Epilepsy & Behavior最新文献

{"title":"Use of intrathecal rituximab in autoimmune epilepsy: A retrospective study","authors":"Christina Wombles ,&nbsp;Emilyn Ballard ,&nbsp;Holly Skinner ,&nbsp;Angel Claudio ,&nbsp;Ki Hyeong Lee ,&nbsp;Mahammed Z. Khan Suheb ,&nbsp;Okorie Okorie ,&nbsp;Amay Parikh ,&nbsp;Raad Bassel ,&nbsp;Elakkat D. Gireesh","doi":"10.1016/j.yebeh.2025.110280","DOIUrl":"10.1016/j.yebeh.2025.110280","url":null,"abstract":"<div><h3>Background</h3><div>Autoimmune encephalitis (AE) is a significant challenge in neurological practice, often proving refractory to conventional treatments. It typically manifests with recurrent seizures or status epilepticus, necessitating early diagnosis and tailored therapy for optimal outcomes. Early institution of effective treatment has been reported to reduce the mortality and morbidity associated with this condition. A subpopulation presenting with acute seizures due to autoimmune encephalitis later develop chronic epilepsy, which can be refractory to conventional modes of treatments. In addition, there is a group of chronic epilepsy patients who did not have acute symptomatic seizures who have autoimmune antibodies suggesting an immunological origin of their seizures. This study aims at evaluating the use of rituximab administered intrathecally, for treating these patients, taking pharmacodynamic properties into account.</div></div><div><h3>Materials and methods</h3><div>We retrospectively evaluated the efficacy and safety of intrathecal rituximab (ITR) in 15 patients with autoimmune-related epilepsy (9 of them with acute presentation with seizures and 6 with chronic intractable epilepsy). The nature of these seizures, laboratory findings, imaging and EEG findings were compared over the course of treatment and follow up.</div></div><div><h3>Results</h3><div>No significant long term side effects related to administration of ITR were noted in the 15 patients reported in this series. Improvement was noted in seizure control in the majority of the patients, especially in the acute presentation category, although definitive conclusions about efficacy could not be made since these patients were also receiving additional modes of therapies. Better seizure control was noted in all patients in 12 months follow up.</div></div><div><h3>Conclusions</h3><div>Our findings underscore the safety of intrathecal rituximab in treating autoimmune-related status epilepticus and refractory epilepsy related to autoimmune etiology.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"Article 110280"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of problem-based learning on stigma toward epilepsy among medical students: An intervention verification study","authors":"Yuto Arai ,&nbsp;Tohru Okanishi ,&nbsp;Yuko Nakamura ,&nbsp;Kento Ohta ,&nbsp;Masaru Ueki ,&nbsp;Izumi Kuramochi ,&nbsp;Yoshihiro Maegaki","doi":"10.1016/j.yebeh.2024.110200","DOIUrl":"10.1016/j.yebeh.2024.110200","url":null,"abstract":"<div><h3>Introduction</h3><div>Stigma toward epilepsy is widespread not only among the general population but also among healthcare professionals. Therefore, the necessity of providing educational opportunities for epilepsy from an early stage in student education has been emphasized. Recently, problem-based learning (PBL) has gained importance in higher education, with reports indicating that it not only enhances knowledge but also reduces stigma.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the effects of an epilepsy-related problem-based learning (E-PBL) program on medical students’ stigma toward epilepsy. Additionally, we assessed whether the E-PBL program improved medical students’ knowledge of epilepsy.</div></div><div><h3>Materials and methods</h3><div>Participants were fourth-year medical students. The E-PBL program was conducted over 5 days, from July 3, 2023 to July 7, 2023. The outcomes included the Japanese version of the Public Attitudes Toward Epilepsy (PATE-J) scale, which was used to assess stigma toward epilepsy before and after the E-PBL program. We also administered a short, structured questionnaire to assess participants’ knowledge of epilepsy.