L. Viswanathan, R. Mundlamuri, K. Raghavendra, A. Asranna, A. Chatterjee, B. Gautham, P. Satishchandra, S. Sinha
{"title":"Long-Term Seizures Outcome in Juvenile Myoclonic Epilepsy (JME): A Retrospective Cohort Study in an Indian Population","authors":"L. Viswanathan, R. Mundlamuri, K. Raghavendra, A. Asranna, A. Chatterjee, B. Gautham, P. Satishchandra, S. Sinha","doi":"10.1055/s-0041-1729459","DOIUrl":"https://doi.org/10.1055/s-0041-1729459","url":null,"abstract":"Abstract Objectives Juvenile myoclonic epilepsy (JME) is the most prevalent form of generalized epilepsy in the community. Though the response to medication is good in most patients, long-term medication usage may lead to poor compliance, side effects, and other epilepsy-related social issues. The aim of this study was to describe the demography, clinical features, and therapeutic response in patients with JME who have had at least 10 years of duration of epilepsy. Materials and Methods A retrospective study of 56 patients (M:F=26:30; mean age: 14.5 ± 5.1 years) with JME attending neurological services in a tertiary care neurological center in South India with more than 10 years disease duration was performed. Results All patients had myoclonic jerks, 94% had generalized tonic–clonic seizure, and only 7.1% had features of absence seizures. Seizures were controlled in 60% of cases at the end of 10 years of epilepsy. Thirty-eight patients (67.8%) were on valproate. Control of seizures at the end of the first and fifth years of epilepsy, frequent myoclonic jerks at the onset, and treatment with valproate in the first year of disease resulted in controlled seizures at the end of 10 years. No patient was off medications at the end of 10 years of epilepsy or at the last follow-up. Conclusion About 40% of our patients continued to have seizures even 10 years after the onset of epilepsy. Regular and long-term medication may be required in JME. Early control of seizures, response to valproate, and frequent myoclonia at onset were found to confer better prognosis.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":"7 1","pages":"15 - 21"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1729459","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47924102","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}
S. Shakya, R. Shakya, Prithuja Poudel, Ashwinee Shrestha
{"title":"Quality of Life Assessment in Pediatric Epilepsy","authors":"S. Shakya, R. Shakya, Prithuja Poudel, Ashwinee Shrestha","doi":"10.1055/s-0040-1718787","DOIUrl":"https://doi.org/10.1055/s-0040-1718787","url":null,"abstract":"Abstract Objectives Quality of life (QOL) is an accepted health outcome measure in clinical practice. This study was performed to assess QOL in pediatric epilepsy patients and identify demographic and clinical factors influencing it. Materials and Methods A cross-sectional study was conducted in the outpatient pediatric department of Dhulikhel Hospital, a tertiary care teaching hospital in Nepal. Parents or caretakers of children receiving one or more antiepileptic drugs were interviewed using QOL childhood epilepsy questionnaire comprising 91 items with seven domains and 16 subscales. All the individual subscales of the questionnaire were found to be compromised with least score on QOL and general health item. Compromised social, physical, psychological, emotional, cognitive as well as behavioral domains were also identified. Results QOL was found to be more impaired in older children and in those from rural areas. They had significant linguistic impairment and lower level of self-esteem. Overall QOL was found to be compromised more in patients with generalized than with focal epilepsy. Seizure frequency and polytherapy were the most important factors influencing overall QOL. Conclusion Despite taking appropriate antiepileptic drugs, epilepsy was found to be detrimental to QOL of patients. Hence, QOL assessment should be an important part of epilepsy management protocol.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":"6 1","pages":"54 - 58"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1718787","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42240682","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":"Partial Status Epilepticus with Paradoxical Protein-Cytologic Dissociation in Cerebrospinal Fluid","authors":"Neeraj Singh, John J. Lansing, Aparna Polavarapu","doi":"10.1055/s-0040-1716432","DOIUrl":"https://doi.org/10.1055/s-0040-1716432","url":null,"abstract":"Abstract Status epilepticus is associated with high morbidity and mortality, often requiring multiple drug interventions and intensive care monitoring. Etiology of status epilepticus plays a crucial role in the treatment, natural course and outcome of the patient, prompting extensive testing and imaging. For example, an important risk for status epilepticus in adults and children is the presence of an underlying viral or bacterial central nervous system infection, appropriate treatment of which can improve the outcome of the patient. We present three cases of new-onset refractory status epilepticus in women who did not have evidence of a central nervous system infection and had significantly elevated leukocytes compared to protein in the cerebrospinal fluid. This finding suggests an autoimmune etiology; however, standard autoimmune testing was unremarkable in all cases. This case series highlights the variability in presentation and clinical course in patients presenting with status epilepticus of unknown cause, and we discuss the importance of further research into appropriate and reliable diagnostic evaluations.