Epilepsy & Behavior最新文献

{"title":"Maternal epilepsy and pregnancy, delivery and neonatal outcomes: A population-based retrospective cohort study","authors":"Noah Margolese ,&nbsp;Ahmad Badeghiesh ,&nbsp;Haitham Baghlaf ,&nbsp;Samantha Jacobson ,&nbsp;Michael H Dahan","doi":"10.1016/j.yebeh.2024.110221","DOIUrl":"10.1016/j.yebeh.2024.110221","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate associations between maternal epilepsy and pregnancy, delivery and neonatal outcomes.</div></div><div><h3>Methods</h3><div>A population-based retrospective cohort study was conducted using the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP–NIS) database, between 2004–2014. Through logistic regression analysis, we compared associations between epilepsy and pregnancy-related outcomes while adjusting for demographic characteristics and comorbidities.</div></div><div><h3>Results</h3><div>Of 9,096,788 pregnancies, 25,044 were in pregnant women with epilepsy (PWWE). PWWE were more likely to be younger, white or black, have a lower income and to be insured through Medicare or Medicaid. Furthermore, PWWE were more likely to have been diagnosed with obesity, chronic hypertension, gestational diabetes, thyroid disease and HIV, and to have smoked tobacco during pregnancy or used illicit drugs. Pregnancy and delivery outcomes associated with epilepsy include pregnancy-induced hypertension(adjusted OR(aOR):1.26, 95 %CI:1.21–1.32), preeclampsia(aOR:1.33, 95 %CI:1.26–1.41), eclampsia(aOR:8.34, 95 %CI:7.14–9.74), superimposed preeclampsia/eclampsia(aOR:1.29, 95 %CI:1.14–1.47), placenta previa(aOR:1.24, 95 %CI:1.06–1.44), preterm delivery(aOR:1.27, 95 %CI:1.21–1.32), abruptio placenta(aOR:1.24, 95 %CI:1.12–1.36), chorioamnionitis(aOR:1.12, 95 %CI:1.02–1.23), cesarean section(aOR:1.29, 95 %CI:1.25–1.33), hysterectomy(aOR:1.79, 95 %CI:1.31–2.45), postpartum hemorrhage(aOR:1.12, 95 %CI:1.05–1.21), wound complications(aOR:1.38, 95 %CI:1.17–1.63), maternal death(aOR:3.42, 95 %CI:1.79–6.53), transfusion(aOR:1.67, 95 %CI:1.53–1.83), maternal infection(aOR:1.18, 95 % CI:1.09–1.28, p &lt; 0.001), deep vein thrombosis(aOR:2.11, 95 %CI:1.43–3.10), pulmonary embolism(aOR:2.98, 95 %CI:1.87–4.76), venous thromboembolism(aOR:2.25, 95 %CI:1.65–3.08) and disseminated intravascular coagulation(aOR:1.48, 95 %CI:1.19–1.83). Epilepsy-linked neonatal complications include small for gestational age(aOR:1.52, 95 %CI:1.43–1.62), intrauterine fetal demise(aOR:1.20, 95 %CI:1.02–1.41) and congenital anomalies(aOR:2.76, 95 %CI:2.47–3.07).</div></div><div><h3>Conclusions</h3><div>PWWE have significantly higher risk of nearly every pregnancy, delivery and neonatal complication investigated, including maternal death and intrauterine fetal demise. PWWE should be considered high risk patients and be carefully followed during pregnancy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110221"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821924","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":"License to drive vehicles: Legal aspects and clinical variables in Brazilian patients with epilepsy","authors":"Gloria M.A.S. Tedrus ,&nbsp;Pedro Augusto Silva Prado","doi":"10.1016/j.yebeh.2024.110218","DOIUrl":"10.1016/j.yebeh.2024.110218","url":null,"abstract":"<div><div>In epilepsy, there may be impairment of psychosocial aspects, including restrictions for the license to drive vehicles.</div></div><div><h3>Objective</h3><div>To evaluate the license to drive a vehicle in patients with epilepsy according to Brazilian legislation and to relate it to demographic and clinical variables.</div></div><div><h3>Methodology</h3><div>The license-to-drive vehicle rate was related to the demographic and clinical data of 305 patients with epilepsy.</div></div><div><h3>Results</h3><div>The mean age was 49.2 years, with 176 females, the mean education was six years, and structural epilepsy occurred in 203 patients. The license to drive vehicles occurred in 35 (11.5 %) patients. In the multiple logistic regression analysis, with stepwise variable selection criteria, it was observed that the variables that together best predict the possession of a driving license are education (<em>p</em>-value = 0.012; OR = 1.15 (1.03, 1.29)), sex (<em>p</em>-value = 0.001; OR = 4.05 (1.80, 9.68)), marital status (<em>p</em>-value = 0.022; OR = 2.67 (1.18, 6.41)), neurological examination (<em>p</em>-value = 0.029; OR = 3.62 (1.25, 13.22)) and number of antiseizure medication (ASM) in use (<em>p</em>-value = 0.019; OR = 3.04 (1.26, 8.28)). The license did not comply with Brazilian legislation in 21 (60 %) patients. In nine patients, the practice violated the law due to the type of vehicle, and in 12 patients, due to the maintenance of seizures in the last year. Patients with non-legal aspects of the license were older, had less education, were male, and had a spouse.