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Hexcollie, Krash, bdrv, eo.s n aderassi Epileptic Fractal rebirth

Hexcollie, Krash, bdrv, eo.s n aderassi Epileptic Fractal rebirth

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Patients with epilepsy can manifest short, sub-clinical epileptic "bursts" in addition to full-blown clinical seizures. We believe the relationship between these two classes of events---something not previously studied quantitatively---could yield important insights into the nature and intrinsic dynamics of seizures. A goal of our work is to parse these complex epileptic events into distinct dynamic regimes. A challenge posed by the intracranial EEG (iEEG) data we study is the fact that the number and placement of electrodes can vary between patients. We develop a Bayesian nonparametric Markov switching process that allows for (i) shared dynamic regimes between a variable number of channels, (ii) asynchronous regime-switching, and (iii) an unknown dictionary of dynamic regimes. We encode a sparse and changing set of dependencies between the channels using a Markov-switching Gaussian graphical model for the innovations process driving the channel dynamics and demonstrate the importance of this model in parsing and out-of-sample predictions of iEEG data. We show that our model produces intuitive state assignments that can help automate clinical analysis of seizures and enable the comparison of sub-clinical bursts and full clinical seizures.

This article is from Journal of Biomedical Science , volume 19 . Abstract Background: Maternal epileptic seizures during pregnancy can affect the hippocampal neurons in the offspring. The polysialylated neural cell adhesion molecule (PSA-NCAM), which is expressed in the developing central nervous system, may play important roles in neuronal migration, synaptogenesis, and axonal outgrowth. This study was designed to assess the effects of kindling either with or without maternal seizures on hippocampal PSA-NCAM expression in rat offspring. Methods: Forty timed-pregnant Wistar rats were divided into four groups: A) Kind+/Seiz+, pregnant kindled (induced two weeks prior to pregnancy) rats that received repeated intraperitoneal (i.p.) pentylenetetrazol, PTZ injections on gestational days (GD) 14-19; B) Kind-/Seiz+, pregnant non-kindled rats that received PTZ injections on GD14-GD19; C) Kind+/Seiz-, pregnant kindled rats that did not receive any PTZ injections; and D) Kind-/Seiz-, the sham controls. Following birth, the pups were sacrificed on PD1 and PD14, and PSA-NCAM expression and localization in neonates’ hippocampi were analyzed by Western blots and immunohistochemistry. Results: Our data show a significant down regulation of hippocampal PSA-NCAM expression in the offspring of Kind+/Seiz+ (p = 0.001) and Kind-/Seiz+ (p = 0.001) groups compared to the sham control group. The PSA-NCAM immunoreactivity was markedly decreased in all parts of the hippocampus, especially in the CA3 region, in Kind+/Seiz+ (p = 0.007) and Kind-/Seiz+ (p = 0.007) group’s newborns on both PD1 and 14. Conclusion: Our findings demonstrate that maternal seizures but not kindling influence the expression of PSA-NCAM in the offspring’s hippocampi, which may be considered as a factor for learning/memory and cognitive impairments reported in children born to epileptic mothers.

Book Source: Digital Library of India Item 2015.268809 dc.contributor.author: Brahm Prakash dc.date.accessioned: 2015-07-27T20:21:28Z dc.date.available: 2015-07-27T20:21:28Z dc.identifier.barcode: 05990010890244 dc.identifier.origpath: /data58/upload/0091/961 dc.identifier.copyno: 1 dc.identifier.uri: http://www.new.dli.ernet.in/handle/2015/268809 dc.description.scannerno: 20003265 dc.description.scanningcentre: IIIT, Allahabad dc.description.main: 1 dc.description.tagged: 0 dc.description.totalpages: 71 dc.format.mimetype: application/pdf dc.language.iso: English dc.publisher.digitalrepublisher: Digital Library Of India dc.publisher: Bundelkhand Uni Jhansi dc.source.library: Bundelkhand Uni Jhansi dc.subject.classification: Medical dc.title: A Study Of Childhood Epilepsy And Epileptic Syndromes dc.type: ptiff dc.type: pdf

