Journal of Epileptology最新文献

{"title":"Biofeedback as complementary treatment in patients with epilepsy – an underestimated therapeutic option? Review, results, discussion","authors":"C. Uhlmann, W. Fröscher","doi":"10.1515/JOEPI-2016-0013","DOIUrl":"https://doi.org/10.1515/JOEPI-2016-0013","url":null,"abstract":"Summary Background Biofeedback methods represent side effect free complementary options in the treatment of epilepsy. In this paper we review the current status of these methods in terms of clinical study results and their evaluation by systematic review papers. Possible mechanisms of action in biofeedback methods are discussed. Aim To present the current status of biofeedback methods applied to patients with epilepsy. Material and Methods With a literature search up to 10/2016 we screened publications containing the search terms “biofeedback”, “neurofeedback” or “neurotherapy” and “epilepsy” or “seizure” for intervention and population search terms respectively. Results Four different techniques of biofeedback were used to improve seizure frequency in patients with epilepsy. Three of these techniques, measuring EEG (slow cortical potentials and sensory motor rhythm) or electrodermal activity (galvanic skin response, GSR) seem to be promising methods for successful seizure control. Nevertheless, methodological standards in the conducted trials were too low for assured empirical evidence in their efficacy. Conclusions Biofeedback methods could be applied to patients to a greater extent. Probably due to the missing empirical evidence of efficacy and the high demand on patients’ and therapists’ time and commitment and therefore low cost effectiveness, these methods are hardly offered. Especially the relatively new approach of GSR biofeedback represents a promising option here.","PeriodicalId":15683,"journal":{"name":"Journal of Epileptology","volume":"100 1","pages":"173 - 180"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73617076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The quality of life of children with epilepsy in Poland – the opinion of children and their parents","authors":"D. Talarska, M. Michalak, Patrycja Talarska","doi":"10.1515/JOEPI-2016-0012","DOIUrl":"https://doi.org/10.1515/JOEPI-2016-0012","url":null,"abstract":"Summary Background Every chronic illness, including epilepsy, has a negative effect on both the quality of life of the sufferer as well as on their relationship with their surroundings. Aims To investigate the quality of life of children suffering from epilepsy and analyse how they assessed and scored their experiences compared to their parents. Materials and methods The study included 209 children with epilepsy and their parents. The research tool was a questionnaire for gathering demographic and clinical data as well as the Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales (PedsQL™ 4.0) questionnaire in two versions, one for 8–12 year olds and one for 13–18 year olds and their parents. Results Cronbach’s alpha coefficient for the entire PedsQL™ 4.0 questionnaire was 0.91 and 0.93 for children with epilepsy and their parents respectively. Children rated their Total Scale Score higher (67.5 points) than their parents (62.5 points). Whilst analyzing children’s functioning in different areas it was observed that girls’ assessments were higher than boys’, except for Emotional Functioning. Both parents and children scored School Functioning the lowest. The greatest agreement of responses was observed in the domain of Physical Functioning, the smallest in the domain of Emotional Functioning. Conclusions Quality of life was rated higher by both age groups of children suffering from epilepsy than by their parents. A statistically significant difference was found when comparing the assessment scores of children and parents in light of the following variables; child age, gender, illness duration, seizure frequency and treatment effectiveness.","PeriodicalId":15683,"journal":{"name":"Journal of Epileptology","volume":"12 1","pages":"105 - 113"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81805477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship of medial temporal lobe epilepsy with the declarative memory system","authors":"P. Halász","doi":"10.1515/JOEPI-2016-0011","DOIUrl":"https://doi.org/10.1515/JOEPI-2016-0011","url":null,"abstract":"Summary Introduction Medial temporal lobe of epilepsy (MTLE) is considered as local/regional epilepsy. However, as was discussed in Part I of this review (Halász, 2016a) there is more evidence regarding the involvement of both temporal lobes so as to consider MTLE as one of the typical bilateral system epilepsies. Aim To provide contemporary review of MTLE in relation to the declarative memory system and the newly recognized hippocampo-frontal memory consolidation during slow wave sleep. Methods A review of the available literature on experimental and clinical data and also the authors own studies in MTLE patients. Review, discussion and results New experimental and clinical neurophysiological data have shown that MTLE is closely linked to the hippocampal memory system. It is likely that hippocampal spiking is the epileptic variations of the normal