SCOPING QUESTION: For adults and children with medication-resistant convulsive epilepsy, which anti-epileptic medications produce benefits and/or harm in the specified outcomes when compared to a placebo or a comparator?
SCOPING QUESTION: In adults with established status epilepticus (i.e., seizures persisting after the first-line treatment with benzodiazepines [or benzodiazepines-resistant status epilepticus]), which anti-epileptic medications are associated with cessation of seizures and reduced adverse effects)?
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Epilepsia, 55(4):475–482, 2014
doi: 10.1111/epi.12550
Received: 16/11/2013 - Accepted: 23/03/2014 - Published: 27/07/2014
Lancet 2012; 380: 1193–1201
Series: Epilepsy 2
www.jogh.org • doi: 10.7189/jogh.02.020405 ~ December 2012 • Vol. 2 No. 2 • 020405
Clinical guideline | Published: 11 January 2012 | nice.org.uk/guidance/cg137
BMC Medicine201210:107
https://doi.org/10.1186/1741-7015-10-107© Katchanov and Birbeck; licensee BioMed Central Ltd. 2012
Received: 10 July 2012Accepted: 24 September 2012Published: 24 September 2012
In 2011, the World Health Organization’s (WHO) mental health Gap Action Programme (mhGAP) r...eleased evidence-based epilepsy-care guidelines for use in low and middle income countries (LAMICs). From a
geographical, sociocultural, and political perspective, LAMICs represent a heterogenous group with significant differences in the epidemiology, etiology, and perceptions of epilepsy. Successful implementation of
the guidelines requires local adaptation for use within individual countries. For effective implementation and sustainability, the sense of ownership and empowerment must be transferred from the global health authorities to the local people. Sociocultural and financial barriers that impede the implementation of the guidelines should be
identified and ameliorated. Impact assessment and program revisions should be planned and a budget allocated to them. If effectively implemented, as intended, at the primary-care level, the mhGAP
guidelines have the potential to facilitate a substantial reduction in the epilepsy treatment gap and improve the quality of epilepsy care in resource-limited settings.
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Q 10: In adults and children with epilepsy, which psychological interventions used as adjunctive therapies with antiepileptic drugs when compared to placebo/comparator produce benefits/harm in specified outcomes?
Q9. In adults and children with convulsive epilepsy in remission, when should treatment be discontinued?
Q6: What is the added advantage of doing neuroimaging in people with convulsive epilepsy in non-specialist settings in low and middle income countries?
Q3: Can febrile seizures (simple or complex) be managed at first or second level care by non-specialist health care providers in low and middle income country settings? What is the role of diagnostic tests in the management of febrile seizures by non-specialists in low and middle income settings? Fo...r prophylaxis to prevent recurrence of simple or complex febrile seizures, which of the pharmacological interventions when compared with placebo/comparator produce benefit/harm in specified outcomes?
- continuous anticonvulsant therapy - intermittent anticonvulsant therapy - intermittent antipyretic treatment
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Q5: What is the added advantage of doing an electroencephalography (EEG) in people with convulsive epilepsy in non- specialist settings in low and middle income countries?
Q8. Should Anti-Epileptic Drug (AED) treatment be started after first unprovoked seizure in non-specialist health settings?
Q 7: For adults and children with convulsive epilepsy, which standard antiepileptic drugs (phenobarbital, phenytoin, carbamazepine, valproic acid) when compared to placebo/a comparator produce benefits/harm in the specified outcomes?
Q4: Can convulsive epilepsy be diagnosed at first level care by a non-specialist health care provider in low and middle income country settings?
Q12: Should the treatment be similar in individuals with intellectual disability and epilepsy compared to people with epilepsy only?
Q11: 11a). In women with epilepsy, should antiepileptic therapy be prescribed as monotherapy or polytherapy to decrease the risk of fetal malformations?
11b). Does the use of folic acid preconceptually decrease the risk of foetal malformations in women with epilepsy?
11c). Do phenytoin, phenobarbi...tal, valproic acid or carbamazepine enter breast milk in quantities which are clinically significant to the baby?
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