Severe psychological distress among patients with epilepsy during the COVID‐19 outbreak in southwest China

Abstract

Objective

To compare the severity of psychological distress between patients with epilepsy and healthy controls during the COVID‐19 outbreak in southwest China, as well as identify potential risk factors of severe psychological distress among patients with epilepsy.

Methods

This cross‐sectional case‐control study examined a consecutive sample of patients older than 15 years treated at the epilepsy center of West China Hospital between February 1 and February 29, 2020. As controls, sex‐ and age‐matched healthy visitors of inpatients (unrelated to the patients) were also enrolled ...

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Peri‐ictal heart rate variability parameters as surrogate markers of seizure severity

Abstract

This study aims at defining objective parameters reflecting the severity of peri‐ictal autonomic changes and their relation to post‐ictal generalized electroencephalography (EEG) suppression (PGES), with the view that such changes could be detected by wearable seizure detection systems and prove useful to assess the risk of sudden unexpected death in epilepsy (SUDEP). To this purpose, we assessed peri‐ictal changes in heart rate variability (HRV) and correlated them with seizure duration, intensity of electromyography‐based ictal muscle activity, and presence and duration ...

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Psychosocial profiles and their predictors in epilepsy using patient‐reported outcomes and machine learning

Abstract

Objective

To apply unsupervised machine learning to patient‐reported outcomes to identify clusters of epilepsy patients exhibiting unique psychosocial characteristics.

Methods

Consecutive outpatients seen at the Calgary Comprehensive Epilepsy Program outpatient clinics with complete patient‐reported outcome measures on quality of life, health state valuation, depression, and epilepsy severity and disability were studied. Data were acquired at each patient’s first clinic visit. We used k‐means++ to segregate the population into three unique clusters. We then used multinomial regression to determine factors that were statistically associated ...

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Utility of genetic testing for therapeutic decision‐making in adults with epilepsy

Abstract

Objective

Genetic testing has become a routine part of the diagnostic workup in children with early onset epilepsies. In the present study, we sought to investigate a cohort of adult patients with epilepsy, to determinate the diagnostic yield and explore the gain of personalized treatment approaches in adult patients.

Methods

Two hundred patients (age span = 18‐80 years) referred for diagnostic gene panel testing at the Danish Epilepsy Center were included. The vast majority (91%) suffered from comorbid intellectual disability. The medical records of ...

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The association of patient weight and dose of fosphenytoin, levetiracetam, and valproic acid with treatment success in status epilepticus

Abstract

The Established Status Epilepticus Treatment Trial was a blinded, comparative‐effectiveness study of fosphenytoin, levetiracetam, and valproic acid in benzodiazepine‐refractory status epilepticus. The primary outcome was clinical seizure cessation and increased responsiveness without additional anticonvulsant medications. Weight‐based dosing was capped at 75 kg. Hence, patients weighing >75 kg received a lower mg/kg dose. Logistic regression models were developed in 235 adults to determine the association of weight (≤ or >75 kg, ≤ or >90 kg), sex, treatment, and weight‐normalized dose with the primary outcome and ...

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Evaluation of subchronic administration of antiseizure drugs in spontaneously seizing rats

Abstract

Objective

Approximately 30% of patients with epilepsy do not experience full seizure control on their antiseizure drug (ASD) regimen. Historically, screening for novel ASDs has relied on evaluating efficacy following a single administration of a test compound in either acute electrical or chemical seizure induction. However, the use of animal models of spontaneous seizures and repeated administration of test compounds may better differentiate novel compounds. Therefore, this approach has been instituted as part of the National Institute of Neurological Disorders and ...

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A rat model of valproate teratogenicity from chronic oral treatment during pregnancy

Abstract

Objective

Sodium valproate (VPA), the most effective antiepileptic drug for patients with genetic generalized epilepsy (GGE), is a potent human teratogen that increases the risk of a range of congenital malformations, including spina bifida. The mechanisms underlying this teratogenicity are not known, but may involve genetic risk factors. This study aimed to develop an animal model of VPA‐induced birth defects.

Methods

We used three different rat strains: inbred Genetic Absence Epilepsy Rats From Strasbourg (GAERS), a model of GGE with absence seizures; inbred ...

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Stereotactic Laser Ablation for Mesial Temporal Lobe Epilepsy: A prospective, multicenter, single‐arm study

Abstract

Objective

To describe the development of the Stereotactic Laser Ablation for Temporal Lobe Epilepsy study protocol in the context of current practice. An ideal treatment for drug‐resistant epilepsy remains an ongoing area of research. Although there are several options available, each has challenges that not only make deciding on the appropriate treatment not clear‐cut but also create difficulties in designing clinical studies to provide evidence in support of the treatment.

Methods

A prospective, single‐arm, multicenter study designed to evaluate safety and efficacy of ...

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Program of Active Consumer Engagement in Self‐Management in Epilepsy: Replication and extension of a self‐management randomized controlled trial

Abstract

Objective

The Program of Active Consumer Engagement in Self‐Management in Epilepsy (PACES) is an evidenced‐based self‐management intervention for adults with epilepsy. Prior randomized controlled trial (RCT) data show that PACES reduces depression and improves self‐management, self‐efficacy, and quality of life for 6 months postprogram. The objective of this study was to replicate a PACES RCT with key extensions: more diverse patient pool from community‐based epilepsy centers; option for telephone‐based participation; and longer follow‐up (12 months with booster support for intervention group), to examine ...

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