sharp wave ripple events mediating the encoding and consolidation of memory engrams by a hippocampo-frontal dialogue during slow wave sleep. Conclusions The source of memory impairment in MTLE patients is not merely the cell loss and synaptic transformation of the hippocampal structure, but the every night interference with memory consolidation due to interictal spiking.","PeriodicalId":15683,"journal":{"name":"Journal of Epileptology","volume":"310 1","pages":"157 - 165"},"PeriodicalIF":0.0,"publicationDate":"2016-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75308551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The medial temporal lobe epilepsy is a bilateral disease – novel aspects","authors":"P. Halász","doi":"10.1515/JOEPI-2016-0010","DOIUrl":"https://doi.org/10.1515/JOEPI-2016-0010","url":null,"abstract":"Summary Introduction Medial temporal lobe epilepsy (MTLE) is the most frequent form of epilepsy in adulthood. It is classified as local/regional epilepsy. However, there is increasing evidence of the involvement of both temporal lobes and this provides abundant arguments to question this view, and consider MTLE as one of the typical bilateral system epilepsies. Aim To provide a contemporary review of medial temporal lobe epilepsy, discussing the bilateral aspects, with reference to epilepsy surgery. Methods A literature review and a resume of the author’s own experiences with MTLE patients. Results Recent electrophysiological and neuroimaging data provide convincing data supporting that MTLE is a bilateral disease. The uni-and bilateral features form a continuum and the participation rate of the two temporal lobes determine course and surgical perspective of the individual patient. Conclusions The contradictory data of invasive presurgical evaluations of MTLE patients suggest that there need to identify further indicatory markers of bilaterality and thus change the presurgical evaluation from the non-invasive towards the invasive ways. The mechanisms of the interrelationship between the two temporal lobes in MTLE warrants further research.","PeriodicalId":15683,"journal":{"name":"Journal of Epileptology","volume":"208 1","pages":"141 - 155"},"PeriodicalIF":0.0,"publicationDate":"2016-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80557612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The epileptic multifactorial patient’s burden. Review of the topic","authors":"J. Pimentel","doi":"10.1515/JOEPI-2016-0009","DOIUrl":"https://doi.org/10.1515/JOEPI-2016-0009","url":null,"abstract":"Summary Background Approximately 26% of the burden of neurologic diseases is due to epilepsy. Its negative impact reflects mainly on people with epilepsy (PWE) themselves. Aims To highlight the negative impacts of epilepsy on the lives of PEW’s so as to identify a realistic approach to their individual needs. Methods For recently published papers PubMed and MEDLINE databases were used. In addition relevant references mentioned in the searched articles were also considered. Review and discussion Generalized tonic-clonic seizures and refractory epilepsy are the most important factors burdening PWE’s, resulting in increased injuries and mortality, including Sudden Unexpected Death in Epilepsy (SUDEP). The need of chronic intake of antiepileptic drugs (AEDs) and of epilepsy surgery are also important with regards to potential for side effects, drug interactions, and different surgery risks. PWE harbour more medical and psychiatric comorbidities than the general population and results in a decreased quality of life. Decreased self-esteem and major stigma are also frequent, linked to social, economic and personal negative consequences. Age also plays a role, younger people being more stigmatized given the interdiction to drive or difficulty in getting a job. In the elderly, seizures may have an impact on mental status, mood and sleep. Gender may also contribute, particularly involving women in childbearing age, linked to the fear or depression due to the possibility of AED-induced fertility disturbances, foetal malformations, or breast feeding side-effects. Conclusions The burden that PWE face must be considered by all people involved in the management of their epilepsy. The causes may be multifactorial, all interconnected and each one influencing the others.","PeriodicalId":15683,"journal":{"name":"Journal of Epileptology","volume":"23 1","pages":"167 - 172"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84123569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the hepatic metabolisation for the interaction between valproic acid and carbapenem antibiotics","authors":"J. Rösche","doi":"10.1515/JOEPI-2016-0008","DOIUrl":"https://doi.org/10.1515/JOEPI-2016-0008","url":null,"abstract":"Dear Sir, I read with great interest the paper by Keränen and Kuusisto (2016) reporting a rapid and substantial decrease in the plasma concentration of valproic acid (VPA) within 24 hours after beginning concomitant treatment with imipenem. When imipenem treatment was stopped four days later, the VPA plasma concentration increased within a few hours. The authors conclude that this time course suggests that mechanisms other than a change in the enzymatic