Acta Neurologica Scandinavica最新文献

{"title":"Anti-dsDNA Is Associated with Favorable Prognosis in Myasthenia Gravis: A Retrospective Study","authors":"Shiyin Li,&nbsp;Jiaxin Chen,&nbsp;Xu Yang,&nbsp;Xin Huang,&nbsp;Haiyan Wang,&nbsp;Huiyu Feng","doi":"10.1155/2023/8939083","DOIUrl":"10.1155/2023/8939083","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. To investigate the presence of serum antinuclear antibody (ANA) and anti-double-stranded DNA antibody (anti-dsDNA) in patients with myasthenia gravis (MG) and analyze the clinical characteristics and prognostic factors associated with MG. <i>Methods</i>. We retrospectively enrolled 363 patients with MG and analyzed the clinical characteristics and follow-up data between patients positive and negative for ANA and anti-dsDNA. We defined a Myasthenia Gravis Activities of Daily Living (MG-ADL) reduction as a main prognosis predictor and used logistic regression to determine independent factors associated with prognosis. We built a nomogram to predict prognosis and evaluate the internal validity of the model. <i>Results</i>. Ninety-eight (27.0%) patients were positive for ANA, and 51 (14.0%) were positive for anti-dsDNA. Patients positive for ANA and anti-dsDNA antibodies tended to be female and positive for acetylcholine receptor antibody (AChR-Ab). The rate of thymoma was higher in anti-dsDNA-positive patients with MG (p-dsDNA-MG) than in patients negative for anti-dsDNA (49.0% vs. 26.0%, <i>p</i> = 0.001), and p-dsDNA-MG was associated with reduced MG-ADL score. Regression analysis showed that except for age of onset (OR = 0.986, 95<i>%</i>CI = 0.973–0.999, <i>p</i> = 0.037), anti-dsDNA (OR = 2.800, 95<i>%</i>CI = 1.381–5.679, <i>p</i> = 0.004), ptosis (OR = 2.930, 95<i>%</i>CI = 1.827–4.699, <i>p</i> &lt; 0.001), and eye movement disorder (OR = 2.815, 95<i>%</i>CI = 1.672–4.741, <i>p</i> &lt; 0.001) were independent predictive factors of a favorable prognosis of MG. These predictors were used to generate a nomogram with an excellent predictive value. <i>Conclusions</i>. Being female and the presence of AChR-Ab were features of ANA- or anti-dsDNA-positive MG. The presence of anti-dsDNA was associated with a favorable prognosis of MG.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8939083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47055051","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":"What Effects Can Expressive Writing Have on Sexual Dysfunction in Women with Multiple Sclerosis? A Randomized Controlled Trial","authors":"Bahare Afshar,&nbsp;Leila Amini,&nbsp;Seyed Massood Nabavi,&nbsp;Maryam Hasani,&nbsp;Mahshad Mohammadnoori,&nbsp;Shayesteh Jahanfar,&nbsp;Amirhossein Sahebkar","doi":"10.1155/2023/6754178","DOIUrl":"10.1155/2023/6754178","url":null,"abstract":"<div>\u0000 <p><i>Background.</i> Sexual dysfunction is a common complication in women with multiple sclerosis due to limitation in physical and mental functioning. Expressive writing as a psychological intervention can significantly improve sexual dysfunction in women with other diseases. <i>Aim.</i> The aim of the current study was to determine the effect of expressive writing on sexual dysfunction in Iranian women with multiple sclerosis. <i>Methods.</i> A randomized controlled trial with a Solomon four-group design was conducted on 116 Iranian women with MS in February 2021. Participants were randomly assigned into two control subgroups of A₁ (without pretest) and A₂ (with pretest) and two intervention subgroups of B₁ (without pretest) and B₂ (with pretest). Expressive writing was conducted for six weeks at home including morning pages (writing three pages about everything that comes to mind everyday), date with inner child (once a week), and performing weekly creative assignments. Sexual dysfunction was assessed using MSISQ-19 before the intervention in two groups of A₂ and B₂ and follows in immediately, four weeks and eight weeks after the intervention in all subgroups. The control group was provided with routine care of treatment. Data were analyzed using the intention to treat method. <i>P</i> &lt; 0.05 was considered significant. <i>Results.