Journal of epilepsy最新文献

{"title":"Quality of life in patients with idiopathic, generalized epilepsy","authors":"Birgit Petersen,&nbsp;Margaret L. Walker,&nbsp;Uwe Runge,&nbsp;Christof Kessler","doi":"10.1016/S0896-6974(98)00035-8","DOIUrl":"10.1016/S0896-6974(98)00035-8","url":null,"abstract":"<div><p>The quality of life (QOL) in patients with idiopathic, generalized epilepsy (IGE) was assessed in 48 patients using the Quality of Life in Epilepsy inventory (QOLIE). Eleven recently diagnosed IGE patients (short-terms) were tested at 0 and 4 weeks, and at 6 months following initial diagnosis and treatment with sodium valproate. These patients were compared to 18 IGE patients who had been taking valproate for more than 1 year (long-terms) and to 19 normal controls. Both groups of IGE patients also were administered the A-B Neurotoxicity Scale and Liverpool Seizure Severity Scale. Recently diagnosed patients scored significantly lower than controls and long-terms on the following QOLIE subscales: work/driving/social function, health discouragement, seizure worry, medication effects, change in health, and overall health. Only with regard to the role limitation-physical subscale did both IGE groups score significantly more poorly than controls. The overall QOL score was significantly different among groups, with the controls scoring highest and the short-terms lowest. Short-terms reported significantly less seizure-associated distress on the Seizure Severity Scale at 4 weeks as compared to the initial test at 0 weeks. This effect was evident for both perceived control of major seizures and severity of postictal events. Seventy percent of short-terms were seizure-free by 4 weeks following initial diagnosis and treatment. The QOL was inversely correlated with both seizure severity and neurotoxicity scores. Taken together, these data indicate that QOL is significantly poorer in recently diagnosed patients than in patients with long-term epilepsy. Moreover, on most indices of QOL, long-term patients did not differ significantly from normal controls, indicating that the postdiagnosis decline in QOL is transient. These findings suggest that QOL in patients with IGE, changes throughout the course of the illness, and that following treatment with valproate, successful seizure control and restored QOL is possible.</p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 6","pages":"Pages 306-313"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(98)00035-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56295577","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":"","authors":"M.D. Douglas O. Lee","doi":"10.1016/S0896-6974(97)00126-6","DOIUrl":"10.1016/S0896-6974(97)00126-6","url":null,"abstract":"","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 6","pages":"Pages 390-391"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(97)00126-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56292306","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":"Minimally-invasive endovascular occlusion therapy in two adults for seizures associated with congenital porencephalic cysts","authors":"Jack Phillips ,&nbsp;Gareth Roberts ,&nbsp;Paul Brennan ,&nbsp;Hugh Staunton","doi":"10.1016/S0896-6974(98)00042-5","DOIUrl":"10.1016/S0896-6974(98)00042-5","url":null,"abstract":"<div><p>Hemispherectomy is currently the surgical treatment of choice for intractable seizures associated with large, unilateral hemisphere porencephalic cysts and a neurologic deficit. We present an alternative minimally-invasive approach using permanent endovascular balloon occlusion in two patients who would otherwise have proceeded directly to hemispherectomy. Clinical, electroencephalogram (EEG), and neuroimaging findings implicated the damaged hemisphere as the source of the seizures in both cases. Under sedation, the distal internal carotid artery was embolized in the first patient and the middle cerebral artery in the second. A significant reduction in seizure frequency occurred postocclusion in both patients and one patient, to date, has not required hemispherectomy. This improvement was correlated with postocclusion EEG and neuroimaging changes. Permanent endovascular balloon occlusion may be a minimally-invasive alternative to resectional surgery or first stage procedure in this special group of patients. Application to a greater number of patients and long-term follow-up is required to demonstrate whether endovascular occlusion is a safe beneficial therapy for regional or focal epilepsies.