Materiały źródłowe

• #1 Seizure prophylaxis in the neuroscience intensive care unit | Journal of Intensive Care | Full Text

  https://jintensivecare.biomedcentral.com/articles/10.1186/s40560-018-0288-6

  Seizures are a considerable complication in critically ill patients. Their incidence is significantly high in neurosciences intensive care unit patients. Seizure prophylaxis with anti-epileptic drugs is a common practice in neurosciences intensive care unit. However, its utility in patients without clinical seizure, with an underlying neurological injury, is somewhat controversial. […] Based on the current evidence and guidelines, we have proposed a presumptive protocol for seizure prophylaxis in neurosciences intensive care unit. Patients with severe traumatic brain injury and possible subarachnoid hemorrhage seem to benefit with a short course of anti-epileptic drug. In patients with other neurological illnesses, the use of continuous electroencephalography would make sense rather than indiscriminately administering anti-epileptic drug.

• #2 Seizure: What It Is, Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/22789-seizure

  Seizures are unpredictable, so its not possible to completely prevent them. The best thing you can do is avoid possible causes or triggers, like managing blood glucose levels or protecting yourself from illness and injury. […] Managing any underlying causes or conditions: Your provider will first treat any underlying conditions like a stroke or low blood sugar. This may prevent future seizures. […] Taking antiseizure medications: Medications may help prevent seizures or decrease how often they happen. […] A healthcare provider can help you find the right treatment for your needs. […] If certain types of treatment arent successful, your provider may recommend changing the foods you eat. A low- or no-carb (ketogenic) diet may reduce how often you have seizures. Studies are ongoing to learn more about the effectiveness of dietary changes in relation to seizures.

• #3 How to Prevent Seizures

  https://www.healthline.com/health/how-to-prevent-seizures

  While theres no one way to prevent a seizure, following a well-rounded treatment and management plan can help. […] If you have epilepsy, or another condition that puts you at risk of recurring seizures, its important to take preventive measures to stop them from occurring. […] Seizure prevention is dependent on an overall management and treatment plan, such as taking your prescribed medications and making lifestyle changes. […] Talk with a doctor about incorporating the following measures into your overall treatment and management plan to help prevent seizures. […] Antiepileptic drugs (AEDs) are prescription medications designed to help prevent seizures. Its important to never stop taking these medications without a doctors approval even if your condition seems to be improving. […] Alcohol isnt recommended for people with epilepsy, due to an increased risk of seizures. You may help prevent future episodes by avoiding alcohol.

• #4

  https://www.who.int/news-room/fact-sheets/detail/epilepsy

  Seizures can be controlled. Up to 70% of people living with epilepsy could become seizure free with appropriate use of antiseizure medicines. […] An estimated 25% of epilepsy cases are potentially preventable. […] Preventing head injury, for example by reducing falls, traffic accidents and sports injuries, is the most effective way to prevent post-traumatic epilepsy. […] Adequate perinatal care can reduce new cases of epilepsy caused by birth injury. […] The use of drugs and other methods to lower the body temperature of a feverish child can reduce the chance of febrile seizures. […] The prevention of epilepsy associated with stroke is focused on cardiovascular risk factor reduction, e.g. measures to prevent or control high blood pressure, diabetes and obesity, and the avoidance of tobacco and excessive alcohol use.

• #5 Epilepsy and Seizures Treatment & Management: Approach Considerations, Anticonvulsant Therapy, Anticonvulsants for Specific Seizure Types

  https://emedicine.medscape.com/article/1184846-treatment

  The goal of treatment in patients with epileptic seizures is to achieve a seizure-free status without adverse effects. This goal is accomplished in more than 60% of patients who require treatment with anticonvulsants. […] For patients who have had more than 1 unprovoked seizure, treatment with an anticonvulsant is recommended. However, the standard of care for a single unprovoked seizure is avoidance of typical precipitants (eg, alcohol, sleep deprivation); anticonvulsants are not recommended unless the patient has risk factors for recurrence. […] The First Seizure Trial Group randomly selected 397 patients with an unprovoked, generalized tonic-clonic first seizure to either receive prophylaxis with a conventional anticonvulsant (ie, carbamazepine, phenobarbital, phenytoin, valproic acid) or to receive no treatment and reported that about 18% of treated patients had seizure recurrence within 1 year, compared with 39% of untreated patients. […] Therefore, patients must be told that anticonvulsants can reduce their risk of having another seizure but will not eliminate that risk.

• #6 Seizure Precautions – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK536958/

  A common, well-accepted clinical axiom in neurology is „seizures beget seizures.” Therefore, seizure prevention, vigorous follow-up, and early therapy are key to success. More importantly, early treatment is not only more effective, but it also stops progression to status epilepticus. […] The key aim of treatment is to control the seizure before any significant neuronal damage occurs, usually between 20 to 60 minutes. Anoxia and central nervous system (CNS) infections correlate with a high mortality rate in status epilepticus. […] The most important thing to emphasize to patients is medication compliance. The anti-seizure medication prescribed depends on the patient’s underlying diagnosis, severity, pre-existing medications, other comorbidity, and potential for drug interactions. A consultation with a neurologist who oversees and directs the medication prescribed is necessary. […] To date, there is no data to suggest that any intervention other than prescribed anti-seizure medications can prevent status epilepticus or recurrent seizures.

