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Ettore Beghi - One of the best experts on this subject based on the ideXlab platform.
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treatment of first Tonic Clonic Seizure does not affect mortality long term follow up of a randomised clinical trial
Journal of Neurology Neurosurgery and Psychiatry, 2011Co-Authors: M Leone, Alessandra Solari, Roberto Vallalta, Ettore BeghiAbstract:Background Information on the effects of early treatment of Seizures on mortality is scarce. The authors assessed the survival of patients with a first generalised Tonic–Clonic Seizure, randomised to immediate treatment (treated) versus treatment only in the event of Seizure recurrence (untreated), over a 20-year period. Methods The authors followed 419 patients. The median follow-up was 19.7 years (range 0.2–21.5) for a total of 7867 person-years. Results 40 persons (9.6%) died during follow-up, 19 (8.9%) treated and 21 (10.3.%) untreated. The probability of surviving was 100% at 1 year, 97% (95% CI 95% to 99%) at 5 years, 94% (91–97) at 10 years and 91% (87–95) at 20 years in treated patients and 100%, 98% (95–100), 97% (94–99) and 89% (85–94), respectively, in untreated patients (p=0.7). After adjustment for treatment of first Seizure and putative risk factors (gender, age, Seizure type, previous uncertain Seizures, family history of Seizures, pre-, peri- and postnatal risk factors, remote aetiological factors for epilepsy, abnormal neurological examination, CT or MRI abnormalities, EEG abnormalities and acute treatment), only the presence of aetiological factors for epilepsy predicted a higher mortality (HR 3.4, 95% CI 2.5 to 4.3%; p Conclusion Starting antiepileptic treatment immediately after the first generalised Tonic–Clonic Seizure or only after Seizure recurrence did not affect survival over the following 20 years.
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treatment of the first Tonic Clonic Seizure does not affect long term remission of epilepsy
Neurology, 2006Co-Authors: M Leone, Alessandra Solari, Ettore BeghiAbstract:We followed 419 patients with a first, unprovoked, primarily or secondarily generalized Tonic-Clonic Seizure, randomized to immediate antiepileptic treatment or to treatment only in the event of Seizure recurrence. The probability of achieving a 2-year remission was 72 vs 57% at 3 months, 84 to 79% at 3 years, and 85 to 86% at 10 years (p = NS). The probability of entering 5-year remission was 47 to 40, 58 to 58, and 64 to 64% (p = NS). Early treatment does not affect the long-term prognosis of epilepsy.
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risk factors for a first generalized Tonic Clonic Seizure in adult life
Neurological Sciences, 2002Co-Authors: M Leone, Ettore Beghi, E Bottacchi, E Morgando, R Mutani, R Cremo, Ravagli L Ceroni, I FlorianiAbstract:To evaluate risk factors for a first generalized Tonic-Clonic Seizure (GTCS) in adults (=15 years), we performed a multicenter, case-control study involving eleven first-referral neurological departments in north-western Italy. The study enrolled 278 patients with a first GTCS, and 556 age- and sex-matched hospital controls. Cases and controls were interviewed through a questionnaire (inter-rater and index-proxy agreement varied between 75% and 100% for the different questions). Risk factors significantly associated with a first GTCS were: severe head trauma (odds ratio 9.9; 95% confidence limits 2.0–67.1), siblings with Seizures (5.7; 1.7–21.4), alcohol intake >50 grams/day (4.9; 3.1–7.9), history of stroke (3.8; 1.8–8.0), complications of delivery (2.7; 1.5–5.1), other relatives with Seizures (2.4; 1.3–4.6), sleep deprivation (2.4; 1.4–4.1), low gestational age (1.9; 1.1–3.4), mild-moderate head trauma (1.8; 1.2–3.0), and low birth weight (1.6; 1.0–2.7). Genetic and late acquired factors and life habits are major risk factors for a first GTCS in adults, while pre- and perinatal events play only a minor role.
