Pharmacological treatments for preventing epilepsy following traumatic head injury

Thompson, Kara; Pohlmann-Eden, B.; Campbell, Leslie Anne

doi:10.1002/14651858.cd009900

Cited by 8 publications

(7 citation statements)

References 15 publications

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“…12 Nonetheless, registries on TBI patients and serial studies of imaging, EEG, and neuropsychiatric features are currently being developed to identify specific variables associated with those who develop epilepsy. 13 Another challenge for TBI is that subjects are usually not followed long enough to determine whether they ever develop PTE. Plans are underway to coopt TBI consortia to extend their follow-up times to collect data of PTE, and considerable effort is underway to create a reliable animal model of TBI that can be used for parallel animal/human studies.…”

Section: Example Patient Populations Amenable To Biomarker Identificamentioning

confidence: 99%

WONOEP appraisal: Development of epilepsy biomarkers—What we can learn from our patients?

et al. 2017

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Summary Objective Current medications for patients with epilepsy work in only two out of three patients. For those medications that do work, they only suppress seizures. They treat the symptoms, but do not modify the underlying disease forcing patients to take these drugs with significant side effects often for the rest of their lives. A major limitation in our ability to advance new therapeutics that permanently prevent, reduce the frequency of, or cure epilepsy comes from a lack of understanding of the disease coupled with a lack of reliable biomarkers that can predict who has or who will get epilepsy. Methods The main goal of this report is to present a number of approaches on how we may be able to identify reliable biomarkers from observing patients with brain disorders that have a high probability of producing epilepsy. Results A given biomarker, or more likely a profile of biomarkers, will have both a quantity and a time course during epileptogenesis that can be used to predict who will get the disease, to confirm epilepsy as a diagnosis, to identify co-existing pathologies, and monitor the course of treatments. Significance Additional studies in patients and animal models could identify common and clinically valuable biomarkers as a means to successfully translate animal studies into new and effective clinical trials.

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Section: Example Patient Populations Amenable To Biomarker Identificamentioning

confidence: 99%

WONOEP appraisal: Development of epilepsy biomarkers—What we can learn from our patients?

et al. 2017

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“…Some limited epilepsy research has focused on secondary prevention: early treatment interventions, as well as attempts to identify agents that may interrupt epileptogenesis following brain insults such as traumatic brain injury (TBI). 6,7 The importance of these efforts in tertiary and secondary prevention cannot be overstated. But the epilepsy community has given rather less attention to primary prevention: the elimination (where possible) or reduction of underlying causes and risk factors of epilepsy.…”

Section: Introductionmentioning

confidence: 99%

The primary prevention of epilepsy: A report of the Prevention Task Force of the International League Against Epilepsy

et al. 2018

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Among the causes of epilepsy are several that are currently preventable. In this review, we summarize the public health burden of epilepsy arising from such causes and suggest priorities for primary epilepsy prevention. We conducted a systematic review of published epidemiologic studies of epilepsy of 4 preventable etiologic categories-perinatal insults, traumatic brain injury (TBI), central nervous system (CNS) infection, and stroke. Applying consistent criteria, we assessed the quality of each study and extracted data on measures of risk from those with adequate quality ratings, summarizing findings across studies as medians and interquartile ranges. Among higher-quality population-based studies, the median prevalence of active epilepsy across all ages was 11.1 per 1000 population in lower- and middle-income countries (LMIC) and 7.0 per 1000 in high-income countries (HIC). Perinatal brain insults were the largest attributable fraction of preventable etiologies in children, with median estimated fractions of 17% in LMIC and 15% in HIC. Stroke was the most common preventable etiology among older adults with epilepsy, both in LMIC and in HIC, accounting for half or more of all new onset cases. TBI was the attributed cause in nearly 5% of epilepsy cases in HIC and LMIC. CNS infections were a more common attributed cause in LMIC, accounting for about 5% of all epilepsy cases. Among some rural LMIC communities, the median proportion of epilepsy cases attributable to endemic neurocysticercosis was 34%. A large proportion of the overall public health burden of epilepsy is attributable to preventable causes. The attributable fraction for perinatal causes, infections, TBI, and stroke in sum reaches nearly 25% in both LMIC and HIC. Public health interventions addressing maternal and child health care, immunizations, public sanitation, brain injury prevention, and stroke prevention have the potential to significantly reduce the burden of epilepsy.

