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Initial Antiepileptic Drug (initial + antiepileptic_drug)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Prognostic Significance of Failure of the Initial Antiepileptic Drug in Children with Absence Epilepsy

EPILEPSIA, Issue 6 2001
Elaine Wirrell
Summary: ,Purpose: In children with childhood absence epilepsy (CAE) and juvenile absence epilepsy (JAE), to determine the impact of failure of initial antiepileptic drug (AED) for lack of efficacy in eventual seizure control and long-term remission of epilepsy. Methods: Centralized EEG records for the province of Nova Scotia allowed identification of all children seen with CAE or JAE between 1977 and 1985. Information regarding success or failure of initial AED in fully controlling seizures and long-term seizure control and remission of epilepsy was collected by patient questionnaire and chart review. Results: Eighty-six of 92 eligible patients were followed up (75 CAE, 11 JAE). Initial AED treatment was successful in 52 (60%) of 86. Success tended to be greater for valproate (VPA) than for other AEDs (p = 0.07), and lower if generalized tonic,clonic or myoclonic seizures coexisted (p < 0.004 and p < 0.03). Terminal remission was more likely if the initial AED was successful than if it had failed (69% vs. 41%; p < 0.02). Compared with those in whom the initial AED was successful, subjects whose initial AED had failed were more likely to progress to juvenile myoclonic epilepsy (JME) at last follow-up (32% vs. 10%; p < 0.02) and to develop intractable epilepsy (17% vs. 2%; p < 0.04). Conclusions: Initial AED was successful in 60% of children with AE. If the first AED failed, the outcome was less favorable, with a lower rate of terminal remission and a higher rate of progression to JME and intractable epilepsy. [source]

Idiopathic generalized epilepsies: a follow-up study in a single-center

ACTA NEUROLOGICA SCANDINAVICA, Issue 3 2010
E. Kharazmi
Kharazmi E, Peltola M, Fallah M, Keränen T, Peltola J. Idiopathic generalized epilepsies: a follow-up study in a single-center. Acta Neurol Scand: 122: 196,201. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objective,,, To characterize adult patients with idiopathic generalized epilepsies (IGEs) with precise evaluation and to assess factors related to refractoriness. Materials and methods,,, Hospital records of all our patients with IGEs (n = 128) were evaluated in 2005 and followed-up until 2008. Results,,, In 2005, 76% of patients were 1-year seizure-free. Seizure freedom increased to 82% during the 3-year follow-up. Seizure freedom was not significantly associated with age, age at diagnosis, epilepsy duration, exposure to inappropriate initial antiepileptic drug (AED), or delay time between starting initial AED and appropriate AED. Women constituted 78% of patients with merely provoked seizures. In 58% of women with recent seizure, one to two avoidable precipitating factors, such as lack of sleep, alcohol, and forgetting to take AED, were observed. In 2008, all patients with no medication, 91% of monotherapy patients, 60% of patients on two AED, and 14% of patients on three AED were seizure-free. Conclusions,,, Most of patients with IGEs can be successfully treated with monotherapy. Refractory seizures in some patients may be because of avoidable factors, especially in young women. [source]

Experience with topiramate monotherapy in elderly patients with recent-onset epilepsy

ACTA NEUROLOGICA SCANDINAVICA, Issue 3 2005
J. Gro
Objectives,,, To evaluate the effect of topiramate in elderly patients with onset of epilepsy after the age of 60, treatment-naive or non-responding to an initial antiepileptic drug. Methods,,, Analysis of patients with epilepsy diagnosed in the preceding 5 years, aged ,65 years (n = 43), enrolled in a larger open-label trial (n = 692). After titration to topiramate 100 mg/day over 4 weeks, the dose was adjusted according to individual response (maximum 400 mg/day). Patients were followed up for at least 7 months. Results,,, After 7 months, 79% of patients remained in the study. Seizure frequency decreased significantly vs baseline (P < 0.001); ,50% reduction in seizure frequency was achieved in 87% of patients, 64% remained seizure-free. Both previously treated and naive patients responded. Fourteen per cent dropped out because of insufficient tolerability. No unexpected or unusual adverse events were observed. Conclusions,,, The results indicate that elderly patients respond well to topiramate monotherapy. The high patient retention rate reflects a favourable tolerability profile in this population. [source]