Rovastar & Che Definitly Not For The Epileptic (Inner Perspective Of Life Mix) (2)

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In many realistic networks, the edges representing the interactions between the nodes are time-varying. There is growing evidence that the complex network that models the dynamics of the human brain has time-varying interconnections, i.e., the network is evolving. Based on this evidence, we construct a patient and data specific evolving network model (comprising discrete-time dynamical systems) in which epileptic seizures or their terminations in the brain are also determined by the nature of the time-varying interconnections between the nodes. A novel and unique feature of our methodology is that the evolving network model remembers the data from which it was conceived from, in the sense that it evolves to almost regenerate the patient data even upon presenting an arbitrary initial condition to it. We illustrate a potential utility of our methodology by constructing an evolving network from clinical data that aids in identifying an approximate seizure focus -- nodes in such a theoretically determined seizure focus are outgoing hubs that apparently act as spreaders of seizures. We also point out the efficacy of removal of such spreaders in limiting seizures.

"An Epileptic Emperor: A Study in the Psychology of the First Caesar" is an article from The Classical Weekly, Volume 5 . View more articles from The Classical Weekly . View this article on JSTOR . View this article's JSTOR metadata . You may also retrieve all of this items metadata in JSON at the following URL: https://archive.org/metadata/jstor-4386498

Zarbsong - Epileptic Drum 2008 Creative Commons License : Zarbsong - Epileptic Drum © 2008 by Zarbsong is licensed under CC BY-NC-ND 4.0

This paper is in the public domain in USA. Metadata comes from the CrossRef API, see full record in the source URL below.

This paper is in the public domain in USA. Metadata comes from the CrossRef API, see full record in the source URL below.

This paper is in the public domain in USA. Metadata comes from the CrossRef API, see full record in the source URL below.

This paper is in the public domain in USA. Metadata comes from the CrossRef API, see full record in the source URL below.

Weisberg, an Office of Strategic Services officer during World War II, U.S. Senate staff member and investigative reporter, devoted 40 years of his life to researching and writing about the Kennedy and King assassinations. His first book, Whitewash: The Report on the Warren Report (1965), was the first critical study of the government's official version of what happened in Dallas on Nov. 22, 1963. Seven of the eight books Weisberg published after Whitewash were about the Kennedy assassination. Over time, Weisberg became recognized, both nationally and internationally, as the dean of writers critical of the official version of the JFK assassination known as the Warren Commission Report. Harold Weisberg donated the world's largest accessible private collection of government documents and public records relating to the assassination of President John F. Kennedy to Hood College and the Beneficial-Hodson Library at Hood College, which donated a copy to the National Security Internet Archive.

Epileptic seizure is an unstable condition of the brain that cause severe mental disorder and can be fatal if not properly diagnosed at an early stage. Electroencephalogram (EEG) plays a major role in early diagnosis of epileptic seizures. The volume of medical databases is enormous. Classification may become less accurate if the dataset contains redundant and irrelevant attributes. To reduce the mortality rate due to epilepsy, a decision support system that can assist medical professionals in taking immediate precautionary measures prior to reaching the critical condition is required. In this work, k-nearest neighbours (KNN) classifier algorithm is optimised using genetic algorithm for effective classification and faster prediction to meet this requirement. Genetic algorithms search for optimal solutions in complex and large environments. Results are compared with other machine learning models such as support vector machine (SVM), KNN, decision tree classifier, and random forest. With optimization using genetic algorithm KNN was able to achieve an enhancement in accuracy at lower training and testing times. It was observed that the accuracy offered by optimized KNN was 92%. Random forest classifiers showed minimum complexity and KNN algorithm provided faster performance with better accuracy.

