How long for epilepsy remission in the <scp>ILAE</scp> definition?

Fisher, Robert S.; Acevedo, Carlos Alberto; Arzimanoglou, Alexis; Bogacz, Alicia; Cross, J. Helen; Elger, Christian E.; Engel, Jerome; Forsgren, Lars; French, Jacqueline A.; Hesdorffer, Dale C.; Lee, Ki Young; Mathern, Gary W.; Moshé, Solomon L.; Perucca, Emilio; Scheffer, Ingrid E.; Tomson, Torbjörn; Watanabe, Masaya; Wiebe, Samuel

doi:10.1111/epi.13821

Cited by 12 publications

(18 citation statements)

References 3 publications

(1 reference statement)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, among the studies we reviewed, only a quarter provided definitions of remission, whereby in most cases these definitions differed. This heterogeneity also reflects the overall lack of consensus of remission in neurological disorders (44)(45)(46) (Havrdova, 2010, Mao, 2015, Fisher, 2017, also including movement disorders (47) (Black, 2016). Based on our extensive review and our critical analysis of the data we suggest the following remission criteria for dystonia.…”

Section: Discussionmentioning

confidence: 97%

Remission in dystonia – Systematic review of the literature and meta-analysis

Mainka

Erro

Rothwell

et al. 2019

Parkinsonism & Related Disorders

View full text Add to dashboard Cite

In isolated, sporadic dystonia, it has been occasionally reported that some patients might undergo symptom remission. However, the exact clinical characteristics of patients with remission remain understudied. Given the important prognostic and pathophysiological implications of dystonic remission, we here provide a systematic review of the literature and a meta-analysis to assess demographic and clinical features associated with this phenomenon. We also provide a list of operational criteria to better define dystonic remission. Using PubMed and Embase, we conducted a systematic literature search in March 2018. 626 records were screened, 31 studies comprising data of 2551 patients with predominantly reports from patients with cervical dystonia (n=1319) or blepharospasm/Meige syndrome (n=704) were included in qualitative analysis. Five studies reporting remission in cervical dystonia were eligible for meta-analysis. Complete remission was reported in 11.8% and partial remission for 4.4% of cases. Remission rates were higher in cervical dystonia than in blepharospasm/Meige (e.g. complete remission 15.4% vs. 5.8% respectively). Remission occurred on average 4.5 years after onset of dystonic symptoms. However, the majority of patients (63.8%) relapsed. Meta-analysis for cervical dystonia showed that patients with remission were significantly younger at symptom onset than patients without remission (mean difference -7.13 years 95% CI: -10.58 − -3.68, p<0.0001). Based on our findings, we propose that the degree, the conditions associated with the onset and the duration of remission are key factors to be considered in a unifying definition of dystonic remission.

show abstract

Section: Discussionmentioning

confidence: 97%

Remission in dystonia – Systematic review of the literature and meta-analysis

Mainka

Erro

Rothwell

et al. 2019

Parkinsonism & Related Disorders

View full text Add to dashboard Cite

show abstract

“…The decision to initiate treatment is likely made at the discretion of each facility. The practical definition of epilepsy published by the International League Against Epilepsy (ILAE) in 2014 states that if the last seizure is a single, unprovoked seizure, treatment may be considered at the time of the first seizure if the seizure is considered highly recurrent for the following 10 years [9]. This would make it easier to determine when to initiate treatment for post-stroke epilepsy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of vagus nerve stimulation for drug-resistant epilepsy in a survivor of poor-grade subarachnoid hemorrhage: A case report

Onuki

Sunaga

Yokoyama

et al. 2023

E&S

View full text Add to dashboard Cite

A man in his 60s had undergone clipping for a subarachnoid hemorrhage (SAH) due to a ruptured anterior communicating artery aneurysm in his 40s. He survived cerebral vasospasms following surgery for poor-grade SAH and required anti-seizure medications (ASMs) for post-stroke epilepsy. More than 20 years after the clipping, he developed focal impaired awareness seizure, which decreased his quality of life (QOL). Computed tomography (CT) showed an infarct in the left frontal lobe. 123 I-iomazenil single-photon emission CT showed decreased benzodiazepine accumulation in the left frontal and medial temporal lobes. An interictal electroencephalogram showed epileptic discharges in the left temporal region. We diagnosed focal epilepsy and adjusted ASMs based on seizure control. However, the seizures were not controlled, and the adverse effects worsened with dosage increase. The condition was diagnosed as drug-resistant epilepsy, and the patient underwent vagus nerve stimulation. Postoperatively, we confirmed control of seizures and improvement of QOL.

show abstract

“…In addition, definitions of epilepsy changed just prior to the time of the estimation of prevalence in 2016 to include persons with epilepsy until they have remained seizure-free for the last 10 years with at least the last 5 year off ASM (i.e. definition B; at least one hospital contact with epilepsy in the previous ten years) [22,40]. Furthermore, we may have missed persons with epilepsy only followed in primary health care by general practitioners, by privately practicing neurologists or patients who go undiagnosed, although we will capture some of these patients using other epilepsy definitions (e.g.…”

Section: Limitations and Generalizabilitymentioning

confidence: 99%