</div></div><div><h3>Results</h3><div>In total, 112 students were examined. The total PATE-J score was significantly lower after E-PBL (median: 18; interquartile range [IQR]: 14–20) than before PBL (median: 19; IQR: 16–23) (<em>p</em> = 0.013). Additionally, the number of correct responses to the short, structured questionnaire after the E-PBL program was significantly higher than before the program (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>E-PBL programs have the potential to decrease stigma toward epilepsy while enhancing knowledge about epilepsy among medical students. E-PBL represents a novel educational approach for medical students in the context of epilepsy education.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110200"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of polytherapy and psychiatric comorbidity in epilepsy","authors":"Mercy A. Odhiambo ,&nbsp;Gilbert K. Kaingu ,&nbsp;Maria Mumbo ,&nbsp;Karin Kipper ,&nbsp;Josemir W. Sander ,&nbsp;Charles R.J.C. Newton ,&nbsp;Symon M. Kariuki ,&nbsp;on behalf of the EPInA investigators","doi":"10.1016/j.yebeh.2024.110215","DOIUrl":"10.1016/j.yebeh.2024.110215","url":null,"abstract":"<div><h3>Purpose</h3><div>Managing epilepsy may require using more than one anti-seizure medication (ASM). While combination therapy may help, risks, including psychiatric problems, are not fully explored in Africa. We examined the relationship between polytherapy and psychiatric comorbidities among attendees of an epilepsy community clinic.</div></div><div><h3>Methods</h3><div>We prospectively assessed individuals attending an outpatient clinic in Kilifi, Kenya, for patterns of ASM prescribing (mono- or polytherapy) and reviewed psychiatric diagnoses. We used the Psychosis Screening Questionnaire and the Patient Health Questionnaire Version 9 to assess for psychosis and depression, and the Child Behavior Checklist to assess for emotional and behavioural problems. We conducted a cross-sectional logistic regression analysis to determine factors associated with polytherapy and examine the impact of polytherapy and specific medication on psychiatric comorbidities.</div></div><div><h3>Results</h3><div>Of 3,016 attendees, most were on older ASM (99.7 %), with about a third (32.9 %) on polytherapy. The most commonly co-administered drugs were phenobarbital and carbamazepine (13.0 %). Children were less likely to be on multiple medications than adults, and there was no difference between the sexes. Polytherapy was associated with focal to bilateralised seizures (aOR 1.2 [95 % confidence interval:1.0–1.4]) and frequent seizures (aOR = 2.1 [1.5–2.9]). Combining drugs increased the likelihood of any psychiatric problems (aOR = 1.3 [1.0–1.8]), with polytherapy associated with depression (aOR = 2.9 [1.0–8.4]) and psychosis (aOR = 1.9 (1.0–3.6)).</div></div><div><h3>Conclusion</h3><div>Polytherapy, especially with older drugs, is associated with psychiatric comorbidities in this population. Resorting to polytherapy needs to be carefully considered. Prioritizing research into the long-term effects of ASM on psychiatric comorbidities is crucial for improving mental health outcomes in epilepsy, particularly in low-income settings.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110215"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of transcutaneous auricular vagus nerve stimulation for depression in patients with epilepsy","authors":"Zheng Yan Ran Xu ,&nbsp;Jia Jia Fang ,&nbsp;Xiao Qin Fan ,&nbsp;Long Long Xu ,&nbsp;Gui Fang Jin ,&nbsp;Mei Hua Lei ,&nbsp;Yu Fei Wang ,&nbsp;Jun Biao Liu ,&nbsp;Fang Dong ,&nbsp;Lu Rong Jiang ,&nbsp;Yi Guo","doi":"10.1016/j.yebeh.2024.110226","DOIUrl":"10.1016/j.yebeh.2024.110226","url":null,"abstract":"<div><h3>Objective</h3><div>Our study aimed to evaluate the effectiveness and safety of transcutaneous auricular vagus nerve stimulation (taVNS) for treating mild to moderate depression in patients with epilepsy (PWE).