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The patient whose topiramate was increased to 600 mg/day suffers with poorly controlled epilepsy and we increased the dose in order to achieve a better seizures control, rather than weight loss.
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Behavioral worsening was not related to better seizure control or increased levels of engagement in activities.
Along with early prediction, alternative therapies may be designed to provide patients better seizure control and quality of life.
Recent studies have confirmed that the effect of uncontrolled seizures are often larger than the effects of drug treatment, leading to the so-called seizure confound, that is, adverse cognitive AED effects may be masked by beneficial effects of better seizure control.
The M/M group had significantly better seizure control than the M/N or N/N groups.
This study demonstrated a higher efficacy of PB compared to Br as a monotherapy, providing better seizure control and showing fewer side effects.
Patients often combine multiple drugs, including natural products, to obtain better seizure control [ 11], or to treat other health conditions [ 12, 13] (reviewed in [ 14]).
More extensive resections have been reported as associated with better seizure control, albeit inconsistently (Ozkara et al., 2008; Dunlea et al., 2010).
Seizure control was associated with age at seizure onset (older age with better seizure control) and coat colour (merle dogs with better seizure control) but appeared unrelated to the ABCB1 (MDR1) genotype (when interpreting the latter finding, it needs to be considered that out of all the epilepsy cases only one dog was determined to be homozygous for the ABCB1-1Δ mutation) [ 9].
Last, we recognize that better seizure suppression after the second, smaller, PTZ dose may reflect tDCS antiepileptic potency which is insufficient to overcome seizures triggered by high-dose PTZ, but adequate to suppress seizures triggered by a lower PTZ dose.
More data are required to establish whether the vacuolar myelopathy is its basis and whether such myelopathy will respond to, or be prevented by, better seizure control or modulation of Na v1.1 function; we note in passing that Nav1.1 channels are expressed in white matter astrocytes (Black et al., 1994) in close relationship with oligodendrocytes (Waxman and Black, 1984).
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