Epilepsy and Behavior Reports最新文献

{"title":"Predictors of poor neurodevelopmental outcomes in neonates with clinically observed seizures: A prospective observational study in a tertiary care hospital of Bangladesh","authors":"Humayra Akter ,&nbsp;Sanjoy Kumer Dey ,&nbsp;Mohammad Kamrul Hassan Shabuj ,&nbsp;Kanij Fatema ,&nbsp;Ismat Jahan ,&nbsp;Nazmus Sihan ,&nbsp;Tareq Rahman ,&nbsp;Md Abdullah Saeed Khan ,&nbsp;Mohammad Jahid Hasan","doi":"10.1016/j.ebr.2024.100665","DOIUrl":"10.1016/j.ebr.2024.100665","url":null,"abstract":"<div><p>Neonatal seizures can lead to long-term neurodevelopmental problems. This study aims to identify predictors of poor developmental outcomes in neonates with seizures to aid in early intervention and referral for follow-up and rehabilitation.</p><p>This observational study was conducted in the Department of Neonatology and Institute of Paediatric Neurodisorder and Autism, Bangabandhu Sheikh Mujib Medical University. Among 75 study cases of neonatal seizure, 23 died, and 46 were followed-up at 6 and 9 months after discharge. EEGs were performed on every patient. A comprehensive neurological examination and developmental evaluation were performed using Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III).</p><p>Three-fourths of neonates were born at term (76.1 %), and over half were male (56.5 %). The majority were appropriate for gestational age (79.7 %) and had an average birth weight of 2607 ± 696 g (±SD). Over half of the neonates (52.2 %) had adverse neurodevelopmental outcomes, with global developmental delay being the most common. Recurrent seizures, the number of anticonvulsants needed to control seizures, and abnormal Electroencephalograms were identified as independent predictors of adverse neurodevelopmental outcomes.</p><p>The study highlights the need for early referral for follow-up and rehabilitation of neonates with seizures having abnormal electroencephalograms, recurrent seizures and requiring more anticonvulsants to control seizures.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"26 ","pages":"Article 100665"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000224/pdfft?md5=da136726b7c173eb6b78b58f1ac62e47&pid=1-s2.0-S2589986424000224-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140773516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical phenotypes of developmental and epileptic encephalopathy-related recurrent KCNH5 missense variant p.R327H in Chinese children","authors":"Sheng Huang ,&nbsp;Chunhui Hu ,&nbsp;Min Zhong ,&nbsp;Qinrui Li ,&nbsp;Yuanyuan Dai ,&nbsp;Jiehui Ma ,&nbsp;Jiong Qin ,&nbsp;Dan Sun","doi":"10.1016/j.ebr.2024.100671","DOIUrl":"10.1016/j.ebr.2024.100671","url":null,"abstract":"<div><p><em>KCNH5</em> gene encodes for the voltage-gated potassium channel protein Kv10.2. Here, we investigated the clinical features of developmental and epileptic encephalopathy (DEE) in five Chinese pediatric patients with a missense mutation (p.R327H) in <em>KCNH5</em> gene. These patients had undergone video EEG to evaluate background features and epileptiform activity, as well as 3.0 T MRI scans for structural analysis and intelligence assessments using the Gesell Developmental Observation or Wechsler Intelligence Scale for Children. Seizure onset occurs between 4 and 10 months of age, with focal and generalized tonic-clonic seizures being common. Initial EEG findings showed multiple multifocal sharp waves, sharp slow waves or spike slow waves, and spike waves. Brain MRI revealed widened extracerebral space in only one patient. Mechanistically, the KCNH5 mutation disrupts the two hydrogen bonds between Arg327 and Asp304 residues, potentially altering the protein’s structural stability and function. Almost 80 % of patients receiving add-on valproic acid (VPA) therapy experienced a reduction in epileptic seizure frequency. Altogether, this study presents the first Chinese cohort of pediatric DEE patients with the KCNH5 p.R327H mutation, highlighting focal seizures as the predominant seizure type and incomplete mutation penetrance. Add-on VPA therapy was likely effective in the early stages of DEE pathogenesis.