Epilepsy & Behavior最新文献

Periconceptional folic acid supplementation for women with epilepsy: A systematic review of the literature 癫痫妇女围产期叶酸补充：文献系统回顾

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2024-09-25 DOI: 10.1016/j.yebeh.2024.110064

Objective

This study aimed to investigate whether folic acid supplementation at normal or high doses could reduce major congenital malformations and improve neurodevelopment in the offspring of women with epilepsy (WWE).

Methods

The MEDLINE, EMBASE, Web of Science, Cochrane Library, and ClinicalTrials.gov databases were searched for observational studies reporting pregnancy outcomes and information about folic acid supplementation in WWE, with a cut-off date of December 5, 2023. Data extraction and synthesis were performed in accordance with the PRISMA guidelines. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. A random-effects meta-analysis was conducted to obtain pooled odds ratios (ORs) and 95% confidence intervals (CI), to estimate the effect of periconceptional folic acid supplementation on pregnancy outcomes in WWE. Sensitivity analyses including only studies with WWE who took anti-seizure medications during pregnancy or studies with a sample size greater than 100 were further performed. This study was registered in PROSPEROID (no. CRD42019141820).

Results

The database search yielded 23 eligible articles. Unexpectedly, the results of subsequent meta-analysis showed that the risk of major congenital malformations was relatively higher in those with periconceptional folic acid supplementation (17463 pregnancies, OR, 1.34; 95 %CI, 1.12–1.6), and was similar between those with and without folic acid supplementation ≧ 4 mg (3822 pregnancies, OR, 0.9; 95 %CI, 0.65–1.24). Results showed that periconceptional folic acid supplementation may be beneficial for neurodevelopment but the evidence was limited.

Conclusions

This systematic review showed no evidence of a beneficial effect of folic acid supplementation in reducing the risk of major congenital malformations, while the relative risk was slightly higher in those receiving periconceptional folic acid supplementation. Nevertheless, folic acid supplementation may improve neurobehavioral outcomes.

方法在MEDLINE、EMBASE、Web of Science、Cochrane Library和ClinicalTrials.gov数据库中检索报告妊娠结局的观察性研究以及有关WWE叶酸补充的信息，截止日期为2023年12月5日。数据提取和综合按照 PRISMA 指南进行。研究的方法学质量采用纽卡斯尔-渥太华量表进行评估。采用随机效应荟萃分析法得出汇总的几率比（ORs）和95%置信区间（CI），以估计围孕期补充叶酸对WWE妊娠结局的影响。敏感性分析仅包括孕期服用抗癫痫药物的 WWE 或样本量大于 100 的研究。本研究已在 PROSPEROID（编号：CRD42019141820）上注册。意外的是，随后的荟萃分析结果显示，围孕期补充叶酸的孕妇发生重大先天性畸形的风险相对较高（17463 例妊娠，OR，1.34；95 %CI，1.12-1.6），而叶酸补充量大于 4 mg 的孕妇和未补充叶酸的孕妇发生重大先天性畸形的风险相似（3822 例妊娠，OR，0.9；95 %CI，0.65-1.24）。结果表明，围孕期补充叶酸可能对神经发育有益，但证据有限。结论该系统综述显示，没有证据表明补充叶酸对降低重大先天性畸形的风险有益，而围孕期补充叶酸的孕妇相对风险略高。不过，补充叶酸可能会改善神经行为的结果。

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引用次数: 0

Experiences of COVID-19 in an Australian community cohort of adults with epilepsy 澳大利亚社区成年癫痫患者队列中的 COVID-19 体验

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2024-09-24 DOI: 10.1016/j.yebeh.2024.110062

A number of studies have been conducted on the effects of the COVID-19 pandemic on people with epilepsy (PWE), some showing increased seizures, poorer psychosocial states, and reductions in Quality of Life (QoL). During the latter stages of COVID-19, well before the UN declared an end to the state of emergency, our study was conducted in Australia of a sample of women and men ≥ 18 years. The study was based on Wave 6 of the Australian Epilepsy Longitudinal Study (AELS). It used mixed methods. Two main scales were used in the study, the QOLIE-31 for QoL and the MOS-8 for social support. The quantitative component of the study looked at QoL in relation to COVID-19 and found no QoL differences in those who contracted the virus. However, there was significantly lower QoL in those having difficulties in seeing a GP, for those with limited access to healthcare, and for those who had problems in gaining ASMs (anti-seizure medicines) and/or other medicines and being unvaccinated. Being younger and living in rental accommodation were most likely significant contributing factors. Those not being vaccinated were less than the proportion in the whole national population., The qualitative component focussed on reasons for being vaccinated or not. Overall, the responses to the question “Were you vaccinated?” demonstrated that people made informed decisions on vaccinations, taking into account their own health as well as protecting family and public health considerations.