elimination of VPA are the cause for the pharmacokinetic interaction. This conclusion is not in line with data presented in an extensive review on the VPA-meropenem interaction by Rösche et al. (2014). At that time 21 reports with one or two patients, with a total of 28 treatment episodes in 25 patients, and nine case series with at least three cases each corresponding to 158 treatment episodes in 155 patients were available. In a patient with decompensated liver cirrhosis (Child-Pugh score 13) there was no interaction with VPA and meropenem (Spriet and Willems, 2011). Therefore liver function may be crucial for the VPA carbapenem interaction, which is commonly regarded as a class effect (Mancl and Gidal, 2009). The decrease of the VPA plasma concentration within 48 hours after meropenem application was 56% (SD 27%) in five patients with intravenous VPA administration and 84% (SD 15%) in 10 patients with enteral VPA administration (p = 0.03) (Rösche et al., 2014). Further treatment resulted in a maximal decrease of 79% (SD 14%) for VPA administered intravenously and 89% (SD 10%) for VPA administered enterally. The small delay of the decrease of the VPA plasma concentration may be an effect of the avoidance of the first pass effect of hepatic metabolism of VPA when administered intravenously. Given that the enhancement of VPA glucuronidation was considered to be the mechanism for the decline of plasma VPA levels, the range of the recovery time after stopping the carbapenem from a few hours (Keränen and Kuusisto 2016 for imipenem) to even 48 days (Gonzáles and Villena 2012 for meropenem) is difficult to explain. After all the small delay of the decrease of the VPA plasma concentration after application of a carbapenem when VPA is administered intravenously may be of limited clinical relevance, since a decrease of 50% in the first 48 hours also will lead in most patients to a subtherapeutic plasma concentration. After 48 hours of combination with meropenem a therapeutic plasma concentration is difficult to achieve. In the only treatment episode of a combination of VPA and meropenem with a VPA plasma concentration in the therapeutic range published before 2014 a daily dose of 12 g VPA was used (Spriet et al., 2007). There are no safety data for such a high dose of VPA. The combination of VPA with a carbapenem should be avoided.","PeriodicalId":15683,"journal":{"name":"Journal of Epileptology","volume":"321 1","pages":"85 - 86"},"PeriodicalIF":0.0,"publicationDate":"2016-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76526945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression and anxiety in people with epilepsy: Why should we identify?","authors":"Sung-Pa Park","doi":"10.1515/JOEPI-2016-0005","DOIUrl":"https://doi.org/10.1515/JOEPI-2016-0005","url":null,"abstract":"Summary Introduction People with epilepsy (PWE) have a higher risk of developing depression and anxiety than people without epilepsy. However, understanding and management of that issue remain under-recognized. Aim To emphesize: a) the relationship between depression, anxiety, and epilepsy, and b) to suggest practical strategies for their identification by clinicians. Methods The current literatures was reviewed investigating the impact of depression and anxiety in PWE and those examining the validity of simple screening tools for the detection of depression and anxiety. Review Approximately one quarter of PWE have been known to be suffered from depression. The frequency of depression and anxiety was closely related to poor seizure control. Depression and anxiety have been reported to have a bidirectional relationship with epilepsy. The higher degree of depression and anxiety was more likely to elicit the suicidal ideation and attempt, adverse events and poor compliance of antiepileptic drugs, poor surgical outcome, and eventually, poor quality of life. Furthermore, depression and anxiety were closely associated with perceived stigma, obsessive-compulsive symptom, aggression, fatigue, and perceived stress. Conclusions Clinicians who take care of PWE in a busy clinical setting should identify their psychiatric problems by brief screening tools and treat them instantly to minimize their negative impacts.","PeriodicalId":15683,"journal":{"name":"Journal of Epileptology","volume":"43 1","pages":"57 - 62"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84136789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticonvulsant therapy in brain-tumor related epilepsy","authors":"W. Fröscher, T. Kirschstein, J. Rösche","doi":"10.1515/JOEPI-2016-0004","DOIUrl":"https://doi.org/10.1515/JOEPI-2016-0004","url":null,"abstract":"Summary Background The lifetime risk of patients with brain tumors to have focal epileptic seizures is 10–100%; the risk depends on different histology. Specific guidelines for drug treatment of brain tumor-related seizures have not yet been established. Aim This review addresses the special aspects of antiepileptic drug (AED) therapy in brain tumor-related epilepsy. Methods We analyzed the literature up to December 2015. Results Based on current evidence the management of tumor-related seizures does not differ substantially from that applied to epilepsies