Abstract:
OBJECTIVE:Optimal choice of antiseizure medication (ASM) depends on seizure type, syndrome, age, gender, comorbidities and co-medications. There are no fixed rules on how to weigh these factors; choices are subjective and experience-driven. We investigated agreement among experts in selecting ASM as monotherapy and used their prevailing choices to validate a web-based decision-support application. METHODS:Twenty-four international experts, blinded to the app, selected the optimal ASM for 25 individual patient-cases covering a wide variation of seizure types and other factors influencing ASM selection. The app ranked ASMs in order of likely appropriateness for each case. In a second step, experts rated anonymously the choices of the app. RESULTS:Of the 25 patient-cases (age 13-74 years), 13 were female, 18 (72%) had comorbidities, six (24%) were on contraceptives, and 13 (52%) had other co-medications. The median number of experts who selected the same ASM for a given case was 15 (62.5%) and interquartile range (IQR) 13-18 (54%-75%). Gwet's agreement coefficient among experts was 0.38 (95% confidence interval [CI] 0.32-0.44), corresponding to a "fair" agreement. Agreement between the app and the prevailing expert choice for each case was 0.48 (95% CI 0.29-0.67), corresponding to a "moderate" beyond chance agreement. The percent agreement between the highest ranked selections of the app and the expert selections was 73% (95% CI 64%-82%). Ninety-five percent of the experts considered that no incorrect or potentially harmful ASMs were ranked highest by the app, and most experts strongly agreed with the app's selections. SIGNIFICANCE:This app, now validated by experts, provides an objective, reproducible method for selecting ASM that accounts for relevant clinical features. It is freely available at: https://epipick.org.
journal_name
Epilepsiajournal_title
Epilepsiaauthors
Beniczky S,Rampp S,Asadi-Pooya AA,Rubboli G,Perucca E,Sperling MRdoi
10.1111/epi.16763subject
Has Abstractpub_date
2021-01-01 00:00:00pages
220-227issue
1eissn
0013-9580issn
1528-1167journal_volume
62pub_type
杂志文章相关文献
EPILEPSIA文献大全abstract::Eleven patients had seizures with unilateral temporal lobe onset recorded with simultaneous bilateral medial temporal depth electrodes and neocortical (subdural) electrodes at least on the side of seizure onset. Of a total of 55 seizures, four had simultaneous onset in neocortex and hippocampus, and 51 had onset in un...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1987.tb03676.x
更新日期:1987-09-01 00:00:00
abstract::The effects of seizures on the hypocretin/orexin system have not yet been investigated in epileptic patients. The present study aimed to assay hypocretin-1 in the cerebrospinal fluid (CSF) of patients after generalized tonic-clonic (GTC) seizures. Study groups consisted of 21 patients after GTC seizures and 19 control...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2008.01990.x
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:Drebrins are crucial for synaptic function and dendritic spine development, remodeling, and maintenance. In temporal lobe epilepsy (TLE) patients, a significant hippocampal synaptic reorganization occurs, and synaptic reorganization has been associated with hippocampal hyperexcitability. This study aimed to e...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.16595
更新日期:2020-08-01 00:00:00
abstract:PURPOSE:To investigate whether atypical language dominance in epilepsy patients is related to localization and type of lesions. METHODS:Four hundred and forty-five epilepsy patients received bilateral Wada testing. Language was classified as left (L), right (R), bilateral-dependent (BD, speech arrest after left and ri...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2008.02000.x
更新日期:2009-06-01 00:00:00
abstract:SUMMARY:Phenobarbital (PB) is the most widely used antiepileptic drug (AED) in the developing world and remains a popular choice in many industrialized countries. Meta-analyses of randomized controlled trials suggest that few differences in efficacy exist between PB and other established AEDs, but its possible deleteri...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.0013-9580.2004.12704.x
更新日期:2004-09-01 00:00:00
abstract::We conducted a retrospective longitudinal self-controlled study of 124 adult patients treated with resective surgery for medically uncontrolled partial epilepsy from 1949 to 1988. Approximately 65% of the patients experienced > 95% reduction in seizure frequency, and 75% had worthwhile improvement of at least 75% seiz...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1994.tb02474.x
更新日期:1994-05-01 00:00:00
abstract::In patients with pharmacoresistant focal epilepsy,we demonstrate that magnetoencephalography (MEG) detects spike-locked and spike-independent epileptic high gamma oscillations (HGOs) using combined MEG and invasive electroencephalography (iEEG) from subdural macroelectrodes. Six patients, who underwent presurgical wor...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2010.02579.x
