Epilepsy Seizure Clusters: Therapeutic Advances and Emergency Plans

Seizure clusters take a toll on patients’ emotional wellbeing, work, and quality of life. Learn from experts about new rescue treatments.

Abstract

Many patients with epilepsy experience seizure clusters, which have consequences such as problems at school or work and decreased quality of life. However, according to the Seizure Cluster Burden of Illness US Study, only one-third of patients report having a seizure emergency plan. Research also suggests that patients and caregivers often respond differently to emergency situations than their clinicians recommend. Multiple options are available for the acute treatment of seizure clusters, and newer nasal spray formulations can easily be used. Seizure Action Plans and Acute Emergency Seizure Action Plans provide direction that may alleviate fear and hospitalization, benefitting the patient and caregiver and the health care system.

From the Series: Today's Options in Epileptic Seizure Rescue Treatment

To cite: Detyniecki K, Penovich P. Epilepsy seizure clusters: therapeutic advances and emergency plans. J Clin Psychiatry. 2021;82(6):MS20093EV1C.

To share: https://doi.org/10.4088/JCP.MS20093EV1C

© Copyright 2021 Physicians Postgraduate Press, Inc.

Target Audience

Primary care clinicians; neurologists; MDs, DOs, nurse practitioners, and physician assistants who treat patients with epilepsy

Learning Objectives

  • Educate patients who are at risk for seizure clusters about rescue medications and emergency plans
  • Provide rescue treatment for seizure clusters that patients and their caregivers will use
Activity summary
Available credit: 
  • 0.75 AMA PRA Category 1 Credit™
  • 0.75 Participation
Activity opens: 
10/12/2021
Activity expires: 
10/31/2023
Cost:
$0.00
Rating: 
0

Support Statement

Supported by educational grants from UCB, Inc., and Neurelis, Inc.

Learning Objective

After completing this educational activity, you should be able to:

  • Educate patients who are at risk for seizure clusters about rescue medications and emergency plans
  • Provide rescue treatment for seizure clusters that patients and their caregivers will use

Release, Review, and Expiration Dates

This CME activity was published in October 2021 and is eligible for AMA PRA Category 1 Credit™ through October 31, 2023. The latest review of this material was October 2021.

Statement of Need and Purpose

Seizure clusters take a toll on patients’ emotional well-being, work, and quality of life and are associated with increased utilization of emergency departments. However, rescue treatment options have been limited; intravenous, intramuscular, and rectal options are impractical and often rejected by patients. With the advent of nasal spray formulations of seizure rescue treatment and potentially a buccal film, clinicians can offer an option that is easily used. Additionally, clinicians have often not documented providing any rescue treatment, and when emergency plans were recommended, patients have often not followed clinicians’ recommendations. Clinicians would therefore benefit from education about identifying patients at risk for seizure clusters, educating them about rescue medication, and making formal action plans with patients and their families. This activity was designed to meet the needs of participants in CME activities provided by the CME Institute of Physicians Postgraduate Press, Inc., who have requested information on epilepsy.

Disclosure of Off-Label Usage

Dr Detyniecki has determined that, to the best of his knowledge, buccal midazolam, diazepam buccal soluble film, intrapulmonary alprazolam, and diazepam autoinjector are not approved by the US Food and Drug Administration for the treatment of seizure clusters.

Review Process

The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair and a peer reviewer who is without conflict of interest.

Acknowledgment

This activity is derived from the teleconference series “Today's Options in Epileptic Seizure Rescue Treatment,” which was held in April and August 2021 and supported by an educational grant from UCB, Inc., and Neurelis, Inc. The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporter.

Faculty Affiliation


Kamil Detyniecki, MD
University of Miami, Florida
 

 


Patricia Penovich, MD
Minnesota Epilepsy Group, St. Paul
 


Financial Disclosure

The faculty for this CME activity and the CME Institute staff were asked to complete a statement regarding all relevant personal and financial relationships between themselves or their spouse/partner and any commercial interest. The Accreditation Council for Continuing Medical Education (ACCME) defines a commercial interest as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME defines relevant financial relationships as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. The CME Institute has resolved any conflicts of interest that were identified. No member of the CME Institute staff reported any relevant personal financial relationships. Faculty financial disclosure is as follows:

Kamil Detyniecki, MD, has received honoraria from Neurelis, UCB, Greenwich, and Aquestive.

Patricia Penovich, MD is a consultant for LVis, Neurelis, Engage Therapeutics, SK-Pharma, and UCB and is a member of the speakers/advisory boards for Greenwich, Neurelis, and SK-Pharma.

Accreditation Statement

The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.

Available Credit

  • 0.75 AMA PRA Category 1 Credit™
  • 0.75 Participation

Price

Cost:
$0.00
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