Evidence map›Paper›PMID 40290094›Full record

Trial reportEpilepsia open2025

Efficacy of naloxone in reducing hypoxemia and duration of immobility following focal to bilateral tonic-clonic seizures.

Sylvain Rheims, Fatima Chorfa, Véronique Michel, Edouard Hirsch, Louis Maillard, Luc Valton, Fabrice Bartolomei, Philippe Derambure, Vincent Navarro, Julien Biberon and 13 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Epilepsia open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Sylvain RheimsDepartment of Functional Neurology and Epileptology, Hospices Civils de Lyon and Lyon 1 University, Lyon, France.ORCID https://orcid.org/0000-0002-4663-8515
Fatima ChorfaDepartment of Biostatistics, Hospices Civils de Lyon and University of Lyon, Lyon, France.
Véronique MichelDepartment of Neurology, Hôpital Pellegrin, Bordeaux, France.
Edouard HirschDepartment of Neurology, University Hospital of Strasbourg, Strasbourg, France.ORCID https://orcid.org/0000-0003-0833-8850
Louis MaillardNeurology Department, University Hospital of Nancy, Nancy, France.
Luc ValtonDepartment of Neurology, University Hospital of Toulouse, Toulouse, France.
Fabrice BartolomeiAPHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France.ORCID https://orcid.org/0000-0002-1678-0297
Philippe DerambureDepartment of Clinical Neurophysiology, Lille University Medical Center, EA 1046, University of Lille2, Lille, France.
Vincent NavarroAP-HP, Epilepsy Unit, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France.ORCID https://orcid.org/0000-0003-0077-8114
Julien BiberonDepartment of Clinical Neurophysiology, University Hospital of Tours, Tours, France.
Arielle CrespelEpilepsy Unit, Montpellier, France.
Anca NicaDepartment of Neurology, University Hospital of Rennes, Rennes, France.
Martine Lemesle MartinDepartment of Neurology, University Hospital of Dijon, Dijon, France.
Laure MazzolaDepartment of Neurology, University Hospital of Saint-Etienne, Saint-Etienne, France.
Jerome PetitLa Teppe Epilepsy Center, Tain l'Hermitage, France.
Vincent RosseroLyon's Neuroscience Research Center, INSERM U1028/CNRS UMR 5292/Lyon 1 University, Lyon, France.
Sébastien BoulogneDepartment of Functional Neurology and Epileptology, Hospices Civils de Lyon and Lyon 1 University, Lyon, France.ORCID https://orcid.org/0000-0001-8681-7369
Mathilde LeclercqDepartment of Functional Neurology and Epileptology, Hospices Civils de Lyon and Lyon 1 University, Lyon, France.
Laurent BezinLyon's Neuroscience Research Center, INSERM U1028/CNRS UMR 5292/Lyon 1 University, Lyon, France.
Catherine MercierDepartment of Biostatistics, Hospices Civils de Lyon and University of Lyon, Lyon, France.
Pascal RoyDepartment of Biostatistics, Hospices Civils de Lyon and University of Lyon, Lyon, France.
Philippe RyvlinDepartment of Clinical Neurosciences, Centre Hospitalo-Universitaire Vaudois, Lausanne, Switzerland.ORCID https://orcid.org/0000-0001-7775-6576
ENALEPSY Study Group

Funding

Agence Nationale de la Recherche ANR-21- NEU2-0006 (AUTONOMIC)Ministère des Affaires Sociales et de la Santé PHRC national 2009 (REPOMSE)Ministère des Affaires Sociales et de la Santé PHRC national 2013 (ENALEPSIE)
6 · The paper itself

Abstract

objectiveEvaluating the efficacy of an opioid antagonist, naloxone (NLX), to reduce the severity of post-ictal hypoxemia and immobility after focal to bilateral tonic-clonic seizures (FBTCS).

methodsENALEPSY is a double-blind placebo (PCB)-controlled trial conducted in patients with focal epilepsy undergoing long-term video-EEG monitoring (LTM). Patients with a FBTCS during LTM were randomized 1:1 to receive intravenous NLX or PCB within the 2 min following the end of FBTCS. After database lock, a discrepancy between the allocated arm and the received treatment was detected, resulting in a 4:1 NLX:PCB ratio. To further explore the efficacy of NLX, we used historical control (HC) data collected in patients included in the REPO

results33 patients contributed to the NLX group, 7 to the PCB group, and 43 to the HC group. The proportion of FBTCS type 1 or 3 was 84% in NLX, 100% in PCB, and 84% in HC. NLX did not improve the delay of recovery of SpO SIGNIFICANCE: NLX did not prevent post-ictal respiratory dysfunction but might reduce the duration of post-ictal immobility. Confirmation of this effect and its impact on SUDEP risk will require additional studies. PLAIN LANGUAGE SUMMARY: Release of endogenous opioids might participate in the severity of post-ictal hypoxemia and immobility after focal to bilateral tonic-clonic seizures (FBTCS). We conducted a multicenter double-blind randomized placebo-controlled trial evaluating the efficacy of an opioid antagonist, naloxone (NLX), administered within 2 min following the end of FBTCS. The efficacy of NLX was further explored with a comparison with historical control. NLX did not improve the delay of recovery or the severity of post-ictal hypoxemia. Post-ictal immobility was significantly shorter in the NLX group when compared to historical control. The impact of these results on SUDEP prevention will require additional studies.

Indexed as

Epilepsies, PartialHypoxiaNaloxoneNarcotic AntagonistsSeizuresAdultDouble-Blind MethodElectroencephalographyFemaleHumansMaleMiddle AgedTreatment OutcomeYoung AdultNaloxoneNarcotic Antagonistsepilepsygeneralized convulsive seizuresnaloxonepost‐ictal EEG hypoxemiapost‐ictal immobilitySUDEP

Identifiers

PMID40290094
PMCPMC12163546

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.