更新日期:2010-08-01 00:00:00
abstract::Before a health education program can be established, one must first know what the target population believes and does with respect to the disease in question. Therefore, we performed a study among Tanzanian rural inhabitants to identify their knowledge, attitude, and practice (KAP) toward epilepsy: 3,256 heads of hou...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1993.tb02127.x
更新日期:1993-11-01 00:00:00
abstract::Despite the introduction of newer antiepileptic drugs (AEDs), nonresponsiveness to AEDs remains a common problem in epilepsy clinics. There may be important genetic determinants for responsiveness, and this discussion focused on some potential areas: drug transporters; drug-metabolizing enzymes, and ion channels. We r...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1046/j.1528-1157.44.s.1.13.x
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To investigate the characteristics of motor manifestation during convulsive epileptic and psychogenic nonepileptic seizures (PNES), captured using a wrist-worn accelerometer (ACM) device. The main goal was to find quantitative ACM features that can differentiate between convulsive epileptic and convulsive PNE...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.14619
更新日期:2019-01-01 00:00:00
abstract::The progressive myoclonus epilepsies (PMEs) are a group of rare genetic disorders previously shrouded in nosological confusion. Recent advances have clarified the features of these disorders and provided a rational approach to diagnosis. The major causes of PME are now known to be Unverricht-Lundborg disease, myoclonu...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.1528-1167.1993.tb06256.x
更新日期:1993-01-01 00:00:00
abstract:PURPOSE:Previous studies have estimated medical care costs of epilepsy by applying unit costs to estimated utilization or by summing costs for (a) ambulatory care and hospitalizations coded as epilepsy and (b) procedures and drugs specifically associated with the diagnosis or treatment of epilepsy. These methods may un...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.2000.tb00288.x
更新日期:2000-08-01 00:00:00
abstract:PURPOSE:To examine the inhibitory effect of anticonvulsants (AEDs) on carnitine transport by the human placental carnitine transporter. METHODS:Uptake of radiolabeled carnitine by human placental brush-border membrane vesicles was measured in the absence and presence of tiagabine (TGB), vigabatrin (VGB), gabapentin (G...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.0013-9580.2004.29603.x
更新日期:2004-03-01 00:00:00
abstract::Neuropsychological evaluation differs from other methods used to localize cerebral lesions in that it analyzes cognitive function. Tests sample widely among cognitive abilities, contrasting language proficiency with visuospatial skills. A thorough assessment of memory is crucial in the investigation because of the pro...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract::Two patients developed clinical and laboratory evidence of systemic lupus erythematosus (SLE) during treatment with valproate (VPA) preparations. The first patient, a 47-year-old man, had fever, malaise, and thrombocytopenia 1 month after VPA was added to phenytoin (PHT) and primidone (PRM). He developed high titers o...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1990.tb05386.x
更新日期:1990-05-01 00:00:00
abstract::Characteristics of spontaneous spindling in electrocorticograms from awake rodents are described. Comparisons are made between this spontaneous activity and epileptic activity generated in the sensorimotor cortex. ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1979.tb04833.x
更新日期:1979-10-01 00:00:00
abstract::In this article, we review the incidence and significance of seizures in well-established autoimmune disorders, including multiple sclerosis (MS), diabetes mellitus, celiac disease, thyroid disease, and systemic lupus erythematosus (SLE). The five following presentations discuss the incidence and possible pathogenesis...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.1528-1167.2011.03030.x
更新日期:2011-05-01 00:00:00
abstract:PURPOSE:To validate a brief screening instrument for identifying people with epilepsy in epidemiologic or genetic studies. METHODS:We designed a nine-question screening instrument for epilepsy and administered it by telephone to individuals with medical record-documented epilepsy (lifetime history of >or=2 unprovoked ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2009.02274.x
更新日期:2010-02-01 00:00:00