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treatment of first Tonic Clonic Seizure does not improve the prognosis of epilepsy
Neurology, 1997Co-Authors: Massimo Musicco, Ettore Beghi, Alessandra Solari, F VianiAbstract:It is widely agreed that after two or more Seizures patients should be given antiepileptic treatment, but there is still controversy about the treatment of patients after a first unprovoked Seizure. In a multicenter, randomized, open trial, patients with a first Tonic-Clonic Seizure were randomized to immediate treatment (carbamazepine, phenytoin, phenobarbital, or sodium valproate) or to treatment only after another Seizure. Fifty-two(24%) of the 215 patients randomized to immediate treatment and 85 (42%) of the 204 randomized to delayed treatment experienced Seizure recurrence during follow-up. Age, acute treatment of the Seizure with benzodiazepines, remote etiologic factors, and EEG abnormalities were significant predictors of relapse. Of the immediately treated patients, 87% had no Seizures for a year and 68% had no Seizures for 2 years, whereas only slightly fewer initially untreated patients (83% and 60%) achieved these endpoints. Patients treated after the first Seizure and those treated after Seizure relapse had the same time-dependent probability of achieving 1 and 2 Seizure-free years. None of the variables that were prognostic predictors of relapse was significantly associated with the probability of having 1 or 2 years of Seizure control. Anticonvulsants in patients presenting a first Tonic-Clonic Seizure reduce the risk of relapse; however, 50% of patients who are not treated will never experience a second Seizure. Moreover, the probability of long-term remission is not influenced by treatment of the first Seizure.
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alcohol use is a risk factor for a first generalized Tonic Clonic Seizure the alc e alcohol and epilepsy study group
Neurology, 1997Co-Authors: M Leone, Ettore Beghi, E Bottacchi, E Morgando, R Mutani, R Cremo, G Amedeo, M Gianelli, Ravagli L CeroniAbstract:We performed a multicenter case-control study to estimate whether chronic alcoholism and alcohol consumption are risk factors for developing a first generalized Tonic-Clonic Seizure (GTCS). We studied 237 first-Seizure patients (158 men, 79 women) matched to 474 hospital controls for center, sex, age (+/-5 years), and weekday of the Seizure. The risk of first GTCS in alcoholics was greater than in non-alcoholics for men (odds ratio, 6.8; 95% confidence limits, 3.6-13.0) and women (6.8, 1.6-32.6). The odds ratio (both sexes) was 1.2 (0.8-1.8) for an average daily intake of absolute alcohol of 1 to 25 g/day and rose with the amount of alcohol consumed daily: 1.3 (0.8-2.1) for 26 to 50 g/day, 3.0 (1.7-5.4) for 51 to 100 g/day, 7.9 (2.9-21.9) for 101 to 200 g/day, and 16.6 (1.9-373.4) for >200 g/day. Our study provides evidence of a powerful association between alcohol use, alcoholism, and the first GTCS.
M Leone - One of the best experts on this subject based on the ideXlab platform.
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treatment of first Tonic Clonic Seizure does not affect mortality long term follow up of a randomised clinical trial
Journal of Neurology Neurosurgery and Psychiatry, 2011Co-Authors: M Leone, Alessandra Solari, Roberto Vallalta, Ettore BeghiAbstract:Background Information on the effects of early treatment of Seizures on mortality is scarce. The authors assessed the survival of patients with a first generalised Tonic–Clonic Seizure, randomised to immediate treatment (treated) versus treatment only in the event of Seizure recurrence (untreated), over a 20-year period. Methods The authors followed 419 patients. The median follow-up was 19.7 years (range 0.2–21.5) for a total of 7867 person-years. Results 40 persons (9.6%) died during follow-up, 19 (8.9%) treated and 21 (10.3.%) untreated. The probability of surviving was 100% at 1 year, 97% (95% CI 95% to 99%) at 5 years, 94% (91–97) at 10 years and 91% (87–95) at 20 years in treated patients and 100%, 98% (95–100), 97% (94–99) and 89% (85–94), respectively, in untreated patients (p=0.7). After adjustment for treatment of first Seizure and putative risk factors (gender, age, Seizure type, previous uncertain Seizures, family history of Seizures, pre-, peri- and postnatal risk factors, remote aetiological factors for epilepsy, abnormal neurological examination, CT or MRI abnormalities, EEG abnormalities and acute treatment), only the presence of aetiological factors for epilepsy predicted a higher mortality (HR 3.4, 95% CI 2.5 to 4.3%; p Conclusion Starting antiepileptic treatment immediately after the first generalised Tonic–Clonic Seizure or only after Seizure recurrence did not affect survival over the following 20 years.
