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Epilepsy: HELP
Articles by Lance Vincent Watkins
Based on 6 articles published since 2010
(Why 6 articles?)

Between 2010 and 2020, L. Watkins wrote the following 6 articles about Epilepsy.
+ Citations + Abstracts
1 Review Valproate, sexual health, and men: A narrative review. 2020

Watkins, Lance Vincent / Angus-Leppan, Heather. ·Swansea Bay University Health Board, Mental Health and Learning Disability Delivery Unit, LLwyneryr Unit, Swansea, United Kingdom. Electronic address: Lance.watkins@wales.nhs.uk. · Epilepsy Initiative Group, Royal Free London, United Kingdom; University College London, United Kingdom. ·Epilepsy Behav · Pubmed #31892466.

ABSTRACT: OBJECTIVE: This article explores current evidence about the effects of valproate (VPA) medicines on sexual health in men, how to monitor symptoms, communicate with patients, and improve clinical outcomes. There has been a lot of focus on VPA use in women of childbearing age following recent changes to prescribing regulations owing to the well-established and significant teratogenic risk. Concerns have been raised by patients and clinicians as to the risk of adverse sexual effects of VPA use in men. RESULTS: The evidence base for the effect of VPA on sexual function compared with other antiepileptic drugs (AEDs) in men is limited with no randomized controlled trials. Sexual function in men with epilepsy is complex, and there is no direct relationship between objective measures of sexual function and sexual satisfaction. Epilepsy, comorbidities, psychosocial factors, and most AEDs including VPA may cause sexual dysfunction in men, including reduced sexual desire, erectile dysfunction, and fertility problems. Sexual and reproductive function should be discussed with men prior to treatment with AEDs including VPA. CONCLUSION: Early and proactive discussion of sexual and reproductive functioning mitigates, rather than increases, the risk of sexual problems and potentially improves adherence. Sexual dysfunction in men with cognitive impairment [such as intellectual disability (ID) and dementia] may present with behavioral disturbance. Identification of sexual adverse effects of medication could significantly change treatment plans which is of particular importance for individuals with treatment resistance. We provide an information fact sheet for men to help guide prescribing discussions.

2 Review Quality improvement in the management of people with epilepsy and intellectual disability: the development of clinical guidance. 2020

Watkins, Lance / O'Dwyer, Máire / Kerr, Michael / Scheepers, Mark / Courtenay, Ken / Shankar, Rohit. ·Neath Port Talbot CLDT, Morriston, Swansea, UK. · School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Republic of Ireland. · Department of Psychological Medicine & Clinical Neuroscience, Cardiff University, Cardiff, UK. · Vice Chair - SUDEP Action, Wantage, UK. · 2gether NHS Foundation Trust, Gloucester, UK. · Royal College of Psychiatrists, London, UK. · Cornwall Partnership NHS Foundation Trust, Truro, UK. · Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, UK. ·Expert Opin Pharmacother · Pubmed #31790280.


3 Review New anti-seizure medication for elderly epileptic patients. 2019

Watkins, Lance / O'Dwyer, Máire / Shankar, Rohit. ·Neath Port Talbot CLDT, Mental Health & Learning Disability Delivery Unit, Abertawe Bro Morgannwg University Health Board, LLwyneryr Unit , Morriston , UK. · School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin , Dublin , Ireland. · Developmental Neuropsychiatry Department, Cornwall Partnership NHS Foundation Trust , Truro , UK. · Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital , Truro , UK. ·Expert Opin Pharmacother · Pubmed #31112437.


4 Review Treatment of psychiatric comorbidities in patients with epilepsy and intellectual disabilities: Is there a role for the neurologist? 2019

Watkins, Lance Vincent / Pickrell, William Owen / Kerr, Michael Patrick. ·Abertawe Bro Morgannwg University Health Board, UK. Electronic address: lancevwatkins@doctors.org.uk. · Neurology and Molecular Neuroscience, Swansea University Medical School, Swansea University, Swansea, UK. · Institute of psychological medicine and clinical neuroscience, Cardiff University, UK. ·Epilepsy Behav · Pubmed #30598258.

ABSTRACT: This paper will explore the nature of psychiatric co-morbidities in people with an intellectual disability (ID) who have epilepsy. The complexity of clinical presentations and associated co-morbidities require thorough assessment utilising both neurological and psychiatric skills. The neurologist plays a central role in the management of epilepsy in people with ID and therefore requires basic competencies in the assessment of neuropsychiatric co-morbidities. This is key to liaison with other specialist services to ensure individuals receive holistic person-centred care. This article is part of the Special Issue "Obstacles of Treatment of Psychiatric Comorbidities in Epilepsy".

