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Article: Driving restrictions and people with epilepsy.

Chadwick, D W

2001 Volume 57, Issue 10, Page(s) 1749–1750

MeSH term(s)	Accidents, Traffic/prevention & control ; Accidents, Traffic/statistics & numerical data ; Automobile Driving/legislation & jurisprudence ; Epilepsy/epidemiology ; Humans ; Risk Assessment ; United Kingdom/epidemiology
Language	English
Publishing date	2001-11-27
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	207147-2
ISSN	1526-632X ; 0028-3878
ISSN (online)	1526-632X
ISSN	0028-3878
DOI	10.1212/wnl.57.10.1749
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Article: Serological characters of hog gastric mucin.

CHADWICK, D W / SMITH, H

Nature

2007 Volume 164, Issue 4158, Page(s) 61

MeSH term(s)	Gastric Mucins ; Humans ; Mucin 5AC ; Mucins
Chemical Substances	Gastric Mucins ; Mucin 5AC ; Mucins
Language	English
Publishing date	2007-08-15
Publishing country	England
Document type	Journal Article
ZDB-ID	120714-3
ISSN	1476-4687 ; 0028-0836
ISSN (online)	1476-4687
ISSN	0028-0836
DOI	10.1038/164061a0
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Article: An overview of the efficacy and tolerability of new antiepileptic drugs.

Chadwick, D W

Epilepsia

1997 Volume 38 Suppl 1, Page(s) S59–62

Abstract: To evaluate the efficacy and tolerability of recently developed antiepileptic drugs (AEDs), a systematic review of placebo-controlled, randomized controlled trials (RCTs) of the AEDs as add-on therapy in refractory partial epilepsy was conducted. Two or ... ...

Abstract	To evaluate the efficacy and tolerability of recently developed antiepileptic drugs (AEDs), a systematic review of placebo-controlled, randomized controlled trials (RCTs) of the AEDs as add-on therapy in refractory partial epilepsy was conducted. Two or more RCTs meeting our inclusion criteria were found for gabapentin (GBP), lamotrigine (LTG), tiagabine (TGB), topiramate (TPM), vigabatrin (VGB), and zonisamide (ZNS). The outcome selected for estimation of efficacy was the proportion of patients experiencing a > or = 50% reduction in seizure frequency from baseline. Tolerability was estimated on the basis of rates of patient withdrawal from study for any reason. Efficacy and tolerability odds ratios (ORs) and 95% confidence intervals (95% CIs) for each measure were generated for each trial included in the analysis, and overall efficacy and tolerability ORs were calculated for each AED across all trials and drug dosages evaluated. Because 95% CIs for both efficacy and tolerability overlapped for the six drugs, conclusive evidence of between-drug differences in effectiveness or safety were not obtained from the analysis. However, the data suggest that the drug with the highest OR for efficacy (TPM) may be approximately twice as effective as the AED with the lowest OR for efficacy (GBP), and that the treatment that appears to most frequently cause withdrawal (ZNS) may be about four times more likely to do so that the AED with the lowest withdrawal rate (LTG). RCTs comparing newer AEDs with the older standard drugs and with each other are needed to further evaluate their relative utility.
MeSH term(s)	Anticonvulsants/adverse effects ; Anticonvulsants/therapeutic use ; Confidence Intervals ; Drug Therapy, Combination ; Epilepsy/drug therapy ; Humans ; Odds Ratio ; Placebos ; Randomized Controlled Trials as Topic ; Treatment Outcome
Chemical Substances	Anticonvulsants ; Placebos
Language	English
Publishing date	1997
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/j.1528-1157.1997.tb04522.x
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Article ; Online: Zonisamide add-on for drug-resistant partial epilepsy.

Chadwick, D W / Marson, A G

The Cochrane database of systematic reviews

2005 , Issue 4, Page(s) CD001416

Abstract: Background: The majority of people with epilepsy have a good prognosis and their seizures can be well controlled with the use of a single antiepileptic agent, but up to 30% develop refractory epilepsy, especially those with partial seizures. In this ... ...

