Epilepsy in prolonged disorders of consciousness: a systematic review.

Disorders of consciousness; antiepileptic drugs; epilepsy; minimally conscious state; vegetative state; Anticonvulsants; Anticonvulsants/therapeutic use; Humans; Seizures/drug therapy; Seizures/epidemiology; Consciousness; Epilepsy/complications; Epilepsy/drug therapy; Epilepsy/epidemiology; Seizures; Neuroscience (miscellaneous); Developmental and Educational Psychology; Neurology (clinical)

Abstract :

[en] To date, no guideline exists for the management of epilepsy in patients with prolonged Disorders of Consciousness (DoC). This review aimed to assess the occurrence of epilepsy and epileptic abnormalities (EA) in these patients, to determine their impact on recovery; and to review the effect of antiepileptic drugs (AED) and therapeutic interventions on seizure occurrence and consciousness recovery. A structured search for studies on prolonged DoC and epilepsy was undertaken following PRISMA guidelines. From an initial search resulting in 5,775 titles, twelve studies met inclusion criteria. The occurrence of epilepsy and EA in DoC was poorly and inconsistently reported across studies. The results estimated a seizure prevalence of 27% in DoC. No conclusive data were found for the effects of AED on recovery nor on the influence of any therapeutic interventions on seizure occurrence. Given the scarcity of data, it is premature to make evidence-based recommendations on epilepsy in prolonged DoC. Based on this review and current clinical practices the following are recommended: (1) repeated standard EEG for detecting seizures and EA; (2) treating epilepsy while avoiding AEDs with sedating or cognitive side-effects. Future research should use standardized classification systems for seizures and EA.

Disciplines :

Neurosciences & behavior

Author, co-author :

Lejeune, Nicolas ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group ; Institute of NeuroScience, Université Catholique De Louvain, Brussels, Belgium ; Centre Hospitalier Neurologique William Lennox, Ottignies-Louvain-la-Neuve, Belgium

Zasler, Nathan ; Concussion Care Centre of Virginia and Tree of Life Services. Department of PM&R, Virginia Commonwealth University, Richmond, Virginia, USA

Formisano, Rita ; IRCCS Santa Lucia Foundation, Rome, Italy

Estraneo, Anna ; Neurology Unit, Santa Maria Della Pietà General Hospital, Nola, Italy ; IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy

Bodart, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > > Service de neurologie

Magee, Wendy L ; Boyer College of Music and Dance, Temple University, Philadelphia, PA USA

Thibaut, Aurore ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group

Language :

English

Title :

Epilepsy in prolonged disorders of consciousness: a systematic review.

Publication date :

10 November 2021

Journal title :

Brain Injury

ISSN :

0269-9052

eISSN :

1362-301X

Publisher :

Taylor and Francis Ltd., England

Volume :

Issue :

12-13

Pages :

1485 - 1495

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://www.tandfonline.com/doi/pdf/10.1080/02699052.2021.1973104

Available on ORBi :

since 21 March 2023

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