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

Probable OSA Common in Refractory Epilepsy

Epilepsia; ePub 2018 Sep 24; McCarter, et al

A recent study identified a high frequency of probable obstructive sleep apnea

(pOSA) in refractory epilepsy monitoring patients, finding that pOSA patients were older and heavier, with higher screening symptoms for sleep apnea and more frequent focal seizures with a longer epilepsy duration. Researchers also found a possible association between OSA and sudden unexpected death in epilepsy (SUDEP) risk. Researchers prospectively recruited 49 consecutive adult patients admitted to the Mayo Clinic Epilepsy Monitoring Unit with focal, generalized, or unclassified epilepsy syndromes. They found:

  • 35% of patients had pOSA, with a mean oximetric oxyhemoglobin desaturation index (ODI) of 11.3 ± 5.1/h (range = 5.1‐22.8).
  • Patients with pOSA were older and heavier, and more frequently had a focal epilepsy syndrome and longer epilepsy duration, with higher Sleep Apnea-Sleep Disorders Questionnaire (SA‐SDQ) and STOP‐BANG Questionnaire scores.
  • Median Revised SUDEP Risk Inventory (rSUDEP‐7) score was 3 ± 1.4 (range = 0‐6).
  • Higher rSUDEP‐7 scores were positively correlated with higher ODI.
  • rSUDEP‐7 score ≥5 was associated with pOSA by ODI, SA‐SDQ, and STOP‐BANG questionnaire criteria.


McCarter AR, Timm PC, Shepard PW, et al. Obstructive sleep apnea in refractory epilepsy: A pilot study investigating frequency, clinical features, and association with risk of sudden unexpected death in epilepsy. [Published online ahead of print September 24, 2018]. Epilepsia. doi:10.1111/epi.14548.

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Unplanned Pregnancy, Fetal Loss, and Epilepsy, JAMA Neurology; ePub 2018 Oct 15; Herzog, et al

Probable OSA Common in Refractory Epilepsy, Epilepsia; ePub 2018 Sep 24; McCarter, et al

Circadian, Circaseptan Rhythms in Epilepsy Examined, Lancet Neurol; ePub 2018 Sep 12; Karoly, et al

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