5 Review Identifying and mitigating Sudden Unexpected Death in Epilepsy (SUDEP) risk factors. 2018

Watkins, Lance / Shankar, Rohit / Sander, Josemir W. ·a Neath Port Talbot CLDT, Mental Health & Learning Disability Delivery Unit , Abertawe Bro Morgannwyg University Health Board , Morriston , Swansea. · b Department of Intellectual Disability Neuropsychiatry , Cornwall Partnership NHS Foundation Trust , Truro , UK. · c Exeter Medical School, Knowledge Spa , Royal Cornwall Hospital Truro , Cornwall , UK. · d UCL Institute of Neurology , NIHR University College London Hospitals Biomedical Research Centre , London , UK. · e Chalfont Centre for Epilepsy , Buckinghamshire , UK. · f Stichting Epilepsie Instellingen Nederland (SEIN) , Heemstede , Netherlands. ·Expert Rev Neurother · Pubmed #29425076.

ABSTRACT: INTRODUCTION: Sudden Unexpected Death in Epilepsy (SUDEP) is a significant cause of death for people with chronic epilepsy. Good practice guidance in the UK and the USA expect SUDEP to be discussed with the individual. The event rarity, methodological variance and lack of robust research into the pathological mechanisms, associated risk factors, and management strategies have created a challenge on how and what to discuss. There are some significant associations which allows for risk assessment and mitigation. Areas covered: The current understanding of static and modifiable risk factors for SUDEP and how to manage these more effectively are reviewed. Longitudinal risk may be assessed using standardised risk assessment tools which help in communicating risk. Technological advancement allows measurement of physiological parameters associated with seizures and risk of SUDEP using small wearable devices. Further evidence is needed to demonstrate such technologies are efficacious and safe. Expert commentary: Risk reduction should be an important part of epilepsy management and we suggest a Gold Standard of Care which healthcare professionals and services should aim for when approaching SUDEP risk management. A Minimum Standard of Care is also proposed that is practical to implement, that all people with epilepsy should expect to receive.

6 Article The provision of care to adults with an intellectual disability in the UK. A Special report from the intellectual disability UK chapter ILAE. 2018

Kerr, M P / Watkins, L V / Angus-Leppan, H / Corp, A / Goodwin, M / Hanson, C / Roy, A / Shankar, R / Anonymous8120936. ·Institute of Psychological Medicine and Clinical Neuroscience, Cardiff University, United Kingdom. · Psychiatry of Intellectual Disability, Abertawe Bro Morgannwg University Health Board, United Kingdom. Electronic address: lancevwatkins@doctors.org.uk. · Institute of Neurology, University College London, United Kingdom. · HS Greater Glasgow and Clyde, United Kingdom. · Northampton General Hospital NHS Trust, United Kingdom. · Abertawe Bro Morgannwg University Health Board, United Kingdom. · Royal College of Psychiatrists, Faculty of Psychiatry of Intellectual Disability, United Kingdom. · Cornwall Partnership NHS Foundation Trust, Exeter Medical School, United Kingdom. ·Seizure · Pubmed #29428900.

ABSTRACT: PURPOSE: This article reflects the report by the British Branch of the International League Against Epilepsy (ILAE) Working Group on services for adults with epilepsy and intellectual disability (ID). Its terms of reference was to explore the current status of aspects of the care of people with an ID and epilepsy. METHODS: Survey content was developed from key themes identified by consensus of the working group. An electronic survey was distributed via email. The sample population was the membership of the ILAE UK, Royal College of Psychiatrists (RCPsych) Faculty of ID, Epilepsy Nurses Association (ESNA), and the Association of British Neurologists (ABN). Following a six week response period the data was then collated, anonymised and distributed to the working group in order that opinion statements could be gathered. RESULTS: The time taken for individuals with both new-onset and established epilepsy to undergo routine investigation was commonly at least 1-3 months, far beyond recommendations made by NICE (CG20). A small minority of clinicians would not consider non-pharmacological interventions including epilepsy surgery, vagus nerve stimulation, and ketogenic diet for this population. Almost universally responders are actively involved in the assessment and management of key risk areas including risk of drowning, hospitalization, medication side effects, and sudden unexpected death in epilepsy (SUDEP). CONCLUSION: This investigation identifies key themes and recommendations relating to care delivery and meeting the complex needs of people with ID and epilepsy. Adults with ID and epilepsy appear to exist in a unique, but inadequate, segment of epilepsy care delivery.