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

Behavioral Activation May Cut Dementia Disparity, JAMA Neurology; ePub 2018 Sep 10; Rovner, et al

GFAP: Marker of Brain Injury in Acute Mild TBI , Neurology; ePub 2018 Sept 12; Gill, Latour, et al

Study Identifies Acute Ischemic Stroke Risk Factors, J Stroke Cerebrovasc Dis; ePub 2018 Sep 8; Kim, et al

Deployment-Related TBI and Back Pain in Veterans, J Pain; ePub 2018 Aug 30; Suri, Stolzmann, et al

Treatment Outcomes Post-Surgery for Moyamoya Disease, J Neurol; ePub 2018 Sep 8; Kahn, Kaur, Stein, et al

Must Reads in Epilepsy & Seizures

Epilepsy Transition Care Gap in Young Adults, Epilepsy Behav; ePub 2018 Aug 25; Baca, et al

FDA Approves Diacomit for Treatment of Seizures, Biocodex news release; 2018 Aug 23

Depression, Suicidality Among People with Epilepsy, Epilepsy Behav; ePub 2018 Aug 13; Friedman, et al

Midlife Risk Factors Linked to Late-Onset Epilepsy, JAMA Neurology; ePub 2018 Jul 23; Johnson, et al

Nearly 1 Million Adults ≥55 Years Have Epilepsy, Epilepsy Behav; ePub 2018 Aug 2; Sapkota, et al