Systematic Review Presented At 68th Annual Meeting Of The American Epilepsy Society Points To Need For Expert Consensus On Seizure Cluster Nomenclature And Diagnosis
Findings from Late-Breaking Abstract Demonstrate That Well-Defined Seizure Cluster Terminology is Necessary to Standardize Patient Diagnosis and Allow for Appropriate Treatment Strategies
SEATTLE, Dec. 8, 2014 /PRNewswire/ -- A new systematic review found that consistent and well-defined terminology to describe seizure clusters, a rare seizure pattern, is necessary for clinicians to reach an accurate diagnosis and to best assess whether or not treatment intervention is appropriate. Findings from the late-breaking abstract were presented at the 68th Annual Meeting of the American Epilepsy Society (AES) in Seattle, December 5-9, 2014. The systematic review was supported by Upsher-Smith Laboratories, Inc. (Upsher-Smith).
Seizure clusters are seizures that happen one after the other over a short period of time. There is a recovery period between each seizure and a pattern that is different from the usual seizure pattern.
The systematic review, Seizure Cluster – The Need for Consistent Terminology, was developed and authored by renowned experts in the field of epilepsy including: John Pellock, M.D., Virginia Commonwealth University School of Medicine, Richmond, VA; Alexis Arzimanoglou, M.D., University Hospitals of Lyon and Lyon Neurosciences Centre, Lyon, France; Dale Hesdorffer, Ph.D., Columbia University, New York, NY; Ilo Leppik, M.D., MINCEP Epilepsy Care, Minneapolis, MN; Shlomo Shinnar, M.D., Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; and Sheryl Haut, M.D., Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
"The data from the systematic review confirms that the nomenclature used to describe seizure clusters is inconsistent and has changed over the years," said John Pellock, M.D., lead study author and Professor of Neurology and Pediatrics, Division of Child Neurology, Virginia Commonwealth University. "A uniform definition of the term 'seizure clusters' would allow healthcare professionals to better determine the most appropriate treatment strategies."
About the Systematic Review
The systematic review included published results of clinical trials using the following search terms: Seizure cluster(s), cluster seizure(s), acute repetitive seizure(s), bout(s) of seizures, serial seizure(s), crescendo seizure(s) and seizure flurry(ies). The search was first conducted using no specific time frame and then was filtered for trials published within the last five years. The number of results was then compared for all search terms. To determine changes in terminology over time, papers from the last five years were compared with papers published prior to 2009.
Only four search terms yielded results (seizure clusters, cluster seizures, acute repetitive seizures and serial seizures), including 114 non-mutually exclusive publications across all years. The most commonly used term was seizure clusters (47 publications), followed by acute repetitive seizures (31), serial seizures (23), and cluster seizures (13). When comparing the 44 clinical trials published in the last five years with the 70 trials published prior to 2009, the proportion of papers reporting each of the four search terms changed. For seizure clusters, there was a 29% increase in use in the last five years (before 2009, 37% of publications; last five years, 48% of publications). A 36% increase was observed for cluster seizures (before 2009, 10%; last five years, 14%). The use of acute repetitive seizures decreased by 13% (before 2009, 29%; last five years, 25%) while the use of serial seizures decreased by 44% (before 2009, 24%; last five years, 14%).
The data from the systematic review demonstrate the need for a clinically relevant and uniform definition of the term "seizure cluster" within the epilepsy community to standardize patient diagnosis and allow for appropriate treatment strategies.
An abstract of the poster presentation can be found online at www.aesnet.org.
About Epilepsy
Epilepsy is a medical condition that is characterized by recurrent seizures. More than two million people in the U.S. are estimated to be affected by epilepsy, with about 150,000 new cases of epilepsy diagnosed each year.1 Epilepsy can be associated with profound physical, psychological and social consequences that negatively impact people's lives.
About Seizure Clusters
Seizure clusters, also referred to as acute repetitive seizures or bouts of increased seizure activity, consist of multiple seizures which occur over a relatively brief period of time with a pattern distinguishable from the patient's usual seizure pattern.2
Reports of seizure cluster prevalence vary, but it has been estimated that approximately 22% of the intractable epilepsy population (approximately 152,000 people) experience them. 3,4,5,6
About Upsher-Smith
Upsher-Smith Laboratories, Inc., founded in 1919, is a growing pharmaceutical company dedicated to its mission of Advancing Pharmacotherapy. Improving Life™. With capabilities ranging from early-stage research to delivering on-market products, Upsher-Smith is committed to offering quality products that enable people to live life to its greatest potential. Upsher-Smith's approach to product development and partnering has resulted in a broad range of both branded and generic therapeutic solutions to address patients' needs. The Company has a particular focus on developing therapies for people living with central nervous system (CNS) conditions, such as seizure disorders, and has a robust pipeline of promising CNS compounds in various stages of development. For more information, visit www.upsher-smith.com.
References
- Epilepsy.com. Available at: http://www.epilepsy.com/learn/epilepsy-statistics. Accessed April 16, 2014.
- Dreifuss FE, Rosman NP, Cloyd JC, et al. A comparison of rectal diazepam gel and placebo for acute repetitive seizures. N Engl J Med. 1998;338:1869-75.
- Kobau R, Zahran H, Thurman DJ, et al. Epilepsy Surveillance Among Adults – 19 States, Behavioral Risk Factor Surveillance System, 2005. MMWR. 2008;57:SS-6.
- Kwan P, Brodie MJ. Early Identification of Refractory Epilepsy. N Engl J Med. 2000;342:314-319.
- Berg AT, Vickrey BG, Testa FM, et al. How long does it take for epilepsy to become intractable? A prospective investigation. Annals of Neurology. 2006;60:73-79.
- Haut SR, Lipton RB, LeValley AJ, et al. Identifying seizure clusters in patients with epilepsy. Neurology. 2005 October 25;65(8):1313-1315.
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