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"26 ","pages":"Article 100671"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000285/pdfft?md5=2c5c406f38803ca87146ef8fec097f32&pid=1-s2.0-S2589986424000285-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140791142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiseizure medication adherence and epilepsy surgery attitude in people with epilepsy in Morocco: A cross-sectional study","authors":"El Bachir Hajji ,&nbsp;Boubacar Traore ,&nbsp;Samira Hassoune ,&nbsp;Salma Bellakhdar ,&nbsp;Mohammed Abdoh Rafai ,&nbsp;Abdelhakim Lakhdar","doi":"10.1016/j.ebr.2024.100672","DOIUrl":"https://doi.org/10.1016/j.ebr.2024.100672","url":null,"abstract":"<div><p>We determine the proportion of non-Antiseizure Medication Adherence (non-AMA) and refusal attitude towards Epilepsy Surgery (ES) and their associated factors in Moroccan People With Epilepsy (PWE). A cross-sectional study was conducted (December 2021-December 2022) among adult Moroccan PWE. PWE were interviewed for their reactions to AMA and the ES attitude. Their medical files were processed to complete their sociodemographic and clinical data. Data were analyzed by the Statistical Package for Social Sciences (SPSS) software 21.0. A Chi-square test was performed to compare variables and multivariate logistic regression was used to highlight associations. Statistical tests were considered significant at a p-value ≤ 0.05 for a Confidence Interval (CI) of 95 %. The median age of our sample (n = 294) was 38 years (IQR: 25.00–55.00). Non-AMA was noted in 24.5 % with indifference as the main reason (55.6 %). ES refusal was found in 33.3 %, attributed mostly to apprehension (61.2 %). In the multivariate analysis, male sex (aOR = 1.94; 95 %CI: 1.03–3.64) and the existence of a family history of epilepsy (aOR = 1.96; 95 %CI: 1.02–3.75) were the factors associated with the non-AMA, whereas the use of allopathic treatments (aOR = 2.32; 95 %CI: 1.20–4.51), exclusively focal or generalized (not combined) seizures (aOR = 2.66; 95 %CI: 1.36–5.21) and the combination of a generic with the originator ASM (aOR = 2.64; 95 %CI: 1.12–6.18) were the predictive factors with the ES refusal attitude. The proportions found of non-AMA and ES refusal were relatively low compared to other studies, which may indicate the effort that medical staff have devoted recently to raising awareness of the importance of PWE’s therapeutic involvement.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"26 ","pages":"Article 100672"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000297/pdfft?md5=890b5d9946867f335943ef34e918a390&pid=1-s2.0-S2589986424000297-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140901437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exploration of anomia rehabilitation in drug-resistant temporal lobe epilepsy","authors":"Véronique Sabadell ,&nbsp;Agnès Trébuchon ,&nbsp;F.-Xavier Alario","doi":"10.1016/j.ebr.2024.100681","DOIUrl":"https://doi.org/10.1016/j.ebr.2024.100681","url":null,"abstract":"<div><p>Around 40% of patients who undergo a left temporal lobe epilepsy (LTLE) surgery suffer from anomia (word-finding difficulties), a condition that negatively impacts quality of life. Despite these observations, language rehabilitation is still understudied in LTLE. We assessed the effect of a four-week rehabilitation on four drug-resistant LTLE patients after their surgery. The anomia rehabilitation was based on cognitive descriptions of word finding deficits in LTLE. Its primary ingredients were psycholinguistic tasks and a psychoeducation approach to help patients cope with daily communication issues. We repeatedly assessed naming skills for trained and untrained words, before and during the therapy using an A-B design with follow-up and replication. Subjective anomia complaint and standardized language assessments were also collected. We demonstrated the effectiveness of the rehabilitation program for trained words despite the persistence of seizures. Furthermore, encouraging results were observed for untrained items. Variable changes in anomia complaint were observed. One patient who conducted the protocol as self-rehabilitation responded similarly to the others, despite the different manner of intervention. These results open promising avenues for helping epileptic patients suffering from anomia. For example, this post-operative program could easily be adapted to be conducted preoperatively.