关于 COVID-19 大流行对癫痫患者（PWE）的影响，已经开展了多项研究，其中一些研究显示癫痫发作次数增加、社会心理状态恶化以及生活质量（QoL）下降。在 COVID-19 的后期阶段，远在联合国宣布结束紧急状态之前，我们在澳大利亚对年龄≥ 18 岁的女性和男性样本进行了研究。这项研究以澳大利亚癫痫纵向研究（AELS）第 6 波为基础。研究采用了混合方法。研究中使用了两个主要量表：QOLIE-31 量表和 MOS-8 社会支持量表。研究的定量部分考察了与 COVID-19 相关的 QoL，发现感染病毒者的 QoL 没有差异。然而，在看全科医生方面遇到困难的人，在获得医疗服务方面受到限制的人，在获得 ASM（抗癫痫药物）和/或其他药物方面遇到困难的人，以及未接种疫苗的人，其 QoL 明显较低。年轻和租房居住很可能是重要的诱因。未接种疫苗者的比例低于全国人口的比例。总体而言，对 "您是否接种过疫苗？"这一问题的回答表明，人们在接种疫苗时会做出明智的决定，同时考虑到自身健康、保护家庭和公共卫生等因素。

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引用次数: 0

Reading and language profiles among children with epilepsy 癫痫儿童的阅读和语言概况

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2024-09-24 DOI: 10.1016/j.yebeh.2024.110057

This study evaluated the profile of language and reading skills among children with epilepsy. We utilized a sample of children from an epilepsy database who were administered a measure of reading comprehension, excluding those whose intellectual skills were in the impaired range (N=147; age range 4–20 years, 52 % female). Additional measures that were considered within the sample included broad language skills, pre-reading skills (phonological processing, rapid naming, decoding), and basic reading skills (sight word reading, reading fluency). We further considered associations between these skills and seizure characteristics (age of onset, number of anti-seizure medications, seizure type, seizure frequency, and localization). We found that our sample performed significantly lower on all language and reading skills, on average, than normative expectations. Within our sample, relative strengths were noted in broad language skills, and relative weaknesses were found in phonological processing, rapid naming, reading fluency, word reading, and reading comprehension. We further identified a subgroup of our sample (31 %) who were characterized as struggling in reading comprehension (performing one standard deviation below the normative mean); these children exhibited a profile more consistent with non-epilepsy samples with reading disabilities/ dyslexia. Seizure variables that were associated with language and reading skills included age of onset, number of anti-seizure medications, seizure frequency, and having generalized (versus focal) seizures. These results have important implications for the identification and treatment of reading problems in children with epilepsy.

本研究评估了癫痫儿童的语言和阅读能力概况。我们利用癫痫数据库中的儿童样本，对他们进行了阅读理解能力测量，并排除了智力受损的儿童（样本数=147；年龄范围为 4-20 岁，52% 为女性）。在样本中考虑的其他测量包括广泛的语言技能、前阅读技能（语音处理、快速命名、解码）和基本阅读技能（视词阅读、阅读流畅性）。我们进一步考虑了这些技能与癫痫发作特征（发病年龄、服用抗癫痫药物的次数、癫痫发作类型、发作频率和定位）之间的关联。我们发现，我们的样本在所有语言和阅读技能方面的平均表现明显低于常模期望值。在我们的样本中，广泛的语言技能相对较强，而语音处理、快速命名、阅读流畅性、单词阅读和阅读理解能力相对较弱。我们还在样本中发现了一个亚群（31%），他们在阅读理解方面表现挣扎（比常模平均值低一个标准差）；这些儿童的表现与患有阅读障碍/诵读困难的非癫痫样本更为一致。与语言和阅读能力相关的癫痫发作变量包括发病年龄、服用抗癫痫药物的次数、癫痫发作频率以及全身性（相对于局灶性）癫痫发作。这些结果对识别和治疗癫痫儿童的阅读问题具有重要意义。

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引用次数: 0

A roadmap to closing the evidence-to-practice gap in status epilepticus 缩小癫痫状态证据与实践差距的路线图

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2024-09-23 DOI: 10.1016/j.yebeh.2024.110033

Status epilepticus (SE) is a time-sensitive, potentially life-threatening neuro-emergency associated with poor functional outcomes and increased hospital resource utilization especially when it progresses to refractory or super-refractory forms. Timely recognition & treatment improves outcomes, however gaps between recommended and implemented care are common and pervasive.