</div></div><div><h3>Conclusion</h3><div>In patients with epilepsy, the rate of license to drive vehicles was low, and it was associated with higher schooling, males, having a spouse, having no alterations in the neurological examination, and the use of a single ASM. The non-compliance with current legislation was high, suggesting a lack of information or denial of the disease.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110218"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823826","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":"Early life stress influences epilepsy outcomes in mice","authors":"Emanuel M. Coleman,&nbsp;Maya White,&nbsp;Pantelis Antonoudiou,&nbsp;Grant L. Weiss,&nbsp;Garrett Scarpa,&nbsp;Bradly Stone,&nbsp;Jamie Maguire","doi":"10.1016/j.yebeh.2024.110217","DOIUrl":"10.1016/j.yebeh.2024.110217","url":null,"abstract":"<div><div>Stress is a common seizure trigger that has been implicated in worsening epilepsy outcomes, which encompasses psychiatric and cognitive comorbidities and sudden unexpected death in epilepsy (SUDEP) risk. The neuroendocrine response to stress is mediated by the hypothalamic–pituitary–adrenal (HPA) axis and HPA axis dysfunction worsens epilepsy outcomes, increasing seizure burden, behavioral comorbidities, and risk for SUDEP in mice. Early life stress (ELS) reprograms the HPA axis into adulthood, impacting both the basal and stress-induced activity. Thus, we propose that ELS may influence epilepsy outcomes by influencing the function of the HPA axis. To test this hypothesis, we utilized the maternal separation paradigm and examined the impact on seizure susceptibility. We show that ELS exerts a sex dependent effect on seizure susceptibility in response to acute administration of the chemoconvulsant, kainic acid, which is associated with an altered relationship between seizure activity and HPA axis function. To further examine the impact of ELS on epilepsy outcomes, we utilized the intrahippocampal kainic acid model of chronic epilepsy in mice previously exposed to maternal separation. We find that the relationship between corticosterone levels and the extent of epileptiform activity is altered in mice subjected to ELS. We demonstrate that ELS impacts behavioral outcomes associated with chronic epilepsy in a sex-dependent manner, with females being more affected. We also observe reduced mortality (presumed SUDEP) in female mice subjected to ELS, consistent with previous findings suggesting a role for HPA axis dysfunction in SUDEP risk. These data demonstrate for the first time that ELS influences epilepsy outcomes and suggest that previous life experiences may impact the trajectory of epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110217"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846247","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":"Effect of antiepileptic drug monotherapy on endogenous sex hormonal profile in men and women with epilepsy","authors":"Neha Kanojia ,&nbsp;Debleena Guin ,&nbsp;Nitin Machahary ,&nbsp;Sarita Thakran ,&nbsp;Samiksha Kukal ,&nbsp;Jyotika Thakur ,&nbsp;Biswajit Panda ,&nbsp;Priyanka Singh ,&nbsp;Ankit Srivastava ,&nbsp;Pooja Singh ,&nbsp;Sandeep Grover ,&nbsp;Anju Singh ,&nbsp;Viren Sardana ,&nbsp;Luciano Saso ,&nbsp;Shrikant Kukreti ,&nbsp;Ritushree Kukreti","doi":"10.1016/j.yebeh.2024.110220","DOIUrl":"10.1016/j.yebeh.2024.110220","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the alterations of endogenous sex hormone profiles in patients with epilepsy (PWE) on different antiepileptic drug (AED) monotherapies compared to healthy controls and drug naïve PWE (DNPWE).