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"27 ","pages":"Article 100681"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000388/pdfft?md5=a48cfd37ac7c5b7aab47e4d6a4ed09cd&pid=1-s2.0-S2589986424000388-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141243118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel BRAT1 variant associated with neurodevelopmental disorder with cerebellar atrophy and seizure: Case report and a literature review","authors":"Mohammad-Reza Ghasemi ,&nbsp;Sahand Tehrani Fateh ,&nbsp;Farzad Hashemi-Gorji ,&nbsp;Morteza Sheikhi Nooshabadi ,&nbsp;Sahar Alijanpour ,&nbsp;Ali Mardi ,&nbsp;Mohammad Miryounesi","doi":"10.1016/j.ebr.2024.100702","DOIUrl":"10.1016/j.ebr.2024.100702","url":null,"abstract":"<div><p>The <em>BRAT1</em> gene plays a crucial role in RNA metabolism and brain development, and mutations in this gene have been associated with neurodevelopmental disorders. The variability in the clinical presentation of <em>BRAT1</em>-related disorders is highlighted, emphasizing the importance of considering this condition in the differential diagnosis of neurodevelopmental disorders. This study aimed to identify a causative variant in an Iranian patient affected by developmental delay, speech delay, seizure, and clubfoot through whole exome sequencing (WES) followed by Sanger sequencing. The WES revealed a novel biallelic variant of the <em>BRAT1</em>, c.398A&gt;G (p.His133Arg), in the patient, which segregated within the family. A literature review suggests that the phenotypic variability associated with <em>BRAT1</em> mutations is likely due to multiple factors, including the location and type of mutation, the specific functions of the protein, and the influence of other genetic and environmental factors. The phenotypic variability of <em>BRAT1-</em>related disorders underscores the importance of considering <em>BRAT1</em>-related disorders in the differential diagnosis of epileptic encephalopathy with rigidity. These findings provide important insights into the role of <em>BRAT1</em> in neurodevelopmental disorders and highlight the potential clinical implications of identifying and characterizing novel variants in this gene.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"27 ","pages":"Article 100702"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000595/pdfft?md5=4d215f696a061ea3cfa6bcd70f85d1ef&pid=1-s2.0-S2589986424000595-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141961557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormal theta-band rhythm: EEG abnormality as potential biomarkers for disease severity in pediatric anti-NMDAR encephalitis","authors":"Yumie Tamura ,&nbsp;Mitsumasa Fukuda ,&nbsp;Akihiko Ishiyama ,&nbsp;Hiroya Nishida ,&nbsp;Hirofumi Kashii ,&nbsp;Hideaki Mashimo ,&nbsp;Kenji Inoue ,&nbsp;Hiroshi Sakuma ,&nbsp;Satoko Kumada","doi":"10.1016/j.ebr.2024.100704","DOIUrl":"10.1016/j.ebr.2024.100704","url":null,"abstract":"<div><p>Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in children often requires early immunosuppressive therapy before antibody detection. While various electroencephalogram (EEG) patterns, including extreme delta brushes (EDBs), have been reported in adults, pediatric EEG characteristics remain understudied. This study aims to assist clinicians in identifying severe cases early, potentially improving treatment outcomes through prompt intervention. This retrospective case series examined EEG features influenced by disease severity in children with anti-NMDAR encephalitis. We evaluated six children (1–13 years old; four females, two males) treated at Tokyo Metropolitan Neurological Hospital from January 2007 to January 2023. The severity of autoimmune encephalitis in our patients was assessed using the Clinical Assessment Scale in Autoimmune Encephalitis (CASE). The literature proposes a severity classification for the CASE score, wherein scores of 0–8 points are categorized as mild, 9–18 points as moderate, and 19–27 points as severe. In our patients, CASE scores ranged from 4 to 25 (median:19). We reviewed acute-phase EEG recordings, including 13 long-term videos and 58 conventional recordings. None of the patients maintained a normal posterior-dominant rhythm, and only one exhibited EDBs. Notably, three patients with higher CASE scores (≥15) displayed abnormal theta-band rhythm during non-REM sleep and prolonged EEG recovery times. Our findings suggest that abnormal theta-band rhythms may serve as a potential acute-phase EEG biomarker for severe anti-NMDAR encephalitis in children.