This review provides a roadmap for incorporating the relatively new field of Implementation Science in promoting the systematic uptake of evidence-based practices into the real-world care of patients with SE. A multifaceted approach − including better integration of real-world implementation and research infrastructure, an emphasis on standardizing and harmonization clinical data, re-examining funding priorities, regulatory reform, and the formation of transdisciplinary teams and learning collaboratives − has the potential to advance the care of patients in SE from its current status quo.

This topic was presented at the 9th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures held in April 2024.

癫痫状态（SE）是一种具有时间敏感性、可能危及生命的神经急症，与不良的功能预后和更多的医院资源使用相关，尤其是当癫痫发展为难治性或超难治性癫痫时。本综述为将相对较新的 "实施科学"（Implementation Science）领域纳入促进将循证实践系统地应用到 SE 患者的实际护理中提供了路线图。多方面的方法--包括更好地整合现实世界中的实施和研究基础设施、强调临床数据的标准化和统一性、重新审查资金的优先次序、监管改革以及组建跨学科团队和学习合作--都有可能从目前的现状出发，推动对 SE 患者的护理。

引用次数: 0

Factors influencing efficacy and relapse of adrenocorticotropic hormone in infantile epileptic spasms syndrome 影响婴儿癫痫痉挛综合征肾上腺皮质激素疗效和复发的因素。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2024-09-22 DOI: 10.1016/j.yebeh.2024.110055

Background

Infantile epileptic spasms syndrome (IESS) is a severe epileptic condition characterized by persistent uncontrolled seizures, with some children experiencing recurrent seizures despite multiple pharmacological therapies. The prognostic risk factors associated with IESS remain unclear. This study aimed to evaluate the factors influencing the efficacy and relapse of adrenocorticotropic hormone (ACTH) treatment for IESS in infants, as well as to assess the correlation between the Burden of Amplitudes and Epileptiform Discharges (BASED) score and clinical outcomes.

Methods

A retrospective analysis was conducted on a cohort of 88 pediatric patients diagnosed with IESS who received ACTH therapy at our hospital from February 2016 to August 2023. Patients were categorized into response (n = 47) and non-response (n = 41) groups based on their treatment response at day 28. Responders were further classified into relapse and non-relapse groups. A modified Poisson regression model and receiver operating characteristic (ROC) curves were employed to evaluate the positive predictive values.

Results

In this study, a total of 47 patients (53.4 %) responded to ACTH treatment. Patients in the response group demonstrated significantly greater reductions in BASED scores by day 14 of ACTH treatment, yielding an area under the curve (AUC) of 0.859 (95 % CI: 0.782–0.937, P＜0.05), with a sensitivity of 68.1 % and a specificity of 95.1 %. The optimal cut-off point was established at ≥ 2, corresponding to a Youden index of 0.632. Notably, patients who were on anti-seizure medications (ASMs) before ACTH treatment and those with developmental delay prior to the onset of spasms exhibited lower short-term response rates (P＜0.05), although these factors did not demonstrate predictive value. Among the responders, 20 cases (42.6 %) experienced a relapse, with only those patients showing specific abnormalities on cranial magnetic resonance imaging (MRI) exhibiting a statistically higher proportion of relapse.

Conclusion

Patients receiving ASMs before ACTH treatment and those with developmental delays prior to the onset of spasms may have a less favorable therapeutic response. A reduction in BASED scores of 2 or greater by day 14 of ACTH treatment may signify a potentially positive treatment response. Additionally, patients with IESS who present with specific abnormalities on cranial MRI may have an increased likelihood of relapse following ACTH treatment.

背景：婴儿癫痫性痉挛综合征（IESS）是一种严重的癫痫疾病，其特点是癫痫发作持续不受控制，有些患儿在接受多种药物治疗后仍会反复发作。与IESS相关的预后风险因素仍不清楚。本研究旨在评估婴儿促肾上腺皮质激素（ACTH）治疗 IESS 的疗效和复发的影响因素，以及评估癫痫样放电和振幅负担（BASED）评分与临床结果之间的相关性：我们对2016年2月至2023年8月期间在本院接受ACTH治疗的88名确诊为IESS的儿科患者进行了回顾性分析。根据第28天的治疗反应，将患者分为有反应组（n = 47）和无反应组（n = 41）。有反应者又分为复发组和非复发组。采用改良泊松回归模型和接收器操作特征曲线来评估阳性预测值：在这项研究中，共有 47 名患者（53.4%）对促肾上腺皮质激素治疗产生了反应。在 ACTH 治疗的第 14 天，应答组患者的 BASED 评分明显降低，曲线下面积（AUC）为 0.859（95 % CI：0.782-0.937，P＜0.05），灵敏度为 68.1%，特异性为 95.1%。最佳临界点确定为≥2，即尤登指数为 0.632。值得注意的是，在接受促肾上腺皮质激素治疗前服用抗癫痫药物（ASMs）的患者和在痉挛发生前发育迟缓的患者的短期反应率较低（P＜0.05），尽管这些因素并未显示出预测价值。在有反应的患者中，有20例（42.6%）复发，只有那些在头颅磁共振成像（MRI）上显示出特殊异常的患者的复发比例在统计学上更高：结论：在接受促肾上腺皮质激素治疗前接受ASMs治疗的患者，以及在痉挛发生前有发育迟缓的患者，其治疗反应可能较差。如果在接受 ACTH 治疗的第 14 天，BASED 评分降低 2 分或更多，则可能意味着治疗反应良好。此外，头颅核磁共振成像（MRI）出现特殊异常的 IESS 患者在接受 ACTH 治疗后复发的可能性可能会增加。

