Journal of epilepsy最新文献

{"title":"Unprovoked Seizures and Epilepsies in Kurayoshi, Japan","authors":"Masahiko Kimura ,&nbsp;Kunio Yoshino ,&nbsp;Eiji Nanba ,&nbsp;Atsushi Ieshima ,&nbsp;Sakae Narai ,&nbsp;Kenzo Takeshita","doi":"10.1016/S0896-6974(98)00007-3","DOIUrl":"10.1016/S0896-6974(98)00007-3","url":null,"abstract":"<div><p>We studied the prevalence and clinical courses of patients with unprovoked seizures aged 0–14 years in Kurayoshi, Japan, from January 1–December 31, 1993. We reviewed the medical records of four hospitals, which covered most of the pediatric patients with neurologic problems in the area. The number of patients who received any form of medical care due to unprovoked seizures was 86 (4.61/1000). Of the 60 patients in whom it was more than 2 years from the onset, 49 (82%) had been seizure-free for more than 1 year. Eleven of the 86 patients did not become seizure-free despite more than 2 years of antiepileptic drug (AED) treatment, and nine of these 11 patients had neurologic abnormalities. The number of patients with idiopathic or cryptogenic epilepsies and unprovoked seizures was 49. Of the 33 patients who underwent more than 2 years of treatment, all except one had been seizure-free for more than 1 year. Seven children were of unclassified epilepsies characterized by normal interictal electroencephalogram (EEG) findings, generalized clinical seizures, no underlying neurologic condition, and an early age of onset (i.e., before 4 years of age). Therefore, there could be benign epileptic syndromes in the first 4 years.</p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 3","pages":"Pages 162-167"},"PeriodicalIF":0.0,"publicationDate":"1998-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(98)00007-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56293728","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":"Evaluation of Gabapentin in an Outpatient and Office-based Sample of Epilepsy Patients","authors":"Cynthia L Harden ,&nbsp;Syed Hosain ,&nbsp;Blagovest Nikolov ,&nbsp;Douglas R Labar","doi":"10.1016/S0896-6974(97)00140-0","DOIUrl":"10.1016/S0896-6974(97)00140-0","url":null,"abstract":"<div><p>A retrospective analysis of charts of patients who received gabapentin (GBP) as adjunctive anticonvulsant therapy in its first year of marketing, between March 1994 and April 1995 was conducted to evaluate patterns of use, side effects, and efficacy in the general epilepsy population. Ninety patients (45 men, 45 women) with an average age of 33.5 years (range: 7 months–78 years) were included. Average GBP dosage was 1700 mg/day; 46 patients took &lt;1800 mg, and 44 patients took ⩾1800 mg/day. Duration of GBP treatment ranged from 1 month–14 months. Patients took an average of 1.7 concurrent antiepileptic drugs while on GBP. A total of 13 patients were on GBP monotherapy, four at the outset joined by nine others during the study. Gabapentin was associated with improvement as assessed by reduction of seizure frequency in 69 patients (77%). Sixty patients (67%) who reported no side effects had a mean GBP dosage of 1900 mg/day (median: 2000 mg/day). The 30 patients who experienced side effects had a mean GBP dosage of 1600 mg/day (median: 1500 mg/day). Gabapentin was discontinued in 21 patients, six because of side effects, nine because of lack of efficacy, and six because of a combination of both. Gabapentin was used in more difficult patients with intractable epilepsy and was generally well tolerated. Higher doses were not associated with more side effects, suggesting that GBP-related side effects may not be dose-related.</p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 3","pages":"Pages 130-135"},"PeriodicalIF":0.0,"publicationDate":"1998-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(97)00140-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56293067","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":"Dramatic Effect of Lamotrigine in Young Adults Suffering from Intractable Absences and Generalized Tonic–Clonic Seizures Since Childhood","authors":"Tally Lerman-Sagie ,&nbsp;Pinchas Lerman","doi":"10.1016/S0896-6974(97)00133-3","DOIUrl":"10.1016/S0896-6974(97)00133-3","url":null,"abstract":"<div><p><span>The purpose of this study was to evaluate the efficacy of adding lamotrigine to </span>valproic acid<span> in patients with refractory absence seizures starting in childhood and persisting into adulthood. Lamotrigine was added to previous anticonvulsants (always including valproic acid) in 10 patients aged 23–44 years, with intractable absence and generalized tonic–clonic seizures. Seven patients became seizure free, three patients had &gt; 75% reduction in seizure frequency. The patients have remained on comedication with valproic acid and lamotrigine, after gradually discontinuing most other anticonvulsants, for a follow-up period ranging from 1–4 years. There has been no increase in seizure frequency during this period. None of the patients reported any side effects. This study supports the growing evidence of therapeutic synergy between lamotrigine and valproic acid. This combination may be the therapy of choice for refractory absence and generalized tonic–clonic seizures both in children and adults.