cochrane]

Interventions for psychotic symptoms concomitant with epilepsy (2011)[Cochrane]

Non-pharmacological interventions for epilepsy in people with intellectual disabilities (2011)[Cochrane]

Pharmacological interventions for epilepsy in people with intellectual disabilities (2011)[Cochrane]

Psychological treatments for epilepsy (2011)[Cochrane]

Strategies for improving adherence to antiepileptic drug treatment in patients with epilepsy (2011)[Cochrane]

Cost-effectiveness of pediatric epilepsy surgery compared to medical treatment in children with intractable epilepsy (2011) (NHS EED)

Lamotrigine adjunctive therapy for refractory generalized tonic-clonic seizures (2010)[Cochrane]

Care delivery and self-management strategies for children with epilepsy (2010)[Cochrane

Tiagabine add-on for drug-resistant partial epilepsy (2010)[Cochrane]

Vagus nerve stimulation for partial seizures (2010)[Cochrane]

Early versus late antiepileptic drug withdrawal for people with epilepsy in remission (2010)[Cochrane]

Therapeutic monitoring of antiepileptic drugs for epilepsy (2010)[Cochrane]

Lamotrigine add-on for drug-resistant partial epilepsy (2010)[Cochrane]

Ethosuximide, sodium valproate or lamotrigine for absence seizures in children and adolescents (2010)[Cochrane]

Carbamazepine versus phenytoin monotherapy for epilepsy (2010)[Cochrane]

Antiepileptic drugs for the primary and secondary prevention of seizures after intracranial venous thrombosis (2010)[Cochrane]

Immediate-release versus controlled-release carbamazepine in the treatment of epilepsy (2010)[Cochrane]

Antiepileptic drugs for the primary and secondary prevention of seizures after stroke (2010)[Cochrane]

Should a child with ADHD and epilepsy be given Ritalin? (2010)[BestBETS]

Oxcarbazepine versus carbamazepine monotherapy for partial onset seizures (2009) [Cochrane]

treatment of seizures in multiple sclerosis (2009) [Cochrane]

Epilepsy (partial)(2009)[Clinical Evidence]

Clinical Guidelines

The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care (2012) [NICE]

Epilepsy (2009)[CKS]

Recent articles in core journals

The LaLiMo Trial: lamotrigine compared with levetiracetam in the initial 26 weeks of monotherapy for focal and generalised epilepsy--an open-label, prospective, randomised controlled multicenter study. (2013) [EvidenceUpdates] NEW

Mortality risks in new-onset childhood epilepsy. (2013) [EvidenceUpdates] NEW

Randomized controlled trial of trigeminal nerve stimulation for drug-resistant epilepsy. (2013) [EvidenceUpdates] NEW

Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. (2012) [JAMA] NEW

Epilepsy in poor regions of the world. (2012) [JAMA] NEW

Risk of sudden unexpected death in epilepsy in patients given adjunctive antiepileptic treatment for refractory seizures: a meta-analysis of placebo-controlled randomised trials. (2011)[Evidence Updates]

The long-term outcome of adult epilepsy surgery, patterns of seizure remission, and relapse: a cohort study. (2011) [Lancet]

Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry. (2011)[EvidenceUpdates]

Randomized, double-blind, placebo-controlled trial of ezogabine (retigabine) in partial epilepsy. (2011)[EvidenceUpdates]

Patterns of nonadherence to antiepileptic drug therapy in children with newly diagnosed epilepsy. (2011)[JAMA]

Risk of recurrence after a first seizure and implications for driving: further analysis of the Multicentre study of early Epilepsy and Single Seizures (2010)[EvidenceUpdates]

Intranasal midazolam vs rectal diazepam for the home treatment of acute seizures in pediatric patients with epilepsy (2010)[EvidenceUpdates]

Polytherapy increases the risk of infertility in women with epilepsy (2010)[EvidenceUpdates]

Adjunctive brivaracetam for refractory partial-onset seizures: a randomized, controlled trial (2010)[EvidenceUpdates]

Cognitive-behavioral therapy for psychogenic nonepileptic seizures: a pilot RCT(2010)[EvidenceUpdates]

Randomized trial of adjunctive topiramate therapy in infants with refractory partial seizures (2010)[EvidenceUpdates]

Ethosuximide, Valproic Acid, and Lamotrigine in Childhood Absence Epilepsy (2010)[EvidenceUpdates]

A self-administered screening instrument for psychogenic nonepileptic seizures (2009)[EvidenceUpdates]

Practice parameter update: management issues for women with epilepsy--focus on pregnancy (an evidence-based review): obstetrical complications and change in seizure frequency (2009)[EvidenceUpdates]

Clinical Neonatal Seizures are Independently Associated with Outcome in Infants at Risk for Hypoxic-Ischemic Brain Injury (2009) [EvidenceUpdates]

Juvenile myoclonic epilepsy 25 years after seizure onset: a population-based study (2009)[EvidencdeUpdates]

Long-term risk of epilepsy after traumatic brain injury in children and young adults: a population-based cohort study (2009)[Lancet]

eTextbooks

Epilepsy (2012) [GPNotebook] NEW

Epilepsy: an update on treatment (2007) [BMJ Learning Module]

Clinical Queries

Should a 27 year old woman with epilepsy and a BMI of 49 take two desogestrel (Cerazette®) tablets for contraception? (2013) [FSRH] NEW

44 year old lady with arhtrogryposis multiplex congenita, also epilepsy, wants to consider varenicline for smoking cessation. Takes lots of meds including clobazam, pregabalin, topiramate and leveltiracetam. Is there any evidence to show that this drug is safe with all these antiepilieptics? (2011)[ATTRACT]

Can you advise on the duration of antiepileptics for post stroke epilepsy. The patient in question had a post stroke seizure 4 years ago, and has been seizure free on epilim since. Do they need to continue the epilim? (2011)[ATTRACT]

In the past every child with a first febrile convulsion was admitted but now paediatricians semm less keen to admit. Are there any guidelines or protocols on when to admit? Is it age related? (2009) [TRIPAnswers]

What is the optimal management of partial epilepsy uncontrolled by a first choice anticonvulsant? (2009)[TripAnswers]

In patients who have epilepsy, is there a quantifiable seizure risk (i.e. how likely are they to have another one because they take an SSRI) in taking an SSRI as new treatment? (2008) [TripAnswers]


Patient Information

Epilepsy (2012)[BUPA Health Information] updated

Epilepsy (2012)[NHS Choices] updated

Epilepsy (2010) [MedlinePlus]

Important

1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at questions@attract.wales.nhs.uk or call 01495 332343.

2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.

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