</i> Twenty-nine women were analyzed in each subgroup. Although expressive writing had a positive and significant effect on primary, tertiary, and overall sexual dysfunction in B₂ intervention subgroup compared with A₂ control subgroup (<i>P</i> ≤ 0.001), it could not improve secondary sexual dysfunction. Since tertiary sexual dysfunction was related to psychological aspects and the present intervention was also a subset of psychotherapy, most of the changes were observed at this level, which included a decrease of 7-8 points. Comparison between the two groups of with and without pretest in each of the control and intervention groups revealed that completing the pretest questionnaire did not have a significant impact on sexual dysfunction score. <i>Conclusion.</i> As a cost-effective and noninvasive intervention, expressive writing can be used along with the main treatment for women suffering from multiple sclerosis to improve sexual dysfunction.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/6754178","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42999286","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":"Verified Parental Cardiovascular Events for Young and Middle-Aged Ischaemic Stroke Patients and Controls","authors":"Solveig Boland,&nbsp;Beenish Nawaz,&nbsp;Halvor Øygarden,&nbsp;Annette Fromm,&nbsp;Halvor Næss,&nbsp;Ulrike Waje-Andreassen","doi":"10.1155/2023/3864506","DOIUrl":"10.1155/2023/3864506","url":null,"abstract":"<div>\u0000 <p><i>Introduction.</i> Nonmodifiable cardiovascular risk factors, like age and sex, are easily quantifiable. Due to immense technical progress in diagnostics and medical data storage, the aim of this study was to quantify, verify, and to compare parental cardiovascular events (CVE) as an additional nonmodifiable risk factor for young and middle-aged ischaemic stroke patients and controls. <i>Methods.</i> Information about parental CVE was first obtained by standardized questionnaires answered by 385 acute ischaemic stroke patients (15-60 years of age) and 260 controls. After consent to contact living and include deceased parents, patients and controls provided necessary personal identification of their parents. Thereafter, CVE were verified by standardized questionnaires answered by parents or medical records in case of deceased parents. <i>Results.</i> One hundred-and-nine (14.2%) of 770 patient parents vs. 128 (24.6%) of 520 control parents were not available for verification. Active participation was obtained for 229 (73.9%) of 310 patient parents vs.113 (58.2%) of 194 control parents. Medical record verification was obtained for 192 (54.7%) of 351 deceased patient parents, vs.103 (52.0%) of 198 deceased control parents. This study showed highest death rates of fathers (65.3% patient fathers and 57.6% control fathers) and highest numbers of CVE, especially myocardial infarction among patient fathers of patients aged 50-60 years. <i>Discussion and Conclusion.</i> Obtaining verified parental CVE as a nonmodifiable risk factor is still challenging, despite widely available digital medical information. To attain more accurate information on parental CVE, we recommend active involvement of family members in addition to medical record verification, especially for patients aged &lt;50 years. <i>Trial Registration.</i> This trial is registered with NCT01597453</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/3864506","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45904216","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":"Immunological, Clinical, and Epidemiological Features of Guillain-Barré Syndrome Associated with SARS-CoV-2 Infection","authors":"Juan Luis Restrepo-Vera,&nbsp;Arnau Llauradó,&nbsp;Antoni Palasí,&nbsp;Victoria González-Martínez,&nbsp;Margarida Gratacòs,&nbsp;Maria Salvadó,&nbsp;Daniel Sánchez-Tejerina,&nbsp;Javier Sotoca,&nbsp;Núria Raguer,&nbsp;Raul Juntas-Morales","doi":"10.1155/2023/5380946","DOIUrl":"10.1155/2023/5380946","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. There is a growing interest in understanding the association between Guillain-Barré syndrome (GBS) and SARS-CoV-2 infection. The aim of this study was to analyse various characteristics of GBS before and after the pandemic outbreak and thus identify possible distinctive features of GBS associated with SARS-CoV-2 (GBS-S). <i>Material and Methods</i>. In our centre, we retrospectively reviewed the records of patients diagnosed with GBS between January 2018 and March 2022. Epidemiological, clinical, and immunological data were analysed and compared between patients with GBS according to the time of diagnosis and antecedent