If treated either manually or surgically within six hours, there is a high chance (approximately 90%) of saving the testicle. At 12 hours the rate decreases to 50%; at 24 hours it drops to 10%, and after 24 hours the ability to save the testicle approaches 0, although salvage of the testicle has been reported beyond 24 hours. About 40% of cases result in loss of the testicle.With prompt diagnosis and treatment the testicle can often be saved. Typically, when a torsion takes place, the surface of the testicle has rotated towards the midline of the body. Non-surgical correction can sometimes be accomplished by manually rotating the testicle in the opposite direction (i.e., outward, towards the thigh); if this is initially unsuccessful, a forced manual rotation in the other direction may correct the problem. : 149   The success rate of manual detorsion is not known with confidence. When salvage of the testicle is accomplished, long-term testicular damage is common. Testicular size is often diminished, and injury to the unaffected testicle is common. The effect of a torsion event on long-term fertility is not fully understood.A repeat doppler ultrasound scan may confirm restoration of blood flow to the testicle following manual detorsion. However, surgical exploration is often performed in order to assess the health and viability of the testicle. An orchiopexy is performed to both the affected and unaffected testicles in order to prevent recurrence. If the testis is not viable, it is removed (orchiectomy).
It acts as a GABAergic agent and as a positive allosteric modulator of GABAA receptor. Stiripentol, can improve focal refractory epilepsy, as well as Dravets syndrome, supplemented with clobazam and valproate was approved in Europe in 2007 as a therapy for Dravet syndrome and has been found to reduce overall seizure rate by 70%. In cases with more drug-resistant seizures, topiramate and the ketogenic diet are used as alternative treatments.Cannabidiol (CBD) was approved in United States for treatment of Dravet syndrome in 2018. A 2017 study showed that the frequency of seizures per month decreased from 12 to 6 with the use of cannabidiol, compared with a decrease from 15 to 14 with placebo.In 2020, fenfluramine was approved for the medical treatment in the European Union and the USA. Epidemiology
Dravet syndrome is a severe form of epilepsy, responsible for roughly 10% of cases in children. It is a rare genetic disorder that affects an estimated 1 in every 20,000–40,000 births. COVID-19
Although it is not clear whether people with Dravet syndrome are specially vulnerable to COVID-19 infection, recent publications have shown that affected individuals and their families have suffered some indirect consequences during the COVID-19 pandemic, such as healthcare barriers, loss of therapies or economic issues. History
Charlotte Dravet first described severe myoclonic epilepsy of infancy in Centre Saint Paul, Marseille, France in 1978 and the name was later changed to Dravet syndrome in 1989.