• #7 Seizure Prophylaxis

  https://mobile.fpnotebook.com/Neuro/Seizure/SzrPrphylxs.htm

  Antiepileptic Medications used for Prophylaxis […] Considered a well tolerated, first-line agent in Seizure Prophylaxis […] Seizure on Antiepileptic agent […] Consider Antepileptic agent related causes […] Consider Seizure triggers […] Seizure Disorder itself increases risk of Suicidal Ideation by 3 fold over baseline […] Anticonvulsant use has also been associated with increased Suicidal Ideation

• #8

  https://scholars.duke.edu/individual/pub1015948

  The incidence of seizures was significantly lower in patients treated with levetiracetam (7.3%) when compared with the expected (15-20%) rate without AED prophylaxis based on the previous literature. […] Levetiracetam appears effective and safe for seizure prevention in patients undergoing brain tumor resection and who are at significantly higher risk of developing post-operative seizures.

• #9 Post-Traumatic Seizure Prophylaxis in Patients with Traumatic Brain Injury Clinical Practice Guideline

  https://med.uth.edu/surgery/post-traumatic-seizure-prophylaxis-in-patients-with-traumatic-brain-injury-clinical-practice-guideline/

  Post-traumatic seizure (PTS) is a known sequela of TBI and can be categorized as immediate (occurring within 24 hours of injury), early (within 24 hours to seven days after injury), or late (occurring greater than seven days after injury). […] Based on the American Academy of Neurology (AAN) and Brain Trauma Foundation (BTF) recommendations, using anti-seizure drugs during the first seven days after an injury has become the standard of care for PTS prophylaxis in severe TBI patients. […] The use of levetiracetam for post-traumatic seizure prophylaxis is somewhat more common, presumably due to the ease of dosing, fewer interactions with other drugs, and lack of need for frequent blood level monitoring. […] Despite the increasing use of levetiracetam, there has been no large, prospective, randomized controlled trial comparing the effectiveness of levetiracetam to phenytoin though there have been prospective observational and small randomized clinical trials. […] Multiple studies have addressed the issue of cost associated with levetiracetam.

• #10 List of 27 Seizure Prevention (Seizure Prophylaxis) Medications Compared

  https://www.drugs.com/condition/seizure-prophylaxis.html

  Medications for Seizure Prevention (Seizure Prophylaxis) […] Measures taken to prevent a seizure – an episode of abnormal electrical activity in the brain where a person’s body may shake rapidly and uncontrollably. […] The medications listed below are related to or used in the treatment of this condition. […] 56 reviews for Lamictal to treat Seizure Prevention […] 95 reviews for lamotrigine to treat Seizure Prevention […] 43 reviews for Topamax to treat Seizure Prevention […] 59 reviews for clonazepam to treat Seizure Prevention […] 70 reviews for topiramate to treat Seizure Prevention […] 25 reviews for Klonopin to treat Seizure Prevention […] 6 reviews for diazepam to treat Seizure Prevention […] 3 reviews for Lamictal XR to treat Seizure Prevention […] 5 reviews for valproic acid to treat Seizure Prevention

• #11 Seizure Prophylaxis After TBI Leads to Reduced Posttraumatic Seizure Risk – Neurology Advisor

  https://www.neurologyadvisor.com/news/seizure-prophylaxis-after-tbi-leads-to-reduced-posttraumatic-seizure-risk/

  Seizure prophylaxis may be effective in preventing early posttraumatic seizures after mild and moderate traumatic brain injury. […] Seizure prophylaxis after mild and moderate traumatic brain injury (TBI) leads to a risk reduction for early posttraumatic seizure, according to study results published in JAMA Neurology. […] The absolute risk reduction with prophylaxis in posttraumatic seizures was 0.6% (95% CI, 0.1%-1.2%; P =.02) for patients with mild and moderate TBI (GCS score, 9-15). […] Among patients with only mild TBI (5 studies; n=3803), the absolute risk reduction of seizure prophylaxis for early posttraumatic seizures was also 0.6% (95% CI, 0.01%-1.2%; P =.04). […] Practitioners should weigh low prevalence of early posttraumatic seizures and low risk reduction against risks of antiseizure medicine, including inappropriate long-term continuation, the researchers concluded.

• #12 Guidelines for Seizure Prophylaxis in Adults Hospitalized with Moderate-Severe Traumatic Brain Injury: A Clinical Practice Guideline for Health Care Professionals from the Neurocritical Care Society – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38316735/

  There is practice heterogeneity in the use, type, and duration of prophylactic antiseizure medications (ASMs) in patients with moderate-severe traumatic brain injury (TBI). […] We did not detect any significant positive or negative effect of ASM compared to no ASM on the outcomes of early seizure, late seizure, adverse events, or mortality. […] If used, we suggest LEV over PHT/fPHT (weak recommendation, very low quality of evidence) for a short duration ( 7 days, weak recommendation, low quality of evidence).

