Literature Monitor

Mobile phone apps could greatly assist neurologists in tailoring treatment for patients with epilepsy, according to information published in the International Journal of Epilepsy. “Careful selection and application of epilepsy apps by the healthcare providers, epileptic patients, and their caregivers with proper understanding of their potential benefits, as well as limitations, will result in better diagnosis, prognosis, and treatment,” said Lakshmi Narasimhan Ranganathan, PhD, Associate Professor of Neurology at Madras Medical College in Chennai, India, and coauthors.

Apps like Dosecast–Medication Reminder include medication trackers, detect potential drug interactions, and remind patients to take their medicine on time. These features can increase the patients’ drug compliance, one of the biggest obstacles doctors face in treating epilepsy. Seizure diary apps (eg, Epilepsy Society app, My Epilepsy Diary) allow patients to record information that can facilitate the diagnosis of specific epileptic syndromes, depending on the time and frequency of seizures or abnormal behavior. Patients with epilepsy often forget this information, especially after an episode followed by loss of consciousness. Information in the form of a drug and seizure diary makes it possible for neurologists to titrate dosage and tailor the treatment plan to each patient’s disorder and needs.

Another uniquely useful aspect of mobile apps is seizure detection. Some apps use gyroscopes or accelerometers to detect repetitive and excessive movement, while other devices use live EEG skin-conductance detectors. One such app, Eppdetect, identifies a potential seizure if it senses 2–5-Hz frequency movements lasting longer than 10 seconds. Most apps also include GPS modules for detecting the location of the patient during a seizure and send real-time information to caregivers or doctors, thus allowing for faster and more efficient medical help. Smartwatches can be synched to phone apps, like Affectiva’s Q Sensor, which detects seizures using changes in galvanic skin response and can predict seizures before they occur. This feature allows patients to take medication or precautions to limit harm. It can also measure the magnitude of seizures, thus providing neurologists with quantitative readings that they can use to titrate antiepileptic drugs to be more effective and specific for each patient.

Current research shows that apps applied to seizure management have the capability to be automated drug monitoring and delivery devices, according to Dr. Ranganathan and colleagues. Mobile apps’ and devices’ current application and future potential show that they could be the next “gold standard” approach in epilepsy treatment.

—Evelyn Tran

Mobile phone apps could greatly assist neurologists in tailoring treatment for patients with epilepsy, according to information published in the International Journal of Epilepsy. “Careful selection and application of epilepsy apps by the healthcare providers, epileptic patients, and their caregivers with proper understanding of their potential benefits, as well as limitations, will result in better diagnosis, prognosis, and treatment,” said Lakshmi Narasimhan Ranganathan, PhD, Associate Professor of Neurology at Madras Medical College in Chennai, India, and coauthors.

Apps like Dosecast–Medication Reminder include medication trackers, detect potential drug interactions, and remind patients to take their medicine on time. These features can increase the patients’ drug compliance, one of the biggest obstacles doctors face in treating epilepsy. Seizure diary apps (eg, Epilepsy Society app, My Epilepsy Diary) allow patients to record information that can facilitate the diagnosis of specific epileptic syndromes, depending on the time and frequency of seizures or abnormal behavior. Patients with epilepsy often forget this information, especially after an episode followed by loss of consciousness. Information in the form of a drug and seizure diary makes it possible for neurologists to titrate dosage and tailor the treatment plan to each patient’s disorder and needs.

Another uniquely useful aspect of mobile apps is seizure detection. Some apps use gyroscopes or accelerometers to detect repetitive and excessive movement, while other devices use live EEG skin-conductance detectors. One such app, Eppdetect, identifies a potential seizure if it senses 2–5-Hz frequency movements lasting longer than 10 seconds. Most apps also include GPS modules for detecting the location of the patient during a seizure and send real-time information to caregivers or doctors, thus allowing for faster and more efficient medical help. Smartwatches can be synched to phone apps, like Affectiva’s Q Sensor, which detects seizures using changes in galvanic skin response and can predict seizures before they occur. This feature allows patients to take medication or precautions to limit harm. It can also measure the magnitude of seizures, thus providing neurologists with quantitative readings that they can use to titrate antiepileptic drugs to be more effective and specific for each patient.