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"27 ","pages":"Article 100704"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000613/pdfft?md5=6bd7295b7e6ad65813dda407fab33983&pid=1-s2.0-S2589986424000613-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141964161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equine-assisted therapy in quality of life and functioning of people with active epilepsy: A feasibility study","authors":"Franciely Oliveira de Andrade Santos ,&nbsp;Caroline Souza-Santos ,&nbsp;Adrielle Andrade Passos ,&nbsp;Roseane Nunes de Santana Campos ,&nbsp;Paulo Ricardo Martins-Filho ,&nbsp;Ricardo Mario Arida ,&nbsp;Lavínia Teixeira-Machado","doi":"10.1016/j.ebr.2024.100707","DOIUrl":"10.1016/j.ebr.2024.100707","url":null,"abstract":"<div><p>People with active epilepsy, which is often associated with specific neurological conditions, endure significant impairments in quality of life (QoL) and functioning, particularly those in middle-income countries. Physical intervention plays an essential role in addressing these challenges. This study investigated the impact of equine-assisted therapy (EAT) on QoL, functional independence, sleep quality, antiseizure medications, and frequency of seizures among people with epilepsy (PWE), with or without additional neurological conditions. Fourteen participants aged 4–34 years old diagnosed with focal epilepsy participated in a structured EAT program. The EAT program consisted of 36 sessions, each lasting 30 min and conducted weekly. Data were collected at four different times: baseline (T1), after 12 sessions (T2), after 24 sessions (T3), and after 36 sessions (T4). The assessments included the Quality of Life in Epilepsy (QOLIE-31), Functional Independence Measure (FIM), Pittsburgh Sleep Quality Index (PSQI), and Liverpool Adverse Event Profile (LAEP) scores. Seizure frequency was monitored continuously. Horse welfare was evaluated using the Horse Welfare Assessment Protocol (HWAP). After the EAT intervention, significant improvements were observed in the QoL scores (from 62.18 [57.88 – 70.25] to 80.18 [65.30 – 86.78]) and in FIM values (from 70.00 [36.50 – 97.75] to 70.00 [51.75 – 116.75]), particularly in the self-care and social cognition domains. Additionally, there was also a decrease in seizure frequency, adverse effects of antiseizure medications, and sleep quality. The HWAP indicated satisfactory welfare conditions for the horses. These findings indicate that EAT holds promise as a therapeutic intervention for improving the QoL and functioning of PWE. Tailored interventions are essential to address the diverse challenges faced by PWE, emphasizing the need for further research on effective therapeutic approaches.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"28 ","pages":"Article 100707"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000649/pdfft?md5=06466a8c19b04273de6379017607f758&pid=1-s2.0-S2589986424000649-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142086906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tiagabine-induced encephalopathy suppressed by vagus nerve stimulation: A case report","authors":"Christine N. Smith ,&nbsp;Stephan Eisenschenk ,&nbsp;Yue Wang","doi":"10.1016/j.ebr.2024.100709","DOIUrl":"10.1016/j.ebr.2024.100709","url":null,"abstract":"<div><p>Tiagabine has been associated with reports of status epilepticus as well as encephalopathy, even when used within therapeutic doses. Vagus nerve stimulation (VNS) has been used successfully to reduce seizure frequency in the outpatient setting as well as in the acute setting of status epilepticus. It is also theorized to reduce cortical synchronization. We present a case of a patient on adjunctive tiagabine therapy who developed sudden onset encephalopathy and rhythmic delta activity soon after vagus nerve stimulation was turned off in preparation for magnetic resonance imaging. The bilateral rhythmic delta activity significantly reduced in burden after VNS was turned back on and encephalopathy also gradually improved to baseline. We hypothesize that vagus nerve stimulation successfully interrupted diffuse hypersynchrony, in the form of bilateral rhythmic delta activity, caused by tiagabine. To our knowledge, this is the first report of such a phenomenon.