</span></p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 3","pages":"Pages 148-151"},"PeriodicalIF":0.0,"publicationDate":"1998-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(97)00133-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56292414","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":"Nonconvulsive Status Epilepticus in the Elderly: A Case Series and a Review of the Literature","authors":"Douglas Labar ,&nbsp;Juan Barrera ,&nbsp;Gail Solomon ,&nbsp;Cynthia Harden","doi":"10.1016/S0896-6974(97)00134-5","DOIUrl":"10.1016/S0896-6974(97)00134-5","url":null,"abstract":"<div><p><span>Because of age related etiologies and complications, nonconvulsive status epilepticus (NCSE) may have a different prognosis in the elderly than in the young. We prospectively studied clinical characteristics and outcomes of 10 patients over age 65 years with NCSE. All underwent continuous video-electroencephalogram monitoring. Patients’ ages ranged between 65 and 95 years (mean = 80). Three patients had complex partial status epilepticus (CPSE), seven had complex partial and secondarily generalized NCSE, and none had primary generalized NCSE. Causes of NCSE were: stroke (four), metabolic derangement (two), brain neoplasia (one), </span>head injury<span> (one), electroconvulsive therapy<span> (one), and preexisting epilepsy (one). One patient with hyponatremia and one patient with a previous seizure disorder recovered. Five patients were discharged with new neurologic deficits due to underlying processes; four of these patients also had infectious complications during hospitalization. Three patients died, all due to infectious complications. We conclude that NCSE in the elderly is associated with a poor prognosis, because of underlying causative processes and medical complications.</span></span></p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 2","pages":"Pages 74-78"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(97)00134-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56292456","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":"Postictal SPECT in Epileptic Versus Nonepileptic Seizures","authors":"Alan B Ettinger ,&nbsp;Patricia K Coyle ,&nbsp;Lina Jandorf ,&nbsp;Cora J Cabahug ,&nbsp;Zvi H Oster ,&nbsp;Harold L Atkins ,&nbsp;Deborah M Weisbrot ,&nbsp;Orrin Devinsky","doi":"10.1016/S0896-6974(97)00112-6","DOIUrl":"10.1016/S0896-6974(97)00112-6","url":null,"abstract":"<div><p>Despite advances in video-electroencephalogram (EEG) technology, in many patients distinguishing epileptic seizures from nonepileptic seizures (NES) remains a challenge. Reliable methods to make this distinction are needed. In a pilot study, we performed postictal and interictal single photon emission computed tomography (SPECT) in 22 patients undergoing video-EEG monitoring who had altered responsiveness during an episode. Eleven had seizures, defined as episodes associated with EEG seizure patterns or postictal prolactin (PRL) elevations greater than 1.5 times the highest interictal baseline PRL; 11 had NES. Among the 11 seizures, postictal SPECT was abnormal in seven (regions of hypoperfusion in six and hyperperfusion in one) and normal in four. In six cases (55%), the interictal and postictal SPECT changed. Among the 11 NES cases, postictal SPECT was abnormal in three cases (all hypoperfusion abnormalities) and normal in eight cases. In no case did the interictal and postictal SPECT change. This small sample revealed a trend toward greater hypometabolism (postictal versus interictal) on SPECT for epileptic seizures compared to NES (<em>p</em> &lt; 0.12). There were postictal SPECT changes in two of five seizures unassociated with postictal PRL elevation. Prolactin was elevated in two cases unassociated with change on SPECT. Comparision of postictal to interictal SPECT may help distinguish epileptic seizures from NES. Results from SPECT may also help identify epileptic seizures unassociated with PRL elevation.