from other etiologies. Therefore, the choice of an AED is based, above all, on tolerability and pharmacokinetic interactions with chemotherapeutic drugs. Levetiracetam is recommended by many authors as first-line therapy in brain tumor-related epilepsy. Due to the possibility of interactions, the combination of enzyme-inducing AEDs and chemotherapeutic drugs, is usually not recommended as a first choice. Currently there is no evidence that prophylactic prescription of long-term AEDs in brain tumor-patients who did not present with seizures is justified. Because of the high risk of recurrence, however, AED treatment should be strongly considered after a single brain tumor-related seizure. The decision to withdraw AEDs must carefully consider the risk of seizure recurrence. Conclusion At present levetiracetam is the preferred drug in brain tumor-related epilepsy, especially when drug interactions need to be avoided. In the future we hope to acquire more targeted drugs against this disorder by uncovering its pathogenesis.","PeriodicalId":15683,"journal":{"name":"Journal of Epileptology","volume":"1 1","pages":"41 - 56"},"PeriodicalIF":0.0,"publicationDate":"2016-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75047448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful treatment of epilepsia partialis continua due to Rassmussen encephalitis with perampanel","authors":"Katja Göde, A. Grossmann, J. Rösche","doi":"10.1515/JOEPI-2016-0003","DOIUrl":"https://doi.org/10.1515/JOEPI-2016-0003","url":null,"abstract":"Summary Background Epilepsia partialis continua (EPC) is a difficult to treat condition, which tends to be refractory to antiepileptic drugs (AEDs). We previously published two other treatment episodes of EPC due to stroke and vascular dementia with a possible effect of perampanel (PER). Aim With the publication of a third treatment episode of EPC terminated by the administration of PER we would like to suggest that PER may be an effective treatment option in this condition. Material and Methods We present a case where PER was the last AED introduced in the treatment of a patient with EPC and individual seizures due to Rasmussen encephalitis before his seizure frequency could be reduced significantly. Results A 44 years old male patient, who had been on a combination therapy of at least 4 AEDs since the age of 24, was admitted to our hospital presenting with an EPC. After the introduction of PER in the therapy EPC stopped and he remained seizure free for more than a year. Two of his other AEDs could be tapered of. Conclusion PER might be especially effective in EPC.","PeriodicalId":15683,"journal":{"name":"Journal of Epileptology","volume":"5 1","pages":"67 - 70"},"PeriodicalIF":0.0,"publicationDate":"2016-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84350480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateralized periodic discharges associated with status epilepticus in the first year after stroke","authors":"H. Dede, N. Bebek, O. Gelisin, M. Atmaca, N. Y. Barlas, C. Gurses, B. Baykan, A. Gokyigit","doi":"10.1515/JOEPI-2016-0002","DOIUrl":"https://doi.org/10.1515/JOEPI-2016-0002","url":null,"abstract":"Summary Backgrand Lateralized periodic discharges (LPDs) are infrequent electroencephalograph (EEG) findings, and may present in ictal or interictal form. They are regarded as potential electrophysiologic signs of convulsive or nonconvulsive status epilepticus (NCSE). We report four patients who presented with NCSE and one who presented with convulsive status epilepticus in the postictal period, characterized by LPDs in EEG recordings in the first year after stroke. Material and methods We prospectively evaluated patients who clinically presented with status epilepticus associated LPDs between March 2014 and March 2015. We investigated patients that presented with a new stroke occurrence. We excluded the other LPD etiologies. EEG studies of five patients (two men) who were admitted to our emergency unit with confusion, three of whom had visual symptoms; four were treated for NCSE as diagnosed with LPDs. The fifth patient had convulsive status epilepticus with LPD in the postictal period. Results and Discussion None of the five patients, who were aged between 68 and 92 years, showed any etiologic factor other than a history of cerebrovascular disease (CVD). Magnetic resonance imaging studies of the patients revealed old infarcts and transitional diffusion restrictions. The clinical and EEG findings decreased substantially upon antiepileptic drug treatment. Herein, we illustrate the first patient who had confusion, visual hallucinations, and ictal and interictal LPD in her consecutive EEGs. Conclusions CVDs may pave the way for LPDs in patients with a history of stroke because CVDs cause structural brain damage. Patients who present with a similar clinical profile and imaging signs of stroke should be checked for NCSE, particularly in the presence of LPDs in EEGs.","PeriodicalId":15683,"journal":{"name":"Journal of Epileptology","volume":"14 1","pages":"15 - 23"},"PeriodicalIF":0.0,"publicationDate":"2016-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89043431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}