{"title":"Factors influencing efficacy and relapse of adrenocorticotropic hormone in infantile epileptic spasms syndrome","authors":"","doi":"10.1016/j.yebeh.2024.110055","DOIUrl":"10.1016/j.yebeh.2024.110055","url":null,"abstract":"<div><h3>Background</h3><div>Infantile epileptic spasms syndrome (IESS) is a severe epileptic condition characterized by persistent uncontrolled seizures, with some children experiencing recurrent seizures despite multiple pharmacological therapies. The prognostic risk factorsassociated with IESS remain unclear. This study aimed to evaluate the factors influencing the efficacy and relapse of adrenocorticotropic hormone (ACTH) treatment for IESS in infants, as well as to assess the correlation between the Burden of Amplitudes and Epileptiform Discharges (BASED) score and clinical outcomes.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on a cohort of 88 pediatric patients diagnosed with IESS who received ACTH therapy at our hospital from February 2016 to August 2023. Patients were categorized into response (n = 47) and non-response (n = 41) groups based on their treatment response at day 28. Responders were further classified into relapse and non-relapse groups. A modified Poisson regression model and receiver operating characteristic (ROC) curves were employed to evaluate the positive predictive values.</div></div><div><h3>Results</h3><div>In this study, a total of 47 patients (53.4 %) responded to ACTH treatment. Patients in the response group demonstrated significantly greater reductions in BASED scores by day 14 of ACTH treatment, yielding an area under the curve (AUC) of 0.859 (95 % CI: 0.782–0.937, P＜0.05), with a sensitivity of 68.1 % and a specificity of 95.1 %. The optimal cut-off point was established at ≥ 2, corresponding to a Youden index of 0.632. Notably, patientswho were on anti-seizure medications (ASMs) before ACTH treatment and those with developmental delay prior to the onset of spasms exhibited lower short-term response rates (P＜0.05), although these factors did not demonstrate predictive value. Among the responders, 20 cases (42.6 %) experienced a relapse, with only those patients showing specific abnormalities on cranial magnetic resonance imaging (MRI) exhibiting a statistically higher proportion of relapse.</div></div><div><h3>Conclusion</h3><div>Patients receiving ASMs before ACTH treatment and those with developmental delays prior to the onset of spasms may have a less favorable therapeutic response. A reduction in BASED scores of 2 or greater by day 14 of ACTH treatment may signify a potentially positive treatment response. Additionally, patients with IESS who present with specific abnormalities on cranial MRI may have an increased likelihood of relapse following ACTH treatment.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525505024004372/pdfft?md5=41b027df4c645eb5171d4764d867d4e0&pid=1-s2.0-S1525505024004372-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307442","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}

引用次数: 0

Ketogenic diet effectiveness is superior for drug resistant epilepsy with causative genetic mutation than those without genetic etiology 生酮饮食对有致病基因突变的耐药性癫痫的疗效优于无致病基因突变者。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2024-09-22 DOI: 10.1016/j.yebeh.2024.110052

Aim

Epilepsy with genetic etiology is high prevalence of DRE, which is reported responsive to ketogenic diet therapy (KDT). Our retrospective cohort study attempted to investigate the KD responsiveness between DRE with genetic and non-genetic etiology.

Method

Non-fasting gradual KD initiation protocol (GRAD-KD) and five-day diet program was implemented. Participants were categorized into genetic epilepsy or non-genetic epilepsy groups based on genetic tests. Monthly seizure frequencies and seizure reduction rate after KDT 3 months and 6 months were compared between two groups.