Current research shows that apps applied to seizure management have the capability to be automated drug monitoring and delivery devices, according to Dr. Ranganathan and colleagues. Mobile apps’ and devices’ current application and future potential show that they could be the next “gold standard” approach in epilepsy treatment.

—Evelyn Tran

Mobile phone apps could greatly assist neurologists in tailoring treatment for patients with epilepsy, according to information published in the International Journal of Epilepsy. “Careful selection and application of epilepsy apps by the healthcare providers, epileptic patients, and their caregivers with proper understanding of their potential benefits, as well as limitations, will result in better diagnosis, prognosis, and treatment,” said Lakshmi Narasimhan Ranganathan, PhD, Associate Professor of Neurology at Madras Medical College in Chennai, India, and coauthors.

Apps like Dosecast–Medication Reminder include medication trackers, detect potential drug interactions, and remind patients to take their medicine on time. These features can increase the patients’ drug compliance, one of the biggest obstacles doctors face in treating epilepsy. Seizure diary apps (eg, Epilepsy Society app, My Epilepsy Diary) allow patients to record information that can facilitate the diagnosis of specific epileptic syndromes, depending on the time and frequency of seizures or abnormal behavior. Patients with epilepsy often forget this information, especially after an episode followed by loss of consciousness. Information in the form of a drug and seizure diary makes it possible for neurologists to titrate dosage and tailor the treatment plan to each patient’s disorder and needs.

Another uniquely useful aspect of mobile apps is seizure detection. Some apps use gyroscopes or accelerometers to detect repetitive and excessive movement, while other devices use live EEG skin-conductance detectors. One such app, Eppdetect, identifies a potential seizure if it senses 2–5-Hz frequency movements lasting longer than 10 seconds. Most apps also include GPS modules for detecting the location of the patient during a seizure and send real-time information to caregivers or doctors, thus allowing for faster and more efficient medical help. Smartwatches can be synched to phone apps, like Affectiva’s Q Sensor, which detects seizures using changes in galvanic skin response and can predict seizures before they occur. This feature allows patients to take medication or precautions to limit harm. It can also measure the magnitude of seizures, thus providing neurologists with quantitative readings that they can use to titrate antiepileptic drugs to be more effective and specific for each patient.

Current research shows that apps applied to seizure management have the capability to be automated drug monitoring and delivery devices, according to Dr. Ranganathan and colleagues. Mobile apps’ and devices’ current application and future potential show that they could be the next “gold standard” approach in epilepsy treatment.

—Evelyn Tran

Childhood brain tumor survivors are susceptible to seizures, according to a study published online ahead of print August 31 in Epilepsia. Among 298 survivors of pediatric brain tumors, seizures were seen in 24% at presentation and were ongoing in 14%. “Seizures are one of the most significant neurologic complications of childhood brain tumors, as they can occur frequently at any time from diagnosis to years after completion of treatment,” said Nicole J. Ullrich, MD, PhD, Director of Neurologic Neuro-Oncology at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.

Dr. Ullrich and colleagues conducted a retrospective, longitudinal review of consecutive patients examined during a 12-month period who were at least two years post initial diagnosis of a brain tumor. Data collected included age at diagnosis, length of follow-up, extent of initial resection, tumor histology, and treatment modalities. The timing and frequency of seizures, seizure semiology, EEG results, and anticonvulsant use also were recorded. Average duration of follow-up was 7.6 years.

The study cohort included 298 patients; nearly half (140) were female. Initial surgical resection was gross-total in 109 patients and subtotal in 143. Twenty-nine patients underwent biopsy alone, and 17 had no surgical intervention. Tumor location included posterior fossa in 104 (36%), midline in 98 (34%), cortical in 85 (29%), and other in 11 (3%). The most frequent diagnoses were low-grade glioma, medulloblastoma, and ependyoma.

Thirty patients had seizures at the time of tumor diagnosis (10% of the entire cohort, 42% of those with seizures), whereas seizure onset occurred during treatment in 12 patients (3% of entire cohort, 17% of those with seizures) and more than two years after completion of treatment in 16 patients (5.3% of entire cohort, 22% of those with seizures). Ongoing seizures at the time of most recent follow-up were present in 43 patients (14% of entire cohort, 58% of those with seizures).

