Treatment initiation in epilepsy: An expert consensus in Spain

Early electroencephalography in patients with Emergency Room diagnoses of suspected new-onset seizures: Diagnostic yield and impact on clinical decision-making

“…In this study, clinical assessments in conjunction with either abnormal EEG and/or MRI were associated with a higher likelihood of being commenced on AED. An expert consensus by Villanueva et al found that the presence of generalized spike and wave discharges, abnormal MRI and older age were important factors in initiating treatment with AEDs [22]. Our study concurs that in clinical practice, abnormalities of EEG and/or MRI appear to be significant factors that aid the clinical decision-making process.…”

“…Our study concurs that in clinical practice, abnormalities of EEG and/or MRI appear to be significant factors that aid the clinical decision-making process. This likely stems from available data indicating that abnormal EEG is associated with a higher risk of seizure recurrence and that early treatment in this group may be beneficial [1,2,4,22,23].…”

“…Most patients who make a full neurological recovery and have no seizure recurrence in the ER can be safely discharged with Seizure 31 (2015) [22][23][24][25][26] Purpose: To assess the utility of acute electroencephalography (EEG) performed in the emergency room (ER) and its impact on subsequent management of patients with new-onset seizures. Adults who recover fully in the ER following suspected isolated new-onset seizures are usually discharged to the neurology clinic for further review.…”

Guía oficial de la Sociedad Española de Neurología de práctica clínica en epilepsia. Epilepsia en situaciones especiales: comorbilidades, mujer y anciano

“…Son escasos los estudios de FAE realizados en la población mayor de 65 años con evidencia alta. Se recogen en la literatura series de casos, opiniones y consensos de expertos en epilepsia [21][22][23][24][25][26] , NE IV. Los FAE recomendados por un perfil más favorable en el anciano serían el LEV, sin metabolismo hepático y posibilidad de interacciones, seguido de LTG, cuyo metabolismo hepático y su unión a proteínas aumentan ligeramente el riesgo de interacciones medicamentosas y de reacciones alérgicas graves, evitables con una titulación lenta 27 .…”

An appraisal of the new operational definition of epilepsy—Then and now

“…The diagnosis of epilepsy and a decision to treat seizures, although related, are two distinct issues. Some epileptologists will choose to treat patients for a limited period after an acute symptomatic seizure, which, to date, has not satisfied the diagnosis of epilepsy [3]. Even when a diagnosis of epilepsy is unquestionable, patients with mild seizures, those with seizures occurring with long interictal periods (oligoepilepsy), or those in PWEs who decline treatment may allow such people to avoid antiepileptic medications despite being so diagnosed [4].…”