Abstract	Background: The majority of people with epilepsy have a good prognosis and their seizures can be well controlled with the use of a single antiepileptic agent, but up to 30% develop refractory epilepsy, especially those with partial seizures. In this review we summarize the current evidence regarding zonisamide, when used as an add-on treatment for drug-resistant partial epilepsy. Objectives: To evaluate the effects of zonisamide when used as an add-on treatment for people with drug-resistant partial epilepsy. Search strategy: We searched the Cochrane Epilepsy Group Specialized Register (August 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2005). In addition, we contacted Eisai Limited (makers and licensees of zonisamide) and experts in the field to seek any ongoing/unpublished studies. Selection criteria: Randomized placebo controlled add-on trials of zonisamide in people with drug-resistant partial epilepsy. Data collection and analysis: Two review authors independently selected trials for inclusion and extracted data. Outcomes were: (1) 50% or greater reduction in total seizure frequency; (2) treatment withdrawal; (3) adverse events. Primary analyses were intention-to-treat. Summary relative risks (RRs) were estimated for each outcome. Main results: Four trials (850 participants) were included. The overall RR with 95% confidence intervals (CIs) for 50% reduction in seizure frequency compared to placebo for 300 to 500 mg/day of zonisamide was 2.44 (95% CI 1.81 to 3.30). The RR for any dose zonisamide (100 to 500 mg per day) was 2.35 (1.74 to 3.17). Two trials provide evidence of a dose response relationship for this outcome. The RR for treatment withdrawal for 300 to 500 mg/day zonisamide compared to placebo was 1.64 (1.20 to 2.26), and for 100 to 500 mg per day was 1.47 (1.07 to 2.02). The CIs of the following adverse effects indicate that they are significantly associated with zonisamide: ataxia 4.50 (99% CI 1.05 to 19.22); dizziness 1.77 (99% CI 1.00 to 3.12); somnolence 1.96 (99% CI 1.12 to 3.44); agitation 2.37 (99% CI 1.00 to 5.64); and anorexia 3.00 (99% CI 1.31 to 6.88). Authors' conclusions: Zonisamide has efficacy as an add-on treatment in people with drug-resistant partial epilepsy. Minimum effective and maximum tolerated doses cannot be identified. The trials reviewed were of 12 week duration and results cannot be used to confirm longer periods of effectiveness in seizure control. The results cannot be extrapolated to monotherapy or to people with other seizure types or epilepsy syndromes.
MeSH term(s)	Anticonvulsants/therapeutic use ; Drug Resistance ; Epilepsies, Partial/drug therapy ; Humans ; Isoxazoles/therapeutic use ; Randomized Controlled Trials as Topic ; Treatment Failure ; Zonisamide
Chemical Substances	Anticonvulsants ; Isoxazoles ; Zonisamide (459384H98V)
Language	English
Publishing date	2005-10-19
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ISSN	1469-493X
ISSN (online)	1469-493X
DOI	10.1002/14651858.CD001416.pub2
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Article: Principles of treatment of epilepsy.

Kadir, Z A / Chadwick, D W

Drugs of today (Barcelona, Spain : 1998)

2003 Volume 35, Issue 1, Page(s) 35–41

Abstract: Epilepsy is a common chronic neurological condition with a prevalence of 4-8 per 1000. The present classification of epilepsy is based on: 1) the etiology, which distinguishes symptomatic epilepsies from those that are idiopathic and cryptogenic, and 2) ... ...

Abstract	Epilepsy is a common chronic neurological condition with a prevalence of 4-8 per 1000. The present classification of epilepsy is based on: 1) the etiology, which distinguishes symptomatic epilepsies from those that are idiopathic and cryptogenic, and 2) the localization of the disorder in the brain, separating the generalized seizures from epilepsies with partial or focal onset. The majority of patients with epilepsy will go into remission and two-thirds will remain so 2 years after drug withdrawal. The impact of epilepsy on individual patients varies. Employment, driving and learning may constitute major problems. There is a small but definite increase in mortality in patients suffering from epilepsy. Treatment of epilepsy usually involves long-term medical treatment, with the ultimate aim being no seizures and no drugs. Before starting treatment, the diagnosis of epilepsy should be assured. Initiation of antiepileptic drug therapy needs a full and adequate discussion with the patient and the choice of the minimum effective dose of an appropriate monotherapy. Nonpharmacological treatments may be necessary at a relatively early stage if pharmacologic treatment is ineffective. In choosing between different anti-epileptic drugs, consideration should be given to the efficacy of the drug for an individual patient and the tolerability of the drug. There is good evidence from many studies that the chief factor determining relative effectiveness is likely to be the spectrum and incidence of adverse effects of antiepileptic drugs. Some 20% of patients developing epilepsy have a chronic disorder uncontrolled by drugs. In patients receiving and complying with optimal doses of a single antiepileptic drug, the addition of further agents is likely to result in a significant improvement in seizure control in only about 10% of patients, but inevitably it increases the risks of dose-related, idiosyncratic and chronic toxicity due to both pharmacokinetic and pharmacodynamic drug interactions. For this group of patients an appropriate aim may not be complete remission of seizures but a compromise of reduced seizure frequency with less severe seizures, to be achieved with one or, at most, two drugs. The management of these patients with unremitting seizures constitutes a treatment challenge for epileptologists.
Language	English
Publishing date	2003-10-03
Publishing country	Spain
Document type	Journal Article
ISSN	1699-3993
ISSN	1699-3993
DOI	10.1358/dot.1999.35.1.522946
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Article: Security issues in the electronic transmission of prescriptions.

