METHODS: A survey was developed by multicenter consensus. The survey captured institutional characteristics, geographic distributions, intracranial EEG utilization, and barriers to SEEG. Respondents were representative epilepsy centers across the region.
RESULTS: Four epilepsy centers with established intracranial/ SEEG and two centers from a country without any access to SEEG participated. The responses identified that 1. Access to SEEG remained highly restricted across the region with an estimated one capable epilepsy center per 100 million people; 2. The region includes over half a billion people living in countries with no access to SEEG; 3. Staffing/ financial constraints were universal factors that limited growth of services or development of new services; 4. SEEG numbers have plateaued as a result of these challenges.
CONCLUSION: The study puts into real numbers the challenges faced by the region in accessing SEEG. SEEG remains highly underutilized and future approaches should focus on regional training and referral pathways.
METHODS: Validated translated versions of the Hiroshima University-Dental Behavioural Inventory (HU-DBI) questionnaire were administered to 1,096 final-year dental students in 17 countries. Hierarchical cluster analysis was conducted within the data to detect patterns and groupings.
RESULTS: The overall response rate was 72%. The cluster analysis identified two main groups among the countries. Group 1 consisted of twelve countries: one Oceanic (Australia), one Middle-Eastern (Israel), seven European (Northern Ireland, England, Finland, Greece, Germany, Italy, and France) and three Asian (Korea, Thailand and Malaysia) countries. Group 2 consisted of five countries: one South American (Brazil), one European (Belgium) and three Asian (China, Indonesia and Japan) countries. The percentages of 'agree' responses in three HU-DBI questionnaire items were significantly higher in Group 2 than in Group 1. They include: "I worry about the colour of my teeth."; "I have noticed some white sticky deposits on my teeth."; and "I am bothered by the colour of my gums."
CONCLUSION: Grouping the countries into international clusters yielded useful information for dentistry and dental education.
METHODS: In May 2015, 15 epilepsy experts attended a Consensus Development Meeting to assess the clinical trial data for perampanel, specific to the adolescent age group (12-17 years) and develop consensus treatment recommendations.
RESULTS AND DISCUSSION: Analysis of the adolescent subgroup data of three pivotal placebo-controlled, double-blind, phase 3 trials investigating perampanel in patients with ongoing focal epileptic seizures despite receiving one to three antiepileptic drugs found that perampanel 4-12 mg was superior to placebo. The tolerability profile of perampanel was generally acceptable. Adolescent patients receiving long-term treatment with perampanel in an open-label extension study maintained improvements in seizure control compared with baseline, with a favorable risk-benefit profile. A phase 2 study showed that perampanel had no clinically important effects on cognitive function, growth, and development.
CONCLUSION: Perampanel is a welcome addition to the armamentarium of existing antiepileptic drugs as it represents a new approach in the management of epilepsy, with a novel mechanism of action, and the potential to have a considerable impact on the treatment of adolescents with epilepsy.