Results

Forty-six patients with genetic epilepsy and ninety-four patients with non-genetic epilepsy were recruited. Among 46 patients with genetic epilepsy, 12 patients withdrew from diet before 3 months of KDT, and 7 patients withdrew from diet before 6 months of KDT, thus, 27 patients retained the diet. Among 94 patients with non-genetic epilepsy, 20 patients withdrew from diet before 3 months of KDT, and 21 patients withdrew from diet before 6 months of KDT, 53 patients retained the diet. For the 46 patients with genetic epilepsy, 12 patients had pathogenic variants related to developmental and epileptic encephalopathy (DEE), whereas other 34 patients had disease-causing variants other than DEE. The mean monthly seizure frequencies showed significantly decreased both in patient with genetic-and non-genetic epilepsy after 6 months of KDT, however, the seizure reduction rate was significantly higher in patients with genetic epilepsy than patients with non-genetic epilepsy after 6 months of KDT. In addition, our data demonstrated that KDT could significantly reduce seizure burden in patients with non-DEE than patients with DEE. In addition, the patients with non-DEE significantly achieved greater seizure reduction rate than patients with DEE after 6 months of KDT.

Interpretation:

Our data highlighted that KD effectiveness is more outstanding in decreasing seizure burdens for epileptic patients with genetic etiology than those without causative gene mutation. Additionally, KDT is also significantly effective for decreasing more seizure burdens for non-DEE patients than for DEE patients. We suggested epileptic patients caused by genetic mutation should implement KDT as early as possible.

目的：遗传性癫痫是 DRE 的高发病症，据报道对生酮饮食疗法（KDT）有反应。我们的回顾性队列研究试图调查遗传性和非遗传性病因的 DRE 对生酮饮食疗法的反应性：方法：采用非空腹渐进生酮饮食启动方案（GRAD-KD）和五天饮食计划。根据基因检测结果将参与者分为遗传性癫痫组和非遗传性癫痫组。比较两组患者在KDT 3个月和6个月后的每月发作频率和发作减少率：结果：招募了 46 名遗传性癫痫患者和 94 名非遗传性癫痫患者。在 46 名遗传性癫痫患者中，12 名患者在 KDT 3 个月前退出饮食，7 名患者在 KDT 6 个月前退出饮食，因此 27 名患者保留了饮食。在 94 名非遺傳性癲癇患者中，20 名患者在接受 "關鍵性治療 "3 個月前退出飲食，21 名患者在接受 "關鍵性治療 "6 個月前退出飲食，53 名患者保留飲食。在46名遗传性癫痫患者中，12名患者的致病变异与发育和癫痫性脑病（DEE）有关，而其他34名患者的致病变异与DEE无关。经过 6 个月的 KDT 治疗后，遗传性和非遗传性癫痫患者的每月平均癫痫发作频率均明显降低，但遗传性癫痫患者的癫痫发作减少率明显高于非遗传性癫痫患者。此外，我们的数据还表明，KDT 能明显减轻非遗传性癫痫患者的癫痫发作负担，而非遗传性癫痫患者的发作负担则明显低于遗传性癫痫患者。此外，在接受 6 个月的 KDT 后，非 DEE 患者的癫痫发作减少率明显高于 DEE 患者：我们的数据强调，与无致病基因突变的癫痫患者相比，有遗传病因的癫痫患者在减少癫痫发作方面的效果更为突出。此外，KDT 在减少非 DEE 患者癫痫发作方面的效果也明显优于 DEE 患者。我们建议由基因突变引起的癫痫患者应尽早实施 KDT。

{"title":"Ketogenic diet effectiveness is superior for drug resistant epilepsy with causative genetic mutation than those without genetic etiology","authors":"","doi":"10.1016/j.yebeh.2024.110052","DOIUrl":"10.1016/j.yebeh.2024.110052","url":null,"abstract":"<div><h3>Aim</h3><div>Epilepsy with genetic etiology is high prevalence of DRE, which is reported responsive to ketogenic diet therapy (KDT). Our retrospective cohort study attempted to investigate the KD responsiveness between DRE with genetic and non-genetic etiology.</div></div><div><h3>Method</h3><div>Non-fasting gradual KD initiation protocol (GRAD-KD) and five-day diet program was implemented. Participants were categorized into genetic epilepsy or non-genetic epilepsy groups based on genetic tests. Monthly seizure frequencies and seizure reduction rate after KDT 3 months and 6 months were compared between two groups.</div></div><div><h3>Results</h3><div>Forty-six patients with genetic epilepsy and ninety-four patients with non-genetic epilepsy were recruited. Among 46 patients with genetic epilepsy, 12 patients withdrew from diet before 3 months of KDT, and 7 patients withdrew from diet before 6 months of KDT, thus, 27 patients retained the diet. Among 94 patients with non-genetic epilepsy, 20 patients withdrew from diet before 3 months of KDT, and 21 patients withdrew from diet before 6 months of KDT, 53 patients retained the diet. For the 46 patients with genetic epilepsy, 12 patients had pathogenic variants related to developmental and epileptic encephalopathy (DEE), whereas other 34 patients had disease-causing variants other than DEE. The mean monthly seizure frequencies showed significantly decreased both in patient with genetic-and non-genetic epilepsy after 6 months of KDT, however, the seizure reduction rate was significantly higher in patients with genetic epilepsy than patients with non-genetic epilepsy after 6 months of KDT. In addition, our data demonstrated that KDT could significantly reduce seizure burden in patients with non-DEE than patients with DEE. In addition, the patients with non-DEE significantly achieved greater seizure reduction rate than patients with DEE after 6 months of KDT.</div></div><div><h3>Interpretation:</h3><div>Our data highlighted that KD effectiveness is more outstanding in decreasing seizure burdens for epileptic patients with genetic etiology than those without causative gene mutation. Additionally, KDT is also significantly effective for decreasing more seizure burdens for non-DEE patients than for DEE patients. We suggested epileptic patients caused by genetic mutation should implement KDT as early as possible.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307443","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}