</div></div><div><h3>Methods</h3><div>Four databases MEDLINE, EMBASE, SCOPUS, and CENTRAL were searched for analytical observational/intervention studies on the assessment of endogenous sex hormones in PWE compared to healthy controls and DNPWE. Two researchers reviewed the title/abstract, and full-text articles for the selection of the studies independently. Extracted data included information on study details, participant demographics, interventions, method of assessment and study results. The study outcomes were used to calculate the standard mean differences (SMD) and 95% confidence interval (CI) as effect size for assessing differences in the endogenous sex hormone levels between the treatment group and control/DNPWE.</div></div><div><h3>Results</h3><div>Among 5888 publications retrieved, 33 studies were included. Enzyme-inducing AEDs (EIAEDs) such as phenytoin (men: SMD = 1.36; 95%CI = 1.06,1.66) and carbamazepine (men: SMD = 0.71; 95%CI = 0.39, 1.04 and women: SMD = 0.54; 95%CI = 0.25, 0.83) and weak-EIAED oxcarbazepine (men: SMD = 0.62; 95%CI = 0.26,0.99) increased the SHBG levels in PWE compared to control. The same trend was observed when comparing it to DNPWE. No significant changes in SHBG were observed for non-EIAEDs valproic acid, lamotrigine and levetiracetam in men. Lamotrigine significantly reduced SHBG in women (SMD = −0.50; 95%CI = −0.85, −0.16) compared to controls. Testosterone (T) levels were significantly reduced for both carbamazepine (SMD = −0.39; 95%CI = −0.67, −0.11) and valproic acid (SMD = −0.48; 95%CI = −0.74, −0.21) treated men compared to control.</div></div><div><h3>Significance</h3><div>Our findings emphasize the importance of screening the endogenous sex hormonal profile in PWE on AED monotherapies to evaluate the associated endocrine-related perturbations which may impact reproductive functions.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110220"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853376","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 relationship between intrinsic spirituality, resilience and hopelessness in patients with epilepsy: A PATH analysis","authors":"Seda Başak ,&nbsp;Gülcan Bahcecioglu Turan ,&nbsp;Zülfünaz Özer ,&nbsp;Mehtap Tan","doi":"10.1016/j.yebeh.2024.110230","DOIUrl":"10.1016/j.yebeh.2024.110230","url":null,"abstract":"<div><h3>Background</h3><div>This study was conducted to examine the relationship between intrinsic spirituality, resilience and hopelessness in patients with epilepsy and to investigate the mediating role of resilience in the relationship between intrinsic spirituality and hopelessness.</div></div><div><h3>Methods</h3><div>This study is a descriptive correlational research. The study was conducted with 120 patients who met the inclusion criteria between January 2023 and July 2023. Data were collected by using Personal Information Form, Intrinsic Spirituality Scale (ISS), Beck Hopelessness Scale (BHS) and Brief Resilience Scale (BRS).</div></div><div><h3>Results</h3><div>According to the results of the study, it was found that the mean ISS score (β = 0.730) affected the mean BRS score positively and the mean BHS score (β = -0.497) negatively (p &gt; 0.05). It was found that the mean BRS score affected the mean BHS score (β = -0.178) negatively (p &gt; 0.05). The indirect effect (β = -0.129) and total effect (β = -0.626) of intrinsic spirituality on hopelessness mediated by the mean BRS score were found to be negative and significant. It was determined that the tested model provided a good fit and explained the direct and indirect effects of the study variables.</div></div><div><h3>Conclusion</h3><div>According to the results of the study, it was found that intrinsic spirituality affected resilience positively and hopelessness negatively. Resilience was found to have a negative effect on hopelessness. It was determined that resilience partially mediated the relationship between intrinsic spirituality and hopelessness and this situation reduced hopelessness more.