#Cannabis-based medicine may cut seizures in half for those with tough-to-treat #epilepsy
https://www.eurekalert.org/pub_releases/2017-04/aaon-cmm041417.php

"Our results suggest that cannabidiol may be effective for those with Lennox-Gastaut syndrome in treating drop seizures," said Patel. "This is important because this kind of epilepsy is incredibly difficult to treat. While there were more side effects for those taking cannabidiol, they were mostly well-tolerated. I believe that it may become an important new treatment option for these patients."

Evidence for cannabis and #cannabinoids for
#epilepsy: a systematic review of controlled and observational evidence

http://jnnp.bmj.com/content/early/2018/02/05/jnnp-2017-317168


The number needed to treat for one person using CBD to experience 50%+ seizure reduction was 8 (95% CI 6 to 17). CBD was more effective than placebo at achieving complete seizure freedom (RR 6.17, 95% CI 1.50 to 25.32, 3 RCTs, 306 patients, low GRADE rating), and improving QoL (RR 1.73, 95% CI 1.33 to 2.26), however increased risk of AEs (RR 1.24, 95% CI 1.13 to 1.36) and SAEs (RR 2.55, 95% CI 1.48 to 4.38). Pooled across 17 observational studies, 48.5% (95% CI 39.0% to 58.1%) of patients reported 50%+ reductions in seizures; in 14 observational studies 8.5% (95% CI 3.8% to 14.5%) were seizure-free. Twelve observational studies reported improved QoL (55.8%, 95% CI 40.5 to 70.6); 50.6% (95% CI 31.7 to 69.4) AEs and 2.2% (95% CI 0 to 7.9) SAEs. Pharmaceutical-grade CBD as adjuvant treatment in paediatric-onset drug-resistant epilepsy may reduce seizure frequency. Existing RCT evidence is mostly in paediatric samples with rare and severe epilepsy syndromes; RCTs examining other syndromes and cannabinoids are needed.

!!
Association Between Midlife Risk Factors and Late-Onset #Epilepsy
Results From the #Atherosclerosis Risk in Communities Study

https://jamanetwork.com/journals/jamaneurology/fullarticle/2688301


.. The incidence was higher in black than in white participants (4.71; 95% CI, 4.12-5.40 vs 2.88; 95% CI, 2.60-3.18 per 1000 person-years). In multivariable analysis, baseline hypertension (hazard ratio HR, 1.30; 95% CI, 1.09-1.55), diabetes (HR, 1.45; 95% CI, 1.17-1.80), smoking (HR, 1.09; 95% CI, 1.01-1.17), apolipoprotein E ε4 genotype (1 allele HR, 1.22; 95% CI, 1.02-1.45; 2 alleles HR, 1.95; 95% CI, 1.35-2.81), and incident stroke (HR, 3.38; 95% CI, 2.78-4.10) and dementia (HR, 2.56; 95% CI, 2.11-3.12) were associated with an increased risk of late-onset epilepsy, while higher levels of physical activity (HR, 0.90; 95% CI, 0.83-0.98) and moderate alcohol intake (HR, 0.72; 95% CI, 0.57-0.90) were associated with a lower risk. Results were similar after censoring individuals with stroke or dementia.

Conclusions and Relevance Potentially modifiable risk factors in midlife and the APOE ε4 genotype were positively associated with risk of developing late-onset epilepsy. Although stroke and dementia were both associated with late-onset epilepsy, vascular and lifestyle risk factors were significant even in the absence of stroke or dementia.

!!
American #Epilepsy Society
Five Things Physicians and Patients Should #Question

http://www.choosingwisely.org/societies/american-epilepsy-society/

1.Avoid routine testing for antiepileptic drug (AED) levels in people with epilepsy

2.Do not treat females of childbearing potential with Valproate if other effective treatments are available

3.Do not routinely order electroencephalogram (EEG) as part of initial syncope work-up.

4.Do not prescribe long-term treatment with antiepileptic drugs after withdrawal seizure

5.Do not routinely perform brain imaging after acute seizure in patients with established epilepsy

Nine-year prospective efficacy and safety of brain-responsive #neurostimulation for focal #epilepsy
https://2medical.news/2020/08/02/nine-year-prospective-efficacy-and-safety-of-brain-responsive-neurostimulation-for-focal-epilepsy/

Prospectively evaluate safety and efficacy of brain-responsive neurostimulation in adults with medically intractable focal onset seizures (FOS) over 9 years.. Adults treated with brain-responsive neurostimulation within 2 year feasibility or randomized controlled trials enrolled into a long-term prospective open label trial (LTT) to assess safety, efficacy, and quality of life (QOL) over an additional 7 years. Safety was assessed as adverse events (AEs), efficacy as …

#Cognitive decline in older adults with #epilepsy: The Cardiovascular Health Study
https://2medical.news/2020/12/09/cognitive-decline-in-older-adults-with-epilepsy-the-cardiovascular-health-study/

Cognitive decline is a major concern for older adults with epilepsy. Whether and how much faster older adults with epilepsy experience cognitive decline beyond expected age‐related cognitive change remain unclear. We sought to estimate and compare rates of cognitive decline in older adults with and without epilepsy.. ..The rate of decline in 3MS was significantly faster in prevalent epilepsy (P < .001) and after incident …

Effects of double-dose #statin therapy for the prevention of post- #stroke #epilepsy: A prospective clinical study
https://2medical.news/2021/04/19/effects-of-double-dose-statin-therapy-for-the-prevention-of-post-stroke-epilepsy-a-prospective-clinical-study/

To determine treatment effects on the incidence of post-stroke epilepsy (PSE) using different doses of statin, a prospective hospital-based cohort study was designed to explore whether a double-dose statin treatment can better prevent the occurrence of PSE. Methods :A total of 1152 patients with newly diagnosed ischemic stroke admitted to our hospital from March to August 2017 were selected, 1033 of whom were followed-up. Patients …

Associations of #overweight and #obesity with drug-resistant #epilepsy

https://2medical.news/2021/07/29/associations-of-overweight-and-obesity-with-drug-resistant-epilepsy/