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*It is only for medical professionals to read and refer to a systematic review of the efficacy of antiepileptic drugs in the treatment of focal progression to bilateral tonic-clonic seizures.
Research background and purpose Focal progression to bilateral tonic-clonic seizures (FBTCS), formerly known as secondary generalized tonic-clonic seizures (SGTCS), bilateral tonic-clonic seizures.
FBTCS, especially during nighttime attacks, is considered a strong risk factor for sudden epileptic death (SUDEP).
The annual incidence of sudden epilepsy death is about 1/1000 on average, and in severe cases the incidence can be as high as 9/1000.
At present, the best plan to prevent sudden epileptic death is to optimize the management of epilepsy and reduce the frequency of convulsive seizures.
Because of the short duration of sudden epilepsy death, a single study is not enough to investigate the incidence of sudden epilepsy death, so instead, choose to study the efficacy of antiepileptic drugs (ASMs) in the treatment of bilateral tonic-clonic seizures.
This article reviews the treatment of antiepileptic drugs.
The effect of focal progression to bilateral tonic-clonic seizures.
Research methods Researchers searched different online databases such as Pubmed, EMBASE, Google Scholar and Cochrane library for all anti-epileptic drugs approved by the U.
S.
Food and Drug Administration (FDA) after 1990 and reported bilateral tonic-clonic epilepsy.
Randomized, double-blind, and placebo-controlled clinical trials of reduced seizures.
Research results ➤ From 30 selected papers, the researchers extracted the focal progression of the treatment group and the placebo group into a reduction in bilateral tonic-clonic seizures.
The drug with the most reported data is Topiramate (TPM), with 6 papers included, followed by Tigabine (TGB), with 4 papers, as well as Brivaracetam (BRV) and Lamotrigine (LTG), each There are 3 articles (see Table 1).
➤ The topiramate trial showed that the frequency of seizures in the topiramate treatment group was reduced by 44.
4%-100%, and the placebo group was reduced by 1%-40.
3%, and the efficacy was 4.
5%-99% higher than that of the placebo group.
Tigabine reduced the seizure frequency by 21.
8% -46.
7% (the rate of decrease is 21.
8%-61% higher than that of the placebo group); ➤ Brivaracetam reduces the frequency of attacks by 33.
9%-82.
1% (the rate of decrease is 11.
6%-57.
4% higher than that of the placebo group); ➤ pull Motriazine reduced seizure frequency by 55.
2% (the rate of decrease was 20.
3%-52% higher than that in the placebo group); ➤ Other anti-epileptic drugs showed effectiveness, but there were only data from one or two studies.
➤ In addition, although the absence of bilateral tonic-clonic epilepsy is related to the prevention of sudden epileptic death, there are few corresponding reports: only a small number of studies (8/30) have been reported in which topiramate treatment resulted in bilateral tonic-clonic epilepsy The seizure-free rate was as high as 63.
6%, including 11 patients.
Table 1 Overview of the included ASMs, compared with placebo, the median reduction in FBTCS frequency.
Research conclusions Among the 30 articles included in the analysis, the number of studies reporting that topiramate reduces FBTCS was the largest (6 in total), and these studies included adult FBTCS.
There are 190 patients.
The frequency of FBTCS attacks in the topiramate treatment group was reduced by 44.
4%-100%, and the placebo group was reduced by 1%-40.
3%, and the efficacy was 4.
5%-99% higher than that in the placebo group.
Only a few studies have reported the seizure-free rate of FBTCS.
The seizure-free rate of FBTCS reported by patients treated with topiramate is as high as 63.
6%, which is higher than that of perampanel in different dose groups.
Traditional drugs such as carbamazepine, phenytoin and valproic acid have little data on their efficacy against FBTCS.
Reference: CutilloG, et al.
Anti-seizure medications and efficacy against focal to bilateraltonic-clonic seizures: A systematic review with relevance for SUDEP prevention.
Epilepsy Behav.