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110230"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871688","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 genetic testing in developmental and epileptic encephalopathy– parents’ perspective","authors":"Ida Stenshorne ,&nbsp;Marte Roa Syvertsen ,&nbsp;Anette Ramm-Pettersen ,&nbsp;Kaja K. Selmer ,&nbsp;Jeanette Koht ,&nbsp;Mari Wold Henriksen","doi":"10.1016/j.yebeh.2024.110174","DOIUrl":"10.1016/j.yebeh.2024.110174","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Developmental and epileptic encephalopathies (DEEs) are a group of severe and heterogeneous epilepsies. Most of the affected patients have treatment refractory seizures, intellectual disability (ID), and multiple comorbidities. The condition has a negative impact on quality of life, both for the patients and their families. In recent decades, genetic testing has become an important part of the diagnostic routine investigation of patients with DEE. However, there are few quantitative studies on parental experiences and their perspectives on the genetic testing of their children. The aim of the present study was to describe parental experiences and perspectives concerning genetic testing, to investigate the importance of receiving an etiologic diagnosis, and consider the emotional impact of test results on parents.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Based on a systematic literature search, a semi-quantitative questionnaire was designed to investigate the experiences of caregivers of patients with DEE, focusing on the period of genetic investigation. Eligible participants were caregivers of patients with epilepsy and intellectual disability or psychomotor delay (DEE) who had been through genetic investigation. Participants were consecutively recruited at Drammen Hospital (Norway) and through online recruitment in 2022–2023. The study was explorative and descriptive, and statistical analyses were performed with STATA.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among the 60 responding caregivers, 59 were biological parents (32–75 years old) of children with DEE (1–43 years old) and were included in the statistical analyses. Among them, 67 % had a child with a genetic diagnosis. Knowing the etiology of the child’s DEE was important for 91 %. Prior to genetic diagnostics, 62 % thought that knowing the cause of disease would make it easier to handle the epilepsy and other medical challenges. A large proportion (71 %) reported having had concerns about the cause of their child’s disease before a potential genetic diagnosis was established, and, among these, 67 % suspected that something had happened during pregnancy or birth. The result of the genetic test led to a significantly higher degree of self-reported relief, grief, sadness, loneliness, and despair for the parents of a child that received a specific genetic diagnosis, compared to those who did not receive a diagnosis. While 24 % of parents had felt guilt concerning their child’s epileptic condition (at any time), only 8,6% reported feeling guilt when receiving the result of the genetic test.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This study provides insight into the parental experiences of genetic testing in children with DEE. It is important for the parents of a child with DEE to know the cause of disease. Parents of children with DEE who received a genetic diagnosis experienced relief, but also negative feelings associated with receiving the result of the genetic test.","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110174"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876559","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":"Can people with epilepsy trust AI chatbots for information on physical exercise?","authors":"Rizia Rocha-Silva ,&nbsp;Bráulio Evangelista de Lima ,&nbsp;Thalles Guilarducci Costa ,&nbsp;Naiane Silva Morais ,&nbsp;Geovana José ,&nbsp;Douglas Farias Cordeiro ,&nbsp;Alexandre Aparecido de Almeida ,&nbsp;Glauber Menezes Lopim ,&nbsp;Ricardo Borges Viana ,&nbsp;Bolivar Saldanha Sousa ,&nbsp;Diego Basile Colugnati ,&nbsp;Rodrigo Luiz Vancini ,&nbsp;Marília Santos Andrade ,&nbsp;Katja Weiss ,&nbsp;Beat Knechtle ,&nbsp;Ricardo Mario Arida ,&nbsp;Claudio Andre Barbosa de Lira","doi":"10.1016/j.yebeh.2024.110193","DOIUrl":"10.1016/j.yebeh.2024.110193","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to evaluate the similarity, readability, and alignment with current scientific knowledge of responses from AI-based chatbots to common questions about epilepsy and physical exercise.</div></div><div><h3>Methods</h3><div>Four AI chatbots (ChatGPT-3.5,ChatGPT 4, Google Gemini, and Microsoft Copilot) were evaluated. Fourteen questions on epilepsy and physical exercise were designed to compare the platforms. Lexical similarity, response patterns, and thematic content were analyzed. Readability was measured using the Flesch Reading Ease and Flesch–Kincaid Grade Level scores. Seven experts rated the quality of responses on a Likert scale from “very poor” to “very good.”