Mundy, D P / Chadwick, D W

Medical informatics and the Internet in medicine

2003 Volume 28, Issue 4, Page(s) 253–277

Abstract: The UK government has stated within its plan of reform for the National Health Service that a secure system for the Electronic Transfer of Prescriptions will be available by 2004. The objectives of this paper are to highlight the significant barriers ... ...

Abstract	The UK government has stated within its plan of reform for the National Health Service that a secure system for the Electronic Transfer of Prescriptions will be available by 2004. The objectives of this paper are to highlight the significant barriers faced in securing an ETP system, to provide a critical analysis of the security mechanisms in the models currently being piloted and to suggest an alternative revised model which overcomes the identified deficiencies and security hurdles. To identify the significant security issues relevant to the adoption of ETP, the authors have combined their analysis of present prescription processing practice with their knowledge of computer security. The authors identify and describe how the issues of patient confidentiality, authorization, identity authentication, audit, scalability, availability and reliability are significant barriers to the adoption of ETP, particularly if they effect ease of use. The paper's contribution to the field of ETP is to suggest solutions to each of the identified security issues and to combine the solutions together in a revised and developed model.
MeSH term(s)	Computer Security ; Drug Prescriptions ; Electronic Mail/organization & administration ; Software ; State Medicine/organization & administration ; United Kingdom
Language	English
Publishing date	2003-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1470814-0
ISSN	1464-5238 ; 1463-9238
ISSN (online)	1464-5238
ISSN	1463-9238
DOI	10.1080/14639230310001621675
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Article: Late-onset temporal lobe epilepsy with unilateral mesial temporal sclerosis and cognitive decline: a diagnostic dilemma.

Lozsadi, D A / Chadwick, D W / Larner, A J

Seizure

2008 Volume 17, Issue 5, Page(s) 473–476

Abstract: We present a patient with new onset temporal lobe epilepsy and cognitive decline in his sixth decade with unilateral hippocampal atrophy on structural brain imaging, compatible with mesial temporal sclerosis. This unusual clinical scenario presented a ... ...

Abstract	We present a patient with new onset temporal lobe epilepsy and cognitive decline in his sixth decade with unilateral hippocampal atrophy on structural brain imaging, compatible with mesial temporal sclerosis. This unusual clinical scenario presented a challenging differential diagnosis since it may overlap with primary cognitive disorders, including early-onset Alzheimer's disease and some forms of frontotemporal dementia, and the recently elucidated syndrome of non-paraneoplastic limbic encephalitis associated with voltage-gated potassium channel antibodies.
MeSH term(s)	Cognition Disorders/etiology ; Cognition Disorders/pathology ; Dementia/diagnosis ; Epilepsy, Temporal Lobe/complications ; Epilepsy, Temporal Lobe/pathology ; Humans ; Male ; Middle Aged ; Sclerosis/complications ; Temporal Lobe/pathology
Language	English
Publishing date	2008-07
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1137610-7
ISSN	1532-2688 ; 1059-1311
ISSN (online)	1532-2688
ISSN	1059-1311
DOI	10.1016/j.seizure.2007.12.001
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Article ; Online: Zonisamide add-on for drug-resistant partial epilepsy.

Chadwick, D W / Marson, A G

The Cochrane database of systematic reviews

2001 , Issue 2, Page(s) CD001416

Abstract: Background: The majority of people with epilepsy have a good prognosis and their seizures can be well controlled with the use of a single antiepileptic agent, but up to 30 per cent develop refractory epilepsy, especially those with partial seizures. In ... ...