引用次数: 0

Exploring religious coping strategies epilepsy patients in Turkey: A descriptive study 探索土耳其癫痫患者的宗教应对策略：描述性研究

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2024-09-21 DOI: 10.1016/j.yebeh.2024.110060

Objective

It is seen that religious coping methods are used in the literature, but the existing literature on religious coping methods and coping strategies used by epilepsy patients is insufficient. Therefore, this study aimed to determine the positive and negative religious coping levels of epilepsy patients.

Methods

This research is a descriptive research type. The research data were collected from patients with epilepsy living in a province in eastern Turkey between April and June 2024. The research population consists of epilepsy patients living in Erzurum province. The sample consisted of 154 patients who agreed to participate in the study. Data collection tools were “Questionnaire Form” and “Religious Coping Scale.” Frequency, percentage calculations, mean and standard deviation values were used to evaluate the data. One Way Anova, Independent Sample t-test, Mann-Whitney U, and Pearson correlation tests were also used.

Results

Positive religious coping scores (22.90 ± 5.35) and Negative religious coping scores (7.24 ± 3.25) of epilepsy patients were found to be at high levels. Participants’ gender, marital status, occupation, income status, prayer, fasting, and Quran reading habits significantly affected their positive religious coping behaviors (p < 0.05). In addition, it was determined that as the age of the participants increased, they resorted to positive religious coping behaviors more (r: 0.215, p < 0.05).

Conclusions

The results of the study show that the positive and negative religious coping levels of epilepsy patients are high. In addition, the participants prefer positive religious coping behaviors more.

目的从文献中可以看到宗教应对方法的使用，但现有文献中关于癫痫患者使用的宗教应对方法和应对策略的研究不足。因此，本研究旨在确定癫痫患者的积极和消极宗教应对水平。研究数据收集自 2024 年 4 月至 6 月期间居住在土耳其东部某省的癫痫患者。研究对象包括居住在埃尔祖鲁姆省的癫痫患者。样本包括同意参与研究的 154 名患者。数据收集工具为 "问卷表 "和 "宗教应对量表"。数据评估采用频率、百分比计算、平均值和标准偏差值。结果发现，癫痫患者的宗教应对积极得分（22.90 ± 5.35）和宗教应对消极得分（7.24 ± 3.25）均处于较高水平。参与者的性别、婚姻状况、职业、收入状况、祈祷、斋戒和阅读古兰经的习惯对其积极宗教应对行为有显著影响（p <0.05）。研究结果表明，癫痫患者的积极和消极宗教应对水平都很高。此外，参与者更倾向于积极的宗教应对行为。

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引用次数: 0

Clinical characteristics of a first seizure evaluation clinic in an academic center 学术中心首次癫痫发作评估门诊的临床特点。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2024-09-21 DOI: 10.1016/j.yebeh.2024.110054

Introduction

Evaluation by an epileptologist can help distinguish epileptic seizures from seizure mimickers. Proper and timely diagnosis of a seizure or new onset epilepsy is of critical importance due to implications regarding treatment, prognosis, quality of life, morbidity, and mortality. The goal of our study is to describe the demographics and clinical characteristics of patients referred to a first seizure clinic at a tertiary academic center within Chicago, Illinois.

Methods

This is a retrospective cohort study of adult patients referred to our clinic. Patients were identified through the electronic medical record from March 2021 to March 2022. Charts were reviewed to assess pertinent clinical characteristics and patient demographic data.