Factors predisposing to seizures included tumor pathology (low- or high-grade glioma, glioneuronal tumor), cortical location, and subtotal initial resection of the tumor. Seizures were mostly well controlled by antiepileptic drugs.

Dr. Ullrich and colleagues proposed that earlier identification of seizure-eliciting factors in tumor survivors could help in weaning the patients from anticonvulsant medication to reduce the probability of continuing seizures sooner after treatment.

—Ashley Payton

Childhood brain tumor survivors are susceptible to seizures, according to a study published online ahead of print August 31 in Epilepsia. Among 298 survivors of pediatric brain tumors, seizures were seen in 24% at presentation and were ongoing in 14%. “Seizures are one of the most significant neurologic complications of childhood brain tumors, as they can occur frequently at any time from diagnosis to years after completion of treatment,” said Nicole J. Ullrich, MD, PhD, Director of Neurologic Neuro-Oncology at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.

Dr. Ullrich and colleagues conducted a retrospective, longitudinal review of consecutive patients examined during a 12-month period who were at least two years post initial diagnosis of a brain tumor. Data collected included age at diagnosis, length of follow-up, extent of initial resection, tumor histology, and treatment modalities. The timing and frequency of seizures, seizure semiology, EEG results, and anticonvulsant use also were recorded. Average duration of follow-up was 7.6 years.

The study cohort included 298 patients; nearly half (140) were female. Initial surgical resection was gross-total in 109 patients and subtotal in 143. Twenty-nine patients underwent biopsy alone, and 17 had no surgical intervention. Tumor location included posterior fossa in 104 (36%), midline in 98 (34%), cortical in 85 (29%), and other in 11 (3%). The most frequent diagnoses were low-grade glioma, medulloblastoma, and ependyoma.

Thirty patients had seizures at the time of tumor diagnosis (10% of the entire cohort, 42% of those with seizures), whereas seizure onset occurred during treatment in 12 patients (3% of entire cohort, 17% of those with seizures) and more than two years after completion of treatment in 16 patients (5.3% of entire cohort, 22% of those with seizures). Ongoing seizures at the time of most recent follow-up were present in 43 patients (14% of entire cohort, 58% of those with seizures).

Factors predisposing to seizures included tumor pathology (low- or high-grade glioma, glioneuronal tumor), cortical location, and subtotal initial resection of the tumor. Seizures were mostly well controlled by antiepileptic drugs.

Dr. Ullrich and colleagues proposed that earlier identification of seizure-eliciting factors in tumor survivors could help in weaning the patients from anticonvulsant medication to reduce the probability of continuing seizures sooner after treatment.

—Ashley Payton

Childhood brain tumor survivors are susceptible to seizures, according to a study published online ahead of print August 31 in Epilepsia. Among 298 survivors of pediatric brain tumors, seizures were seen in 24% at presentation and were ongoing in 14%. “Seizures are one of the most significant neurologic complications of childhood brain tumors, as they can occur frequently at any time from diagnosis to years after completion of treatment,” said Nicole J. Ullrich, MD, PhD, Director of Neurologic Neuro-Oncology at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.

Dr. Ullrich and colleagues conducted a retrospective, longitudinal review of consecutive patients examined during a 12-month period who were at least two years post initial diagnosis of a brain tumor. Data collected included age at diagnosis, length of follow-up, extent of initial resection, tumor histology, and treatment modalities. The timing and frequency of seizures, seizure semiology, EEG results, and anticonvulsant use also were recorded. Average duration of follow-up was 7.6 years.

The study cohort included 298 patients; nearly half (140) were female. Initial surgical resection was gross-total in 109 patients and subtotal in 143. Twenty-nine patients underwent biopsy alone, and 17 had no surgical intervention. Tumor location included posterior fossa in 104 (36%), midline in 98 (34%), cortical in 85 (29%), and other in 11 (3%). The most frequent diagnoses were low-grade glioma, medulloblastoma, and ependyoma.