</div></div><div><h3>Methods</h3><div>A single-arm, prospective, multi-center, pre-post controlled study was conducted in Eastern China. After a four-week baseline period, PWE with mild to moderate depression began treatment with taVNS, administered for 30 min, three times daily, over a 12-week period. The primary outcome measure was the change in 24-item Hamilton Depression Rating Scale (HAMD) scores from baseline to week 12. Secondary outcomes included the response and remission rates for depression at week 12, as well as changes in the 14-item Hamilton Anxiety Rating Scale (HAMA), the Pittsburgh Sleep Quality Index (PSQI), and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31) scores, and seizure frequency at weeks 4 and 12 compared to baseline. Adverse events (AEs) were recorded to assess the safety of taVNS. Both modified Intention-To-Treat (mITT) and Per-Protocol (PP) analyses were employed.</div></div><div><h3>Results</h3><div>Sixty-nine participants were enrolled in this study. Of these, 61 (88.4 %) completed the 4-week treatment phase, and 50 (72.5 %) finished the 12-week treatment phase. In the mITT analysis, HAMD scores significantly decreased by 4.54 ± 7.44 (p &lt; 0.001) from baseline to week 12, with clinical response in 16 (26.2 %) and remission in 15 (24.6 %) patients. HAMA scores also decreased significantly by week 4 (3.23 ± 5.18, p &lt; 0.001) and week 12 (4.95 ± 6.78, p &lt; 0.001). PSQI scores and seizure frequency showed non-significant changes at week 4, but seizure frequency decreased significantly by week 12 (0.03 ± 10.47, p = 0.038). In the PP analysis, similar improvements were observed. After 12 weeks of taVNS compared to baseline, HAMD scores decreased significantly by 5.32 ± 8.98 (p &lt; 0.001), with 32 % of patients achieving a clinical response and 24 % achieving clinical remission. And HAMA scores also decreased by 5.66 ± 7.54 (p &lt; 0.001), seizure frequency by 0.14 ± 11.03 (p = 0.018), and PSQI scores by 1.06 ± 4.14 (p = 0.076).There was a significant increase in QOLIE-31 scores by 5.17 ± 14.71 (p = 0.020). Ten (14.5 %) patients experienced non-serious adverse events, the most common of which was ear pain (n = 4); one patient withdrew due to tinnitus enhancement; all resolved after reducing the stimulation intensity or stopping the treatment.</div></div><div><h3>Conclusion</h3><div>Our study suggests that taVNS may effectively improve depressive symptoms in PWE. This may be an efficacious and safe treatment for mild to moderate depression in PWE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110226"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-related semiology changes over time","authors":"Anthony Fine,&nbsp;Katherine Nickels","doi":"10.1016/j.yebeh.2024.110185","DOIUrl":"10.1016/j.yebeh.2024.110185","url":null,"abstract":"<div><div>Understanding how seizure semiology changes with age is essential to determine the seizure onset zone. Epilepsy can be considered the prototypical neurologic disorder for demonstrating age-related changes over time. The maturational changes that occur in the brain over the lifespan demonstrate themselves most clearly through semiologic changes. Due to the immaturity of the neonatal brain, seizure recognition is challenging. Electroclinical seizures are classified as motor, non-motor, sequential, or unclassified and are typically focal in onset. During infancy, the most common seizure types are epileptic spasms, myoclonic, tonic, atonic, clonic, and hypomotor/behavioral arrest seizures. Correlation between seizure semiology and localization of seizure onset zone can be variable. The most observed seizure types in preschool-aged children are generalized myoclonic, generalized tonic, focal tonic, or clonic seizures. Many of the epileptic encephalopathies present at this age. Ictal behaviors continue to be limited, but lateralizing motor manifestations during focal seizures are better developed compared to infants. In school-aged children, the most common seizure types involve change in awareness. Seizure semiology at this age resembles that of adults, with increasing number and complexity of seizure components.