Epilepsia
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Comparative Study
The prevalence of seizures in comatose children in the pediatric intensive care unit: a prospective video-EEG study.
Studies in adult and neonatal intensive care units (ICUs) report a high prevalence of epileptic seizures in comatose patients. The prevalence of seizures in pediatric ICUs is variably reported in a few retrospective studies using different electroencephalography (EEG) methods. We aimed to determine prospectively the prevalence of epileptic seizures (clinical and subclinical) in comatose children in the pediatric ICU using continuous video-EEG (v-EEG) monitoring. ⋯ The lower prevalence of epileptic seizures and the shorter length of ICU stay in children compared to adults and neonates suggest a different spectrum of disease and neurologic response. Short-duration v-EEG in patients with a history of prior seizures, epilepsy, or clinical events suspected to be seizures seems more appropriate than routine v-EEG in all comatose children in the pediatric ICU.
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The incidence of constipation as an adverse effect of pregabalin has previously been reported as low, with all cases described as either mild or moderate. From the experience of a tertiary referral epilepsy hospital center, we report several cases of severe and disabling constipation after initiating pregabalin, and resolving only on drug withdrawal. ⋯ The severity of symptoms was dose dependent. Pregabalin can cause marked constipation in some patients, and can lead to multiple unnecessary investigations and procedures if the clinician is not aware of this entirely reversible side effect.
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Meta Analysis Comparative Study
Long-term add-on pregabalin treatment in patients with partial-onset epilepsy: pooled analysis of open-label clinical trials.
To evaluate the safety, tolerability, and efficacy of long-term pregabalin as add-on therapy for patients with poorly controlled partial seizures. ⋯ Adjunctive pregabalin was effective, generally well tolerated, and safe in the long-term treatment of partial seizures, and provided clinically meaningful seizure reduction and freedom without evidence of tolerance over 2 years of follow-up.
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Randomized Controlled Trial Multicenter Study Comparative Study
Lacosamide as adjunctive therapy for partial-onset seizures: a randomized controlled trial.
To evaluate the efficacy and safety of lacosamide (400 and 600 mg/day) as adjunctive treatment in patients with uncontrolled partial-onset seizures taking one to three concomitant antiepileptic drugs (AEDs). ⋯ Adjunctive treatment with lacosamide 400 and 600 mg/day reduced seizure frequency for patients with uncontrolled partial-onset seizures. Lacosamide 400 mg/day provided a good balance of efficacy and tolerability; lacosamide 600 mg/day may provide additional benefit for some patients as suggested by secondary efficacy analyses, including response in patients with secondarily generalized tonic-clonic seizures.
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Multicenter Study Comparative Study Clinical Trial
Intravenous lacosamide as short-term replacement for oral lacosamide in partial-onset seizures.
Lacosamide is a new antiepileptic drug effective for adjunctive treatment of partial-onset seizures. We evaluated the safety and tolerability of an intravenous (i.v.) formulation of lacosamide (200-800 mg/day) infused over 10, 15, and 30 min as short-term replacement for oral lacosamide in patients with partial-onset seizures. ⋯ This comprehensive evaluation supports the safety of an intravenous lacosamide infusion duration as short as 15 min for short-term (2-5 days) replacement for patients temporarily unable to take oral lacosamide.