Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Hyperammonemia and Generalized Seizures Linked

Epilepsia; ePub 2016 Jun 1; Albadareen, et al

There is evidence of a link between transient hyperammonemia (THA) seizures and generalized convulsive seizures (GCS), utilizing video-electroencephalography (vEEG) monitoring, according to a recent study. In a prospective cohort (n=78), researchers screened all consented adults (>18 years) admitted to the epilepsy monitoring unit. Ammonia was checked at baseline, within 60 minutes of the event and 24 hours after event (whenever possible). Patients were grouped in GCS, psychogenic nonepileptic seizures with convulsions (PNES-C), or focal seizures (FS) based on vEEG. They found:

• Of total patients enrolled, 13 had GCS, 8 had FS, and 9 had PNES-C.

• The groups differed with regard to gender and baseline ammonia, but not age.

• The change in ammonia postictally from baseline was significantly different among the 3 groups.

• The area under the receiver operator characteristic (ROC) curve for postictal ammonia to distinguish GCS from other groups was 0.88, suggesting ammonia to be a good test for differentiating epileptic GCS from other events.

Citation: Albadareen R, Gronseth G, Landazuri P, He J, Hammond N, Uysal U. Postictal ammonia as a biomarker for electrographic convulsive seizures: A prospective study. [Published online ahead of print June 1, 2016]. Epilepsia. doi:10.1111/epi.13426.

This Week's Must Reads

TBI Linked with 2-fold Increase Risk of Dementia, JAMA Neurology; ePub 2018 May 7; Barnes, et al

APOE ε2ε4 Genotype Linked with Cognitive Impairment, Neurology; ePub 2018 May 11; Oveisgharan, et al

Depressive Symptoms, Memory, and the Aging Brain , Neurology; ePub 2018 May 9; Al Hazzouri, et al

Patient Satisfaction with Sleep Study Experience, Sleep; ePub 2018 May 8; Kapur, Johnston, et al

More Severe Seizure Patterns Favor Daytime, Epilepsia; ePub 2018 Apr 23; Goldenholz, et al

Must Reads in Epilepsy & Seizures

More Severe Seizure Patterns Favor Daytime, Epilepsia; ePub 2018 Apr 23; Goldenholz, et al

Epilepsy, Fertility, and Birth Outcomes Examined , JAMA Neurology; ePub 2018 Apr 30; Pennell, et al

FDA Approves Medtronic’s DBS Therapy for Epilepsy, Medtronic news release; 2018 May 1

Incidence of Periictal Apnea in Epileptic Seizures, Epilepsia; ePub 2018 Jan 16; Lacuey, Zonjy, et al

Epilepsy Seizure Rate and Education Level Linked, Epilepsy Behav; ePub 2017 Dec 24; Kumar, et al