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Treatment of Lennox‐Gastaut syndrome

The optimum treatment for Lennox‐Gastaut syndrome has yet to be established. Lennox‐Gastaut syndrome is a seizure (epilepsy) disorder that is commonly associated with behavioural and mental health problems. Many different treatments are currently used in the treatment of this disorder and many more have been tried in the past, often with little success. The review of trials found that there was no evidence to suggest that any one drug was more effective than another in the treatment of this disorder in terms of controlling the different seizure types. More research is needed to compare the therapies currently available.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Monitoring the bispectral index (BIS) to improve anaesthetic delivery and patient recovery from anaesthesia

The results from this updated review indicate that BIS can be useful in guiding the anaesthetic dose to avoid the risk of intraoperative awareness in surgical patients at high risk for awareness. Furthermore, anaesthesia guided by BIS improves anaesthetic delivery and recovery from anaesthesia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

EEG for children with complex febrile seizures

Febrile seizures (fits) can be classified as simple or complex. Complex febrile seizures are associated with a high temperature (fever), last longer than 15 minutes, occur more than once within 24 hours and are confined to one side of the child's body. It is common in some countries for doctors to recommend an electroencephalograph (EEG), which records electrical activity in the brain, on children with complex febrile seizures. The EEG may help identify why the seizures occur and predict the risk of future seizures.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Entropy or EEG‐based depth of anaesthesia monitoring for adults and children undergoing general anaesthesia

We wanted to assess if giving anaesthetic medicines according to the values shown in the entropy monitor would help in avoiding overdosing or underdosing of patients with these drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

What happens during a neurological examination?

In neurological examinations, neurologists carry out tests in order to identify medical conditions affecting the nervous system.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 27, 2016

Epilepsy: Overview

In epilepsy, certain areas of the brain or all areas of the brain are overactive, sending too many signals. Some people have their first seizure in childhood, and others have their first seizure in older age.Medication can help to prevent seizures and maintain a good quality of life.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 13, 2016

Epilepsy in adults: Treatment with medication

Epilepsy medications can prevent seizures. But they do not work in everyone. It is sometimes possible for people to stop taking medication if they haven't had a seizure for several years.An epileptic seizure is caused by hyperactivity in the brain's nerve cells. Anti-epileptic drugs (AEDs) work by lowering this level of activity. Although AEDs do not cure the underlying causes of epilepsy, they can lower the risk of seizures.The medicine is available in the form of tablets, capsules or syrups. Some can also be injected into a vein, given intravenously through a drip (IV infusion), or inserted into the rectum in the form of a suppository. They can have some unpleasant side effects, but are usually well tolerated at low doses. That is why it is important for each individual person to consider whether to have treatment and, if so, what dose of which medication would be suitable.It is impossible to know beforehand whether a particular drug will help. Some people stop having seizures after taking the first medication they try. Other times it can take much longer to find the right treatment. In some cases the drugs do not help, or only help very little.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 13, 2016

What happens during a sleep study?

If you’ve had a sleep disorder for a very long time and previous medical examinations and advice have not helped, a sleep study is the usual next step. In the study, your sleep will be monitored for one or more nights monitor using special instruments. Sleep studies demand a bit of time.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 9, 2016

Surgery for epilepsy

Focal epilepsies are caused by abnormal electrical discharges in specific (localised) parts of the brain. In most people the resulting epileptic seizures can be controlled with medication. In up to 30% of people these seizures are not controlled by medication. If the site of origin of these signals (the epileptogenic zone) can be located from the description of the seizures, or from magnetic resonance imaging (MRI) (a medical imaging scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body) and electroencephalography (EEG) findings (recording of electrical activity along the scalp) the person should be offered the chance of having the epileptogenic zone removed. We studied the factors (characteristics of the people undergoing surgery and details of surgery type) that might be linked to the best chance of surgical cure of epileptic seizures.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Treatment of infantile spasms

The optimum treatment for infantile spasms has yet to be proven with confidence, in part because of the different aims of existing studies. However, some useful conclusions can be drawn from current evidence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Early versus late antiepileptic drug withdrawal for people with epilepsy in remission

Epilepsy is a disorder where recurrent seizures are caused by abnormal electrical discharges in the brain. Antiepileptic drugs (AEDs) are commonly used to prevent these seizures but have long‐term side effects. When in remission (seizure free), it may be best to stop using the drugs but the right time to withdraw them is still unclear.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Ethosuximide, sodium valproate or lamotrigine for absence seizures in children and adolescents