Results

A total of 123 out of 138 (89.0 %) scheduled patients checked in to the visit between March 2021-March 2022, of which 87/123 (70.7 %) were diagnosed with a seizure. Other diagnoses included syncope (17/123, 13.8 %), undifferentiated event (16/123, 13.0 %), suspected psychogenic non-epileptic event (2/123, 1.6 %), and migraine (1, 0.8 %). Of those with a seizure, 73/87 (83.9 %) were unprovoked and 14/87 (16.1 %) were provoked. The average wait time to be seen as a new patient by an epileptologist was significantly shorter with the establishment of this clinic compared to the year prior (17 days versus 53 days, p value < 0.001). The majority of patients had an EEG prior to or after the visit (121/123, 98.4 %), of which 24/121 (19.8 %) had interictal epileptiform activity. Findings relevant to the patient’s cause of epilepsy were found in 26/108 (24.1 %) of patients who underwent an MRI or CT scan of the head. There were 40/123 (32.5 %) patients prescribed an anti-seizure medication (ASM) prior to the first office visit and 65/123 (52.8 %) patients prescribed an ASM within the first three office visits.

Conclusion

A first seizure evaluation clinic in an urban setting is an achievable and efficient way to evaluate patients with paroxysmal events concerning for seizure in a timely manner. Most patients in this clinic were diagnosed with epileptic seizures. Timely ancillary testing with head imaging and EEG can help contribute to the diagnosis of epilepsy and guide treatment.

导言：由癫痫专科医生进行评估有助于区分癫痫发作和癫痫发作模拟者。正确及时地诊断癫痫发作或新发癫痫至关重要，因为这对治疗、预后、生活质量、发病率和死亡率都有影响。我们的研究旨在描述伊利诺伊州芝加哥市一家三级学术中心首次癫痫发作门诊转诊患者的人口统计学和临床特征：这是一项针对转诊至本诊所的成年患者的回顾性队列研究。通过电子病历确定了 2021 年 3 月至 2022 年 3 月期间的患者。审查病历以评估相关临床特征和患者人口统计学数据：2021年3月至2022年3月期间，138名预约患者中共有123人（89.0%）办理了就诊手续，其中87/123人（70.7%）被诊断为癫痫发作。其他诊断包括晕厥（17/123，13.8 %）、未分化事件（16/123，13.0 %）、疑似精神性非癫痫事件（2/123，1.6 %）和偏头痛（1，0.8 %）。在癫痫发作患者中，73/87（83.9%）为无诱因发作，14/87（16.1%）为诱因发作。与前一年相比，设立该门诊后癫痫专科医生接诊新患者的平均等待时间明显缩短（17 天对 53 天，P 值结论：该门诊的设立使癫痫专科医生的接诊时间明显缩短（17 天对 53 天，P 值结论：该门诊的设立使癫痫专科医生的接诊时间明显缩短（17 天对 53 天，P 值结论）：在城市环境中开设首次癫痫发作评估门诊，是及时评估阵发性癫痫发作患者的可行且高效的方法。该诊所的大多数患者都被确诊为癫痫发作。及时进行头部成像和脑电图辅助检查有助于癫痫诊断和指导治疗。

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引用次数: 0

Risk factors for secondary epilepsy following febrile seizures in children: A meta-analysis 儿童发热性癫痫发作后继发癫痫的风险因素：荟萃分析

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2024-09-21 DOI: 10.1016/j.yebeh.2024.110051

Objective

To systematically assess the risk factors for secondary epilepsy in children with febrile seizures, in order to promptly identify early signs of epilepsy and establish a reliable foundation for timely clinical intervention and improved prognosis.

Methods

The databases, including CNKI, WanFang, VIP, CBM, PubMed, Embase, Web of Science, and the Cochrane Library were searched for relevant studies, up to October 2023. Two researchers independently collected and extracted data from selected studies, adhering to predefined criteria. Statistical analysis was performed using Stata 15.0.

Results

A total of 23 studies included 714 cases in the case group and 5269 cases in the control group. The results of Meta-analysis showed that preterm birth (OR=3.30, P=0.02), history of perinatal asphyxia (OR=3.94, P=0.001), age at the first seizure < 12 months (OR=2.93, P=0.003), peak temperature < 39℃ (OR=2.51, P<0.001), onset of fever to seizure < 1 h (OR=5.61, P<0.001), Complex FS(OR=4.08, P<0.001), duration of the seizure > 15 min (OR=6.21, P<0.001), Multiple seizures (≥2/episode) in one attack (OR=2.92, P<0.001), focal seizures (OR=2.53, P=0.018), recurrent FS (≥2) (OR=3.49, P<0.001), neurodevelopmental abnormality(OR=8.68, P<0.001), developmental delay(OR=10.04, P<0.001), family history of epilepsy (OR=2.74, P=0.004), family history of FS (OR=2.07, P=0.022), electroencephalogram (EEG) abnormal(OR=4.06, P<0.001)and Brain imaging abnormalities (OR=2.84, P=0.002)were Risk factors for secondary epilepsy following FS in Children. Notably, gender (female) was not a significant factor.