Thirty patients had seizures at the time of tumor diagnosis (10% of the entire cohort, 42% of those with seizures), whereas seizure onset occurred during treatment in 12 patients (3% of entire cohort, 17% of those with seizures) and more than two years after completion of treatment in 16 patients (5.3% of entire cohort, 22% of those with seizures). Ongoing seizures at the time of most recent follow-up were present in 43 patients (14% of entire cohort, 58% of those with seizures).

Factors predisposing to seizures included tumor pathology (low- or high-grade glioma, glioneuronal tumor), cortical location, and subtotal initial resection of the tumor. Seizures were mostly well controlled by antiepileptic drugs.

Dr. Ullrich and colleagues proposed that earlier identification of seizure-eliciting factors in tumor survivors could help in weaning the patients from anticonvulsant medication to reduce the probability of continuing seizures sooner after treatment.

—Ashley Payton

Researchers learned that in a survey population of patients with epilepsy who required surgical treatment, 68% of patients returned to regular driving post-surgery. Of the 148 patients in the survey population, 78 patients returned the questionnaire. A pre-surgical history of driving on a regular basis and Engel Class I outcome post-surgery were associated with significantly higher rates of good driving outcomes. Intracranial electroencephalography prior to resection was associated with worse driving outcomes.

Dawkins RL, Omar NB, Agee BS, Walters BC, Riley KO. Assessment of driving outcomes after epilepsy surgery. Epilepsy Behav. 2015;52(A):25-30.

Researchers learned that in a survey population of patients with epilepsy who required surgical treatment, 68% of patients returned to regular driving post-surgery. Of the 148 patients in the survey population, 78 patients returned the questionnaire. A pre-surgical history of driving on a regular basis and Engel Class I outcome post-surgery were associated with significantly higher rates of good driving outcomes. Intracranial electroencephalography prior to resection was associated with worse driving outcomes.

Dawkins RL, Omar NB, Agee BS, Walters BC, Riley KO. Assessment of driving outcomes after epilepsy surgery. Epilepsy Behav. 2015;52(A):25-30.

Researchers learned that in a survey population of patients with epilepsy who required surgical treatment, 68% of patients returned to regular driving post-surgery. Of the 148 patients in the survey population, 78 patients returned the questionnaire. A pre-surgical history of driving on a regular basis and Engel Class I outcome post-surgery were associated with significantly higher rates of good driving outcomes. Intracranial electroencephalography prior to resection was associated with worse driving outcomes.

Dawkins RL, Omar NB, Agee BS, Walters BC, Riley KO. Assessment of driving outcomes after epilepsy surgery. Epilepsy Behav. 2015;52(A):25-30.

Researchers identified 215 cases in the Multicenter Study of Epilepsy Surgery database who reported having seizure(s) while driving—141 were involved in a motor vehicle accident (MVA), 74 were not. There was no difference in the presence and length of auras between the 2 groups. The results question auras as a protective role against MVAs in patients with epilepsy.

Punia V, Farooque P, Chen W, Hirsch LJ, Berg A, Blumenfeld H; the Multicenter Study of Epilepsy Surgery. Epileptic auras and their role in driving safety in people with epilepsy. Epilepsia. 2015; doi:10.1111/epi.13189.

Researchers identified 215 cases in the Multicenter Study of Epilepsy Surgery database who reported having seizure(s) while driving—141 were involved in a motor vehicle accident (MVA), 74 were not. There was no difference in the presence and length of auras between the 2 groups. The results question auras as a protective role against MVAs in patients with epilepsy.

Punia V, Farooque P, Chen W, Hirsch LJ, Berg A, Blumenfeld H; the Multicenter Study of Epilepsy Surgery. Epileptic auras and their role in driving safety in people with epilepsy. Epilepsia. 2015; doi:10.1111/epi.13189.

Researchers identified 215 cases in the Multicenter Study of Epilepsy Surgery database who reported having seizure(s) while driving—141 were involved in a motor vehicle accident (MVA), 74 were not. There was no difference in the presence and length of auras between the 2 groups. The results question auras as a protective role against MVAs in patients with epilepsy.

Punia V, Farooque P, Chen W, Hirsch LJ, Berg A, Blumenfeld H; the Multicenter Study of Epilepsy Surgery. Epileptic auras and their role in driving safety in people with epilepsy. Epilepsia. 2015; doi:10.1111/epi.13189.

