Sudden unexpected death in epilepsy. A nationwide population‐based study

Abstract

Objective

The incidence of sudden unexpected death in epilepsy (SUDEP) varies between studies. We determined the incidence of SUDEP in the entire Icelandic population during a 20‐year period.

Methods

All individuals in Iceland with epilepsy who died unexpectedly from January 1, 1991 through December 31, 2010 were included. Case ascertainment was based on autopsies, reimbursement for antiepileptic drugs, death certificates, information from neurologists, and medical records. The incidence of SUDEP was calculated according to the total number of residents in Iceland during the ...

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Design and validation of two measures to detect anxiety disorders in epilepsy: The Epilepsy Anxiety Survey Instrument and its brief counterpart

Abstract

Objective

The study objective was to develop and validate the first epilepsy‐specific anxiety survey instrument (Epilepsy Anxiety Survey Instrument [EASI]) alongside a briefer screening instrument to detect anxiety disorders in routine clinical practice (brEASI).

Methods

The instruments were developed utilizing a mixed‐methods approach in four related studies. Pilot items were developed following qualitative interviews with people with epilepsy (PWE; Study 1) and consultation with multidisciplinary experts in anxiety and epilepsy (Study 2). PWE (n = 314) then completed pilot items alongside existing measures of anxiety ...

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Disclosure strategies in adults with epilepsy when telling, “I have epilepsy”: The How2tell study

Abstract

Objective

To generate evidence‐based knowledge about the strategies that adult people with epilepsy (PWEs) use in the process of telling others about their epilepsy.

Methods

In‐depth, one‐to‐one interviews explored PWEs’ first‐hand experiences of self‐disclosure (or not), and grounded theory methods of inductive‐deductive analysis were used to identify strategies used in disclosing. Interviews were audio‐recorded, transcribed, coded, and independently recoded by two researchers using a coding framework specifically developed in this study. To account for maximum variation, PWEs (aged 18+ years) with different life ...

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Epilepsy occurrence after neonatal morbidities in very preterm infants

Abstract

Objective

This study investigated the incidence of epilepsy and identified neonatal risk morbidities for epilepsy in children born extremely preterm.

Methods

Of the 806 very preterm infants (birth weight <  1500 g, gestational age < 32 weeks) who survived and were discharged from the four neonatal intensive care units in southern Taiwan between 2003 and 2012, 686 (85.1%) had longitudinal neurodevelopmental follow‐up assessments up to 5 years of age.

Results

Among the 686 very preterm children, 19 (2.8%) exhibited epilepsy at a mean age of 19 ± 14 months. The incidence of epilepsy was highest ...

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Seizure detection based on heart rate variability using a wearable electrocardiography device

Summary

Objective

To assess the feasibility and accuracy of seizure detection based on heart rate variability (HRV) using a wearable electrocardiography (ECG) device. Noninvasive devices for detection of convulsive seizures (generalized tonic‐clonic and focal to bilateral tonic‐clonic seizures) have been validated in phase 2 and 3 studies. However, detection of nonconvulsive seizures still needs further research, since currently available methods have either low sensitivity or an extremely high false alarm rate (FAR).

Methods

In this phase 2 study, we prospectively recruited patients admitted to ...

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Electroencephalographic seizures in critically ill children: Management and adverse events

Abstract

Objective

Guidelines recommend that encephalopathic critically ill children undergo continuous electroencephalographic (CEEG) monitoring for electrographic seizure (ES) identification and management. However, limited data exist on antiseizure medication (ASM) safety for ES treatment in critically ill children.

Methods

We performed a single‐center prospective observational study of encephalopathic critically ill children undergoing CEEG. Clinical and EEG features and ASM utilization patterns were evaluated. We determined the incidence, types, and risk factors for adverse events associated with ASM administration.

Results

A total of 472 consecutive critically ill children ...

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Early reduced dopaminergic tone mediated by D3 receptor and dopamine transporter in absence epileptogenesis

Abstract

Objective

In Genetic Absence Epilepsy Rats From Strasbourg (GAERSs), epileptogenesis takes place during brain maturation and correlates with increased mRNA expression of D3 dopamine receptors (D3R). Whether these alterations are the consequence of seizure repetition or contribute to the development of epilepsy remains to be clarified. Here, we addressed the involvement of the dopaminergic system in epilepsy onset in GAERSs.

Methods

Experiments were performed using rats at different stages of brain maturation from three strains according to their increasing propensity to develop absence ...

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High‐resolution mapping of epilepsy prevalence, ambulance use, and socioeconomic deprivation in an urban area of Sweden

Abstract

Objective

Geographic differences in epilepsy prevalence between areas of different socioeconomic standing have been demonstrated in the United Kingdom, but knowledge from other health care systems is scarce. Our objective was to compare epilepsy prevalence and emergency medical service (EMS) assignments for seizures in areas of different socioeconomic standings in the urban area of Gothenburg.

Methods

Register‐based study in Gothenburg (population 690 000), the second largest city in Sweden. Epilepsy cases were identified in the comprehensive national patient register in 2014‐2015. EMS assignments were ...

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A somatic mutation in MEN1 gene detected in periventricular nodular heterotopia tissue obtained from depth electrodes

Abstract

Periventricular nodular heterotopia (PNH) is a common structural malformation of cortical development. Mutations in the filamin A gene are frequent in familial cases with X‐linked PNH. However, many cases with sporadic PNH remain genetically unexplained. Although medically refractory epilepsy often brings attention to the underlying PNH, patients are often not candidates for surgical resection. This limits access to neuronal tissue harboring causal mutations. We evaluated a patient with PNH and medically refractory focal epilepsy who underwent a presurgical evaluation with ...

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Machine learning applications in epilepsy

Abstract

Machine learning leverages statistical and computer science principles to develop algorithms capable of improving performance through interpretation of data rather than through explicit instructions. Alongside widespread use in image recognition, language processing, and data mining, machine learning techniques have received increasing attention in medical applications, ranging from automated imaging analysis to disease forecasting. This review examines the parallel progress made in epilepsy, highlighting applications in automated seizure detection from electroencephalography (EEG), video, and kinetic data, automated imaging analysis and pre‐surgical ...

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