• #13

  https://link.springer.com/article/10.1007/s12028-023-01907-x

  PICO 3: There were no significant differences in early or late seizures with longer versus shorter ASM use, though cognitive outcomes and adverse events appear worse with protracted use. […] Based on GRADE criteria, we suggest that ASM or no ASM may be used in patients hospitalized with moderatesevere TBI (weak recommendation, low quality of evidence). […] If used, we suggest LEV over PHT/fPHT (weak recommendation, very low quality of evidence) for a short duration (7 days, weak recommendation, low quality of evidence).

• #14

  https://journals.lww.com/md-journal/fulltext/2024/07120/use_of_antiepileptic_medications_for_seizures_.30.aspx

  The use of prophylactic antiepileptic drugs (AEDs) post-subarachnoid hemorrhage (SAH), particularly aneurysmal SAH, is controversial, with limited data available. […] This study is aimed at determining whether the use of AEDs for primary prophylaxis is effective in reducing the incidence of seizures post-SAH. […] Our findings support the 2023 AHA/ASA guideline recommendation to avoid using routine AEDs for prophylaxis for all SAH patients. […] The previous American Heart Association/American Stroke Association (AHA/ASA) guidelines supported the use of prophylactic antiepileptic drugs (AEDs) in the immediate post-hemorrhagic period (37 days from ictus). […] However, the AHA/ASA guidelines did not specify either the drug of choice or the appropriate dose. […] Most importantly, there is no reliable data or evidence regarding the efficacy of AED continuing or stopping once an aneurysm is secured.

• #15

  https://journals.lww.com/md-journal/fulltext/2024/07120/use_of_antiepileptic_medications_for_seizures_.30.aspx

  The 2023 AHA/ASA guidelines recommend the use of AEDs as prophylactic agents if a patient with SAH is presented with high-grade Hunt and Hess or Fisher scale, hydrocephalus complications, or MCA involvement. […] In conclusion, our findings support the 2023 AHA/ASA guideline recommendations to avoid using routine AEDs for prophylaxis in all SAH cases.

• #16 Seizure Prophylaxis After Spontaneous Intracerebral Hemorrhage | Harvard Kennedy School

  https://www.hks.harvard.edu/publications/seizure-prophylaxis-after-spontaneous-intracerebral-hemorrhage

  Importance Limited evidence is available concerning optimal seizure prophylaxis after spontaneous intracerebral hemorrhage (sICH). […] Conclusions and Relevance This decision analytical model suggests that short-term (7-day) prophylaxis dominates longer-term therapy after sICH. Use of the 2HELPS2B score to guide clinical decisions for initiation of short-term primary vs secondary early-seizure prophylaxis should be considered for all patients after sICH.

• #17 Literature Watch

  https://currents.neurocriticalcare.org/Literature-Watch/Article/levetiracetam-prophylaxis-is-safe-and-may-reduce-s

  Levetiracetam Prophylaxis is Safe and May Reduce Seizures in Acute Intracerebral Hemorrhage: Results of the PEACH Trial […] This study sought to evaluate the safety and efficacy of levetiracetam for primary prevention of seizures in a parallel-group, double-blind, randomized, placebo-controlled trial. […] Seizures occurred in 3 patients in the treatment arm and 10 in placebo (16% vs 43%; OR 0.16, 95% CI, 0.03-0.94; P=.043). […] This parallel-group, double-blind, randomized, placebo-controlled trial suggests that that levetiracetam is safe and may reduce seizures after ICH. […] This study reinforces the emerging data showing seizure occurrence has been underestimated and further supports current AHA/ASA and the American Clinical Neurophysiology Society recommendations for EEG monitoring in supratentorial ICH with altered mental status.

• #18

  https://aesnet.org/abstractslisting/duration-of-seizure-prophylaxis-in-focal-circumscribed-intracranial-infections

  Focal circumscribed intracranial infections have been associated with increased risk of seizures and subsequent epilepsy in 30-32% of cases. There are no clear existing guidelines on the type or duration of prophylaxis of seizures resulting from these infections. We looked at the duration and type of prophylaxis and treatment of seizures related to focal intracranial infections in patients of all age groups at a single institution from 2004-2021. […] Of the 213 patients, 25 (11%) had both prophylaxis and treatment as they had seizure while they were receiving the prophylaxis. 98 (46%) had only prophylaxis and 49 (23%) had only treatment. 40 (19%) did not receive any prophylaxis or treatment. Of the 123 with prophylaxis, 25 transitioned to treatment (20.3%). This is significantly lower compared to 49 of 89 (55%) of those without prophylaxis. The median duration of seizure prophylaxis and treatment were 2 months and 32 months, respectively.