</p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 6","pages":"Pages 374-382"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(98)00042-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56295841","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":"","authors":"M.D. Gregory L. Holmes","doi":"10.1016/S0896-6974(97)00130-8","DOIUrl":"10.1016/S0896-6974(97)00130-8","url":null,"abstract":"","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 6","pages":"Pages 391-392"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(97)00130-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"104017007","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":"Patient reporting of seizure exacerbation near the time of menses helps distinguish epileptic from nonepileptic seizures","authors":"Alan B. Ettinger ,&nbsp;Deborah M. Weisbrot ,&nbsp;Orrin Devinsky","doi":"10.1016/S0896-6974(98)00039-5","DOIUrl":"10.1016/S0896-6974(98)00039-5","url":null,"abstract":"<div><p>The purpose of this study was to determine whether patient reporting of a relationship between seizure exacerbation and menses helps distinguish premenopausal women with epileptic seizures from those with nonepileptic seizures (NES). We reviewed the responses to the question “What tends to bring on your seizures?”, administered during the initial evaluation of women ages 18–45 years with epileptic seizures (<em>n</em> = 27) and NES (<em>n</em> = 38) at our outpatient clinic. Only one out of 38 women with NES versus 13 of 27 women with epilepsy reported a relationship of seizures with the menstrual cycle (<em>p</em> = .0001). Other precipitants identified for seizure exacerbation such as stress, or emotional upset, did not distinguish these two groups. Patient reporting of a relationship between seizure exacerbation and menses can help distinguish epileptic from NES in premenopausal women.</p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 6","pages":"Pages 332-334"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(98)00039-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56295337","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":"","authors":"M.D. Gregory L. Holmes","doi":"10.1016/S0896-6974(97)00127-8","DOIUrl":"10.1016/S0896-6974(97)00127-8","url":null,"abstract":"","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 6","pages":"Page 390"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(97)00127-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56291847","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":"An audit of the use of vigabatrin in the treatment of medically refractory epilepsy at a presurgical unit","authors":"Stanislaw Kozak ,&nbsp;Wolfgang Russ ,&nbsp;Heinz Gregor Wieser","doi":"10.1016/S0896-6974(98)00033-4","DOIUrl":"10.1016/S0896-6974(98)00033-4","url":null,"abstract":"<div><p>In this retrospective study we examined the use of vigabatrin (VGB) in the presurgical evaluation unit at the Department of Epileptology and Electroencephalography of the University Hospital of Zürich. Vigabatrin had been used in 125 out of 750 difficult-to-treat patients with epilepsy. They received VGB primarily as add-on therapy because of drug-resistance to first-line antiepileptic drugs (AEDs). With a few exceptions, most patients suffered from frequent partial seizures with and without secondary generalization. In 22.4% of patients VGB showed a beneficial long-term effect with &gt; 50% seizure reduction and an additional 5.5% of patients became seizure-free without epilepsy surgery. Most frequent reasons for discontinuation were “no efficacy” and “loss of efficacy” after short-turn improvement, followed by adverse events. Adverse events most frequently observed were weight gain (5%); tiredness (3%); and “confusion, depersonalization, and psychosis” (2%). The year-by-year retention rate for VGB for the 125 patients was 55% after 1 year and 22% after 5 years. These long-term retention rates are lower than those observed in controlled clinical trials. We conclude that the year-by-year retention rate represents a more realistic and most probably the most useful measure for the value of VGB in the long-term management of a difficult-to-treat epilepsy population.</p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 6","pages":"Pages 290-295"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(98)00033-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56295182","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":"Oxcarbazepine in treatment of childhood epilepsy: A survey of 46 children and adolescents","authors":"Peter Borusiak,&nbsp;Elisabeth Korn-Merker,&nbsp;Nils Holert,&nbsp;Hans Erich Boenigk","doi":"10.1016/S0896-6974(98)00041-3","DOIUrl":"10.1016/S0896-6974(98)00041-3","url":null,"abstract":"<div><p>Oxcarbazepine (OCBZ) is one of the new antiepileptic drugs (AEDs) currently available in several countries. While it is rated as having fewer side effects than carbamazepine (CBZ) there has been a paucity of studies in children. We retrospectively reviewed our results in 46 children (26 female, 20 male) with a mean age of 10.3 years (range: 1.3–17.9 years) with a mean duration of the epilepsy of 7.2 years. The patients previously were treated with three to 15 (mean 8.2) other AEDs. The mean dose of OCBZ was 56.7 mg/kg/d (range: 19–123 mg/kg/d); the mean blood serum level of monohydroxy derivative was 29.9 mg/l. The most common comedication was valproic acid. After 1 year follow-up, OCBZ was beneficial in 50%: one child had a seizure reduction of 50%–74%, 18 had a reduction of 75%–99%, and four became seizure free. We were not able to identify any relevant parameter as indicator whether OCBZ will be efficient or not. The spectrum of side effects was similar to that of CBZ. Despite the severity of the epilepsy in our patients, OCBZ was efficacious and safe and is a helpful advancement in the treatment of epilepsies.