Stress Management Intervention for Living With Epilepsy (SMILE)
EpilepsyThe study will examine whether a stress reduction intervention reduces the number of seizures in people with drug resistant epilepsy.
Ketogenic Diet for Child Epilepsy and Seizure Control
EpilepsySeizures1 moreTwenty to thirty percent of children with epilepsy continue to suffer from seizures, even when treated with currently available anticonvulsant medications. Children with Lennox-Gastaut Syndrome (LGS) are particularly handicapped by atonic-myoclonic seizures. Preliminary data suggest that even when other medications have failed, these seizures may respond rapidly and dramatically to a high-fat-low-carbohydrate ketogenic diet. The purpose of the study is to assess if the classic ketogenic diet is efficacious in reducing seizure frequency, medication toxicity, and improves quality of life.
Transcranial Magnetic Stimulation to Treat Epilepsy
EpilepsyThis study will use transcranial magnetic stimulation, or TMS (described below), to treat epilepsy in certain patients whose seizures persist despite optimum medical treatment. TMS used in this study is intended to lessen the number of seizures a patient has by decreasing excitability of the brain in the region where the seizures originate. Patients between 5 and 65 years of age who have had epilepsy for two or more years and have had at least one seizure a week for at least 6 months may be eligible for this 18-week study. Their seizures must come from a neocortical focus-that is, near the surface of the brain. Candidates will be selected from the NIH Epilepsy clinic and will be screened with an electroencephalogram (EEG), magnetic resonance imaging (MRI) scans, and blood tests. Participants will keep a diary of the seizures they experience over an 8-week period. After the 8 weeks, they will come to the NIH outpatient clinic for 6 consecutive days for the following procedures: Day 1: A regular clinic visit, plus 6 hours of video-EEG recording (described below) Days 2 through 5: Video-EEG monitoring and TMS as follows: 8:00 - 11: 00 a.m. 3 hours video-EEG monitoring 11:00 - 12:30 p.m. TMS (includes set-up time; actual stimulation time lasts 30 minutes) 12:30 - 3:00 p.m. Lunch + rest 3:00 - 4:30 p.m. TMS 4:30 - 7:30 p.m. 3 hours video-EEG monitoring (On the fifth day, subjects will have 6 hours of video-EEG monitoring in the afternoon instead of 3 hours.) Participants will be randomly assigned to one of two TMS groups. One group will have TMS delivered in a way that is thought to have a chance of reducing seizures; the other will have sham, or placebo, stimulation. When the TMS sessions are completed, participants will keep a diary of their seizures for another 8 weeks. Transcranial Magnetic Stimulation For TMS, an insulated wire coil is placed on the subject's scalp. A brief electrical current passes through the coil, creating a magnetic pulse that travels through the scalp and skull and causes small electrical currents in the cortex, or outer part of the brain. The stimulation may cause muscle, hand or arm twitching, or may cause twitches or temporary tingling in the forearm, head, or face muscles. During the stimulation, electrical activity of muscles is recorded with a computer or other recording device, using electrodes attached to the skin with tape. Some TMS sessions may be videotaped. Video-EEG Recordings The EEG recording device is housed in a small pouchlike container that is worn below the shoulder, attached to a belt worn around the waist.
Multicentre Study on Rapid Versus Slow Withdrawal of Antiepileptic Monotherapy
EpilepsyThe main objective of the present study will be to establish whether a slow (within 160 days) or a rapid (within 60 days) withdrawal schedule of antiepileptic monotherapy influence relapse rate in adult patients with epilepsy, who have been seizure free for at least 2 years. Secondary objectives will be to establish the compliance rates with these two schedules and the differences in terms of severity of relapses, based on the occurrence of status epilepticus, seizure-related injuries and death.
Sleep Intervention for Pediatric Epilepsy
EpilepsyThe purpose of the study is to develop and evaluate a sleep intervention program for improving sleep and health in youth with epilepsy and their parents.
Pharmacokinetics, Efficacy and Tolerability of BIA 2-093
EpilepsyThe purpose of this study is to characterize the pharmacokinetics of Eslicarbazepine acetate in children and adolescents with epilepsy.
A Open-label, Drug Interaction Study Between Eslicarbazepine Acetate and Topiramate
EpilepsySingle centre, open-label, multiple doses, one-sequence design study in two parallel groups of healthy volunteers
Effect of BIA 2-093 on the Pharmacokinetics of a Combined Oral Contraceptive.
EpilepsySingle centre, two-way crossover, randomised, open-label study in 20 healthy female volunteers.The volunteers received an oral single-dose of a combined contraceptive containing with an oral once daily dose of 1200 mg of BIA 2-093
Efficacy of Fluoxetine Against Seizure-induced Central Apneas
EpilepsyIctal/Post-ictal HypoxemiaSudden unexpected death in epilepsy (SUDEP) is a tragic outcome of seizure disorders that primarily affect young adults suffering from refractory epilepsy. In this population, SUDEP incidence is estimated at 0.5%. While the mechanisms of SUDEP are not completely understood, it appears that the majority of such death occurs in the immediate aftermath of a general tonic-clonic seizure. There is currently no validated preventive treatment for SUDEP. Some evidence suggest that modulation of the serotoninergic tone, and more specifically selective serotonin recapture inhibitor (SSRI) such as fluoxetine, might prevent SUDEP. Indeed, fluoxetine prevents seizure-induced lethal central apneas in DBA/2 and DBA/1 mice, one of the few animal models of SUDEP. Furthermore, serotoninergic bulbar nuclei are known to play a major role in the control of breathing, especially during sleep and in response to repeated hypoxia. In patients with epilepsy undergoing in-hospital video-EEG monitoring, about one third of seizures are associated with decrease in SpO2 <90%, an abnormality suspected to represent a risk factor of SUDEP. In a retrospective uncontrolled study, patients treated with SSRIs displayed less frequent ictal/post-ictal hypoxemia than patients not taking SSRIs. The investigators project aimed at testing whether fluoxetine can reduce the risk of ictal/post-ictal hypoxemia by performing a double-blind, randomized, placebo-controlled trial in patients undergoing video-EEG monitoring as part of the pre-surgical evaluation of their focal drug-resistant epilepsy.
Stopping and Preventing Epileptic Seizures Using a Partial Rebreathing Mask
EpilepsyBy enabling a partial rebreathing of expired gas, a moderate respiratory acidosis is induced, without causing hypoxia in the patient. Based on the scientific literature on the subject, the study hypothesis is that the fall in body pH will be able to stop and/or prevent epileptic brain activity.