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Update: Efficacy and Tolerability of the New Antiepileptic Drugs I: Treatment of New-onset Epilepsy
Published June 2018
This is an update to the 2004 American Academy of Neurology (AAN) guideline for treating new-onset focal or generalized epilepsy with second- and third-generation antiepileptic drugs (AEDs). This update reviews new evidence for efficacy, safety, and tolerability of CLB, VGB, and the 8 second-generat
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Update: Management Issues for Women with Epilepsy—Focus on Pregnancy: Vitamin K, Folic Acid, Blood Levels, and Breastfeeding
Published July 2009
We reassessed the evidence for management issues related to the care of women with epilepsy (WWE) during pregnancy, including preconceptional folic acid use, prenatal vitamin K use, risk of hemorrhagic disease of the newborn, clinical implications of placental and breast milk transfer of antiepilept
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The Use of Felbamate in the Treatment of Patients with Intractable Epilepsy
Published May 1999
The purpose of this advisory is to: 1) Determine the current role of felbamate for treatment of various types of epilepsy; 2) Provide guidelines to ensure maximum safety and effectiveness when the risk/benefit ratio is in favor of the use of felbamate. Reaffirmed on April 30, 2022.
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Reassessment: Neuroimaging in the Emergency Patient Presenting with Seizure
Published October 2007
This reassessment is aimed at analyzing the usefulness of neuroimaging as a screening procedure for altering management of the emergency patient presenting with a seizure, and at determining which clinical and historical characteristics indicate the need for a neuroimaging study for such patients.
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Update: Vagus Nerve Stimulation for the Treatment of Epilepsy
Published August 2013
The objective of this guideline is to evaluate the evidence since the 1999 assessment regarding efficacy and safety of vagus nerve stimulation (VNS) for epilepsy, currently approved as adjunctive therapy for partial-onset seizures in patients >12 years. Reaffirmed on July 16, 2022. Endorsed by the
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Use of Serum Prolactin in Diagnosing Epileptic Seizures
Published September 2005
Based on the evidence classification scheme of the American Academy of Neurology (AAN), we propose recommendations for the use of serum PRL assay to differentiate ES from psychogenic NES. We also reviewed the usefulness of serum PRL in other settings, such as following syncope and repetitive seizure
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Management of an Unprovoked First Seizure in Adults
Published April 2015
This practice guideline considers the evidence for prognosis and treatment to provide evidence-based recommendations for treatment of adults with an unprovoked first seizure. Reaffirmed on February 10, 2024. Codeveloped with the American Epilepsy Society. Endorsed by the American Neurological Ass
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Evaluating a First Nonfebrile Seizure in Children
Published September 2000
For this practice parameter, the authors reviewed available evidence on evaluation of the first nonfebrile seizure in children in order to make practice recommendations based on this available evidence. Last reaffirmed on October 21, 2023.
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Temporal Lobe and Localized Neocortical Resections for Epilepsy
Published March 2003
This article addresses published evidence on the safety and efficacy of localized resective surgery, either temporal or neocortical, as treatment for uncontrolled complex partial seizures. Reaffirmed on July 16, 2022.
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Antiseizure medication withdrawal in seizure-free patients practice advisory update
Published December 2021
This practice advisory update reviews the risks and benefits of discontinuing antiseizure medication use in seizure-free patients. According to the practice advisory, people with epilepsy who have been seizure-free (two years for adults and 1.5 to two years for children/adolescents) and stop use of
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Update: Management Issues for Women with Epilepsy—Focus on Pregnancy: Obstetrical Complications and Change in Seizure Frequency
Published July 2009
We reassessed the evidence for management issues related to the care of women with epilepsy (WWE) during pregnancy, including the risk of pregnancy complications or other medical problems during pregnancy in WWE compared to other women, change in seizure frequency, the risk of status epilepticus, an
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Update: Efficacy and Tolerability of the New Antiepileptic Drugs II: Treatment-resistant Epilepsy
Published June 2018
Since the 2004 publications, the US Food and Drug Administration (FDA) approved 6 new third-generation AEDs and 2 older AEDs. This update reviews new evidence for efficacy of these AEDs in managing treatment-resistant (TR) focal epilepsies and generalized epilepsies (GEs) in children and adults. Re
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Sudden Unexpected Death in Epilepsy Incidence Rates and Risk Factors
Published April 2017
The goal of this practice guideline is to examine evidence for the SUDEP incidence rate in epilepsy populations and for prognostic factors for SUDEP occurrence. This in turn will inform an honest and balanced discussion when clinicians counsel people about SUDEP, and provide insight into areas where
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Teratogenesis, Perinatal, and Neurodevelopmental Outcomes After In Utero Exposure to Antiseizure Medication
Published May 2024
This practice guideline provides updated evidence-based conclusions and recommendations regarding the effects of antiseizure medications and folic acid supplementation on the prevalence of major congenital malformations, adverse perinatal outcomes, and neurodevelopmental outcomes in children born to
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Antiepileptic Drug Selection for People with HIV/AIDS
Published January 2012
The objective of this guideline is to develop guidelines for selection of antiepileptic drugs (AEDs) among people with HIV/AIDS. Reaffirmed on February 10, 2024. Endorsed by the American Epilepsy Society.
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Treatment of the Child with a First Unprovoked Seizure
Published January 2003
This practice parameter reviews the current evidence about treatment with AED after a child experiences a first unprovoked seizure. Reaffirmed on July 12, 2024.
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Diagnostic Assessment of the Child with Status Epilepticus
Published November 2006
This Practice Parameter reviews available evidence concerning the value of diagnostic testing in children and adolescents with SE and provides recommendations based upon this evidence. Treatment guidelines are not included but are under development. Reaffirmed on January 22, 2022.
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Use of fMRI in the Presurgical Evaluation of Patients with Epilepsy
Published January 2017
The goal of this practice guideline is to review available evidence and provide practitioners with evidence-based recommendations for the role of fMRI in epilepsy surgery evaluation and postsurgical outcome prediction. Reaffirmed on February 25, 2023. Endorsed by the American College of Radiology
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Questions?
Email guidelines@aan.com
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