</div></div><div><h3>Results</h3><div>The responses showed lexical similarity, with approaches to physical exercise ranging from conservative to holistic. Microsoft Copilot scored the highest on the Flesch Reading Ease scale (48.42 ± 13.71), while ChatGPT-3.5 scored the lowest (23.84 ± 8.19). All responses were generally rated as difficult to read. Quality ratings ranged from “Good” to “Acceptable,” with ChatGPT 4 being the preferred platform, chosen by 48.98 % of reviewers.</div></div><div><h3>Conclusion</h3><div>The findings highlight the potential of AI chatbots as useful sources of information on epilepsy and physical exercise. However, simplifying language and tailoring content to user’s needs is essential to enhance their effectiveness.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110193"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784523","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":"Understanding the lived experiences of people living with epilepsy: Oral history assessment in the Shai Osudoku and Ningo Prampram districts, Ghana","authors":"Sabina Asiamah ,&nbsp;Phyllis Dako Gyeke ,&nbsp;Emmanuel Kwame Darkwa ,&nbsp;Sloan Mahone ,&nbsp;John Williams ,&nbsp;Albert Akpalu ,&nbsp;Charles R. Newton ,&nbsp;Cynthia Sottie ,&nbsp;Patrick Adjei","doi":"10.1016/j.yebeh.2024.110211","DOIUrl":"10.1016/j.yebeh.2024.110211","url":null,"abstract":"<div><h3>Introduction</h3><div>Epilepsy is a prevalent neurological condition globally, especially in Sub-Saharan Africa. In Ghana, it is one of the top five causes of premature death and disability, impacting children’s neurological development and learning outcomes. Although 25% of epilepsy cases are preventable, many go undiagnosed and untreated. People with epilepsy face social stigma and rejection, hindering their ability to seek healthcare, employment, and social interactions, which worsens their self-esteem and social integration.</div></div><div><h3>Purposes</h3><div>The study aims to address the critical gaps in understanding and supporting people living with epilepsy (PLWE), through recording and analysing their experiences, and seeks to inform policy and practice, finally contributing to improve healthcare delivery, reduce stigma, and enhance support systems for PLWE.</div></div><div><h3>Methods</h3><div>A qualitative research design was employed for the study. Oral histories (OHs) were conducted with ten PLWE. These interviews encourage interviewees to focus on the life stories and experiences that mean the most to them and can be shared in their own words The interview questions were constructed in English and conducted in English, Twi, Ga and Dangme.</div></div><div><h3>Results</h3><div>The residents of Shai Osudoku and Ningo Prampram hold robust religious convictions and engage in profound spiritual practices as is the case throughout Ghana. When faced with health challenges, the PLWE and their caregivers often seek assistance from faith-based spiritual healers, including pastors or religious leaders, as their initial source of support and healing. These healers provide care by offering prayers, spiritual counselling, and incorporating various religious rituals into their healing practices. It was revealed that many PLWE, caregivers and community members perceived epilepsy differently. Some perceived it as a spiritual or demonic disease. Whilst others attributed to curse and disease of witches, idols, or gods. However, the healthcare practitioners perceived epilepsy as a medical condition. Also, it was found that individuals faced challenges, such as stigma and discrimination.</div></div><div><h3>Conclusion</h3><div>It is recommended that public education on epilepsy be intensified. Furthermore, there is the need to ensure that PLWE have access to improved healthcare to increase their quality of life.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110211"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821926","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":"Factors in the development of refractory status epilepticus in status epilepticus patients","authors":"Oruç Şahin,&nbsp;Muzaffer Güneş","doi":"10.1016/j.yebeh.2024.110232","DOIUrl":"10.1016/j.yebeh.2024.110232","url":null,"abstract":"<div><h3>Objectives</h3><div>Status epilepticus (SE) is a severe neurological condition associated with a poor prognosis. Refractory status epilepticus (RSE) is a treatment-resistant form of SE with an even worse prognosis. The exact mechanisms underlying the development of RSE are not fully understood. The aim of this study was to investigate the factors contributing to the development of RSE in SE patients and to identify predictors of RSE occurrence.