A 2-year study of 175 patients with partial-onset seizures showed that responsive neurostimulation using the RNS^® System was not associated with cognitive decline. There was modest cognitive improvement in response to neurostimulation. The areas of improvement were related to the region of the brain from which seizures arose and where neurostimulation was delivered.

Loring DW, Kapur R, Meador KJ, Morrell MJ. Differential neuropsychological outcomes following targeted responsive neurostimulation for partial-onset epilepsy. Epilepsia. 2015; doi:10.111/epi.13191.

A 2-year study of 175 patients with partial-onset seizures showed that responsive neurostimulation using the RNS^® System was not associated with cognitive decline. There was modest cognitive improvement in response to neurostimulation. The areas of improvement were related to the region of the brain from which seizures arose and where neurostimulation was delivered.

Loring DW, Kapur R, Meador KJ, Morrell MJ. Differential neuropsychological outcomes following targeted responsive neurostimulation for partial-onset epilepsy. Epilepsia. 2015; doi:10.111/epi.13191.

A 2-year study of 175 patients with partial-onset seizures showed that responsive neurostimulation using the RNS^® System was not associated with cognitive decline. There was modest cognitive improvement in response to neurostimulation. The areas of improvement were related to the region of the brain from which seizures arose and where neurostimulation was delivered.

Loring DW, Kapur R, Meador KJ, Morrell MJ. Differential neuropsychological outcomes following targeted responsive neurostimulation for partial-onset epilepsy. Epilepsia. 2015; doi:10.111/epi.13191.

A Taskforce for the Commission on Classification and Terminology and the Commission on Epidemiology of the International League Against Epilepsy (ILAE) has proposed a new definition of status epilepticus: Status epilepticus is a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1). It is a condition, which can have long-term consequences (after time point t2), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures.

The Taskforce also proposed a new diagnostic classification system for status epilepticus that consists of 4 axes: Semiology, Etiology, Electroencephalography (EEG) correlates; and Age.  Each axis is further divided into subcategories, providing a framework for clinical diagnosis, investigation, and therapeutic approaches for patients.

Trinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticus—report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015; doi:10.111/epi.13121.

A Taskforce for the Commission on Classification and Terminology and the Commission on Epidemiology of the International League Against Epilepsy (ILAE) has proposed a new definition of status epilepticus: Status epilepticus is a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1). It is a condition, which can have long-term consequences (after time point t2), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures.

The Taskforce also proposed a new diagnostic classification system for status epilepticus that consists of 4 axes: Semiology, Etiology, Electroencephalography (EEG) correlates; and Age.  Each axis is further divided into subcategories, providing a framework for clinical diagnosis, investigation, and therapeutic approaches for patients.

Trinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticus—report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015; doi:10.111/epi.13121.

A Taskforce for the Commission on Classification and Terminology and the Commission on Epidemiology of the International League Against Epilepsy (ILAE) has proposed a new definition of status epilepticus: Status epilepticus is a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1). It is a condition, which can have long-term consequences (after time point t2), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures.

The Taskforce also proposed a new diagnostic classification system for status epilepticus that consists of 4 axes: Semiology, Etiology, Electroencephalography (EEG) correlates; and Age.  Each axis is further divided into subcategories, providing a framework for clinical diagnosis, investigation, and therapeutic approaches for patients.

Trinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticus—report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015; doi:10.111/epi.13121.

Investigators examined intracranial seizure termination (ST) of 59 patients with mesial temporal (MT) or neocortical (NC) complex partial seizures (CPS). They found:

•  88% of patients with MT CPS had exclusively synchronous pattern of ST (38%) or mixed synchronous/asynchronous ST patterns (50%)
• 82% in the NC group had exclusively synchronous pattern of ST (52%) or mixed (30%)
• Patients with only synchronous ST had low variability in seizure duration

Afra P, Jouny CC, Bergey. Termination patterns of complex partial seizures: an intracranial EEG study. Seizure. 2015; doi: 10.1016/j.seziure.2015.08.00. 2015; doi: 10.1016/j.seziure.2015.08.004.