</p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 6","pages":"Pages 355-360"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(98)00041-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56295824","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":"Continued caregiver burden: Seizure-free may not equal burden-free","authors":"Angela Bollich Lane,&nbsp;Duane E. Dede,&nbsp;Sapna P. Chandra,&nbsp;Robin Gilmore","doi":"10.1016/S0896-6974(98)00026-7","DOIUrl":"10.1016/S0896-6974(98)00026-7","url":null,"abstract":"<div><p>While caregiver burden has been studied in various patient populations, it has not been addressed in caregivers of patients with epilepsy. This study investigated the incidence of perceived caregiver burden in caregivers of patients following surgical treatment for epilepsy, usually temporal lobectomy. The extent to which caregiver and patient variables were related to burden was explored. Data were collected on caregiver depression, caregiver coping skills, the caregiver's evaluation of the patient's functioning, demographic information, and the patient's seizure control for 34 caregiver-patient dyads. The occurrence of significant burden in this population was comparable with the literature for other populations; however, the frequency of item endorsement varied. Regression analysis suggests that depression and patient functioning, separate from seizure control, predicted caregiver burden. The use of emotion-focused coping styles predicted depression. There were no differences in the levels of burden or depression in caregivers over time. Additional research is required to evaluate whether these relationships reflect presurgical functioning or an adjustment to the postsurgical state. Aspects of patient functioning that are important in caregiver burden also need to be clarified. This research may lead to the development of intervention strategies designed to prevent or reduce caregiver burden.</p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 6","pages":"Pages 361-367"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(98)00026-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56294713","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":"Study on the P300 of adult epileptic patients (unmedicated and medicated patients)","authors":"Fumio Kubota ,&nbsp;Akira Kifune ,&nbsp;Nobuyoshi Shibata ,&nbsp;Takushirou Akata ,&nbsp;Kazuo Takeuchi ,&nbsp;Shigeru Takahashi","doi":"10.1016/S0896-6974(98)00040-1","DOIUrl":"10.1016/S0896-6974(98)00040-1","url":null,"abstract":"<div><p>On cognitive function there have been few reports that examined the difference between unmedicated epileptics and normals. There have been relatively few reports in epileptic patients to use P300 (event-related potential) in order to assess cognitive function. We undertook this study to assess cognitive function in adult epileptic patients who were receiving or not receiving drug therapy and to investigate the factors causing their cognitive dysfunction by using P300. The subjects consisted of 46 unmedicated epileptic patients (the unmedicated group), 74 medicated epileptic patients (the medicated group), and 78 healthy subjects (the control group). The oddball paradigm was used in the measurement of P300. There were no significant differences in either latency or amplitude between the unmedicated group and the control group, but the latencies were significantly longer in the medicated group than in the control group. Significant positive correlations were found between the seizure frequency and latency prolongation, the number of drugs and latency prolongation, and the blood concentrations of all antiepileptic drugs (AEDs) administrated and latency prolongation, while no relationships were found with age at onset, duration of illness, or seizure type. These results suggest that the cognitive function of epileptic patients may be impaired by multidrug combination and high doses of AEDs, in addition to the possibility that it is impaired by frequently recurring seizures.</p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 6","pages":"Pages 325-331"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(98)00040-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56295410","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}