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110185"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of familiarity and knowledge about epilepsy on associated cultural stereotypes in French society","authors":"Sophie Hennion ,&nbsp;Valentyn Fournier ,&nbsp;Philippe Derambure ,&nbsp;Gérald Delelis ,&nbsp;Loris Schiaratura","doi":"10.1016/j.yebeh.2024.110216","DOIUrl":"10.1016/j.yebeh.2024.110216","url":null,"abstract":"<div><div>People with epilepsy face stigma that impacts numerous aspects of their daily lives. Although the stigma surrounding people with epilepsy has been extensively documented, the mechanisms underlying it—such as cultural stereotypes—remain to be explored. Cultural stereotypes are widely shared beliefs within a cultural context about attributes typically associated with members of a particular group. This study, conducted within French society, has two primary objectives: 1) to define the content of cultural stereotypes associated with people suffering from epilepsy and 2) to examine how familiarity and knowledge about epilepsy influence these stereotypes.</div><div>To explore these stereotypes, a free association task was conducted across three cultural groups (n = 96): (1) the general population, with low familiarity and knowledge about epilepsy (n = 39); (2) healthcare professionals without epilepsy specialization, who have more familiarity and knowledge than the general population (n = 38); and (3) healthcare professionals specialized in epilepsy, who have the highest familiarity and knowledge of the three groups (n = 29). All participants held higher education qualifications to ensure a more homogeneous socio-cultural background across groups. Using the software program “IraMuTeQ”, we analyzed the diversity of terms each group associated with “people with epilepsy.” Additionally, we examined the valence and typicality of cultural stereotypes in each group.</div><div>The results reveal that, regardless of familiarity and knowledge levels, cultural stereotypes linked to epilepsy are generally negative. Across the entire sample, the most prototypical associations with people with epilepsy included “madness,” “possession,” “tongue,” and “intellectual deficiency.” The general population shares some cultural stereotypes with non-specialized healthcare professionals (e.g., “photosensitivity”), while non-specialized professionals share other associations with specialized healthcare professionals (e.g., “intellectual deficiency” and “mental illness”). However, no overlap was found between the cultural stereotypes of the general population and those of healthcare professionals specialized in epilepsy. Stereotypes related to epilepsy appear to be less typical among healthcare professionals compared to the general population. This distinction between cultural stereotypes and personal beliefs is further discussed below. Considering cultural stereotypes may allow for more tailored and effective interventions to reduce epilepsy-related stigma by addressing specific socio-cultural groups. Further research within a cross-cultural approach is recommended to deepen these findings.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110216"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling cognitive disengagement syndrome: A hidden challenge in children with epilepsy","authors":"Cansu Mercan Isik ,&nbsp;Dilek Cebeci","doi":"10.1016/j.yebeh.2024.110182","DOIUrl":"10.1016/j.yebeh.2024.110182","url":null,"abstract":"<div><h3>Background</h3><div>In our study, we aimed to investigate the prevalence of cognitive disengagement syndrome (CDS) and attention deficit hyperactivity disorder (ADHD) in children with epilepsy and to identify the associated factors.</div></div><div><h3>Method</h3><div>The study included 62 patients with epilepsy aged 6–18 and 51 healthy controls. Sociodemographic data, epilepsy characteristics, and medication usage were collected. Psychiatric evaluations used various structured interviews and scales.</div></div><div><h3>Results</h3><div>The mean ages for patients and controls were 9.7 and 9.9 years, respectively. CDS was present in 76 % of patients with epilepsy compared to 26 % of controls (p &lt; 0.01). Patients with epilepsy scored higher on Barkley Child Attention Scale <strong>(</strong>BCAS) and Turgay DSM-IV Disruptive Behavior Disorders Symptom Screening Scale <strong>(</strong>T-DSM-IV-S). CDS prevalence was higher in patients without seizure control and those over age 12. Linear regressions demonstrated that age predicted BCAS-sluggish scores (R²: 0.284, p &lt; 0.001) and T-DSM-IV-S hyperactivity scores (R²: 0.065, p: 0.023). The number of antiseizure medications (R²: 0.065, p: 0.023) and the duration of antiseizure medication usage (R²: 0.079, p: 0.014) predicted T-DSM-IV-S oppositional scores.