Abstract	Background: The majority of people with epilepsy have a good prognosis and their seizures can be well controlled with the use of a single antiepileptic agent, but up to 30 per cent develop refractory epilepsy, especially those with partial seizures. In this review we summarize the current evidence regarding zonisamide, when used as an add-on treatment for drug-resistant partial epilepsy. Objectives: To evaluate the effects of zonisamide when used as an add-on treatment for people with drug -resistant partial epilepsy. Search strategy: We searched the Cochrane Epilepsy Group trial register (14/12/01), the Cochrane Controlled Trials Register (Cochrane Library Issue 4, 2001). In addition, we contacted Dainippon and Elan Pharma (makers and licensees of zonisamide) and experts in the field to seek any ongoing studies or unpublished studies. Selection criteria: Randomized placebo controlled add-on trials of zonisamide in people with drug-resistant partial epilepsy. Data collection and analysis: Two reviewers independently selected trials for inclusion and extracted relevant data. Outcomes were: (a) fifty per cent or greater reduction in total seizure frequency; (b) treatment withdrawal (any reason); (c) adverse events. Primary analyses were intention to treat. Summary odds ratios (ORs) were estimated for each outcome. Main results: Three trials (499 participants) were included. The overall odds ratio (OR, 95% Confidence Interval (CI)) for 50 per cent reduction in seizure frequency compared to placebo was 2.07(1.36 to 3.15) for a 400mg/day dose of zonisamide. When the full treatment period of 12 weeks was considered for all three trials including varied rates of titration to 400mg/day the OR compared to placebo was 2.72(95% CI 1.74 to 4.25). There was insufficient evidence to support a dose response relationship for this outcome. The OR for treatment withdrawal was 1.74(95% CI 1.03 to 2.95). The 99% CI for the following side effects indicate that they are significantly associated with zonisamide: ataxia 3.94(1.23 to 12.57); somnolence 2.11(1.11 to 3.98); agitation 3.52(1.26 to 9.68); agitation and irritability 2.43(1.04 to 5.66) and anorexia 2.98(1.38 to 6.42). Reviewer's conclusions: Zonisamide has efficacy as an add-on treatment in people with drug-resistant partial epilepsy. Minimum effective and maximum tolerated doses cannot be identified. The trials reviewed were of 12 week duration and results cannot be used to confirm longer periods of effectiveness in seizure control. The results cannot be extrapolated to monotherapy or to people with other seizure types or epilepsy syndromes.
MeSH term(s)	Anticonvulsants/therapeutic use ; Epilepsies, Partial/drug therapy ; Humans ; Isoxazoles/therapeutic use ; Randomized Controlled Trials as Topic ; Treatment Failure ; Zonisamide
Chemical Substances	Anticonvulsants ; Isoxazoles ; Zonisamide (459384H98V)
Language	English
Publishing date	2001-12-19
Publishing country	England
Document type	Journal Article ; Review ; Systematic Review
ISSN	1469-493X
ISSN (online)	1469-493X
DOI	10.1002/14651858.CD001416
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Article: New drug treatments for epilepsy.

Marson, A G / Chadwick, D W

Journal of neurology, neurosurgery, and psychiatry

2001 Volume 70, Issue 2, Page(s) 143–147

MeSH term(s)	Anticonvulsants/therapeutic use ; Epilepsy/drug therapy ; Humans
Chemical Substances	Anticonvulsants
Language	English
Publishing date	2001-01-09
Publishing country	England
Document type	Editorial
ZDB-ID	3087-9
ISSN	1468-330X ; 0022-3050
ISSN (online)	1468-330X
ISSN	0022-3050
DOI	10.1136/jnnp.70.2.143
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Article: The District General Hospital as a Resource for the Provision of Neurological Services.

Boggild, M D / Bowden, A N / Chadwick, D W / Doran, M / Enevoldson, T / Fletcher, N A / Hart, I / Humphrey, P / Lecky, B R F / Moore, A P / Smith, D / Steiger, M / Williams, I R / Young, C A

Journal of the Royal College of Physicians of London

2019 Volume 30, Issue 5, Page(s) 478–479

Language	English
Publishing date	2019-01-22
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	3005-3
ISSN	0035-8819
ISSN	0035-8819
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