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treatment of the first Tonic Clonic Seizure does not affect long term remission of epilepsy
Neurology, 2006Co-Authors: M Leone, Alessandra Solari, Ettore BeghiAbstract:We followed 419 patients with a first, unprovoked, primarily or secondarily generalized Tonic-Clonic Seizure, randomized to immediate antiepileptic treatment or to treatment only in the event of Seizure recurrence. The probability of achieving a 2-year remission was 72 vs 57% at 3 months, 84 to 79% at 3 years, and 85 to 86% at 10 years (p = NS). The probability of entering 5-year remission was 47 to 40, 58 to 58, and 64 to 64% (p = NS). Early treatment does not affect the long-term prognosis of epilepsy.
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risk factors for a first generalized Tonic Clonic Seizure in adult life
Neurological Sciences, 2002Co-Authors: M Leone, Ettore Beghi, E Bottacchi, E Morgando, R Mutani, R Cremo, Ravagli L Ceroni, I FlorianiAbstract:To evaluate risk factors for a first generalized Tonic-Clonic Seizure (GTCS) in adults (=15 years), we performed a multicenter, case-control study involving eleven first-referral neurological departments in north-western Italy. The study enrolled 278 patients with a first GTCS, and 556 age- and sex-matched hospital controls. Cases and controls were interviewed through a questionnaire (inter-rater and index-proxy agreement varied between 75% and 100% for the different questions). Risk factors significantly associated with a first GTCS were: severe head trauma (odds ratio 9.9; 95% confidence limits 2.0–67.1), siblings with Seizures (5.7; 1.7–21.4), alcohol intake >50 grams/day (4.9; 3.1–7.9), history of stroke (3.8; 1.8–8.0), complications of delivery (2.7; 1.5–5.1), other relatives with Seizures (2.4; 1.3–4.6), sleep deprivation (2.4; 1.4–4.1), low gestational age (1.9; 1.1–3.4), mild-moderate head trauma (1.8; 1.2–3.0), and low birth weight (1.6; 1.0–2.7). Genetic and late acquired factors and life habits are major risk factors for a first GTCS in adults, while pre- and perinatal events play only a minor role.
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alcohol use is a risk factor for a first generalized Tonic Clonic Seizure the alc e alcohol and epilepsy study group
Neurology, 1997Co-Authors: M Leone, Ettore Beghi, E Bottacchi, E Morgando, R Mutani, R Cremo, G Amedeo, M Gianelli, Ravagli L CeroniAbstract:We performed a multicenter case-control study to estimate whether chronic alcoholism and alcohol consumption are risk factors for developing a first generalized Tonic-Clonic Seizure (GTCS). We studied 237 first-Seizure patients (158 men, 79 women) matched to 474 hospital controls for center, sex, age (+/-5 years), and weekday of the Seizure. The risk of first GTCS in alcoholics was greater than in non-alcoholics for men (odds ratio, 6.8; 95% confidence limits, 3.6-13.0) and women (6.8, 1.6-32.6). The odds ratio (both sexes) was 1.2 (0.8-1.8) for an average daily intake of absolute alcohol of 1 to 25 g/day and rose with the amount of alcohol consumed daily: 1.3 (0.8-2.1) for 26 to 50 g/day, 3.0 (1.7-5.4) for 51 to 100 g/day, 7.9 (2.9-21.9) for 101 to 200 g/day, and 16.6 (1.9-373.4) for >200 g/day. Our study provides evidence of a powerful association between alcohol use, alcoholism, and the first GTCS.
