From the Literature: Seizures

Review the key findings from three recently published studies looking at management of seizures in the hospital setting.

Epilepsia (October 2010)

Authors: Buckingham S, Chervoneva I, Sharan A, et al.

Purpose: To determine the prognostic significant of the time from surgery to first seizure relapse in predicting long-term impact in patients.

Results: Retrospective analysis of patients who reported at least one complex partial seizure or generalized tonic-clonic seizure after anterior temporal lobectomy showed that “the latency from surgery to the first postoperative disabling seizure was significantly associated with long-term outcome.” Longer latency was associated with higher odds of being seizure-free or improved relative to the unimproved state, while “shorter latency increased the likelihood of achieving the worst prognosis.”

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Correlation between Serum Selenium Level and Febrile SeizuresJournal: Pediatric Neurology (November 2010)

Authors: Mahyar A, Ayazi P, Fallahi M, Javadi A.

Purpose: A case-control study was conducted in the Children’s Hospital in Qazvin, Iran, to assess the association between serum selenium level and simple febrile seizures in children

Results: A comparison of serum selenium levels in 30 children who experienced simple febrile seizures with those of febrile children without seizure showed that levels were significantly lower in those who had simple febrile seizures. Researchers concluded that there seems to be “an association between serum selenium deficiency and simple febrile seizures.” Further study, however, is recommended.

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A Comparison of the Pharmacokinetics and Pharmacodynamics of Pregabalin and GabapentinJournal: Clinical Pharmacokinectics (October 1, 2010)

Authors: Bockbrader H, Wesche D, Miller R, et al.

Purpose: To compare the pharmacokinetics of pregabalin and gabapentin, two drugs that “share a similar mechanism of action, inhibiting calcium influx and subsequent release of excitatory neurotransmitters,” yet differ in their pharmacokinetic and pharmacodynamic characteristics. “Gabapentin is absorbed slowly after oral administration, with maximum plasma concentrations attained within 3—4 hours,” while “orally administered pregabalin is absorbed more rapidly, with maximum plasma concentrations attained within 1 hour.”

Results: Both drugs show dose-response relationships in the treatment of postherpetic neuralgia and partial seizures; a pregabalin dosage of 450 mg/day appears to reduce neuropathic pain comparably to the predicted maximum effect of gabapentin, while as an antiepileptic, “pregabalin may be more effective based on the magnitude of the reduction in the seizure frequency.” Researchers concluded that “pregabalin appears to have some distinct pharmacokinetic advantages over gabapentin that may translate into an improved pharmacodynamic effect.”

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