</div></div><div><h3>Conclusion</h3><div>Our study is the first study in this field. Our study findings highlight the need for further research to understand the pathophysiological mechanisms underlying CDS in epilepsy and to develop targeted interventions.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110182"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Seizures: Psychiatric comorbidities in children with epilepsy","authors":"Dana Ayoub ,&nbsp;Amal Al-Hajje ,&nbsp;Pascale Salameh ,&nbsp;Jeremy Jost ,&nbsp;Ghassan Hmaimess ,&nbsp;Fatima Jaafar ,&nbsp;Tarek Halabi ,&nbsp;Farid Boumediene ,&nbsp;Ahmad Beydoun","doi":"10.1016/j.yebeh.2024.110234","DOIUrl":"10.1016/j.yebeh.2024.110234","url":null,"abstract":"<div><h3>Purpose</h3><div>Children with epilepsy are at an increased risk of developing psychiatric comorbidities, which exacerbate the overall disease burden. However, these disorders are often underreported in developing countries. This study, conducted in a developing country, aims to evaluate the frequency of psychiatric disorders and associated factors in a large cohort of children with epilepsy.</div></div><div><h3>Methods</h3><div>This study is part of a large, ongoing prospective study on a cohort of children with epilepsy in Lebanon. Children were recruited at the onset of their seizures between March 2010 and May 2016 and were followed for periods ranging from 2 to 12 years. The medical records of 598 children with new-onset seizures were analyzed throughout their follow-up period to identify the presence of any psychiatric disorders. Psychiatric disorders were classified as internalizing or externalizing disorders based on DSM-5 criteria and were considered present if the child had been referred and diagnosed by a pediatric psychiatrist, therapist, or neurologist, or if the medical record provided clear evidence of the child taking medication for a psychiatric disorder. Multivariable logistic regression was used to identify factors associated with psychiatric disorders.</div></div><div><h3>Results</h3><div>Of the 598 children with new onset seizures, 75 (12.5 %) were diagnosed with a psychiatric disorder, with 30 (5.0 %) having an internalizing disorder and 47 (7.9 %) having an externalizing disorder. Externalizing psychiatric disorders were most commonly reported children with developmental epileptic encephalopathies (18.2 %) compared to other epilepsy groups. Intellectual and developmental delay was the most important factor associated with externalizing disorders (OR 3.36, 95 %CI 1.48–7.62, p = 0.004). In contrast, the frequency of internalizing disorders didn’t differ across epilepsy groups. The most significant factors associated with the occurrence of internalizing psychiatric comorbidity were the failure of at least two antiseizure medications (OR 3.25, 95 % CI 1.37–7.71, p = 0.007) and an older age at seizure onset (&gt; 10 years vs. &lt; 2 years, OR 6.86, 95 % CI 1.49–31.57, p = 0.013).</div></div><div><h3>Conclusion</h3><div>The prevalence of diagnosed psychiatric comorbidities in children with epilepsy in this study was lower than previously reported in developed countries. This may indicate potential underreporting of psychiatric disorders in Lebanon, where local practices may prioritize epilepsy management over mental health. This study highlights the need for systematic psychiatric screening during routine clinic visits, particularly for children with intellectual or developmental delays and those with poor seizure control.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110234"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a rapid screener to elicit patient preferences for antiseizure medication discontinuation","authors":"Samuel W. Terman ,&nbsp;Jordan M. Silva ,&nbsp;Max Kuster ,&nbsp;Jasper Lee ,&nbsp;Amanda Brand ,&nbsp;Kara Manuel ,&nbsp;Navya Kalia ,&nbsp;Micaela Dugan ,&nbsp;Marla Reid ,&nbsp;Katherine Mortati ,&nbsp;Alexandra Tolmasov ,&nbsp;Palak S. Patel ,&nbsp;James F. Burke ,&nbsp;Arthur C. Grant ,&nbsp;Susanna S. O’Kula ,&nbsp;Chloe E. Hill","doi":"10.1016/j.yebeh.2024.110240","DOIUrl":"10.1016/j.yebeh.2024.110240","url":null,"abstract":"<div><h3>Objective</h3><div>While guidelines encourage individualized discussions of the risks and benefits of antiseizure medication (ASM) withdrawal after a period of seizure-freedom, no formal methods exist for assessing patient preferences. We report the initial development of a rapid patient preferences screener.