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alcohol use is a risk factor for a first generalized Tonic Clonic Seizure
Neurology, 1997Co-Authors: M Leone, Ettore Beghi, E Bottacchi, E Morgando, R Mutani, R Cremo, G Amedeo, M Gianelli, Ravagli L CeroniAbstract:We performed a multicenter case-control study to estimate whether chronic alcoholism and alcohol consumption are risk factors for developing a first generalized Tonic-Clonic Seizure (GTCS). We studied 237 first-Seizure patients (158 men, 79 women) matched to 474 hospital controls for center, sex, age (+/-5 years), and weekday of the Seizure. The risk of first GTCS in alcoholics was greater than in non-alcoholics for men (odds ratio, 6.8; 95% confidence limits, 3.6-13.0) and women (6.8, 1.6-32.6). The odds ratio (both sexes) was 1.2 (0.8-1.8) for an average daily intake of absolute alcohol of 1 to 25 g/day and rose with the amount of alcohol consumed daily: 1.3 (0.8-2.1) for 26 to 50 g/day, 3.0 (1.7-5.4) for 51 to 100 g/day, 7.9 (2.9-21.9) for 101 to 200 g/day, and 16.6 (1.9-373.4) for >200 g/day. Our study provides evidence of a powerful association between alcohol use, alcoholism, and the first GTCS.
K V Leeper - One of the best experts on this subject based on the ideXlab platform.
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successful treatment of amoxapine induced refractory status epilepticus with propofol diprivan
Academic Emergency Medicine, 1995Co-Authors: Kevin S Merigian, Randall G Browning, K V LeeperAbstract:Tonic-Clonic Seizure activity is a recognized complication of amoxapine overdose. Refractory drug-induced status epilepticus is associated with significant morbidity and mortality. Standard regimens for controlling status epilepticus may be ineffective for aborting drug-induced Seizures. The authors report the case of a 30-year-old woman who presented with an amoxapine overdose that deteriorated into status epilepticus refractory to conventional therapy. Propofol given by intravenous bolus and maintenance infusion successfully halted the patient's Seizure activity. This case suggests that propofol may be effective as an anticonvulsant in refractory drug-induced status epilepticus.
Jarogniew J łuszczki - One of the best experts on this subject based on the ideXlab platform.
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new derivative of 1 2 4 triazole 3 thione tp427 potentiates the anticonvulsant action of valproate but not that of carbamazepine phenytoin or phenobarbital in the mouse Tonic Clonic Seizure model
Pharmacological Reports, 2019Co-Authors: Jarogniew J łuszczki, Maria W Kondratwrobel, Slawomir Karwan, Pawel Marzeda, Agata Gutlepiech, Paula Wroblewskałuczka, Tomasz PlechAbstract:Abstract Background To assess the effects of 5-(3-chlorobenzyl)-4-hexyl-2,4-dihydro-3H-1,2,4-triazole-3-thione (TP427) on the protective anticonvulsant action of four classical antiepileptic drugs (carbamazepine, phenobarbital, phenytoin and valproate) in the Tonic-Clonic Seizure model in mice, an isobolographic transformation of data was used. Methods Electrically-induced Tonic-Clonic Seizures were experimentally evoked in adult male albino Swiss mice. The anticonvulsant effects of TP427, when used singly, were determined by the calculation of the threshold increasing the dose by 20% (TID20 value). The influence of TP427 on the anticonvulsant potency of four various classical antiepileptic drugs was determined with a subthreshold method. Types of interactions between drugs were determined using the isobolographic transformation of data. Additionally, total brain antiepileptic drug concentrations were measured. Results TP427, when administered separately, significantly increased the threshold for electroconvulsions. The experimentally determined TID20 value for TP427 was 11.71 mg/kg. Moreover, TP427 (10 mg/kg) significantly increased the anticonvulsant activity of valproate (p Conclusion The synergistic interaction between TP427 and valproate in the mouse Tonic-Clonic Seizure model might occur favorable for epilepsy patients in future. The combinations of TP427 with carbamazepine, phenobarbital and phenytoin were additive in the mouse Tonic-Clonic Seizure model and also deserves clinical attention.