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"28 ","pages":"Article 100709"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000662/pdfft?md5=2ccce8e89ee215768f64dea8c61ef0b5&pid=1-s2.0-S2589986424000662-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142136640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise in patients with epilepsy and neurostimulation devices - physical activity levels, barriers, and beliefs","authors":"Sarah Mauney ,&nbsp;Papul Chalia ,&nbsp;Justine Julien ,&nbsp;Tiffany Fisher","doi":"10.1016/j.ebr.2024.100699","DOIUrl":"10.1016/j.ebr.2024.100699","url":null,"abstract":"<div><p>Exercise improves many comorbidities associated with epilepsy in addition to seizure control. Despite the ILAE consensus statement noting the positive effects of exercise in patients with epilepsy (PWE) and individual assessment of risks pertaining to these activities, many healthcare professionals, including neurologists, are unfamiliar with these guidelines. Neurostimulation is an increasingly prevalent treatment option for refractory epilepsy. To date, no literature exists regarding how PWE treated with neurostimulation devices view and participate in exercise. We surveyed 36 adult PWE treated with neurostimulation (11 VNS, 21 RNS, 3 DBS, 1 VNS+RNS) on their barriers, beliefs, activity levels, and interests in exercise. Forty-three percent of patients reported meeting AHA guidelines for physical activity. Ninety percent of participants noted at least one barrier to exercise with transportation being most common. Fear of embarrassment of a seizure during exercise was reported by 44% with 39% endorsing prior seizure while exercising. Device-specific barriers included fear of device damage or avoidance of specific exercises. There was a statistically significant effect on activity level and prior seizure while exercising. Only 8% of participants reported knowledge of exercise guidelines for PWE. This data provides insight into the views of PWE treated with neurostimulation devices on exercise.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"27 ","pages":"Article 100699"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258998642400056X/pdfft?md5=ff2e88cb3f92936b0ece25f2ba250a33&pid=1-s2.0-S258998642400056X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141961558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Understanding, Acceptance and utilization of Ketogenic diet therapy for epilepsy in Australia and New Zealand: An online survey","authors":"Tania E. Farrar ,&nbsp;Arlene D’Silva ,&nbsp;Michael Cardamone ,&nbsp;Melissa L. Bartley ,&nbsp;Chong H. Wong ,&nbsp;Michelle A. Farrar","doi":"10.1016/j.ebr.2024.100711","DOIUrl":"10.1016/j.ebr.2024.100711","url":null,"abstract":"<div><div>Ketogenic diet therapy (KDT) is an established treatment for people with epilepsy. As increasing evidence demonstrates effectiveness and safety of KDT on seizure reduction, cognition and behaviour, it is essential to evaluate factors hindering and supporting neurologists in prescribing KDT to strengthen quality, evidence-based, appropriate and equitable care. A study of Australian and New Zealand (ANZ) neurologists was undertaken via an online survey. Demographics, clinical role characteristics, perceptions of knowledge, use and experiences of KDT for epilepsy treatment were assessed. Responses were analysed using the Capability, Opportunity, Motivation and Behaviour (COM-B) model. 114 neurologists participated (18 % response rate). All were aware of KDT for epilepsy treatment, most (90 %) perceived it as acceptable and 85 % identified suitable patients in their practice. Poor knowledge of the KDT referral processes was a barrier for 64 %. Clinical role characteristics were significantly associated with perceived level of knowledge and use of KDT in practice, being more likely among paediatric neurologists), epileptologists and those in urban practices (p &lt; 0.00001). Most neurologists (90 %) endorsed adoption of a KDT guideline to facilitate use of KDT in epilepsy management. This study established that KDT is accepted as a suitable treatment for epilepsy in ANZ. There is high variability in perceived knowledge and skills related to KDT, which impacts on utilization in clinical practice. Further education and resources for clinicians, allied health and community support agencies are needed to optimise the use of this valuable therapy. Additionally, a clear referral pathway would improve patient access.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"28 ","pages":"Article 100711"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}