Meeting the Challenge of Epilepsy in Persons With Multiple Handicaps

Sunder, Theodore R.

doi:10.1177/0883073897012001091

Cited by 23 publications

(14 citation statements)

References 14 publications

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“…In population studies, comorbidity—the co‐occurrence of two or more separate medical conditions in the same individual—is of greatest interest when it appears at above‐chance levels, that is, when it is associated. Several comorbid conditions associated with epilepsy have been described (Sunder, 1997; Hermann et al., 2000; Boro & Haut, 2003; Trinka, 2003; Gaitatzis et al., 2004; McLachlan, 2006; De Simone et al., 2007) and are listed in Appendix, . Associations between epilepsy and other medical and psychiatric conditions may exist because epilepsy and the comorbid condition share an underlying etiology or because epilepsy or epilepsy treatment lead to a higher than expected occurrence of the comorbid condition.…”

Section: Epidemiologic Methods For the Study Of Epilepsymentioning

confidence: 99%

Standards for epidemiologic studies and surveillance of epilepsy

Thurman¹,

et al. 2011

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SUMMARYWorldwide, about 65 million people are estimated to have epilepsy. Epidemiologic studies are necessary to define the full public health burden of epilepsy; to set public health and health care priorities; to provide information needed for prevention, early detection, and treatment; to identify education and service needs; and to promote effective health care and support programs for people with epilepsy. However, different definitions and epidemiologic methods complicate the tasks of these studies and their interpretations and comparisons. The purpose of this document is to promote consistency in definitions and methods in an effort to enhance future population-based epidemiologic studies, facilitate comparison between populations, and encourage the collection of data useful for the promotion of public health. We discuss: (1) conceptual and operational definitions of epilepsy, (2) data resources and recommended data

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Section: Epidemiologic Methods For the Study Of Epilepsymentioning

confidence: 99%

Standards for epidemiologic studies and surveillance of epilepsy

Thurman¹,

et al. 2011

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“…The ideal AED for the treatment of epilepsy in patients with developmental handicaps would have efficacy against both partial and generalized seizures, minimal adverse cognitive and behavioural effects, and minimal pharmacokinetic drugs interactions 5 . Since 1993, five new AEDs have been introduced to the US market, and the usage of these drugs instead of the older antiepileptics is debated 6 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of lamotrigine in institutionalized, developmentally disabled patients with epilepsy: a retrospective evaluation

Gidal

Walker²,

Lott³

et al. 2000

Seizure

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The paper evaluates the efficacy of the newer anticonvulsant lamotrigine in a developmentally disabled patient population. A retrospective evaluation was done at two institutional centres to assess adjunctive lamotrigine (Lamictal) efficacy in a developmentally disabled population. Mean seizure frequency was compared between a 2-month pre-lamotrigine baseline period and a 2-month treatment period. A 3-month lamotrigine titration phase occurred between baseline and treatment periods. Seizure frequency data was obtained from standardized, daily seizure records. Adverse effect data was obtained from medical and nursing notes. An intent to treat analysis was performed. Data were analysed using Student's t-test for paired data. We evaluated 44 centre residents (25 male, 19 female, average age 33 +/- 11 years). Mean lamotrigine dose was 272 +/- 133 mg per day. A significant reduction in seizure frequency was noted. Seizure frequency (all seizures) was 10.1 +/- 11.2 during the baseline period vs. 5.8 +/- 7.9 seizures per month during the treatment period (P = 0.002). Thirty-two percent of patients (n = 14) had greater than a 75% reduction in seizure frequency. Twenty-three percent of patients (n = 10) had a 50-74% seizure reduction. Twenty-five percent of patients (n = 11) had less than a 50% reduction in seizures, while 20% (n = 9) had an increase in seizures. A significant reduction of 48% in generalized seizures (9.5 +/- 11.6 vs. 4.9 +/- 6.5 seizures per month, P = 0.013) was noted. Reductions in partial seizure frequency of 48% (7.9 +/- 10 vs. 4 +/- 6.6 seizures per month, P = 0.16) as well as in mixed-type seizures (19.9 +/- 9.3 was vs. 15 +/- 12.1 seizures per month, P = 0.11) were also seen; however, these changes did not reach significance. Overall, lamotrigine was well tolerated by the subject population. Adjunctive treatment with lamotrigine appears to be an efficacious and well-tolerated treatment for seizures in a significant percentage of developmentally disabled patients with epilepsy.

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“…One-third to one-half of individuals with mental retardation suffer from epilepsy, which is often characterized in this population by multiple concurrent seizure types that are refractory to treatment [1][2][3] . The refractoriness of the seizures and the heightened vulnerability of individuals with mental retardation to adverse cognitive and behavioral effects of medications make optimizing pharmacotherapy challenging 1,4 .…”

Section: Introductionmentioning

confidence: 99%

“…Drug interactions and side effects are common with this approach. Efforts continue to use better tolerated medications and to reduce the number of concomitant antiepileptic drugs required to maintain seizure control 3 .…”

Section: Introductionmentioning

confidence: 99%