• #19 Seizure prophylaxis in the neuroscience intensive care unit | Journal of Intensive Care | Full Text

  https://jintensivecare.biomedcentral.com/articles/10.1186/s40560-018-0288-6

  AED prophylaxis for aSAH is somewhat controversial. Limited randomized controlled trials (RCT) justifying the prophylactic use and serious adverse effects of AED make the decision even more challenging. Seizures in acutely ill patients with aSAH can lead to additional injury or rebleeding from an unsecured aneurysm, which make AED prophylaxis critical in some cases. […] Given its relatively safer profile, there is a growing interest in support of using levetiracetam for seizure prophylaxis. […] Guidelines for prophylactic use of AED in patients with metastatic brain neoplasms were derived from analysis of a RCT, evaluating the efficacy of AED phenobarbital, phenytoin versus no treatment. No significant differences were observed in seizure incidence between two groups in the trial. It was concluded that seizure prophylaxis was not beneficial in patients with metastatic brain tumors.

• #20 Postoperative Seizure Prophylaxis in Meningioma Resection: A Systematic Review and Meta-Analysis

  https://www.mdpi.com/2075-4418/13/22/3415

  Background: Seizures in the early postoperative period may impair patient recovery and increase the risk of complications. The aim of this study is to determine whether there is any advantage in postoperative seizure prophylaxis following meningioma resection. […] The current evidence does not provide sufficient support for the effectiveness of prophylactic AED medications in preventing postoperative seizures in patients undergoing meningioma resection. This underscores the importance of considering diagnostic criteria and conducting individual patient analysis to guide clinical decision-making in this context. […] Postoperative seizure prophylaxis involves the administration of antiepileptic drugs (AEDs) with the aim of preventing seizures following tumor resection. […] The primary goal of seizure prophylaxis is to minimize the risk of early postoperative seizures, which can have detrimental effects on patient recovery and increase the risk of complications.

• #21 Seizure prophylaxis in meningiomas: a systematic review and meta-analysis | Neurología (English Edition)

  https://www.elsevier.es/en-revista-neurologia-english-edition–495-articulo-seizure-prophylaxis-in-meningiomas-systematic-S2173580822000360

  Seizure prophylaxis in meningiomas: a systematic review and meta-analysis […] No formal indication currently exists for seizure prophylaxis in neurosurgical oncology patients. Neither have specific recommendations been made on the use of antiepileptic drugs (AED) in seizure-free patients with meningiomas scheduled for surgery. […] AED prophylaxis in patients with meningioma and no history of seizures did not significantly reduce the incidence of post-operative seizures in comparison to controls (Mantel-Haenszel combined odds ratio, random effects model: 1.26 [95% confidence interval, 0.60-2.78]; 2041 patients). However, we are unable to establish a robust recommendation against this treatment due to the lack of prospective studies, the presence of selection bias in the studies reviewed, the likelihood of underestimation of seizure frequency during follow-up, and the strong influence of one study on the overall effect.

• #22 Post-traumatic seizures, their prevention and management | Deranged Physiology

  https://derangedphysiology.com/main/required-reading/neurological-intensive-care/Chapter-116/post-traumatic-seizures-their-prevention-and-management

  Post-traumatic seizures, their prevention and management […] The best resource for such things is the Brain Trauma Organisation Guidelines for Management Traumatic Brain Injury. […] The below-linked review article on post-traumatic seizure prophylaxis presents an even more extensive table, which is perhaps more than is expected of a 2-mark SAQ answer. […] A good 2013 review article is available for the time-rich exam candidate to scrutinise. […] Approximately 5-7% of TBI patients experience post-traumatic seizures. […] Neurotoxicity from such seizures represents a preventable morbidity […] Antiepileptic therapy is not without its risks, but uncontrolled seizures in TBI represent an even greater risk […] However, there does not seem to be any evidence that reduction in post-traumatic seizures within the first week decreases long term mortality in any way. […] The 2003 AAN guidelines recommend a one-week course of therapy. […] There is no evidence to support prophylaxis for longer than seven days after TBI, even if risk factors are present. […] Phenytoin has been the drug of choice. […] Levitiracetam is becoming the drug of choice.

• #23

  https://www.healio.com/news/neurology/20210802/shortterm-seizure-prophylaxis-provides-greatest-benefit-after-intracerebral-hemorrhage

  Results from an analytical decision model demonstrated that short-term, 7-day prophylaxis dominates long-term therapy for seizure prophylaxis after spontaneous intracerebral hemorrhage. […] Investigators, who published the findings in JAMA Neurology, also reported that using the 2HELPS2B score, a risk stratification tool, to guide clinical decisions about starting short-term primary vs. secondary early seizure prophylaxis should be considered for all patients following a spontaneous intracerebral hemorrhage. […] We found short-term (7 days) early-seizure prophylactic regimens are preferred over long-term (lifelong) regimens under most realistic clinical scenarios, Jones and colleagues wrote. […] Our results also suggest that a strategy that incorporates an early-seizure risk stratification tool (2HELPS2B) to identify patients most likely to benefit from short-term primary vs. secondary early-seizure prophylaxis is favored over alternative strategies in most settings.