Conclusions

This study provides a comprehensive and systematic discussion of the risk factors associated with secondary epilepsy in children with febrile seizures. It actively formulates intervention measures for modifiable risk factors and conducts early detection and continuous follow-up observation for non-modifiable high-risk children, thereby reducing the risk of epilepsy.

目的系统评估发热性癫痫发作患儿继发性癫痫的危险因素，以便及时发现癫痫的早期征兆，为及时临床干预和改善预后奠定可靠的基础。方法检索 CNKI、万方、VIP、CBM、PubMed、Embase、Web of Science 和 Cochrane Library 等数据库中截至 2023 年 10 月的相关研究。两名研究人员按照预先设定的标准独立收集和提取所选研究的数据。结果共有 23 项研究，病例组中有 714 例，对照组中有 5269 例。Meta 分析结果显示，早产（OR=3.30，P=0.02）、围产期窒息史（OR=3.94，P=0.001）、首次发作年龄 < 12 个月（OR=2.93，P=0.003）、最高体温 < 39℃（OR=2.51，P<0.001）、发热开始至发作<1 h（OR=5.61，P<0.001）、复杂FS（OR=4.08，P<0.001）、发作持续时间>15 min（OR=6.21，P<0.001）、一次发作中多次发作（≥2次/次）（OR=2.92，P<0.001）、局灶性癫痫发作（OR=2.53，P=0.018）、反复发作的 FS（≥2 次）（OR=3.49，P<0.001）、神经发育异常（OR=8.68，P<0.001）、发育迟缓（OR=10.04，P<0.001）、癫痫家族史（OR=2.74，P=0.004）、FS家族史（OR=2.07，P=0.022）、脑电图（EEG）异常（OR=4.06，P<0.001）和脑成像异常（OR=2.84，P=0.002）是儿童FS后继发性癫痫的危险因素。结论本研究全面系统地探讨了热性惊厥儿童继发性癫痫的相关危险因素。积极针对可改变的风险因素制定干预措施，对不可改变的高危儿童进行早期发现和持续随访观察，从而降低癫痫风险。

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引用次数: 0

The concept of “control” in people with epilepsy: A qualitative study 癫痫患者的 "控制 "概念：定性研究

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2024-09-21 DOI: 10.1016/j.yebeh.2024.110059

Epilepsy fundamentally involves a struggle with “control,” commonly framed in terms of reducing the frequency and severity of seizures. This paper seeks to understand how people with epilepsy (PWE) think about and define control, as well as the psychosocial outcomes of self-managing epilepsy and low perceived control.

Here, we employ a qualitative analysis of interviews with 64 adults with epilepsy in treatment in a tertiary referral center in New York City, conducted between July 2020 and July 2022 as part of a larger study of the lived experiences of PWE. The interviews were coded, and thematic analysis was used to identify participants’ constructions of control and the breadth of illness intrusiveness they experienced.

Findings indicate that applying the illness intrusiveness concept to epilepsy aligns with existing research, revealing that PWE are impacted in numerous ways beyond seizure frequency and severity. Participants reported significant anxiety related to the unpredictability of seizures and the potential embarrassment of having seizures in public. These insights highlight that illness self-management and social challenges are critical components of the experience of having epilepsy.

Our findings underscore the need for a wholistic approach to improving quality of life for PWE that recognizes the broader context of illness intrusiveness. By understanding and enhancing perceived control, future interventions can better support the mental health and overall well-being of PWE.

从根本上说，癫痫涉及与 "控制 "的斗争，而 "控制 "通常是指减少癫痫发作的频率和严重程度。本文试图了解癫痫患者（PWE）如何看待和定义控制，以及自我管理癫痫和低感知控制的社会心理结果。在此，我们采用定性分析的方法，对纽约市一家三级转诊中心的 64 名接受治疗的成年癫痫患者进行了访谈，访谈于 2020 年 7 月至 2022 年 7 月期间进行，是一项关于癫痫患者生活经历的大型研究的一部分。研究结果表明，将疾病侵扰性的概念应用于癫痫与现有研究一致，揭示了癫痫发作频率和严重程度之外，公共卫生参与者还受到多方面的影响。参与者报告了与癫痫发作的不可预测性有关的严重焦虑，以及在公共场合癫痫发作可能带来的尴尬。我们的研究结果突出表明，有必要采取一种全面的方法来提高残疾人的生活质量，这种方法应认识到疾病侵扰的更广泛背景。通过了解和加强感知控制，未来的干预措施可以更好地支持癫痫患者的心理健康和整体福祉。

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引用次数: 0