Nuerology

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new folder for anything related to Lupus , MCTD, Autoimmune with Nuerology & Epilepsy information

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National Headache Foundation Unveils Migraine Prevention Consensus Statement
Summit Held to Discuss Issues Surrounding Migraine and Current Treatment Strategies Demonstrate the Unmet Need of Patients Suffering from Migraine

CHICAGO, IL -- Feb. 02, 2007 -- The National Headache Foundation (NHF) announced the release of a consensus statement aimed at migraine prevention as determined by an expert panel convened at the Migraine Prevention Summit. Migraine, which affects nearly 30 million Americans, is underdiagnosed in a majority of patients due to a breakdown in doctor - patient communication and a low patient awareness of available treatment options.

The consensus statement was created by a panel including a neurologist, a primary care physician, a physician assistant, a nurse practitioner and a patient who suffers from migraine.

"I believe that this consensus statement serves as a major step forward for patients suffering from migraine and will foster better communication between patients and their healthcare team which will result in improved migraine care," said Suzanne Simons, Executive Director of the National Headache Foundation.

~Consensus Statement Overview: Focus on Prevention
The understanding of migraine has evolved over the past 10 to 15 years, influencing approaches to disease management and changing the perception that migraine was only an episodic disorder. In their full consensus statement, experts explain that migraine is now viewed as a chronic disorder with episodic manifestations and must be treated as such. For example, healthcare teams are encouraged to assess the patient's impairment due to migraine both during and between attacks.

 Impairment during the attack may be linked to bed rest needed, lost or less productive work time, or missed activities. Impairment between attacks or interictal burden should also be evaluated. Interictal burden may include worrying or thinking about the next migraine attack that leads to an inability to plan daily activities due to concern that a migraine may occur.

The consensus statement recommends that healthcare teams should not only probe about impairment during a migraine attack but also about impairment between the attacks as patients may simply accept this interictal burden as part of the disease and may not proactively discuss it.

Recent studies have showcased the need for awareness of preventive treatment options among migraine sufferers and provided evidence to show that migraine may progress as a disease in some patients. In addition, guidelines for initiating preventive therapy have been developed to minimize the frequency and intensity of attacks. Guidelines for initiating preventive therapy include:

· Frequency of headache >/= 2 per month with disability >= 3 days per month
· Recurring migraines that, in the patient's opinion, significantly interfere with daily routines
· Use of acute medication more than 2 times a week
· Acute medications are contraindicated, not tolerated, or are ineffective
· The consensus statement addresses the need for awareness of preventive treatment options and suggests that healthcare professionals work with patients to properly assess the frequency of attacks and the disability caused by migraine, so that an appropriate treatment regimen may be prescribed.

"The panel was eager to discuss how we can better communicate with patients suffering from migraine and more quickly identify their needs," said Richard B. Lipton, MD, professor and vice chair of neurology at the Albert Einstein College of Medicine in New York City and director of the Montefiore Headache Unit. "As a medical community, we are always looking to improve upon our treatment practices and this served as an ideal format."

While there are many treatment options and strategies available to patients with migraine, the experts agree that patient education remains central to optimal care. Patients are likely to adhere to treatment recommendations, including medication and lifestyle modifications, once they have a greater understanding of their disease and treatment options.

~About the Studies
The consensus statement was based on two breakthrough migraine studies, The American Prevalence and Prevention (AMPP) study and the American Migraine Communications Study (AMCS).

Findings from the AMPP study, the largest study on migraine ever conducted, show that while migraine affects 17 percent of women and six percent of men, only 56 percent of patients self-report their diagnosis. The study also found that while nearly 40 percent of patients may benefit from preventive therapy, only 13 percent are currently using a preventive medication. In addition, nearly half of all migraine patients are unaware of preventive treatment options.

In the second study discussed, AMCS found that there is a significant need for improved communication between patients suffering from migraine and healthcare professionals. In fact, only 10 percent of patient visits addressed migraine impairment in any way. The study concluded that healthcare professionals must use open-ended questions, such as "how do migraines impact your daily life," to facilitate an accurate assessment of total impairment (during and between attacks) due to migraine.

The Migraine Prevention Summit was conducted by the National Headache Foundation through funding from Ortho-McNeil Neurologics, Inc.

~About Migraine
Migraine is characterized by throbbing pain, usually located on one side of the head, often accompanied by nausea or sensitivity to light and sound. The combination of disabling pain and associated symptoms often prevents sufferers from performing daily activities. The uncertainty of when attacks may occur leads to additional patient burden. Symptoms, incidence and severity vary by individual. Attacks can last anywhere from four to 72 hours.
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No More Seizures? New Drug Holds Promise For Epilepsy Patients

Feb 07, 2007— People with newly diagnosed epilepsy experienced few, if any, seizures while taking the drug levetiracetam as a single therapy, giving hope to epilepsy patients who don't respond to or can't tolerate existing treatments, according to a study published in the February 6, 2007 issue of Neurology, the scientific journal of the American Academy of Neurology.


For the multi-center, double-blind study, researchers assigned nearly 600 adults who had at least two seizures in the previous year to the drug levetiracetam or to controlled-release carbamazepine, a common epilepsy treatment. While levetiracetam is currently used as an add-on therapy by epilepsy patients, this is the first time its effectiveness as a single therapy has been tested through a clinical trial that provided class 1 evidence of efficacy as defined by the International League Against Epilepsy.

The study found 73 percent of people taking levetiracetam and 72.8 percent of people receiving controlled-release carbamazepine remained seizure free for at least six months.
"Both drugs produced equivalent seizure freedom rates in newly diagnosed epilepsy. Levetiracetam helps fill a need for safe and well-tolerated, easy-to-use epilepsy drugs, particularly because more than 30 percent of patients do not achieve seizure control with existing treatments," said study author Martin Brodie, MD, with the Western Infirmary Epilepsy Unit in Glasgow, Scotland.

Of those remaining seizure free for six months, the study also found 80.1 percent of those taking levetiracetam and 85.4 percent of those taking carbamazepine did so at the lowest dose level.
"This trial confirms previous uncontrolled observations that most people with epilepsy will respond to their first epilepsy drug at low dosage," said Brodie.

Researchers say 14.4 percent of people taking levetiracetam withdrew from the study because of side effects such as drowsiness or dizziness, while 19.2 percent of people taking carbamazepine withdrew from the study with rash being the most common side effect.
The study was supported by UCB Pharma.

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Thank you Karyl as always