• #24

  https://biomedres.us/fulltexts/BJSTR.MS.ID.006154.php

  Seizures are common sequelae to cranial surgical interventions for tumors, subarachnoid hemorrhage, traumatic brain injury, cerebral venous thrombosis, and stroke. In the post-operative period, seizures are a marker of poor outcomes and impaired quality of life. […] About 60-70% of patients in the neurosurgical intensive care need prophylaxis for seizures and levetiracetam is the preferred choice. Other antiepileptic agents used for prophylaxis include phenytoin and lacosamide. […] Brivaracetam has clinical benefits for seizure prophylaxis in neurosurgical settings. However, prohibitive cost and lack of an intravenous formulation may limit the clinical utility of brivaracetam in a developing country like India. […] Prophylactic antiepileptic drugs help in preventing seizures in patients with brain tumors who do not have a history of seizures. Such patients are candidates for short-term prophylaxis after surgery for cerebral tumors.

• #25 How to Prevent Seizures – Neurology Center For Epilepsy & Seizures

  https://www.neurocenternj.com/blog/how-to-prevent-seizures/

  Lack of sleep is a big contributing factor to seizures. […] Enforcing an early bedtime for you or your kids may seem difficult, but it could help reduce seizures. […] Skipping meals can lead to hypoglycemia, which can trigger seizures in some people. […] Eating meals at regular times and having healthy snacks between meals can help with seizure prevention. […] You need to make sure your children are aware that alcohol and drug use can contribute to seizures. […] However, they simply are not worth risking triggering a seizure. […] Exercise may be the single most-effective “medicine” that a doctor can suggest. […] While exercise is not directly linked to a reduction in seizures, it is linked to reducing stress levels. […] If your child is experiencing a high fever, contact a medical professional for help on how to bring down body temperature.

• #26 How to Prevent Seizures

  https://www.healthline.com/health/how-to-prevent-seizures

  In addition to alcohol avoidance, its important to avoid substance misuse as part of your seizure management plan. […] Stress can be a trigger for seizures in epilepsy. It may help you reduce your risk of seizures if you manage your stress by: […] Waking up and going to bed at the same time every day can help you maintain a sleep schedule. […] Its a good practice to keep a consistent meal schedule and have fast-acting sources of glucose on you at all times if you have diabetes. […] According to the Epilepsy Society, its estimated that about 3% of people with epilepsy have a rare form called photosensitive epilepsy. […] Head injuries can lead to a single seizure or recurrent seizures in someone who doesnt have epilepsy. […] Some children between the ages of 6 months and 5 years may be at risk of developing febrile seizures.

• #27 How to Prevent Seizures – Neurology Center For Epilepsy & Seizures

  https://www.neurocenternj.com/blog/how-to-prevent-seizures/

  Flashing lights are a commonly known seizure symptom trigger. […] If you have photosensitive epilepsy, you need to limit exposure to flashing lights. […] If you have epilepsy or another seizure-disorder, you need a pediatric neurologist to manage your care. […] This is one of the key ways to prevent seizures and how to stop seizures in adults. […] Lifestyle changes such as getting regular sleep, maintaining a balanced diet, exercising regularly, and avoiding triggers like stress, alcohol, and drugs are some effective ways to prevent seizures. […] Learning how to stop a seizure from happening mainly involves managing triggers and taking prescribed medications consistently. […] If possible, avoid common triggers such as flashing lights, lack of sleep, stress, and alcohol. […] A neurologist plays a crucial role in seizure prevention by investigating the cause of the seizures and creating a personalized treatment plan.

• #28 Febrile Seizures: Overview, Symptoms, Treatment and Prevention

  https://www.nationwidechildrens.org/conditions/febrile-seizures

  Many children get fevers when theyre sick. Medicines like acetaminophen (Childrens Tylenol) or ibuprofen (Childrens Motrin or Advil) can help with fevers. These fever-reducing medicines may not prevent a seizure. […] You cant make the seizure stop. Do your best to stay calm and keep your child safe. […] If its less than 5 minutes, you dont have to get emergency help. You can update your childs doctor or health care provider for further direction. For seizures longer than 5 minutes, there may be medicine to give to stop the seizure. […] Typically, if your child has a febrile seizure, they don’t need to go to a neurologist.

• #29 Seizures – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/seizure/diagnosis-treatment/drc-20365730

  In vagus nerve stimulation, a device placed under the skin of the chest stimulates the vagus nerve in the neck. This sends signals to the brain that lessen seizures. […] The goal in seizure treatment is to find the best therapy that stops seizures with the fewest side effects. […] Treatment of seizures often involves antiseizure medicines. There are many types of antiseizure medicine. […] Following a ketogenic diet can improve seizure management. A ketogenic diet is high in fat and very low in carbohydrates. […] If treatment with at least two antiseizure medicines doesn’t work, you might have surgery to stop the seizures. […] If surgeons can’t remove or separate the area of the brain where seizures start, devices that provide electrical stimulation may help. They can work with antiseizure medicines to reduce seizures.