Epileptic seizure is an unstable condition of the brain that cause severe mental disorder and can be fatal if not properly diagnosed at an early stage. Electroencephalogram (EEG) plays a major role in early diagnosis of epileptic seizures. The volume of medical databases is enormous. Classification may become less accurate if the dataset contains redundant and irrelevant attributes. To reduce the mortality rate due to epilepsy, a decision support system that can assist medical professionals in taking immediate precautionary measures prior to reaching the critical condition is required. In this work, k-nearest neighbours (KNN) classifier algorithm is optimised using genetic algorithm for effective classification and faster prediction to meet this requirement. Genetic algorithms search for optimal solutions in complex and large environments. Results are compared with other machine learning models such as support vector machine (SVM), KNN, decision tree classifier, and random forest. With optimization using genetic algorithm KNN was able to achieve an enhancement in accuracy at lower training and testing times. It was observed that the accuracy offered by optimized KNN was 92%. Random forest classifiers showed minimum complexity and KNN algorithm provided faster performance with better accuracy.

Zylot & Pinbi7 Definitly Not For The Epileptic (Cancerous Growth reMix) killigulaey roam3

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We investigate the suitability of selected measures of complexity based on recurrence quantification analysis and recurrence networks for an identification of pre-seizure states in multi-day, multi-channel, invasive electroencephalographic recordings from five epilepsy patients. We employ several statistical techniques to avoid spurious findings due to various influencing factors and due to multiple comparisons and observe precursory structures in three patients. Our findings indicate a high congruence among measures in identifying seizure precursors and emphasize the current notion of seizure generation in large-scale epileptic networks. A final judgment of the suitability for field studies, however, requires evaluation on a larger database.

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Artykuł w: Annales Universitatis Mariae Curie-Skłodowska. Sectio D, Medicina. Vol. 63, N1, 30 (2008), strony 177-182

This article is from BMC Genomics , volume 15 . Abstract None

This article is from Frontiers in Genetics , volume 4 . Abstract The sodium channel Nav1.6, encoded by the gene SCN8A, is one of the major voltage-gated channels in human brain. The sequences of sodium channels have been highly conserved during evolution, and minor changes in biophysical properties can have a major impact in vivo. Insight into the role of Nav1.6 has come from analysis of spontaneous and induced mutations of mouse Scn8a during the past 18 years. Only within the past year has the role of SCN8A in human disease become apparent from whole exome and genome sequences of patients with sporadic disease. Unique features of Nav1.6 include its contribution to persistent current, resurgent current, repetitive neuronal firing, and subcellular localization at the axon initial segment (AIS) and nodes of Ranvier. Loss of Nav1.6 activity results in reduced neuronal excitability, while gain-of-function mutations can increase neuronal excitability. Mouse Scn8a (med) mutants exhibit movement disorders including ataxia, tremor and dystonia. Thus far, more than ten human de novo mutations have been identified in patients with two types of disorders, epileptic encephalopathy and intellectual disability. We review these human mutations as well as the unique features of Nav1.6 that contribute to its role in determining neuronal excitability in vivo. A supplemental figure illustrating the positions of amino acid residues within the four domains and 24 transmembrane segments of Nav1.6 is provided to facilitate the location of novel mutations within the channel protein.

This article is from Journal of Medical Signals and Sensors , volume 4 . Abstract We propose a novel approach for detecting precursors to epileptic seizures in intracranial electroencephalograms (iEEG), which is based on the analysis of system dynamics. In the proposed scheme, the largest Lyapunov exponent of the discrete wavelet packet transform (DWPT) of the segmented EEG signals is considered as the discriminating features. Such features are processed by a support vector machine (SVM) classifier to identify whether the corresponding segment of the EEG signal contains a precursor to an epileptic seizure. When consecutive EEG segments contain such precursors, a decision is made that a precursor is in fact detected. The proposed scheme is applied to the Freiburg dataset, and the results show that seizure precursors are detected in a time frame that unlike other existing schemes is very much convenient to patients, with sensitivity of 100% and negligible false positive detection rates.