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“…[6] Kafa travmasının, çeşitli spektrumlarda motor ve kognitif özürlülük gelişimine neden olabildiği, nöbetlerin ise sık ortaya çıkan komplikasyonu olduğu bildirilmiştir. [7] Yapılan çalışmada cerrahi sonrası nöbet gelişimi açısından risk faktörleri olarak ameliyat öncesi nöbet olması, tümörün yeri, geniş tümör rezeksiyonu belirtilmiştir. Nöbet geçirmeyen hastalarda ameliyat öncesi veya sonrası antiepileptik ilaç (AEİ) profilaksisini destekleyen kesin bir veriye rastlanamamıştır.…”

Section: Introductionunclassified

Epilepsy due to Intracranial Surgery: 15 Years of Experience

Akdağ¹

2016

Epilepsi

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Objectives: Epidemiological studies have shown increased incidence of epilepsy in cases of brain trauma, central nervous system infection, cerebrovascular disease (CVD), and brain tumors. Etiology of epilepsy varies according to age. In the etiology of partial and secondarily generalized partial seizures in adult patients, CVD is the most common cause of acute, symptomatic seizures. Frequency of seizures is estimated to be 15%-20% after cranial operations. In this study, characteristics of patients undergoing cranial surgery were investigated retrospectively. Methods:Eighty-four patients who were admitted to epilepsy clinic between 2000 and 2015 with history of cranial surgery and symptomatic seizures were included in the present study.Results: Etiology indications were 41 cases of (48.8%) space-occupying lesions, 19 (22.6%) instances of trauma, 19 (22.6%) cases of CVD, and 5 (6.0%) with ventriculoperitoneal shunt. Preoperative seizures had been observed in 17 (20.2%) of patients. No seizure was seen in 11 (13.1%) patients. EEG findings revealed focal abnormalities in 39 (46.4%) patients and were normal in 26 (31.0%) patients. Total of 43 (51.2%) patients were treated with monotherapy, and 32 (38.1%) patients were under polytherapy.Conclusion: Most common etiological factors for patients with pre/postoperative epilepsy who underwent cranial surgery were spaceoccupying lesions. Occurrence of seizures may be delayed. EEG results indicated focal findings most often in cases of lesions. Patients were seen to respond well to treatment of seizures with monotherapy. ÖzetAmaç: Epidemiyolojik çalışmalar beyin travmaları, santral sinir sistemi (SSS) enfeksiyonu, beynin damarsal hastalığı (BDH) ve beyin tümörlerinin epilepsi insidansını artırdığını göstermiştir. Epilepsi etiyolojisi yaşlara göre değişiklik göstermektedir. Yetişkin hastalarda sekonder jeneralize ve parsiyel nöbetlerin etiyolojisinde en sık serebrovasküler hastalık yer almaktadır. Ayrıca kranyal operasyon sonrası nöbetlerin sıklığı %15-20 olduğu tahmin edilmektedir. Bu çalışmada, kranyal cerrahi geçiren hastaların özellikleri geriye dönük olarak araştırıldı. Gereç veYöntem: Çalışmamıza 2000-2015 yılları arasında epilepsi polikliniğimize başvuran, semptomatik epilepsi nedeniyle cerrahi öyküsü olan 84 hasta dahil edildi. Diğer semptomatik nöbet geçiren hastalar ve epilepsi cerrrahisi yapılan hastalar çalışmaya alınmadı. Bulgular: Etiyolojide 41 kişide (%48.8) yer kaplayan lezyon (YKL) ilk sırada iken, 19 (%22.6) kişide travma, 19 (%22.6) kişide beyin damar hastalıkları (BDH), 5 (%6.0) kişide ventriküloperitoneal şant (VPŞ) görülmekteydi. On yedi (%20.2) hastada ameliyat öncesi dönemde nöbet gözlendi. On bir (%13.1) hastada nöbet görülmedi. Elektroensefalografi (EEG) bulguları 39 (%46.4) hastada fokal bulgular saptanırken, 26 (%31.0) hastada normal idi. Kırk üç (%51.2) hasta monoterapi, 32 (%38.1) hasta politerapi altındaydı.Sonuç: Kranyal cerrahi geçiren ameliyat öncesi/sonrası epilepsili hastalarda en sık görülen etiyolojik nedenin yer kaplayan lezyonlar olduğ...

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Pharmacological treatments for preventing epilepsy following traumatic head injury

Cited by 8 publications

References 15 publications

WONOEP appraisal: Development of epilepsy biomarkers—What we can learn from our patients?

WONOEP appraisal: Development of epilepsy biomarkers—What we can learn from our patients?

The primary prevention of epilepsy: A report of the Prevention Task Force of the International League Against Epilepsy

Epilepsy due to Intracranial Surgery: 15 Years of Experience

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