• #30 Natural remedies for epilepsy: Diet, herbs, vitamins, and more

  https://www.medicalnewstoday.com/articles/317922

  Vagus nerve stimulation (VNS) involves implanting a device in the chest that sends electrical signals to the brain. […] The effect of VNS varies widely among people with epilepsy. Some people see a significant improvement, while others do not find that it helps. […] For people with epilepsy, stress and anxiety may increase the risk of having a seizure. […] Knowing and avoiding their triggers may help people reduce the risk of experiencing a seizure. […] Some common triggers include: a lack of sleep, stress, exposure to flashing lights, the use of alcohol or drugs, including medications, not taking medication for epilepsy. […] Learning about epilepsy may improve quality of life for people who have seizures and their families. […] Some of the ingredients in essential oils can cross the blood-brain barrier, which means that they may be either helpful or harmful, depending on the substance.

• #30 Natural remedies for epilepsy: Diet, herbs, vitamins, and more

  https://www.medicalnewstoday.com/articles/317922

  Epilepsy is a condition in which disruption to electrical activity in the brain results in seizures. Some people suggest that cannabis, acupuncture, and essential oils are effective natural remedies for seizures. […] However, epilepsy is a complex condition. People should discuss any natural remedies with a doctor before using them, as some options may not be safe or effective for everyone. […] There is some evidence to suggest that a ketogenic, or keto, diet which is a high fat, low carbohydrate diet could help prevent seizures in people who do not find antiepileptic drugs effective. […] The diet causes ketosis, which is the chemical breakdown of proteins in the muscles. This suppresses seizure activity. […] When antiepileptic drugs do not work, some people use biofeedback therapy to reduce seizures. Biofeedback is a medical technique that helps a person recognize changes in their body.

• #31 Seizures – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/seizure/diagnosis-treatment/drc-20365730

  People who’ve had seizures most often can have healthy pregnancies. But some medicines used to treat seizures sometimes can cause health conditions that are present at birth. […] Taking folic acid before pregnancy may help prevent some complications related to taking antiseizure medicines while pregnant. […] Some antiseizure medicines keep birth control from working as well. Check with your healthcare professional to see whether your medicine affects your birth control. […] Researchers study other therapies that might treat seizures. These include therapies to stimulate the brain without surgery. […] Here are some steps you can take to help manage seizures: Take medicine correctly. Don’t change the dose without first talking with your healthcare professional. […] Lack of sleep can trigger seizures. Be sure to get enough rest every night.

• #32

  https://journals.lww.com/pccmjournal/fulltext/2003/07001/chapter_19__the_role_of_anti_seizure_prophylaxis.20.aspx

  Prophylactic anticonvulsant therapy is not recommended to prevent late posttraumatic seizures in children.

• #33 New Published Guidelines Inform Prevention of Continued Epileptic Seizures in Outpatient Management

  https://www.neurologylive.com/view/new-published-guidelines-inform-prevention-continued-epileptic-seizures-outpatient-management

  Experts have published new guidelines to standardize the definition and treatment of seizures, emphasizing early intervention to prevent severe seizure emergencies. […] New recommendations published in Epileptic Disorders proposed by a global group of experts provided a robust and uniform definition framework for different types of seizures as well as guidelines for early treatment to prevent progression to seizure emergencies. […] It is essential that we prevent seizures from progressing to more severe and complex types which result in significant physical, psychological, cognitive and socioeconomic burden for patients, caregivers and healthcare systems alike, Jesus Eric Pina-Garza, MD, cochair of the Seizure Termination Project and director of Pediatric Epilepsy at Centennial Childrens Hospital, said in a statement.

• #34 New Published Guidelines Inform Prevention of Continued Epileptic Seizures in Outpatient Management

  https://www.neurologylive.com/view/new-published-guidelines-inform-prevention-continued-epileptic-seizures-outpatient-management

  Early intervention is crucial to prevent seizures from progressing to more severe forms, reducing the burden on patients, caregivers, and healthcare systems. […] Based on the literature reviewed, all the experts agreed strongly that an ideal treatment for rapid and early seizure termination (REST) would start to act in 2 minutes of administration to stop ongoing seizure activity. […] Providing a clearer picture for clinicians, patients, and caregivers, on how and when to effectively treat prolonged seizures through the introduction of the concept of REST is an important step forward in disease management which will help to facilitate improved outcomes for patients and reduce healthcare resource utilization, Pina-Garza said in a statement. […] All of the expert group members also strongly agreed or agreed that patients who experienced a prolonged seizure should be offered a REST treatment option, and all patients who experienced a seizure cluster should be offered an acute cluster treatment (ACT).