This article is from Upsala Journal of Medical Sciences , volume 117 . Abstract Background. Valproic acid (VPA) apparent clearance (CL) estimated from total serum concentrations is analogous in elderly and non-elderly adult patients. As drug–protein binding decreases in old age, the aim of our study was to evaluate the confounding effect of the serum albumin concentration on the VPA apparent CL in elderly patients. Methods. In 102 epileptic out-patients treated with VPA in monotherapy, serum total steady-state trough concentrations (Css) were determined. Css concentrations were normalized for a 42 g/L albumin concentration (CssN), and the apparent CL and normalized apparent CLN were calculated. Results. A poor concordance of 53% was found in the classification of Css and CssN levels of VPA as subtherapeutic, therapeutic, or supratherapeutic dose. In the elderly (≥65 years) and non-elderly adult patients, the VPA apparent CL was similar; however, normalized apparent CLN was significantly lower in older patients (P < 0.01), with a 40% median decrease. Conclusions. Total VPA concentrations should be interpreted with caution, mainly in older patients, in which determination of unbound or normalized total drug concentrations may be clinically useful. Normalization of total concentrations permits an estimation of the masking effect of serum albumin concentrations on the VPA apparent CL in elderly patients.

This article is from PLoS ONE , volume 9 . Abstract Cell transplantation has been suggested as an alternative therapy for temporal lobe epilepsy (TLE) because this can suppress spontaneous recurrent seizures in animal models. To evaluate the therapeutic potential of human neural stem/progenitor cells (huNSPCs) for treating TLE, we transplanted huNSPCs, derived from an aborted fetal telencephalon at 13 weeks of gestation and expanded in culture as neurospheres over a long time period, into the epileptic hippocampus of fully kindled and pilocarpine-treated adult rats exhibiting TLE. In vitro, huNSPCs not only produced all three central nervous system neural cell types, but also differentiated into ganglionic eminences-derived γ-aminobutyric acid (GABA)-ergic interneurons and released GABA in response to the depolarization induced by a high K+ medium. NSPC grafting reduced behavioral seizure duration, afterdischarge duration on electroencephalograms, and seizure stage in the kindling model, as well as the frequency and the duration of spontaneous recurrent motor seizures in pilocarpine-induced animals. However, NSPC grafting neither improved spatial learning or memory function in pilocarpine-treated animals. Following transplantation, grafted cells showed extensive migration around the injection site, robust engraftment, and long-term survival, along with differentiation into β-tubulin III+ neurons (∼34%), APC-CC1+ oligodendrocytes (∼28%), and GFAP+ astrocytes (∼8%). Furthermore, among donor-derived cells, ∼24% produced GABA. Additionally, to explain the effect of seizure suppression after NSPC grafting, we examined the anticonvulsant glial cell-derived neurotrophic factor (GDNF) levels in host hippocampal astrocytes and mossy fiber sprouting into the supragranular layer of the dentate gyrus in the epileptic brain. Grafted cells restored the expression of GDNF in host astrocytes but did not reverse the mossy fiber sprouting, eliminating the latter as potential mechanism. These results suggest that human fetal brain-derived NSPCs possess some therapeutic effect for TLE treatments although further studies to both increase the yield of NSPC grafts-derived functionally integrated GABAergic neurons and improve cognitive deficits are still needed.

Seizure prediction has proven to be difficult in clinically realistic environments. Is it possible that fluctuations in cortical firing could influence the onset of seizures in an ictal zone? To test this, we have now used neural network simulations in a computational model of cortex having a total of 65,536 neurons with intercellular wiring patterned after histological data. A spatially distributed Poisson driven background input representing the activity of neighboring cortex affected 1% of the neurons. Gamma distributions were fit to the interbursting phase intervals, a non-parametric test for randomness was applied, and a dynamical systems analysis was performed to search for period-1 orbits in the intervals. The non-parametric analysis suggests that intervals are being drawn at random from their underlying joint distribution and the dynamical systems analysis is consistent with a nondeterministic dynamical interpretation of the generation of bursting phases. These results imply that in a region of cortex with abnormal connectivity analogous to a seizure focus, it is possible to initiate seizure activity with fluctuations of input from the surrounding cortical regions. These findings suggest one possibility for ictal generation from abnormal focal epileptic networks. This mechanism additionally could help explain the difficulty in predicting partial seizures in some patients.