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":"6 1","pages":"59 - 64"},"PeriodicalIF":0.0,"publicationDate":"2020-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1716432","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48447006","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":"Impact of Income on Perceived Stress, Coping, and Family Functioning in Indian Females with Pseudoseizures","authors":"R. Mehta, A. Mittal, D. C. Singh, Chirag Patel","doi":"10.1055/s-0040-1715766","DOIUrl":"https://doi.org/10.1055/s-0040-1715766","url":null,"abstract":"Abstract Background Pseudoseizures are paroxysmal alterations in behavior that resemble epileptic seizures but are without any organic cause. Stress, coping, and family functioning are contributing factors in the development and maintenance of pseudoseizures. Literature has found patients with pseudoseizures to belong to lower economic strata; however, no study has directly looked at the impact of income on the core contributing and maintaining factors of pseudoseizures. Aim This article studies the impact of income on perceived stress, coping, and family functioning in females with pseudoseizures. Materials and Methods Ninety-one females with pseudoseizures were recruited from the psychiatry department of a tertiary care hospital in New Delhi, India. Each participant completed the Perceived Stress Scale, Ways of Coping Questionnaire, and McMasters Family Assessment Device–General Functioning Scale. Other sociodemographic variables including per capita family monthly income, level of education, area of residence, and employment status were also recorded. Results Planful Problem Solving and Positive Reappraisal were positively associated with per capita income, while escape-avoidance coping was found to be negatively associated with per capita income. Results also showed a statistically significant negative relationship between perceived stress scores, family functioning, and per capita family income, with income having the highest contribution to family functioning in females with dissociative convulsions. Conclusion Income was a significant contributor to perceived stress, coping processes, and family functioning. Therefore, high levels of perceived stress, greater familial dysfunction, and maladaptive coping had negative impacts on the outcome of female patients with pseudoseizures belonging to lower income group.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":"6 1","pages":"43 - 49"},"PeriodicalIF":0.0,"publicationDate":"2020-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1715766","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43000544","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":"Education, Marriage, and Employment in People with Epilepsy: The Barriers that Patients Perceive","authors":"A. Asadi-Pooya, M. Homayoun, Shahla Keshavarz","doi":"10.1055/s-0040-1715767","DOIUrl":"https://doi.org/10.1055/s-0040-1715767","url":null,"abstract":"Abstract Objectives We surveyed people with epilepsy (PWE) and uncontrolled seizures on the challenges which they have had in their lives with respect to educational achievement, employment, and marriage. We tried to scrutinize their reasons and perceptions for their social underachievement and difficulties. Materials and Methods Adult patients above 25 years of age, with epileptic seizures for more than 5 years, who were investigated at Shiraz Comprehensive Epilepsy Center, from January until March 2019, were studied. We prepared a questionnaire for our study and asked whether they have any college education? If they have ever married? And, if they are employed? Results Seventy patients enrolled in our study. Age of the patients was 33 ± 6 years (range: 26–59 years) and their age at onset of epilepsy was 14 ± 9 years (range: 0–35 years). Forty-four patients (63%) never received any college education; 30 patients (43%) were single; and finally, 37 patients (53%) were unemployed. The most common reasons perceived by the patients for these life challenges were functional disability (e.g., inability to study or to work), social discrimination and stigmatization, and uncontrolled seizures and the associated consequences (i.e., fear of having seizures). Conclusion Many PWE (both men and women) and uncontrolled seizures suffer from social underachievement and challenges in their daily lives. Various strategies may help PWE to overcome these challenges.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":"6 1","pages":"50 - 53"},"PeriodicalIF":0.0,"publicationDate":"2020-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1715767","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46789997","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}
Samuel Moran, C. Peterson, I. Blackberry, M. Cook, C. Walker, J. Furler, G. Shears, L. Piccenna