Investigators examined intracranial seizure termination (ST) of 59 patients with mesial temporal (MT) or neocortical (NC) complex partial seizures (CPS). They found:

•  88% of patients with MT CPS had exclusively synchronous pattern of ST (38%) or mixed synchronous/asynchronous ST patterns (50%)
• 82% in the NC group had exclusively synchronous pattern of ST (52%) or mixed (30%)
• Patients with only synchronous ST had low variability in seizure duration

Afra P, Jouny CC, Bergey. Termination patterns of complex partial seizures: an intracranial EEG study. Seizure. 2015; doi: 10.1016/j.seziure.2015.08.00. 2015; doi: 10.1016/j.seziure.2015.08.004.

Investigators examined intracranial seizure termination (ST) of 59 patients with mesial temporal (MT) or neocortical (NC) complex partial seizures (CPS). They found:

•  88% of patients with MT CPS had exclusively synchronous pattern of ST (38%) or mixed synchronous/asynchronous ST patterns (50%)
• 82% in the NC group had exclusively synchronous pattern of ST (52%) or mixed (30%)
• Patients with only synchronous ST had low variability in seizure duration

Afra P, Jouny CC, Bergey. Termination patterns of complex partial seizures: an intracranial EEG study. Seizure. 2015; doi: 10.1016/j.seziure.2015.08.00. 2015; doi: 10.1016/j.seziure.2015.08.004.

Researchers identified 38 studies of pregnant women with epilepsy and compared women with epilepsy vs women without epilepsy. They found that pregnant women with epilepsy had increased odds of:

• Spontaneous miscarriage
• Antepartum hemorrhage
• Post-partum hemorrhage
• Hypertensive disorders
• Induction of labor
• Cesarean section
• Preterm birth
•  Fetal growth restriction

The authors state that these increased risks should be taken into account when counseling women with epilepsy.

Viale L, Allotey J, Cheong-See F, et al; EBM CONNECT Collaboration. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet. 2015; doi:10.1016/S0140-6736(15)00045-8.

Researchers identified 38 studies of pregnant women with epilepsy and compared women with epilepsy vs women without epilepsy. They found that pregnant women with epilepsy had increased odds of:

• Spontaneous miscarriage
• Antepartum hemorrhage
• Post-partum hemorrhage
• Hypertensive disorders
• Induction of labor
• Cesarean section
• Preterm birth
•  Fetal growth restriction

The authors state that these increased risks should be taken into account when counseling women with epilepsy.

Viale L, Allotey J, Cheong-See F, et al; EBM CONNECT Collaboration. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet. 2015; doi:10.1016/S0140-6736(15)00045-8.

Researchers identified 38 studies of pregnant women with epilepsy and compared women with epilepsy vs women without epilepsy. They found that pregnant women with epilepsy had increased odds of:

• Spontaneous miscarriage
• Antepartum hemorrhage
• Post-partum hemorrhage
• Hypertensive disorders
• Induction of labor
• Cesarean section
• Preterm birth
•  Fetal growth restriction

The authors state that these increased risks should be taken into account when counseling women with epilepsy.

Viale L, Allotey J, Cheong-See F, et al; EBM CONNECT Collaboration. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet. 2015; doi:10.1016/S0140-6736(15)00045-8.

Researchers examined generalized convulsive status epilepticus (GCSE) in 1,457,869 patients hospitalized with traumatic brain injury (TBI) in the United States from 2002 to 2010. They found that GCSE, despite its low incidence, was associated with worse outcomes in this patient cohort.  The study showed:

• Incidence of GCSE in TBI is low (0.16%)
• In-hospital mortality was significantly higher in patients with GCSE
• Patients with GCSE had longer hospital stay and were less likely to be discharged home
• Epilepsy was a negative predictor of GCSE in hospitalized patients with TBI

Dhakar MB, Sivakumar S, Bhattacharya P, Shah A, Basha MM. A retrospective cross-sectional study of the prevalence of generalized convulsive status epilepticus in traumatic brain injury: United States 2002-2010. Seizure. doi:10.1016/j.seizure.2015.08.005.