I was bored -w-

hexcollie Super Cool Epileptic Spiral Thing

Includes bibliographical references and original printed wrappers

Background Levetiracetam is a novel antiepileptic drug. It is marketed worldwide since 2000. Aim The paper reviewed the mechanism of action, pharmacokinetics, adverse drug reactions, contraindications and uses of levetiracetam in the treatment of various types of epileptic seizures. Methods Literature searches were done to identify relevant studies. Results Levetiracetam acts by binding to the synaptic vesicle protein SV2A, thereby modulation of one or more of its actions and ultimately affecting neural excitability. It has less protein binding and lacks hepatic metabolism. In contrast to traditional therapy, it has a wide safety margin and does not require serum drug monitoring. It does not interact with other anti epileptics. Conclusion The above mentioned favourable pharmacological benefits of LEV make it an important first line or adjunctive therapy for epileptic seizures. Parth Nikam | Rishikesh Bachhav "A Review on Epileptic Treatment by Levetiracetam" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-1 , December 2021, URL: https://www.ijtsrd.com/papers/ijtsrd46374.pdf Paper URL: https://www.ijtsrd.com/pharmacy/analytical-chemistry/46374/a-review-on-epileptic-treatment-by-levetiracetam/parth-nikam

Background Levetiracetam is a novel antiepileptic drug. It is marketed worldwide since 2000. Aim The paper reviewed the mechanism of action, pharmacokinetics, adverse drug reactions, contraindications and uses of levetiracetam in the treatment of various types of epileptic seizures. Methods Literature searches were done to identify relevant studies. Results Levetiracetam acts by binding to the synaptic vesicle protein SV2A, thereby modulation of one or more of its actions and ultimately affecting neural excitability. It has less protein binding and lacks hepatic metabolism. In contrast to traditional therapy, it has a wide safety margin and does not require serum drug monitoring. It does not interact with other anti epileptics. Conclusion The above mentioned favourable pharmacological benefits of LEV make it an important first line or adjunctive therapy for epileptic seizures. Parth Nikam | Rishikesh Bachhav "A Review on Epileptic Treatment by Levetiracetam" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-1 , December 2021, URL: https://www.ijtsrd.com/papers/ijtsrd46374.pdf Paper URL: https://www.ijtsrd.com/pharmacy/analytical-chemistry/46374/a-review-on-epileptic-treatment-by-levetiracetam/parth-nikam

This article is from Iranian Journal of Pediatrics , volume 20 . Abstract Objective: Parents of epileptic children are willing to know if specific foods precipitate or aggravate their kids' seizures. Nonetheless conclusive data are limited. Alternative medicine has become a popular approach to many diseases in the world and there are limited data about this approach to epilepsy in Iran. We tried to evaluate attitude of parents of epileptic children to food-epilepsy relationship and alternative therapeutic approach to epilepsy. Methods: We carried out a cross-sectional study with analytic aspect at Children's Medical Center, Tehran, Iran in 2008, by asking the parents of epileptic children to fill out a valid and excellently reliable questionnaire. We collected parents‘ attitude and analyzed it using SPSS software. Findings: One-hundred and fifty one families participated in the study. Fifty-nine of participants (39.1%) believed that foods had no effect on epilepsy. Fifty one cases (33.8%) said that foods might have negative or positive effect on epilepsy and 27.1% (41 cases) had no idea. Higher percent of parents believed in food-epilepsy relation in cases that fathers had educational levels above high school graduation. Sixteen cases (10.6%) said that alternative medicine might improve epilepsy and 55% had no idea about efficacy of this approach to epilepsy. Conclusion: Compared with previous published study from Iran, parents of epileptic children believed less in food-epilepsy relation. Majority of parents either believed that foods had no effect on epilepsy or had no idea. More than half of parents had no idea about efficacy of alternative medicine to epilepsy. Only a few of them believed in ameliorating effects of alternative medicine on epilepsy.