Epilepsy is a disorder where seizures are caused by abnormal electrical discharges from the brain. Absence epilepsy involves seizures that cause a sudden loss of awareness. It often starts in childhood or adolescence. Three antiepileptic drugs are often used for absence epilepsy: valproate; ethosuximide and lamotrigine. Valproate can lead to weight gain, and may cause fetal abnormalities. The review found some evidence that individuals taking lamotrigine are more likely to be seizure free than those using placebos. No difference in effectiveness has been found between valproate and ethosuximide, but more research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Rapid versus slow withdrawal of antiepileptic drugs

Epilepsy is a disorder where recurrent seizures are caused by abnormal electrical discharges of the brain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Different regimens of intravenous sedatives or hypnotics for electroconvulsive therapy (ECT) in adult patients with depression

Depression is a common mental disorder. It can present as loss of interest or pleasure, sadness, disturbed sleep or appetite, feelings of guilt or low self worth. In 2008, the World Health Organization (WHO) estimated that depression was the second leading cause of disability‐adjusted life‐years among all men and women between 15 and 44 years of age. The treatment of choice for severe and recurrent depression is electroconvulsive therapy (ECT). ECT involves the application of an electrical current to the patient's head. The aim is to induce a controlled convulsion. Patients usually undergo several sessions of ECT.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Carbamazepine for schizophrenia

People with schizophrenia will often hear voices or see things (hallucinations) and have strange beliefs (delusions). They may also experience apathy, tiredness, lack of drive and disorganised thoughts and behaviour. These symptoms make schizophrenia a severe illness that affects many people throughout their life.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Non‐pharmacological interventions for people with epilepsy and intellectual disabilities

Epilepsy is a neurological condition characterised by involuntary activity of the brain, which manifests in seizures. The rate of epilepsy in people with intellectual diabilities is significantly higher than in the general population. Epilepsy in this population is often less responsive to antiepileptic drugs (AEDs) and is associated with higher rates of morbidity and mortality. One relevant study comparing two surgical procedures has been included in this review. This study found that anterior corpus callosotomy (a procedure in which a section of the corpus callosum is severed) with anterior temporal lobectomy (a procedure in which part of the temporal lobe is removed) is more effective than anterior temporal lobectomy alone in improving quality of life and performance on IQ tests among people with epilepsy and intellectual disabilities. No support was found for a relative benefit of either procedure for improved seizure control. This review accentuates the lack of randomised controlled trials (RCTs) evaluating non‐pharmacological interventions for people with epilepsy and intellectual disabilities. Given the prevalence and nature of epilepsy in this population, well‐designed RCTs are needed to ascertain the effects of non‐pharmacological interventions on seizure and behavioural outcomes in people with intellectual disabilities. However, good quality evidence derived from RCTs including the non‐intellectually disabled should be assessed for side effects and efficacy before such studies are undertaken.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Hearing loss and deafness: Hearing tests in newborns

In Germany and other countries,  newborn babies are routinely given hearing tests in order to detect and treat hearing impairments as early as possible. This can improve early language development in children who have hearing problems.Nearly all babies can hear well: 997 out of 1,000 babies are born with normal hearing. Up to 3 out of 1,000 newborns have a moderate or severe hearing impairment. Although these children hear a little worse than normal, most of them are not deaf. Without early hearing tests, hearing problems are often first detected when a child is between two and four years old. But hearing tests in newborns cannot detect hearing impairments in all children because some hearing impairments only develop later on in childhood.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 12, 2014

Yoga for epilepsy

This review assessed the utility of yoga as a treatment for control of epilepsy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Antiepileptic drugs versus no treatment or placebo for children with benign epilepsy with centro temporal spikes

Benign epilepsy with centro temporal spikes is one of the most common childhood seizure disorders . Treatment for this disorder has been controversial as almost all individuals achieve seizure freedom by adolescence. However, this seizure disorder may not be as benign as the name suggests as children may have specific cognitive impairment. Treatment is started if seizures are felt to be frequent and intrusive.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Nicergoline may improve cognition and behavioural function of people with mild to moderate dementia

Nicergoline is an ergot derivative which has been registered in over 50 countries and has been used for more than three decades for the treatment of cognitive, affective, and behavioural disorders of older people. During the time it has been in use, the rationale for its clinical use has evolved. Initially regarded as a vasoactive drug, it was mainly prescribed for cerebrovascular disorders. Since then, findings suggesting a more complex pharmacological profile of nicergoline have led to its being considered for the treatment of other forms of dementia, including Alzheimer's Disease. There is some evidence of positive effects of nicergoline on cognition and behaviour and these effects are supported by an effect on clinical global impression.There was some evidence that there was increased risk of adverse effects associated with nicergoline. This drug has not been evaluated using current diagnostic categories such as MCI or in association with therapeutic agents of different nature such as cholinesterase or antioxidant drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Systematic Reviews in PubMed

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Systematic Review Methods in PubMed

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