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influence of dronedarone a class iii antiarrhythmic drug on the anticonvulsant potency of four classical antiepileptic drugs in the Tonic Clonic Seizure model in mice
Journal of Neural Transmission, 2019Co-Authors: Katarzyna M Sawicka, Agnieszka Wawryniuk, Jadwiga Daniluk, Slawomir Karwan, Magdalena Florekłuszczki, Jaroslaw Chmielewski, Jarogniew J łuszczkiAbstract:Increasing evidence indicates that some antiarrhythmic drugs play a pivotal role in Seizures, not only in vivo studies on animals, but also in clinical trials. Some of these antiarrhythmic drugs potentiate or alleviate the anticonvulsant action of the classical antiepileptic drugs. The aim of this study was to determine the influence of dronedarone (DRO-a multichannel blocker belonging to the class III of antiarrhythmic drugs) on the anticonvulsant effects of four standard antiepileptic drugs (carbamazepine, phenobarbital, phenytoin and valproate) in the Tonic-Clonic Seizure model in mice. Potential acute adverse effects exerted by the antiepileptic drugs combined with DRO were evaluated in three behavioral tests (chimney, grip-strength and passive avoidance). To confirm the nature of interaction, total brain concentrations of antiepileptic drugs were measured. DRO (50 mg/kg, i.p.) significantly reduces the anticonvulsant potency of phenytoin (P < 0.05), having no impact on that of carbamazepine, phenobarbital and valproate in the Tonic-Clonic Seizure model in mice. DRO (50 mg/kg) neither changed total brain concentrations of phenytoin in mice, nor affected normal behavior in experimental animals subjected to the chimney, grip-strength and passive avoidance tests. In conclusion, DRO should not be combined with phenytoin because it reduced the anticonvulsant effects of the latter drug in experimental animals. The combined administration of DRO with carbamazepine, phenobarbital and valproate resulted in neutral interaction between these drugs in the Tonic-Clonic Seizure model in mice.
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isobolographic additivity among lacosamide lamotrigine and phenobarbital in a mouse Tonic Clonic Seizure model
Advances in Clinical and Experimental Medicine, 2018Co-Authors: Maria W Kondratwrobel, Jarogniew J łuszczkiAbstract:Background Epilepsy is a serious neurological disease affecting about 1% of people worldwide (65 million). Seizures are controllable with antiepileptic drugs (AEDs) in about 70% of epilepsy patients, however, there remains about 30% of patients inadequately medicated with these AEDs, who need a satisfactory control of their Seizure attacks. For these patients, one of the treatment options is administration of 2 or 3 AEDs in combination. Objectives To determine the anticonvulsant effects of a combination of 3 selected AEDs (i.e., lacosamide - LCM, lamotrigine - LTG and phenobarbital - PB) at the fixed-ratio of 1:1:1 in a mouse maximal electroshock-induced (Tonic-Clonic) Seizure model by using isobolographic analysis. Material and methods Seizure activity was evoked in adult male albino Swiss mice by a current (sinewave, 25 mA, 500 V, 50 Hz, 0.2 s stimulus duration) delivered via auricular electrodes. Type I isobolographic analysis was used to detect interaction for the 3-drug combination. Results With type I isobolographic analysis, the combination of LCM, LTG and PB (at the fixed-ratio of 1:1:1) exerted additive interaction in the mouse maximal electroshock-induced (Tonic-Clonic) Seizure model. Conclusions The combination of LCM with LTG and PB produced additive interaction in the mouse TonicClonic Seizure model, despite various molecular mechanisms of action of the tested AEDs.
Ravagli L Ceroni - One of the best experts on this subject based on the ideXlab platform.