This article is from Annals of Indian Academy of Neurology , volume 16 . Abstract Aims:: To evaluate clinical profile and short-term outcome of psychogenic non-epileptic seizures (PNES) in Indian adult population. Setting and Design:: A prospective observational study, conducted at tertiary teaching institute at New Delhi. Materials and Methods:: Sixty-three patients with confirmed PNES were enrolled. The diagnosis was based on witnessing the event during video-electroencephalography (Video-EEG) monitoring. A detailed clinical evaluation was done including evaluation for coexistent anxiety or depressive disorders. Patients were divided into two groups on the basis of excessive or paucity of movements during PNES attacks. Patients were followed-up to 12 months for their PNES frequency. Statistical Analysis:: Means and standard deviations were calculated for continuous variables. Chi-square and Students t-test were used to compare categorical and continuous variables respectively. Results:: The mean age at onset of PNES was 25.44 years; with F:M ratio of 9.5:1. Coexistent epilepsy was present in 13 (20.63%) cases. Twenty-two patients (44%) with only PNES (n = 50) had received antiepileptic drugs. Out of 63 patients of PNES 24 (38.1%) had predominant motor phenomenon, whereas 39 (61.9%) had limp attacks. The common features observed were pre-ictal headache, ictal eye closure, jaw clenching, resistant behavior, ictal weeping, ictal vocalization, and unresponsiveness during episodes. Comorbid anxiety and depressive disorders was seen in 62.3% and 90.16% patients, respectively. Short-term (6-12 months) outcome of 45 patients was good (seizure freedom in 46.66% and >50% improvement in 24.44% cases). Conclusion:: PNES is common, but frequently misdiagnosed and treated as epileptic seizures. A high index of suspicion is required for an early diagnosis. Proper disclosure of diagnosis and management of the psychiatric comorbidities can improve their outcome. Limitation:: Limited sample size and change in seizures frequency as the only parameter for the assessment of the outcome are the two major limitations of our study.

This article is from Experimental and Therapeutic Medicine , volume 7 . Abstract The objective of this study was to analyze the changes in expression and the possible functions of interleukin-6 (IL-6) in electrical kindling of the basolateral amygdala (BLA) in epileptic rats. Bipolar electrodes were implanted into the BLA of Sprague-Dawley rats, and the rats were then subjected to chronic electrical stimulation through the electrodes to induce kindling. The seizure characteristics and behavioral changes of the rats were observed, and electroencephalograms were recorded during and following kindling. The IL-6 mRNA expression in the hippocampi of the rats was analyzed using semi-quantitative reverse transcription-polymerase chain reaction, and control and topiramate (TPM)-treated groups were compared. The mean time-period required for kindling was 13.50±3.99 days, and the afterdischarge duration (ADD) measured between 21,450 and 119,720 msec. The expression of IL-6 mRNA was significantly upregulated in the kindled rats. TPM was able to depress the seizures and decrease the IL-6 level in the kindled rats. In conclusion, IL-6 mRNA was upregulated in the hippocampi of epileptic rats, and IL-6 may have participated in the process of kindling.

This article is from Italian Journal of Pediatrics , volume 40 . Abstract None

This article is from Italian Journal of Pediatrics , volume 40 . Abstract None

This article is from Italian Journal of Pediatrics , volume 40 . Abstract None

A brief history of the mistreatment of epileptics in the United States.

Description After I noticed that one of my games neared 10,000th gameplay, I had to celebrate by making something utterly disturbing. That “something” became this. Use arrow keys to repeatedly smash your head on the wall, but be warned, the longer you do it, the more unplayable the game becomes. Ohh, and if you didn’t get it already THIS GAME CAN CAUSE SEIZURES. The music is I’m A Raver by ZeRo-BaSs : http://www.newgrounds.com/audio/listen/145149 Instructions Just believe.