• #35 Global experts release new guidelines on prevention of progression of epileptic seizures, addressing critical treatment gaps | UCB

  https://www.ucb.com/newsroom/press-releases/article/global-experts-release-new-guidelines-on-prevention-of-progression-of-epileptic-seizures-addressing-critical-treatment-gaps

  This approach not only seeks to prevent the escalation of seizures but also aims to alleviate the healthcare burden by reducing the need for hospitalization […] It is essential that we prevent seizures from progressing to more severe and complex types which result in significant physical, psychological, cognitive and socioeconomic burden for patients, caregivers and healthcare systems alike […] Providing a clearer picture for clinicians, patients, and caregivers, on how and when to effectively treat prolonged seizures through the introduction of the concept of REST is an important step forward in disease management which will help to facilitate improved outcomes for patients and reduce healthcare resource utilization […] Our goal is to ensure that every individual with epilepsy has the chance to live a life unburdened by the fear of seizure emergencies, and we are committed to advancing scientific and clinical research in this area.

• #36 Guidelines for the Treatment of Adults with Metastatic Brain Tumors

  https://www.cns.org/guidelines/treatment-adults-metastatic-brain-tumors/role-of-prophylactic-anticonvulsants-in-treatment-

  Target Populations: Adults with solid brain metastases who have not experienced a seizure. […] Level 3: Prophylactic AEDs are not recommended for patients with brain metastases who did not undergo surgical resection and are otherwise seizure-free. […] Level 3: Routine post-craniotomy anti-epileptic drug use for seizure-free patients with brain metastases is not recommended. […] The objective of this guideline is to address the role of AED prophylaxis in patients with brain metastases without prior seizures in the 1) non-surgical and 2) postoperative settings. […] Of the 2 studies identified pertaining to the use of prophylactic AEDs in patients with brain metastases, neither found a beneficial effect of AEDs on seizure rates. […] These studies are Class III evidence, leading to the Level 3 recommendation that the use of prophylactic AEDs is not justified for patients with brain metastases who did not undergo surgical resection and are otherwise seizure-free.

• #37 Effect of prophylaxis and treatment of seizures on outcome of adults following cardiac arrest: ALS TFSR

  https://costr.ilcor.org/document/effect-of-prophylaxis-and-treatment-of-seizures-on-outcome-of-adults-following-cardiac-arrest-als-tfsr

  Effect of prophylaxis and treatment of seizures on outcomes for adult and paediatric patients post-cardiac arrest (Nicholson/Scholefield 2024, pg No PROSPERO CRD42023460746 and CRD42023463581), by clinical content experts of the Adult and Paediatric Task Forces of ILCOR, with assistance from Jessie Cunningham, Information Specialist at The Hospital for Sick Children, Toronto, Canada. […] For the critical outcome of survival with favourable neurological outcome at discharge/30 days or longer, we identified two prospective RCTs {BRCT Study Group 1986 397; Longstreth 2002 506} 1,2 involving a total of 562 subjects which provided very low-certainty evidence (downgraded for risk of bias, indirectness and imprecision) of no benefit from prophylactic anti-seizure medication administration. […] We suggest against the use of prophylactic anti-seizure medication in adults post-cardiac arrest (weak recommendation, very low-certainty evidence).

• #38 Don’t routinely use seizure prophylaxis in patients following ischemic stroke. | AAFP

  https://www.aafp.org/pubs/afp/collections/choosing-wisely/209.html

  Seizures may complicate the clinical course of patients who have suffered a stroke. However, there is no evidence that using prophylactic antiepileptic drugs prevents seizure occurrence. […] For patients who suffer a seizure after a stroke, seizure treatment may be required.

• #39

  https://www.who.int/news-room/fact-sheets/detail/epilepsy

  Central nervous system infections are common causes of epilepsy in tropical areas, where many low- and middle-income countries are concentrated. Elimination of parasites in these environments and education on how to avoid infections can be effective ways to reduce epilepsy worldwide, for example those cases due to neurocysticercosis.

• #40 How to Prevent Seizures: 11 Techniques for Seizure Prevention

  https://resources.healthgrades.com/right-care/epilepsy/how-to-prevent-seizures

  How to Prevent Seizures: Techniques and Advice […] Effective treatment can help manage seizures. However, additional steps to prevent seizures may further reduce health risks and improve quality of life. […] It may not be possible to stop all cases of seizures. However, you can take steps to reduce risks and protect yourself from triggering seizure episodes. […] Following are 11 techniques for reducing the risk of seizures. […] 1. Follow your treatment plan […] Following your prescribed treatment plan can be the most effective way to prevent seizures. […] For your treatment plan to be most effective, take medications exactly as your doctor prescribes and follow their additional advice. […] Skipping medication and other factors that compromise treatment may put you at risk of experiencing more seizures.