2021 Apr;117:107815.
*This article is only for medical and health professionals Provide scientific information and do not represent the position of the platform
Research background and purpose Focal progression to bilateral tonic-clonic seizures (FBTCS), formerly known as secondary generalized tonic-clonic seizures (SGTCS), bilateral tonic-clonic seizures.
FBTCS, especially during nighttime attacks, is considered a strong risk factor for sudden epileptic death (SUDEP).
The annual incidence of sudden epilepsy death is about 1/1000 on average, and in severe cases the incidence can be as high as 9/1000.
At present, the best plan to prevent sudden epileptic death is to optimize the management of epilepsy and reduce the frequency of convulsive seizures.
Because of the short duration of sudden epilepsy death, a single study is not enough to investigate the incidence of sudden epilepsy death, so instead, choose to study the efficacy of antiepileptic drugs (ASMs) in the treatment of bilateral tonic-clonic seizures.
This article reviews the treatment of antiepileptic drugs.
The effect of focal progression to bilateral tonic-clonic seizures.
Research methods Researchers searched different online databases such as Pubmed, EMBASE, Google Scholar and Cochrane library for all anti-epileptic drugs approved by the U.
S.
Food and Drug Administration (FDA) after 1990 and reported bilateral tonic-clonic epilepsy.
Randomized, double-blind, and placebo-controlled clinical trials of reduced seizures.
Research results ➤ From 30 selected papers, the researchers extracted the focal progression of the treatment group and the placebo group into a reduction in bilateral tonic-clonic seizures.
The drug with the most reported data is Topiramate (TPM), with 6 papers included, followed by Tigabine (TGB), with 4 papers, as well as Brivaracetam (BRV) and Lamotrigine (LTG), each There are 3 articles (see Table 1).
➤ The topiramate trial showed that the frequency of seizures in the topiramate treatment group was reduced by 44.
4%-100%, and the placebo group was reduced by 1%-40.
3%, and the efficacy was 4.
5%-99% higher than that of the placebo group.
Tigabine reduced the seizure frequency by 21.
8% -46.
7% (the rate of decrease is 21.
8%-61% higher than that of the placebo group); ➤ Brivaracetam reduces the frequency of attacks by 33.
9%-82.
1% (the rate of decrease is 11.
6%-57.
4% higher than that of the placebo group); ➤ pull Motriazine reduced seizure frequency by 55.
2% (the rate of decrease was 20.
3%-52% higher than that in the placebo group); ➤ Other anti-epileptic drugs showed effectiveness, but there were only data from one or two studies.
➤ In addition, although the absence of bilateral tonic-clonic epilepsy is related to the prevention of sudden epileptic death, there are few corresponding reports: only a small number of studies (8/30) have been reported in which topiramate treatment resulted in bilateral tonic-clonic epilepsy The seizure-free rate was as high as 63.
6%, including 11 patients.
Table 1 Overview of the included ASMs, compared with placebo, the median reduction in FBTCS frequency.
Research conclusions Among the 30 articles included in the analysis, the number of studies reporting that topiramate reduces FBTCS was the largest (6 in total), and these studies included adult FBTCS.
There are 190 patients.
The frequency of FBTCS attacks in the topiramate treatment group was reduced by 44.
4%-100%, and the placebo group was reduced by 1%-40.
3%, and the efficacy was 4.
5%-99% higher than that in the placebo group.
Only a few studies have reported the seizure-free rate of FBTCS.
The seizure-free rate of FBTCS reported by patients treated with topiramate is as high as 63.
6%, which is higher than that of perampanel in different dose groups.
Traditional drugs such as carbamazepine, phenytoin and valproic acid have little data on their efficacy against FBTCS.
Reference: CutilloG, et al.
Anti-seizure medications and efficacy against focal to bilateraltonic-clonic seizures: A systematic review with relevance for SUDEP prevention.
Epilepsy Behav.
2021 Apr;117:107815.
*This article is only for medical and health professionals Provide scientific information and do not represent the position of the platform