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risk factors for a first generalized Tonic Clonic Seizure in adult life
Neurological Sciences, 2002Co-Authors: M Leone, Ettore Beghi, E Bottacchi, E Morgando, R Mutani, R Cremo, Ravagli L Ceroni, I FlorianiAbstract:To evaluate risk factors for a first generalized Tonic-Clonic Seizure (GTCS) in adults (=15 years), we performed a multicenter, case-control study involving eleven first-referral neurological departments in north-western Italy. The study enrolled 278 patients with a first GTCS, and 556 age- and sex-matched hospital controls. Cases and controls were interviewed through a questionnaire (inter-rater and index-proxy agreement varied between 75% and 100% for the different questions). Risk factors significantly associated with a first GTCS were: severe head trauma (odds ratio 9.9; 95% confidence limits 2.0–67.1), siblings with Seizures (5.7; 1.7–21.4), alcohol intake >50 grams/day (4.9; 3.1–7.9), history of stroke (3.8; 1.8–8.0), complications of delivery (2.7; 1.5–5.1), other relatives with Seizures (2.4; 1.3–4.6), sleep deprivation (2.4; 1.4–4.1), low gestational age (1.9; 1.1–3.4), mild-moderate head trauma (1.8; 1.2–3.0), and low birth weight (1.6; 1.0–2.7). Genetic and late acquired factors and life habits are major risk factors for a first GTCS in adults, while pre- and perinatal events play only a minor role.
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alcohol use is a risk factor for a first generalized Tonic Clonic Seizure the alc e alcohol and epilepsy study group
Neurology, 1997Co-Authors: M Leone, Ettore Beghi, E Bottacchi, E Morgando, R Mutani, R Cremo, G Amedeo, M Gianelli, Ravagli L CeroniAbstract:We performed a multicenter case-control study to estimate whether chronic alcoholism and alcohol consumption are risk factors for developing a first generalized Tonic-Clonic Seizure (GTCS). We studied 237 first-Seizure patients (158 men, 79 women) matched to 474 hospital controls for center, sex, age (+/-5 years), and weekday of the Seizure. The risk of first GTCS in alcoholics was greater than in non-alcoholics for men (odds ratio, 6.8; 95% confidence limits, 3.6-13.0) and women (6.8, 1.6-32.6). The odds ratio (both sexes) was 1.2 (0.8-1.8) for an average daily intake of absolute alcohol of 1 to 25 g/day and rose with the amount of alcohol consumed daily: 1.3 (0.8-2.1) for 26 to 50 g/day, 3.0 (1.7-5.4) for 51 to 100 g/day, 7.9 (2.9-21.9) for 101 to 200 g/day, and 16.6 (1.9-373.4) for >200 g/day. Our study provides evidence of a powerful association between alcohol use, alcoholism, and the first GTCS.
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alcohol use is a risk factor for a first generalized Tonic Clonic Seizure
Neurology, 1997Co-Authors: M Leone, Ettore Beghi, E Bottacchi, E Morgando, R Mutani, R Cremo, G Amedeo, M Gianelli, Ravagli L CeroniAbstract:We performed a multicenter case-control study to estimate whether chronic alcoholism and alcohol consumption are risk factors for developing a first generalized Tonic-Clonic Seizure (GTCS). We studied 237 first-Seizure patients (158 men, 79 women) matched to 474 hospital controls for center, sex, age (+/-5 years), and weekday of the Seizure. The risk of first GTCS in alcoholics was greater than in non-alcoholics for men (odds ratio, 6.8; 95% confidence limits, 3.6-13.0) and women (6.8, 1.6-32.6). The odds ratio (both sexes) was 1.2 (0.8-1.8) for an average daily intake of absolute alcohol of 1 to 25 g/day and rose with the amount of alcohol consumed daily: 1.3 (0.8-2.1) for 26 to 50 g/day, 3.0 (1.7-5.4) for 51 to 100 g/day, 7.9 (2.9-21.9) for 101 to 200 g/day, and 16.6 (1.9-373.4) for >200 g/day. Our study provides evidence of a powerful association between alcohol use, alcoholism, and the first GTCS.