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This article is from Journal of Injury and Violence Research , volume 4 . Abstract Background:: The analysis of the brain CT Scan results in patients with epilepsy referred to the neurology clinic of Kermanshah during 1996-2007. Epilepsy is a transient disorder of the nervous system due to sudden discharge of brain neurons. The sudden and abnormal neuronal discharge may lead to consciousness level reduction, changes in perception or mental dysfunction of seizure movements, sensorineural disorders or a combination of these symptoms. Methods:: This was a descriptive-cross sectional study. Patients with epilepsy referred to the neurology clinic in Kermanshah (Iran) who were studied by Brain CT scan during 1996-2007 were investigated. After confirming the epilepsy of patients by neurosurgery experts and removal of the seizure of consciousness loss due to other causes such as syncope, 931 patients were enrolled in our study. Results:: Among 931 patients, only 905 patients had undergone Brain CT of which 464 were female and the rest were male. 325 patients suffered from focal motor epilepsy, patients referred with temporal epilepsy, 473 patients with Grand Mal epilepsy, 12 patients with absence epilepsy, 54 patients with myoclonic epilepsy, and 7 patients suffered from other types of epilepsy. The greatest Brain CT disorder was related to focal epilepsy. Among 125 patients with abnormal Brain CT, the greatest disorder was associated with cerebrovascular disorders (58 cases). In this study, the age range of samples was 1-89 years old. The lowest disorder was found in the age group of 10-19 and 20-39 years old (8.7% and 12.4%, respectively). The greatest disorder was observed in patients over 60 years old (38.3%). It should be noted that no Brain CT disorder was found in patients with youth myoclonic and absence epilepsy. Conclusions:: The results of the present study can be helpful for proper use of brain imaging in patients with epilepsy. Keywords:: Epilepsy, Brain CT, Neurology Clinic, Mayoclonic epilepsy

This article is from Systematic Reviews , volume 3 . Abstract Background: Epilepsy affects about 1% of the general population. Anti-epileptic drugs (AEDs) prevent or terminate seizures in individuals with epilepsy. Pregnant women with epilepsy may continue taking AEDs. Many of these agents cross the placenta and increase the risk of major congenital malformations, early cognitive and developmental delays, and infant mortality. We aim to evaluate the comparative safety of AEDs approved for chronic use in Canada when administered to pregnant and breastfeeding women and the effects on their infants and children through a systematic review and network meta-analysis. Methods: Studies examining the effects of AEDs administered to pregnant and breastfeeding women regardless of indication (e.g., epilepsy, migraine, pain, psychiatric disorders) on their infants and children will be included. We will include randomized clinical trials (RCTs), quasi-RCTs, non-RCTs, controlled before-after, interrupted time series, cohort, registry, and case-control studies. The main literature search will be executed in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. We will seek unpublished literature through searches of trial protocol registries and conference abstracts. The literature search results screening, data abstraction, and risk of bias appraisal will be performed by two individuals, independently. Conflicts will be resolved through discussion. The risk of bias of experimental and quasi-experimental studies will be appraised using the Cochrane Effective Practice and Organization of Care Risk-of-Bias tool, methodological quality of observational studies will be appraised using the Newcastle-Ottawa Scale, and quality of reporting of safety outcomes will be conducted using the McMaster Quality Assessment Scale of Harms (McHarm) tool. If feasible and appropriate, we will conduct random effects meta-analysis. Network meta-analysis will be considered for outcomes that fulfill network meta-analysis assumptions.The primary outcome is major congenital malformations (overall and by specific types), while secondary outcomes include fetal loss/miscarriage, minor congenital malformations (overall and by specific types), cognitive development, psychomotor development, small for gestational age, preterm delivery, and neonatal seizures. Discussion: Our systematic review will address safety concerns regarding the use of AEDs during pregnancy and breastfeeding. Our results will be useful to healthcare providers, policy-makers, and women of childbearing age who are taking anti-epileptic medications. Systematic review registration: PROSPERO CRD42014008925.

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