events. <i>Results</i>. Thirty-nine patients with GBS were included: nine (23.1%) were diagnosed with GBS-S. GBS-S was most frequent in 2020 (6/13, 46.1%). Most of these patients developed a postinfectious classic demyelinating variant (4/9, 44.4%) with frequent bilateral facial paralysis (4/9, 44.4%). Serum antiganglioside antibodies (AGAs) were found in 1/9 patients with GBS-S. Serum anti-SSA/Ro60 antibodies were highly prevalent in GBS-S (7/9 (77.8%) vs. 3/11 (27.3%), <i>p</i> = 0.019). Three cases associated with SARS-CoV-2 vaccination (GBS-V) were detected. Of note, two had bilateral facial paralysis and anti-SSA/Ro60 antibodies. <i>Conclusion</i>. Our findings suggest that SARS-CoV-2 has become an important antecedent event associated with GBS in our setting. GBS-S shows a postinfectious demyelinating immune-mediated profile with negative serological testing for AGAs. Serum anti-SSA/Ro60 antibodies were found frequently in these patients. Bilateral facial paralysis stands out as a possible characteristic clinical feature both in GBS-S and GBS-V. Larger, prospective studies are needed for a better understanding of its immunopathogenesis.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5380946","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48660420","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":"Prognosis and Outcome of Cerebral Sinus Venous Thrombosis—A Multicenter Cohort Study","authors":"Naaem Simaan,&nbsp;Asaf Honig,&nbsp;Hen Hallevi,&nbsp;Estelle Seyman,&nbsp;Ofer Rotschild,&nbsp;Einor Ben Assayag,&nbsp;Andrei Filioglo,&nbsp;Shlomi Peretz,&nbsp;Rom Mendel,&nbsp;Rani Barnea,&nbsp;Eitan Auriel,&nbsp;Shorooq Aladdin,&nbsp;David Orion,&nbsp;Khalil Darawsha,&nbsp;Fadi Shbat,&nbsp;Ronen R. Leker,&nbsp;Jeremy Molad","doi":"10.1155/2023/8016006","DOIUrl":"10.1155/2023/8016006","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. Cerebral sinus venous thrombosis (CSVT) is a rare stroke subtype and data regarding prognostic factors to predict outcomes are lacking. Thus, we aimed to identify predictors for outcome among CSVT patients. <i>Materials and Methods</i>. Prospective CSVT databases from four academic medical centers were retrospectively studied. Demographics, clinical presentations, risk factors, radiological, and outcome parameters were compared. <i>Results</i>. Out of 508 patients diagnosed with CSVT, 21 patients (4%) died, and 91 (18.6%) had unfavorable outcome (mRS ≥ 2). Age (55.0 vs. 38.5, <i>p</i> &lt; 0.001), hypertension (26% vs. 6%, <i>p</i> &lt; 0.001), hyperlipidemia (23% vs. 6%, <i>p</i> &lt; 0.001), diabetes (17% vs. 4%, <i>p</i> &lt; 0.001), malignancy (35% vs. 11%, <i>p</i> &lt; 0.001), absence of headache (51% vs. 78%, <i>p</i> &lt; 0.001), focal neurological deficit (54% vs. 19%, <i>p</i> &lt; 0.001), and ICH (28% vs. 13%, <i>p</i> &lt; 0.001) were all associated with unfavorable outcome. After multivariate analysis malignancy (OR 4.2, <i>p</i> = 0.003), the presence of focal neurological deficit (OR 5.2, <i>p</i> &lt; 0.001) and the presence of headache upon presentation (OR 0.334, <i>p</i> = 0.018) remained significant predictors for favorable outcome. <i>Conclusions</i>. Among CSVT patients, malignancy, focal neurological deficits, and absence of headache at presentation were associated with unfavorable outcomes.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8016006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42518019","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":"Serum Markers of Neuronal Damage and Astrocyte Activity in Patients with Chronic Epilepsy: Elevated Levels of Glial Fibrillary Acidic Protein","authors":"Monika Mochol,&nbsp;Erik Taubøll,&nbsp;Pål Aukrust,&nbsp;Thor Ueland,&nbsp;Ole A. Andreassen,&nbsp;Sigrid Svalheim","doi":"10.1155/2023/7246373","DOIUrl":"10.1155/2023/7246373","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. Blood-brain barrier (BBB) dysfunction is one of the key pathogenic mechanisms in the development of epilepsy. There is therefore an increasing need to identify BBB biomarkers as these will have prognostic and therapeutic implications. The purpose of this study was to assess the levels of the BBB permeability markers, glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), S100B, and furin in patients with stable epilepsy compared with the levels in healthy controls. <i>Materials and Methods</i>. This cross-sectional study