{"title":"Antiepileptic Drugs, Polypharmacy, and Quality of Life in People Living with Epilepsy Managed in General Practice","authors":"Samuel Moran, C. Peterson, I. Blackberry, M. Cook, C. Walker, J. Furler, G. Shears, L. Piccenna","doi":"10.1055/s-0040-1712074","DOIUrl":"https://doi.org/10.1055/s-0040-1712074","url":null,"abstract":"Abstract Objective Recently, instances of general practitioners (GPs) prescribing antiepileptic drugs (AEDs) have increased. We aimed to investigate the use of AEDs in a community sample of people with epilepsy and the effect on quality of life (QoL). Methods Responses from the Australian Epilepsy Longitudinal Study (AELS), Pharmaceutical Benefit Scheme (PBS), and Medicare Benefit Scheme (MBS) data were used. Linear regression was used to investigate the relationship between the numbers of AEDs and QoL. Results Fifty people with epilepsy were prescribed an average of two AEDs. The most common were lamotrigine, sodium valproate, and levetiracetam. Eighty-two percent were prescribed medications from two or more categories of medications. A lower QoL at wave 2 of the AELS was significantly associated with a higher number of AEDs. Conclusion Given the high number of people with epilepsy being cared for in general practice, GPs must understand the risks and benefits of epilepsy monotherapy, polytherapy, and polypharmacy.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":"06 1","pages":"24 - 29"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1712074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48136110","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}
Mohammed S. Hadi, Arjuna Rao, S. Vooturi, S. Jayalakshmi
{"title":"Reading Epilepsy—An Interesting Case Report","authors":"Mohammed S. Hadi, Arjuna Rao, S. Vooturi, S. Jayalakshmi","doi":"10.1055/s-0040-1712772","DOIUrl":"https://doi.org/10.1055/s-0040-1712772","url":null,"abstract":"Abstract Reading epilepsy is a language induced reflex epilepsy with common ictal manifestations of regional myoclonus. The electroencephalogram (EEG) often shows focal, regional, or generalized discharges, rarely there may not be any associated EEG changes. We report case of a 25-year-old male with three episodes of seizures, precipitated while reading a book. Reported semiology was stuttering while reading with jerking of tongue as perceived by the patient followed by generalized tonic–clonic seizures (GTCS). Magnetic resonance imaging (MRI) of brain with 3 Tesla (3T) was normal. During videoelectroencephalogram (vEEG), reading precipitated recurrent stuttering each lasting for 1 to 2 seconds. Corresponding vEEG showed rhythmic 1/second symmetrical generalized spike and wave discharges lasting for 2 to 4 seconds during episodes of stuttering with intervening normal background activity, followed by generalized spike and wave discharges intermixed with artifacts recorded during secondary generalization. Patient was prescribed levetiracetam and responded well and is currently seizure-free for more than 6 years.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":"06 1","pages":"39 - 41"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1712772","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45063406","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":"Epilepsy Care in Pandemic Times: When the Going Gets Tough, the Tough Gets Going","authors":"R. Menon, A. Mahadevan, S. Sinha","doi":"10.1055/s-0040-1715924","DOIUrl":"https://doi.org/10.1055/s-0040-1715924","url":null,"abstract":"","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":"06 1","pages":"01 - 03"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1715924","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45261824","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}
D. Goel, P. Aggarwal, S. Kandpal, R. Kakkar, Deepak Negi, Nidhi Mittal
{"title":"Epidemiology of New Onset Seizures and Epilepsy Cases: A Prospective Cohort Study","authors":"D. Goel, P. Aggarwal, S. Kandpal, R. Kakkar, Deepak Negi, Nidhi Mittal","doi":"10.1055/s-0040-1712771","DOIUrl":"https://doi.org/10.1055/s-0040-1712771","url":null,"abstract":"Abstract Introduction Incidence is the number of new epilepsy cases occurring during a given time interval, usually in 1 year, in a specified population. Most incidence studies of epilepsy are from developed countries with a rate of 40 to 70 per 100,000 population. Aims We conducted this survey to study incidence of all new onset unprovoked in rural and semiurban areas of the Uttarakhand State. This study is conducted on more than 100,000 of population with longitudinal follow-up of 3 years. Methods This was a community-based, longitudinal, observational study in two blocks of Dehradun district of Uttarakhand state. Total population of approximately 100,000 from two blocks will be surveyed (50,000 in each block). This door-to-door survey was conducted annually for 3 years duration from May 2014 to April 2017. The initial data were collected on National Institute of Mental Health and Neurosciences (NIMHANS) questionnaire by door-to-door survey. Results After longitudinal follow-up for 3 years of 103,610 of population in two blocks of Uttarakhand state, we found age-adjusted prevalence rate of unprovoked seizures to the tune of 623.63 cases per 100,000 of population. Age-adjusted incidence rate of epilepsy was 38.28 per 100,000 population and annual incidence of acute symptomatic seizures was 14.79 per 100,000 of population. Overall annual incidence rate of all afebrile seizures was 51.63 per of 100,000 people. Among all sociodemographic factors, age, poverty, diet, and hygiene were significantly associated with seizures. Conclusion Age-adjusted incidence rate of unprovoked seizure in Uttarakhand state was 38.28 per 100,000 people. Diet and hygiene were significant risk factors for seizures.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":"06 1","pages":"30 - 38"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1712771","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41388289","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}