The Medicines and Healthcare Products Regulatory Agency (MHRA) has banned the antiepileptic drug sodium valproate in the UK in all women of childbearing potential who are not enrolled in a pregnancy prevention programme.
The regulator said that it had made the decision to protect public health and in close collaboration with professional bodies, NHS organisations, and patient and campaign groups.
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Convulsive status epilepticus (CSE) is one of the more worrying paediatric emergencies. It’s less common now because of more ready availability of rapidly-acting anticonvulsants such as buccal midazolam in the community; but there remain concerns about what might happen to the child once the acute fits have stopped. Some earlier work suggested that a high proportion develop problems, but a recent unselected population-based study is more reassuring.. To read the full article, log in using your NHS OpenAthens details.
To determine the outcomes of combined stereo-electroencephalography-guided and MRI-guided stereotactic laser interstitial thermal therapy (LITT) in the treatment of patients with drug-resistant mesial temporal lobe epilepsy (mTLE).. To read the full article, log in using your NHS OpenAthens details.
Individual motor improvement after deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson’s disease (PD) varies considerably. Stereotactic targeting of the dorsolateral sensorimotor part of the STN is considered paramount for maximising effectiveness, but studies employing the midcommissural point (MCP) as anatomical reference failed to show correlation between DBS location and motor improvement. The medial border of the STN as reference may provide better insight in the relationship between DBS location and clinical outcome.. To read the full article, log in using your NHS OpenAthens details.
To determine clinical and structural imaging predictors of impulsive–compulsive behaviour (ICB) in de novo Parkinson’s disease (PD).. To read the full article, log in using your NHS OpenAthens details.
Open access. To review clinical and investigation findings in patients referred to a specialist prion clinic who were suspected to have sporadic Creutzfeldt-Jakob disease (sCJD) and yet were found to have an alternative final diagnosis.
Little is known about disease-modifying treatments (DMTs) for multiple sclerosis (MS) and infection risk in clinical practice. We examined the association between DMTs and infection-related medical encounters.. To read the full article, log in using your NHS OpenAthens details.
Open access. The Journal of Neurology, Neurosurgery & Psychiatry brought together a panel of experts on World MS Day 2017 to discuss the importance of time in MS—timing of initiation and withdrawal of disease-modifying treatment, time to consider contributory factors such as vascular disease, and the time and cost burden of MS. This paper, which originated in the round table discussion, reviews the following: latest thinking in timing of disease management; how treatment and prevention of vascular injury may buy additional time for people with MS; new data about the true economic and social burden of the disease for people with MS and their carers.
Sudden unexpected death in epilepsy (SUDEP) in children, although rare, needs critical attention given the tragic nature and devastating consequences for families and caregivers. True incidence is unknown and risk factors are not completely understood, more so in children compared with adults. A focused narrative review of available studies on paediatric SUDEP was undertaken to comprehend its risk factors and to develop strategies to recognise and where possible modify SUDEP risk and ultimately reduce incidence.. To read the full article, log in using your NHS OpenAthens details.
To evaluate the long-term effect of 60 Hz stimulation of the subthalamic nucleus (STN) on dysphagia, freezing of gait (FOG) and other motor symptoms in patients with Parkinson’s disease (PD) who have FOG at the usual 130 Hz stimulation.. To read the full article, log in using your NHS OpenAthens details.
After 20 years of data collection, pregnancy registers have informed prescribing practice. Various populations show trends for a reduction in valproate prescribing, which is associated with an increased risk of anatomical teratogenesis and neurodevelopmental effects in those exposed in utero. Our aim was to determine if any shifts in prescribing trends have occurred in the UK and Ireland Epilepsy and Pregnancy Register cohort and to assess if there had been any change in the overall major congenital malformation (MCM) rate over time.. To read the full article, log in using your NHS OpenAthens details.
In children with epilepsy, fever and infection can trigger seizures. Immunization can also induce inflammation and fever, which could theoretically trigger a seizure. The risk of seizure after immunization in children with pre-existing epilepsy is not known. The study objective was to determine the risk of medically attended seizure after immunization in children with epilepsy < 7 years of age.
Phosphorylated neurofilament heavy chain (pNfH) levels are elevated in cerebrospinal fluid (CSF) of patients with amyotrophic lateral sclerosis (ALS). Instead of CSF, we explored blood as an alternative source to measure pNfH in patients with ALS.. To read the full article, log in using your NHS OpenAthens details.
Severe attacks of neuromyelitis optica spectrum disorder (NMO-SD) are improved by plasma exchange (PLEX) given as an adjunctive therapy. Initial studies failed to demonstrate a delay of PLEX treatment influenced clinical outcome; however PLEX was always used late. We examine the clinical consequences of delay in PLEX initiation on severe optic neuritis and spinal cord attacks in NMO-SD.. To read the full article, log in using your NHS OpenAthens details.
Editorial commentary. Oral standardized frankincense extracts could open a new therapeutic era in treatment of relapsing-remitting multiple sclerosis patients. To read the full article, log in using your NHS OpenAthens details.
Epilepsy is a common neurological disorder occurring in 3% of the US adult population. It is characterised by seizures resulting from aberrant hypersynchronous neural activity. Approximately one-third of newly diagnosed epilepsy cases fail to become seizure-free in response to antiseizure drugs. Optimal seizure control, in cases of drug-resistant epilepsy, often requires neurosurgical intervention targeting seizure foci, such as the temporal lobe. Advances in minimally invasive ablative surgical approaches have led to the development of MRI-guided laser interstitial thermal therapy (LITT). For refractory epilepsy, this surgical intervention offers many advantages over traditional approaches, including real-time lesion monitoring, reduced morbidity, and in some reports increased preservation of cognitive and language processes. We review the use of LITT for epileptic indications in the context of its application as a curative (seizure freedom) or palliative (seizure reduction) measure for both lesional and non-lesional forms of epilepsy. Furthermore, we address the use of LITT for a variety of extratemporal lobe epilepsies. Finally, we describe clinical outcomes, limitations and future applications of LITT for epilepsy.. To read the full article, log in using your NHS OpenAthens details.
We performed a meta-analysis to synthesise current evidence on amyloid-positron emission tomography (PET) burden and presumed preferential occipital distribution in sporadic cerebral amyloid angiopathy (CAA).. To read the full article, log in using your NHS OpenAthens details.