included 119 epilepsy patients and 80 healthy controls. Circulating levels of GFAP, NSE, S100B, and furin were measured and questionnaires regarding epilepsy, use of drugs, and comorbidities were completed by all participants. <i>Results</i>. GFAP levels were higher in epilepsy patients after adjustment for potential confounders (sex, age, and BMI) in linear regression (<i>p</i> = 0.042). No significant differences were found in levels of S100B, NSE, or furin. None of the markers were significantly associated with epilepsy duration, seizure type or severity, or seizures in the preceding six months. The majority of the patients (79.7%) did not report seizures within the last 6 months. <i>Conclusion</i>. Our main finding is elevated serum levels of GFAP in epilepsy patients. The results may suggest the presence of astrocyte activation in our patient population with stable epilepsy. Future prospective studies focusing on the longitudinal relationship between epilepsy debut, seizures, and time of blood sampling for BBB markers, also within CSF, could provide valuable knowledge including regarding novel treatment options. The study registration number is 2011/1096, 2018/1437.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/7246373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49569621","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":"Perampanel Monotherapy for Focal and Generalized Epilepsy in Clinical Practice","authors":"Yotin Chinvarun,&nbsp;Rafael Toledano Delgado,&nbsp;Alexandra Astner-Rohracher,&nbsp;Tim Wehner,&nbsp;Manuel Toledo,&nbsp;Sara Matricardi,&nbsp;Eugen Trinka,&nbsp;Manoj Malhotra,&nbsp;Oliver Shastri,&nbsp;Vicente Villanueva","doi":"10.1155/2023/2852853","DOIUrl":"10.1155/2023/2852853","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. To investigate the effectiveness, safety, and tolerability of perampanel (PER) when used as monotherapy to treat focal or generalized epilepsy in everyday clinical practice, using data from the PERMIT study. <i>Methods</i>. PERMIT was a pooled analysis of 44 real-world studies from 17 countries, in which people with focal and generalized epilepsy were treated with PER. This post hoc analysis included people with epilepsy (PWE) from PERMIT who were treated with PER monotherapy at baseline. Retention and effectiveness were assessed after 3, 6, and 12 months. Effectiveness assessments included ≥50% responder rate and seizure freedom rate (no seizures since at least the prior visit). Safety and tolerability were assessed by evaluating adverse events (AEs) and discontinuation due to AEs. <i>Results</i>. Overall, 268 PWE were treated with PER monotherapy at baseline. Retention was assessed for 168 PWE, effectiveness for 183 PWE, and safety and tolerability for 197 PWE. Retention rates were 91.1%, 87.3%, and 73.3% at 3, 6, and 12 months, respectively. At 12 months, responder rates were 84.2% overall, 82.9% in PWE with only focal-onset seizures at baseline, and 88.0% in those with only generalized-onset seizures at baseline; corresponding freedom rates were 62.9%, 57.7%, and 80.0%, respectively. AEs were reported for 45.2% of PWE. The most frequently reported AEs (≥5% of PWE) were dizziness/vertigo (16.8%), irritability (11.2%), somnolence (9.1%), and depression (6.6%). Over 12 months, 13.7% discontinued due to AEs. <i>Conclusions</i>. PER was effective when used as monotherapy in clinical practice, particularly in those with generalized-onset seizures, and was generally well tolerated.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/2852853","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41266981","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":"Mutation Screening of MED27 in a Large Dystonia Cohort","authors":"Junyu Lin,&nbsp;Chunyu Li,&nbsp;Yanbing Hou,&nbsp;Lingyu Zhang,&nbsp;Ruwei Ou,&nbsp;Qianqian Wei,&nbsp;Kuncheng Liu,&nbsp;Yi Xiao,&nbsp;Qirui Jiang,&nbsp;Huifang Shang","doi":"10.1155/2023/4967173","DOIUrl":"10.1155/2023/4967173","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. Recently, biallelic variants in <i>MED27</i> have been identified to correlate with complex dystonia. However, no replicative study has been conducted in larger dystonia cohorts. In this study, we aimed to systematically evaluate the genetic associations of <i>MED27</i> with dystonia in a large dystonia cohort. <i>Materials and Methods</i>. We analyzed rare variants (minor allele frequency &lt; 0.01) of <i>MED27</i> in a large Chinese dystonia cohort with whole exome sequencing. The overrepresentation of rare variants in patients was examined with Fisher’s exact test at allele and gene levels. <i>Results</i>. A total of 688 patients with dystonia were included in the study, including 483 isolated dystonia, 133 combined dystonia, and 72 complex dystonia. The average age at onset (SD) was 34.3 (19.1) years old. After applying filtering criteria, five rare variants, namely, p.R247H, p.P174A, p.P123A, p.L120F, and p.F56C, were identified in six individuals. All of them carried the variant in the heterozygous form, and no patients with compound heterozygous or homozygous alleles were identified. At allele level, no variant was associated with risk of dystonia. Gene-based burden analysis did not detect enrichment of rare variants of <i>MED27</i> in dystonia either<i>. Conclusion</i>. Variants of <i>MED27</i> were rare in Chinese dystonia patients, probably because that mutations in <i>MED27</i> are more associated with more complex neurodevelopmental disorders that can also include dystonia among the various neurological features. Further studies are needed to confirm the role of <i>MED27</i> in dystonia and other neurological disorders.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/4967173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46130269","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":"Advances in sudden unexpected death in epilepsy","authors":"Haiting Zhao,&nbsp;Lili Long,&nbsp;Bo Xiao","doi":"10.1111/ane.13715","DOIUrl":"10.1111/ane.13715","url":null,"abstract":"<p>Sudden unexpected death in epilepsy (SUDEP) is the major cause of premature death in epilepsy patients, particularly those with refractory epilepsy. Sudden unexpected death in epilepsy is thought to be related to peri-ictal cardiac dysfunction, respiratory depression, and autonomic dysfunction, albeit the exact etiology is unknown. Sudden unexpected death in epilepsy prevention remains a huge challenge. The sole presence and frequency of generalized tonic–clonic seizures (GTCS) are the most important risk factors for SUDEP, and nocturnal monitoring may lower the risk with the use of remote listening devices. In addition, studies in animal models of SUDEP have discovered that multiple neurotransmitters, including serotonin (5-HT) and adenosine, may be involved in the pathophysiological mechanisms of SUDEP and that these neurotransmitters could be the targets of future pharmacological intervention for SUDEP. The latest research findings on the epidemiology, clinical risk factors, and probable causes of SUDEP are presented in this review.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"146 6","pages":"716-722"},"PeriodicalIF":3.5,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40458624","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":"Non-convulsive seizures and non-convulsive status epilepticus in neuro-intensive care unit","authors":"Xuan Wang,&nbsp;Fang Yang,&nbsp;Beibei Chen,&nbsp;Wen Jiang","doi":"10.1111/ane.13718","DOIUrl":"10.1111/ane.13718","url":null,"abstract":"<p>Most seizures in critical ill patients are non-convulsive, and some patients may develop non-convulsive status epilepticus (NCSE), a state of continuous or repetitive seizures without convulsions. With the growing use of continuous electroencephalogram (EEG) monitoring in neuro-intensive care units, non-convulsive seizure (NCS) and NCSE are increasingly diagnosed in patients with impaired consciousness, and progress has been made in identifying various EEG characteristics of NCS/NCSE. Epidemiological studies have contributed to a better understanding of etiologies and risk factors for NCS and NCSE. However, sufficient clinical trials about the treatment of NCS and NCSE are still lacking. The appropriate level of aggressiveness in the treatment of NCSE is still debated, particularly with regard to the use of anesthetics in patients with refractory NCSE. In this review, we summarize the EEG, clinical, epidemiological, diagnostic and therapeutic knowledge of NCS and NCSE in the neuro-intensive care setting in detail.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"146 6","pages":"752-760"},"PeriodicalIF":3.5,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46984142","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}