Researchers examined generalized convulsive status epilepticus (GCSE) in 1,457,869 patients hospitalized with traumatic brain injury (TBI) in the United States from 2002 to 2010. They found that GCSE, despite its low incidence, was associated with worse outcomes in this patient cohort.  The study showed:

• Incidence of GCSE in TBI is low (0.16%)
• In-hospital mortality was significantly higher in patients with GCSE
• Patients with GCSE had longer hospital stay and were less likely to be discharged home
• Epilepsy was a negative predictor of GCSE in hospitalized patients with TBI

Dhakar MB, Sivakumar S, Bhattacharya P, Shah A, Basha MM. A retrospective cross-sectional study of the prevalence of generalized convulsive status epilepticus in traumatic brain injury: United States 2002-2010. Seizure. doi:10.1016/j.seizure.2015.08.005.

Researchers examined generalized convulsive status epilepticus (GCSE) in 1,457,869 patients hospitalized with traumatic brain injury (TBI) in the United States from 2002 to 2010. They found that GCSE, despite its low incidence, was associated with worse outcomes in this patient cohort.  The study showed:

• Incidence of GCSE in TBI is low (0.16%)
• In-hospital mortality was significantly higher in patients with GCSE
• Patients with GCSE had longer hospital stay and were less likely to be discharged home
• Epilepsy was a negative predictor of GCSE in hospitalized patients with TBI

Dhakar MB, Sivakumar S, Bhattacharya P, Shah A, Basha MM. A retrospective cross-sectional study of the prevalence of generalized convulsive status epilepticus in traumatic brain injury: United States 2002-2010. Seizure. doi:10.1016/j.seizure.2015.08.005.

Researchers analyzed the records of 6150 patients with a primary or secondary diagnosis of epilepsy in this retrospective cohort study. The purpose of the study was to examine the relationship between adherence to epilepsy quality measures (EQM) and seizure control. Researchers found:

• The following EQM exceed 80% adherence:
  • Documentation of seizure frequency
  • Addressing therapeutic interventions
  • Referral to a comprehensive epilepsy center
• The following EQM ranged from 40% to 57% adherence:
  • Documentation of seizure type
  • Etiology or syndrome
  • Assessment of side effects
  • Counseling about epilepsy safety and women’s issues
  • Screening for psychiatric disorders
• Average EQM adherence was associated with seizure control
• Adherence to all EQM was low and not associated with seizure control

Moura LM, Mendez DY, DeJesus J, et al. Association of adherence to epilepsy quality standards with seizure control. Epilepsy Res. 2015;doi:10.1016/j.eplepsyres.2015.08.008.

Researchers analyzed the records of 6150 patients with a primary or secondary diagnosis of epilepsy in this retrospective cohort study. The purpose of the study was to examine the relationship between adherence to epilepsy quality measures (EQM) and seizure control. Researchers found:

• The following EQM exceed 80% adherence:
  • Documentation of seizure frequency
  • Addressing therapeutic interventions
  • Referral to a comprehensive epilepsy center
• The following EQM ranged from 40% to 57% adherence:
  • Documentation of seizure type
  • Etiology or syndrome
  • Assessment of side effects
  • Counseling about epilepsy safety and women’s issues
  • Screening for psychiatric disorders
• Average EQM adherence was associated with seizure control
• Adherence to all EQM was low and not associated with seizure control

Moura LM, Mendez DY, DeJesus J, et al. Association of adherence to epilepsy quality standards with seizure control. Epilepsy Res. 2015;doi:10.1016/j.eplepsyres.2015.08.008.

Researchers analyzed the records of 6150 patients with a primary or secondary diagnosis of epilepsy in this retrospective cohort study. The purpose of the study was to examine the relationship between adherence to epilepsy quality measures (EQM) and seizure control. Researchers found:

• The following EQM exceed 80% adherence:
  • Documentation of seizure frequency
  • Addressing therapeutic interventions
  • Referral to a comprehensive epilepsy center
• The following EQM ranged from 40% to 57% adherence:
  • Documentation of seizure type
  • Etiology or syndrome
  • Assessment of side effects
  • Counseling about epilepsy safety and women’s issues
  • Screening for psychiatric disorders
• Average EQM adherence was associated with seizure control
• Adherence to all EQM was low and not associated with seizure control

Moura LM, Mendez DY, DeJesus J, et al. Association of adherence to epilepsy quality standards with seizure control. Epilepsy Res. 2015;doi:10.1016/j.eplepsyres.2015.08.008.