</p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 2","pages":"Pages 67-73"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(97)00112-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56292169","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":"Quality of Life in Epilepsy: Multidimensional Profile and Underlying Latent Dimensions","authors":"Theo P.B.M Suurmeijer ,&nbsp;Marieke F Reuvekamp ,&nbsp;Bert P Aldenkamp ,&nbsp;Jan Overweg ,&nbsp;On Gie Sie","doi":"10.1016/S0896-6974(97)00141-2","DOIUrl":"10.1016/S0896-6974(97)00141-2","url":null,"abstract":"<div><p>Part of our study, the <strong><em>Du</em></strong>tch <strong><em>Q</em></strong>uality of Life and <strong><em>Q</em></strong>uality of Care <strong><em>I</em></strong>nvestigation in <strong><em>E</em></strong>pilepsy (<em>DUQQIE</em>), intended to cover several of the components of the quality of life (QoL) concept. To this end, a series of already existing generic and disease-specific instruments was selected covering several parts of the QoL components in order to construct a multidimensional “QoL profile” for people with epilepsy and to look for underlying second-order QoL dimensions. From the records of four outpatient clinics, 210 persons with epilepsy were randomly selected. During their visit to the outpatient clinic, they completed a questionnaire assessing, among others, health perceptions, psychological well-being, and social functioning. Additional information about their medical and psycho–social status was gathered from the patient files. A large part of our research group was not seizure-free. As far as comparisons with other patient or healthy groups could be made, it appeared that they mostly did not (much) worse and all scores were above the scale midpoint. However, almost two-thirds of the scale means lied below a so-called “normative mean.” Higher-order factor analysis yielded one general factor measuring the “Overall Quality of Life.” Furthermore, after rotation of this general factor, two separate factors could be constructed referring to the psycho–physical and psycho–social aspects of QoL, respectively. We decided not to develop “quality of life instrument” de novo to the already vast and ever increasing area of QoL instruments, but to use already existing, mostly generic, and well-validated instruments. The most important advantage of this approach is that it allows for “normative controls” (norms; other groups) and “conceptual modeling.” The latter is that the QoL concept can be unfolded into its component parts and hypothetically related to each other.</p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 2","pages":"Pages 84-97"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(97)00141-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56293085","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":"Patients with Epilepsy and Psychosis Treated with Vigabatrin","authors":"Michael Trimble","doi":"10.1016/S0896-6974(97)00106-0","DOIUrl":"10.1016/S0896-6974(97)00106-0","url":null,"abstract":"<div><p>Eight patients with difficult to control epilepsy and an active or a history of psychosis were treated with vigabatrin<span><span>, and the results of this clinical intervention are described. In five cases there was no untoward deterioration of the mental state, in three cases a change was reversed by judicious adjustment of both the anticonvulsant and </span>psychotropic medications. Recommendations for the use of new anticonvulsants in patients with comorbid psychopathology and epilepsy are given.</span></p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 2","pages":"Pages 61-66"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(97)00106-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56291675","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":"Fatigue and Depression in Epilepsy","authors":"Alan B Ettinger ,&nbsp;Deborah M Weisbrot ,&nbsp;Lauren B Krupp ,&nbsp;Patricia K Coyle ,&nbsp;Lina Jandorf ,&nbsp;Orrin Devinsky","doi":"10.1016/S0896-6974(97)00139-4","DOIUrl":"10.1016/S0896-6974(97)00139-4","url":null,"abstract":"<div><p>Fatigue is commonly reported as an adverse effect of antiepileptic drugs. In other disorders, fatigue has been closely correlated with depression. We examined the frequency of fatigue in epilepsy patients, the contribution of depression to fatigue, and the impact of fatigue upon quality of life. We measured fatigue and depression with the Fatigue Severity Scale (FSS) and Center