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New approved extended release medication for epilepsy

FDAThe US Food and Drug Administration (FDA) has approved another once-daily extended-release formulation of topiramate (Qudexy XR, Upsher-Smith Laboratories Inc), the company announced.

It is indicated as initial monotherapy in patients 10 years of age or older with partial-onset seizures or primary tonic-clonic seizures, and also approved as adjunctive therapy in patients 2 years of age or older with partial-onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome.

The new formulation is available in 25-, 50-, 100-, 150-, and 200-mg extended-release capsules, the statement notes. Capsules can be opened and the contents sprinkled on a spoonful of soft food to facilitate dosing. “This makes it the only approved extended-release topiramate product for patients who experience challenges swallowing whole capsules or tablets,” the release adds.

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New Device Approved For Migraine

FDAA headband delivering electrical nerve stimulation can prevent onset of migraine headaches and can be marketed for that purpose in the U.S., the FDA said Tuesday.

Called Cefaly, the Belgian-made device is the first to win FDA approval for migraine prevention and is also the first transcutaneous electrical nerve stimulation (TENS) system OK’d for any type of pain prevention, as opposed to acute treatment, the agency said.

The device is battery-powered and worn around the head, with the actual TENS stimulator centered on the forehead just above the eyes. It delivers a small, steady current to trigeminal nerve branches. Patients will be instructed to use the device once daily for a maximum of 20 minutes. It is approved for adults only.

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New device to monitor heart arrythmias!

HealthyHeartDMC Among First to Implant New Device for Irregular Heartbeats

The Detroit Medical Center is among the first hospitals in the world to implant a new cardiac monitoring device used to diagnose and monitor irregular heartbeats with hopes of possibly thwarting strokes or other heart ailments.

“The device revolutionizes the whole clinical approach to the workup and management of symptoms potentially caused by arrhythmias of the heart, and is likely to prevent many, many strokes due to atrial fibrillation,” Dr. Theodore Schreiber, president of DMC Cardiovascular Institute and the DMC Heart Hospitalsaid in a statement.

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All you need to know about ARB’s

ARB'sAngiotensin II Receptor Blockers (ARBs)

What are angiotensin receptor blockers, and how do they work?

Angiotensin II is a very potent chemical that causes muscles surrounding blood vessels to contract, thereby narrowing blood vessels. This narrowing increases the pressure within the vessels and can cause high blood pressure (hypertension). Angiotensin II receptor blockers (ARBs) are medications that block the action of angiotensin II by preventing angiotensin II from binding to angiotensin II receptors on blood vessels. As a result, blood vessels enlarge (dilate) and blood pressure is reduced. Reduced blood pressure makes it easier for the heart to pump blood and can improve heart failure. In addition, the progression of kidney disease due to high blood pressure or diabetes is slowed. ARBs have effects that are similar to angiotensin converting enzyme (ACE) inhibitors, but ACE inhibitors act by preventing the formation of angiotensin II rather than by blocking the binding of angiotensin II to muscles on blood vessels.

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What everyone needs to know about ACE Inhibitors

ACE-InhibitorsWhat are ACE inhibitors, and how do they work?

Angiotensin II is a very potent chemical produced by the body that causes the muscles surrounding blood vessels to contract, thereby narrowing the vessels. The narrowing of the vessels increases the pressure within the vessels causing increases in blood pressure (hypertension). Angiotensin II is formed from angiotensin I in the blood by the enzyme angiotensin converting enzyme (ACE). ACE inhibitors are medications that slow (inhibit) the activity of the enzyme ACE, which decreases the production of angiotensin II. As a result, the blood vessels enlarge or dilate, and blood pressure is reduced. This lower blood pressure makes it easier for the heart to pump blood and can improve the function of a failing heart. In addition, the progression of kidney disease due to high blood pressure or diabetes is slowed.

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Patients With Dizziness Treated Effectively with VENG diagnosis and vestibular rehabilitation

balance trainingThe number of people who present to emergency departments with dizziness is increasing, as is the percentage of emergency department visits resulting from dizziness, according to research presented at the 2013 Annual Meeting of the American Neurological Association. Benign positional vertigo is one of the major causes of dizziness, yet clinicians are administering a proven cure, the Epley maneuver, less often, said Kevin Kerber, MD.

At the same time, an increasing proportion of patients who present with dizziness are receiving CAT scans, which may have little value in this context and may entail more harm than benefit for these patients, in terms of radiation exposure, cost, length of stay in the emergency department, and misdiagnoses, said Dr. Kerber, Associate Professor of Neurology at the University of Michigan in Ann Arbor. The system used to document emergency department visits may be contributing to the high rate of CAT scans, he added.

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Epilepsy surgery effective also on patients older than 60

epilepsySurgery in older patients with epilepsy has the potential to improve overall health and quality of life, as well as provide a favorable seizure outcome, according to a study presented at the 67th Annual Meeting of the American Epilepsy Society.

Investigators at the University of California, Los Angeles (UCLA), reviewed the records of 10 patients who had undergone resective epilepsy surgery for medically refractory focal onset seizures at their institution between 1992 and 2012. Patients ages 60 and older (age range: 60 to 74) with a minimum follow-up of one year (range 1 to 7.5 years) were included in the study. Comorbidities at the time of surgery, including hypertension, hyperlipidemia, diabetes mellitus, hypothyroidism, osteoporosis, obstructive sleep apnea, depression, and falls, were noted. A modified Liverpool life satisfaction tool was administered postoperatively, with a maximum score of 40.

Patients’ mean age at surgery was 65.4. The mean duration of epilepsy before surgery was 27.8 years. At the time of surgery, 70% of patients had at least one medical comorbidity in addition to refractory seizures. No patients experienced any postsurgical complications.

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Important advances in epilepsy and seizure management

EpilepsyA report on long-term outcomes in patients treated with a newly approved electrical therapy for refractory seizures is among the highlights at this year’s American Epilepsy Society annual meeting here.

Also on tap: studies of a new form of laser surgery for seizure ablation, a wearable seizure detector, and a device for home monitoring of anti-epileptic drug blood levels, said Kimford Meador, MD, of Stanford University in Stanford, Calif., the organization’s scientific program committee chairman.

Another study, led by Meador himself, examines whether children of mothers taking the epilepsy drug valproate while breastfeeding suffered adverse consequences at age 6 as a result. (Answer: it was definitely not harmful and may have been beneficial.)

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Alzheimer’s Gene Effects May Show Up in Infancy

infancyInfants and toddlers with the Alzheimer’s disease-associated APOE4 genotype already showed distinctive patterns of brain structure relative to other young children, researchers said.

MRI scans carried out in 60 normally developing children, age 2 to 25 months, who carried the APOE epsilon-4 allele, showed smaller volumes of gray matter and and lower white matter myelin water fraction (MWF) compared with 102 children in the same age range whose APOE genes only include the epsilon-2 and/or epsilon-3 alleles, according to Sean C. L. Deoni, PhD, of Brown University in Providence, R.I., and colleagues.

“While our findings should be considered preliminary, this study demonstrates some of the earliest brain changes associated with the major genetic risk factor for late-onset Alzheimer’s disease,” the researchers wrote online in JAMA Neurology.

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