</div></div><div><h3>Methods</h3><div>This retrospective study was conducted on patients diagnosed with SE and RSE between 2014 and 2024. Demographic information, comorbid conditions, and blood sample data of the patients were recorded for statistical analysis. The statistical analyses used included the Mann-Whitney <em>U</em> test, Chi-square test, Fisher’s exact test, ROC curve analysis, and logistic regression.</div></div><div><h3>Results</h3><div>A total of 82 SE patients were included in the study. Of these, 44 were non-RSE patients (control group), and 38 were RSE patients. Significant differences were observed between the groups in terms of median age (p = 0.001), blood glucose level (p = 0.023), pan-immune inflammation value (PIV) (p = 0.002), Monocyte/Lymphocyte Ratio (MLR) (p = 0.009), Neutrophil/Albumin Ratio (NAR) (p = 0.003), Systemic Immune Inflammation Index (SII) (p = 0.013), Eosinophil/Lymphocyte Ratio (ELR) (p = 0.016), Eosinophil/Neutrophil Ratio (ENR) (p = 0.006), and Eosinophil/Monocyte Ratio (EMR) (p = 0.002). The multivariate logistic regression model identified the presence of arterial hypertension as the only factor significantly associated with the development of RSE (p &lt; 0.001). In the ROC curve analysis, PIV (AUC = 0.696) and NAR (AUC = 0.689) were found to be predictive factors for RSE.</div></div><div><h3>Conclusions</h3><div>The findings obtained in the current study suggest that systemic inflammation and arterial hypertension may be associated with the progression of SE to RSE. Further research is needed to confirm these findings and integrate them into routine clinical practice.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110232"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909445","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":"Reconsidering the ethics of provocation techniques for Psychogenic Non-Epileptic Attacks and proposed ethical guidelines for use","authors":"James Dolbow ,&nbsp;Matt Deaton ,&nbsp;Marshall Kirsch ,&nbsp;Jeanne Lackamp ,&nbsp;Jonathan Zande","doi":"10.1016/j.yebeh.2024.110184","DOIUrl":"10.1016/j.yebeh.2024.110184","url":null,"abstract":"<div><div>Patients with psychogenic non-epileptic attacks (PNEA) are subject to considerable direct and indirect comorbid psycho-socio-economic impact from their condition. Fortunately, diagnosis and treatment of PNEA has shown to be both medically effective and cost-efficient, ultimately improving PNEA symptoms, mental health, quality of life, and healthcare resource utilization. Though provocation techniques for PNEA have proven highly effective in diagnosing and providing expedited treatment to these patients, they have recently begun to fall out of favor due to ethical concerns about their use. Today, over one-fourth of epilepsy monitoring units do not utilize PNEA provocation techniques in those suspected of the condition. Of the monitoring units that do, less than 10% have an established protocol, and only 20% reported patient consent. The ethics and implications of the methods of diagnosing PNEA have been debated for decades. Specifically, the ethicality of attempting to provoke PNEA episodes using the proven effective methods of suggestion, nocebo, and other techniques have often left clinicians and medical ethicists offering opposing views. Here we review the personal and societal costs of PNEA, the efficacy of these provocation techniques, and the ethical considerations regarding their use, with specific emphasis on the importance of how these techniques are described to patients, as to both ensure informed consent and removed deception. Additionally, addressing these concerns, we propose ethical guidelines for the use of provocation techniques for the diagnosis of PNEA, concluding that such techniques can be ethically applied when certain conditions are met.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110184"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791317","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}