for Epidemiological Studies-Depression scale (CES-D), respectively in 89 patients with epilepsy at an epilepsy center, 26 depressed controls (DC), and 30 normal health adults (NHA). Patients with epilepsy also completed the Quality of Life in Epilepsy (QOLIE-10) scale. Forty-four percent of epilepsy patients met criteria for severe fatigue, while 52% were depressed. The correlation between fatigue and depression was high among epilepsy patients (<em>r</em> = .60, <em>p</em> = .0001). Both fatigue and depression had an inverse relationship with quality of life in epilepsy (<em>p</em> &lt; .0001). Fatigue in epilepsy is common and is closely associated with depression. Fatigue is associated with significant impairment in quality of life in epilepsy.</p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 2","pages":"Pages 105-109"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(97)00139-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56292808","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":"Estimation of Epileptic Foci Using the Dipole Tracing Method in Epileptic Seizures with Structural Lesions of the Brain","authors":"Nobuyoshi Shibata ,&nbsp;Fumio Kubota ,&nbsp;Yukiteru Machiyama ,&nbsp;Akio Takahashi ,&nbsp;Keiichi Miyamoto","doi":"10.1016/S0896-6974(97)00132-1","DOIUrl":"10.1016/S0896-6974(97)00132-1","url":null,"abstract":"<div><p><span>We estimated the position of the epileptic focus using the dipole tracing method (DTM) in three patients with </span>epileptic seizures<span><span> and structural lesions, and made comparisons between the foci and their lesions. Patient 1 had a large arachnoid cyst<span><span> in the right temporal lobe<span>, patient 2 had a tumor in the right hippocampus, and patient 3 had a tumor in the right </span></span>amygdala<span>. In patient 1, the epileptic focus was estimated to lie in the lateral portion of the right temporal lobe just outside the cyst; in patient 2, in the right hippocampus just under the tumor; and in patient 3, one in the right hippocampus just behind the tumor, another in the right superior temporal gyrus (rSTG). Except for the focus of patient 3 on rSTG, the epileptic foci in all three patients were estimated to lie near the lesions. These estimations correlated with past reports that most foci of seizures caused by </span></span></span>brain lesions<span> were located near the lesions. The results of ECoGs in patient 3 were in close correlation with those of DTM. Therefore, we conclude that DTM is a highly accurate method in the estimation of the foci in patients with brain lesions associated with epileptic seizures.</span></span></p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 2","pages":"Pages 98-104"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(97)00132-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56292378","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":"Features of Leao’s Spreading Depression in Patients with Lesions Near Sensory Cortex","authors":"Jeffrey A Loeb","doi":"10.1016/S0896-6974(97)00136-9","DOIUrl":"10.1016/S0896-6974(97)00136-9","url":null,"abstract":"<div><p>Although it has been produced experimentally only in animal models, Leao’s spreading depression<span><span> has been postulated as the basis for the slowly expanding scintillating scotoma of </span>migraine aura<span>, but has never been directly observed in human cortex. In the present report, two patients with lesions near somatosensory cortex are described who developed episodes of slowly spreading numbness reminiscent of migraine aura. Quantitative comparison was made between these symptoms and experimental models of Leao’s spreading depression. The rate of spread, duration, and characteristics of the sensory deficits suggested that cortical spreading depression underlies the pathophysiology<span> of these episodes. Even though their symptoms more resembled those described in migraine than in epilepsy, anticonvulsant medication prevented further episodes in both patients. These two cases provide further, albeit indirect evidence for the existence of spreading depression in human cortex. Clinical criteria are suggested to differentiate the symptoms of migraine aura and epilepsy in the sensory cortex.</span></span></span></p></div>","PeriodicalId":81656,"journal":{"name":"Journal of epilepsy","volume":"11 2","pages":"Pages 110-115"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0896-6974(97)00136-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56292588","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}