IT'S TIME TO START ASKING ABOUT CLUSTER SEIZURES - Multiple seizures within a 24-hour period can leave your patients vulnerable. Read on to recognize the risks and understand the impact.
While Most Epilepsy Patients Gain Seizure Control, Your Patients With Refractory Epilepsy May Be at Risk for Cluster Seizures

The National Epilepsy Foundation reports that over 50% of patients with epilepsy achieve seizure control.1 However, 20-40% of patients live with uncontrollable seizures because they are refractory to treatment, leaving them vulnerable to cluster seizures.2 Clear identification of those patients at risk for cluster seizures is critical to help prevent serious, lasting damage.3,4

Consider the Consequences

While all epileptic seizures are serious5, those patients who experience cluster seizures are at higher risk of life-threatening outcomes.3,6

Epilepsy: How Many of Your Patients Are Refractory to Treatment?

Epilepsy is a common condition affecting approximately 2.2 million Americans, with approximately 150,000 new cases diagnosed annually. In fact, 1 in 26 Americans will develop epilepsy at some point in their lifetime, and 20% to 40% of those patients will become refractory to treatment.2,7

The goal of reaching seizure control

The definition of seizure control varies, but generally, a patient is well controlled when their treatment has significantly reduced the number of seizures they experience.8

What is refractory epilepsy?

The International League Against Epilepsy (ILAE) definition for refractory epilepsy is failure of 2 or more adequate trials of tolerated, appropriately chosen and used antiepileptic drug (AED) schedules (as monotherapies or in combination) to achieve sustained seizure freedom.9

In some cases, adult patients may be experiencing 3 or more seizures in a 24-hour period. This may be a sign of cluster seizures.8

learn about cluster seizures
Ask your patients
How many seizures
do you have in a
24-hour period?
Understanding Cluster Seizures
What is the difference between a breakthrough seizure and a cluster seizure?

A breakthrough seizure is defined as an epileptic seizure that occurs despite the use of antiepileptic drugs (AEDs) in a patient who has achieved seizure control. Some of the possible causes of breakthrough seizures include non-adherence to AEDs, infection/fever, severe stress, sleep deprivation, and metabolic or hormonal events/changes.8,10

In adults, cluster seizures are defined as 3 or more seizures within a 24-hour period with a return to baseline between events. They are also highly individualized, lasting anywhere from minutes up to a day. In effect, no 2 patients with cluster seizures are the same.3,11,12

Patients with uncontrolled, refractory epilepsy have an increased risk of cluster seizures10

There are several clinical terms for cluster seizures, including acute repetitive seizures, seizure clusters, serial seizures, recurrent seizures, and crescendo seizures. Some of the possible triggers for cluster seizures include physiological stresses like:3,10,14

  • Fever
  • Hormonal changes
  • Sleep deprivation
  • Other illnesses
175,000 people in the United States suffer from cluster seizures.13
Cluster seizures may include any type of epileptic seizure and may occur at any age.10
Recognize the Risks and Impact of Cluster Seizures

Because each seizure increases the risk of serious injuries, increased frequency of seizures could mean elevated risk of head injury (24%, n=297), burns (16%, n=302), dental injury (10%, n=290), seizure while swimming or bathing (14%, n=313), and fractures (6%, n=278).5*

The risk of drowning is 15- to 19-fold greater for patients with epilepsy, compared to the general population.15

In some patients who experience cluster seizures, there can also be more serious consequences, such as lasting brain damage and status epilepticus (SE).4,10

Cluster seizures increase the risk of SE, which is nearly 4 times more common in patients with cluster seizures than those without. In fact, the overall adult mortality rate of SE is 26%.6,16†

Epilepsy is associated with missed work, missed school, and a greater utilization of health care resources. This can affect anyone with a seizure disorder, regardless of age or gender.4,10

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*In a study including 31 general practices (177,703 total practice population), 1,341 were identified as having active epilepsy. Surveys asked about injuries in the past year resulting from seizures. Data relate only to patients who had at least 1 seizure in the previous 12 months.5

In a study including patients with intractable epilepsy who underwent presurgical evaluation in an epilepsy clinic from 1993 to 1997, 21 (28%) of 76 eligible patients experienced at least 1 episode of convulsive status epilepticus (CSE, or SE), and 36 (47%) typically experienced cluster seizures (CS). SE occurred in 16 (44%) of 36 patients with CS, compared to 5 (12.5%) of 40 patients without CS. (P<0.002).6

In a large, prospective, population-based study in Richmond, VA, 433 cases of SE were identified in adults; incidence of SE was 41-61 per 100,000 patients per year, and frequency of total SE episodes was 50-78 per 100,000 patients per year.17,18

Identifying patients at risk for cluster seizures is critical.
Remember to ask your patients
How many seizures
do you have in a
24-hour period?

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