• #41 How to Prevent Seizures: 11 Techniques for Seizure Prevention

  https://resources.healthgrades.com/right-care/epilepsy/how-to-prevent-seizures

  If you feel that your current treatment plan is not working effectively or is difficult to follow, talk with your doctor. […] 2. Track your seizures and triggers […] Recording information about your seizures can help you to identify when seizures occur and what their triggers may be. […] This information will help doctors to provide the most effective care and will help you avoid your own personal triggers. […] 3. Consult a doctor before taking new medications and supplements […] Always contact your doctor before making any changes to your medication or supplement routine. […] 4. Manage stress and anxiety […] Stress is a common trigger for seizures. As a result, finding a way to appropriately manage and reduce stress can help prevent seizures. […] 5. Limit alcohol consumption

• #42 How to Prevent Seizures: 11 Techniques for Seizure Prevention

  https://resources.healthgrades.com/right-care/epilepsy/how-to-prevent-seizures

  A high intake of alcohol over a short time may cause some people to experience a seizure. […] 6. Avoid the misuse of substances […] Certain drugs and intoxication from drugs are common causes of seizures. […] 7. Optimize your sleep quality […] Good quality sleep can reduce the risk of a seizure. […] 8. Keep regular meal times […] Not eating enough or regularly enough can lead to hypoglycemia, or low blood sugar. […] 9. Protect yourself from head injury […] Traumatic brain injury (TBI) can trigger seizures in both people already diagnosed with epilepsy and people who have never had a seizure before. […] 10. Avoid infection and take care when ill […] Being unwell may trigger a seizure in people with or without epilepsy. […] 11. Avoid flashing lights and other strong stimuli

• #43 Seizure Detection and SUDEP Prevention

  https://practicalneurology.com/articles/2018-nov-dec/seizure-detection-and-sudep-prevention

  Seizure detection and alerting devices hold promise for preventing sudden death in epilepsy. […] Interventions that reduce seizure frequency (eg, epilepsy surgery or add-on drug therapy) also reduce SUDEP rates. […] Increased nighttime supervision appears to be protective; having a roommate or use of a nocturnal listening device is associated with reduced SUDEP risk. […] There has been a growing interest in seizure detection and alerting devices for use in the home to notify caregivers of a seizure and turn unwitnessed seizures into attended seizures, as a method to reduce SUDEP risk. […] Although performance of some of these devices is uncertain, especially in the outpatient setting, there is sufficient information available to help choose between available options and determine which device may work best for a particular patient. […] Despite the lack of direct evidence that seizure detection devices prevent SUDEP, they may be a good tool to augment nocturnal supervision as a SUDEP-prevention strategy.

• #44 FF #229 Seizure Management in the Dying Patient | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/seizure-management-in-the-dying-patient/

  Family Education Family members should be counseled that all medications used to manage seizures can cause sedation and cardiopulmonary depression. Family members who have witnessed prior seizures often have great fear about seizure recurrence. Many hospice agencies have established seizure protocols and medication kits which can be stored at home, and will collaborate with physicians and families on establishing a ‘seizure plan’ for acute seizures. Review seizure safety with families, including not putting anything in the patient’s mouth and making sure the patient is in a safe environment.

• #45 Optimization of Seizure Prevention by Cannabidiol (CBD) | bioRxiv

  https://www.biorxiv.org/content/10.1101/2024.08.24.609518v1

  Objective Cannabidiol (CBD) is one of the most prominent non-psychotropic cannabinoids with known therapeutic potentials. Based on its anti-seizure efficacy, the first cannabis derived, pharmaceutical grade CBD-based medication was approved in the USA in 2018 for the treatment of seizures in patients 2 years and older. […] Our findings showed that all forms of CBD reduced seizures severity. Among the combination of CBD tested. CBD broad spectrum via inhalation was the most effective in the treatment of epileptic seizures (p<0.05) compared to other forms of CBD treatments. [...] Our data suggest that route and CBD formulations affect its efficacy in the prevention of epileptic seizures. Inhaled broad spectrum CBD showed a potential superior effect compared to other delivery routes and CBD formulations in the prevention of epileptic seizures, warrants further research.

• #46 Management & Prevention | Florida Department of Health

  https://www.floridahealth.gov/diseases-and-conditions/epilepsy/Management-Prevention.html

  Taking an active role in your epilepsy can be an important part of helping to reduce your seizures and feel more in control of your condition. […] You can learn how to manage your epilepsy to feel better and have a more active and full life. Practice these self-management strategies to better control your seizures and your health. Self-management is what you do to take care of yourself. […] Seek assistance for traumatic brain injuries, if they happen. Taking good care of the injury may help to avoid epilepsy. […] Getting regular health checkups may help you prevent and find diseases. […] Lower the chances of stroke and heart disease. […] Stay healthy during your pregnancy. Some health issues during pregnancy and childbirth can lead to epilepsy.

• #47 Seizures – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/seizure/diagnosis-treatment/drc-20365730

  Seizures don’t often result in serious injury. But if you have repeated seizures, you might injure yourself. […] It’s helpful to know what to do if you see someone having a seizure. If you’re at risk of having seizures, give this information to family, friends and co-workers. […] Stress due to living with a seizure condition can affect your mental health. Talk with your healthcare professional about your feelings.

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