</div></div><div><h3>Methods</h3><div>We conducted a mixed-methods study of adults who were ≥1 year seizure-free and seen for epilepsy across three institutions. We reviewed existing questionnaires and adapted three questions measuring core constructs influencing ASM decisions – views about ASMs, driving restrictions, and seizures. We added one additional “global” question, for 4 total questions. Participants rated question clarity and utility from 1 (low) to 7 (high).</div></div><div><h3>Results</h3><div>Of 32 participants, the median patient age was 46 (interquartile range [IQR] 33–56), with a median 3 years since their last seizure (IQR 2–11). Median responses were: 2 (IQR 1–5) for being bothered by ASMs, 2 (IQR 1–6) for feeling that a driving restriction would be disruptive, and 5 (IQR 4–7) for feeling that another seizure would be serious. Respondents tended to disagree that ASMs are doing more harm than good (median 1, IQR 1–2). Participants rated question clarity (median 6, IQR 6–7) and utility (median 7, IQR 6–7) highly.</div></div><div><h3>Conclusions</h3><div>We report the initial development of a pre-visit rapid screener of patient preferences pertinent to ASM withdrawal in well-controlled epilepsy. Patients endorsed the utility of such a screener and provided guidance to improve items. We hope that this work will ultimately improve shared decision-making.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110240"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerometer-measured physical activity patterns in daily life and their association with factors of sedentary behavior in people with epilepsy","authors":"Burcin Aktar ,&nbsp;Birgul Balci ,&nbsp;Hatice Eraslan Boz ,&nbsp;Sevgi Ferik Ozalan ,&nbsp;Ibrahim Oztura ,&nbsp;Baris Baklan","doi":"10.1016/j.yebeh.2024.110198","DOIUrl":"10.1016/j.yebeh.2024.110198","url":null,"abstract":"<div><h3>Objectives</h3><div>Being physically active is important, but people with epilepsy (PWE) tend to have a sedentary lifestyle. There is limited evidence about physical activity patterns in PWE using objective measures. The aims of this study were: (1) to examine the physical activity patterns of PWE, (2) compare activity patterns between PWE in terms of drug-resistant epilepsy and medically controlled epilepsy with age- and sex-matched healthy controls; and (3) explore the association between physical activity patterns and body function and structure, activity and participation, and quality of life of PWE.</div></div><div><h3>Methods</h3><div>Seventy-three PWE and 74 healthy controls were enrolled. Physical activity data were collected prospectively over a 7-day period using a SenseWear Arm Band. Body function and structure in PWE were evaluated using the Fatigue Severity Scale, 30-second Chair Stand (30CST), Biodex-Fall Risk, Generalized Anxiety Disorder, Beck Depression Inventory, Pittsburg Sleep Quality Index, and Montreal Cognitive Assessment (MoCA). Activity and participation in PWE were measured using Activities-specific Balance Confidence, Timed Up and Go Test, Six-Minute Walk Test, and Tinetti-Balance and Tinetti-Gait. The quality of life of PWE was evaluated using the Quality of Life in Epilepsy Inventory-31.</div></div><div><h3>Results</h3><div>PWE took fewer steps per day and were sedentary for more time compared with healthy controls (7826 vs. 10,564 steps, <em>P</em> = 0.01; 534 min/day vs. 463 min/day, <em>P</em> &lt; 0.001), especially PWE with drug-resistant epilepsy. 30CST, MoCA, and Biodex-Fall Risk were associated with sedentary behavior, with Biodex-Fall Risk explaining 7.2 % of the variance.</div></div><div><h3>Conclusions</h3><div>PWE demonstrated lower physical activity levels compared with healthy individuals, especially those with drug-resistant epilepsy. Our study highlights the need to tailor strategies including postural stability exercises for the enhancement of physical activity levels in PWE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110198"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}