abstract::A 25-year-old man presented with seizures characterized by unconsciousness, automatic behavior, and myoclonic jerks lasting 0.5 to 8 sec. Videotape analysis of 300 simultaneously recorded electroencephalographic and clinical attacks revealed 8- to 9-Hz 150 to 200 muV sharp waves beginning in both medial temporal areas...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1975.tb06081.x
更新日期:1975-09-01 00:00:00
abstract::Quantitative evidence of hippocampal atrophy has been correlated with site of seizure onset, hippocampal neuronal loss, and seizure relief after resection. Most studies have quantified hippocampal atrophy using ratios or differences between right and left hippocampal values. However, bilateral hippocampal atrophy may ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1995.tb01634.x
更新日期:1995-09-01 00:00:00
abstract::This chapter covers the syndromes of benign epilepsy with centrotemporal spikes (BECTS), nonlesional focal epilepsy in otherwise normal children (NLFN), and the genetic generalized epilepsies. BECTS is an epilepsy syndrome that always enters terminal remission before the general age of a planned transition of adolesce...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/epi.12706
更新日期:2014-08-01 00:00:00
abstract:PURPOSE:Study of families containing multiple affected individuals is essential for genetic research on the epilepsies, yet practically nothing has been published about methods for identification and recruitment of families or expected participation rates. Here we describe the strategy used for data collection in a gen...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.0013-9580.2005.41904.x
更新日期:2005-02-01 00:00:00
abstract::A child had two to three generalized tonic-clonic (GTC) seizures per week unresponsive to phenobarbital (PB) and valproate (VPA). Interictal EEG demonstrated left occipital spikes. When carbamazepine (CBZ) therapy was started, he developed very frequent (4-6/day) complex partial seizures (CPS) characterized on ictal E...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1991.tb05255.x
更新日期:1991-03-01 00:00:00
abstract:PURPOSE:Adult epilepsy studies have demonstrated cerebral and cerebellar volume reduction beyond the epileptogenic zone, correlating this with an inferior surgical outcome. We determined whether brain volumes were reduced in childhood epilepsy and the significance of this. METHODS:Cerebral, cerebellar, and hippocampal...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.2000.tb00122.x
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:Automatic detection of generalized tonic-clonic seizures (GTCS) will facilitate patient monitoring and early intervention to prevent comorbidities, recurrent seizures, or death. Brain Sentinel (San Antonio, Texas, USA) developed a seizure-detection algorithm evaluating surface electromyography (sEMG) signals ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.13083
更新日期:2015-09-01 00:00:00
abstract:PURPOSE:Epileptic spasms are seizures that occur predominantly in children and are characterized by clusters of brief axial movements. Epileptic spasms may occur in the context of a variety of syndromes. Previous research has found that epileptic spasms occur in a sleep/wake and diurnal rhythm. The purpose of this stud...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2012.03499.x
更新日期:2012-07-01 00:00:00
abstract:PURPOSE:To assess the usefulness of an early postictal EEG in neurologically normal children with complex febrile seizures. METHODS:We conducted a retrospective chart review of all neurologically normal children who were hospitalized over a period of 2.5 years after complex febrile seizures, and had an EEG up to 1 wee...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.2000.tb00143.x
更新日期:2000-02-01 00:00:00
abstract:PURPOSE:To identify the temporal lobe cortical dysplasia (CD) histopathology classification subtype and determine the seizure outcome of patients who underwent temporal lobectomy with coincident CD. METHODS:We reviewed the data of 28 patients with temporal lobe epilepsy who underwent surgery with pathologically verifi...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1046/j.1528-1157.2003.16703.x
更新日期:2003-11-01 00:00:00
abstract::Felbamate (2-phenyl-1,3-propanediol dicarbamate), phenytoin, phenobarbital, ethosuximide, and valproate were evaluated in mice and rats with a battery of well-standardized anticonvulsant test procedures. The results obtained indicate that felbamate exhibits a wider range of experimental anticonvulsant activity than ei...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1986.tb03497.x
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Multidrug transporters are postulated to contribute to antiepileptic drug (AED) resistance. The transporter best studied is P-glycoprotein, an ATP-Binding Cassette (ABC) transporter superfamily member. RLIP76 is suggested to be an energy-dependent non-ABC transporter, reducing AED blood-brain barrier penetra...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2007.00926.x
更新日期:2007-04-01 00:00:00