Early response to epileptic seizures is critical. In children, epileptic seizures can occur at school, and practical programs are required to enable teachers to respond. In Japan, schoolteachers may administer buccal midazolam orally under certain conditions; however, there are no established training programs for responding to epileptic seizures in schools. In this study, we aimed to develop a training program on how to respond to seizures, including buccal midazolam administration, and evaluate its effectiveness. We conducted a training program for Yogo teachers at special needs schools and evaluated the differences in confidence in responding to epileptic seizures and administering oral buccal midazolam before and after the program. The results demonstrated that confidence in responding to epileptic seizures and administering oral buccal midazolam significantly improved after the program. We concluded that this training program can help special needs Yogo teachers gain confidence in administering buccal midazolam and responding to epileptic seizures in the school setting.
{"title":"A practical program for responding to epileptic seizures including buccal midazolam administration in schools: Effectiveness evaluation for Yogo teachers in Japan","authors":"Noriko Ozawa , Etsuko Tomisaki , Hikaru Sou , Shoko Miyagawa , Junki Yoshioka , Hiroko Horie , Ayaka Kandatsu , Naoko Kumada Deguchi , Etsuko Soeda","doi":"10.1016/j.yebeh.2024.110156","DOIUrl":"10.1016/j.yebeh.2024.110156","url":null,"abstract":"<div><div>Early response to epileptic seizures is critical. In children, epileptic seizures can occur at school, and practical programs are required to enable teachers to respond. In Japan, schoolteachers may administer buccal midazolam orally under certain conditions; however, there are no established training programs for responding to epileptic seizures in schools. In this study, we aimed to develop a training program on how to respond to seizures, including buccal midazolam administration, and evaluate its effectiveness. We conducted a training program for <em>Yogo teachers</em> at special needs schools and evaluated the differences in confidence in responding to epileptic seizures and administering oral buccal midazolam before and after the program. The results demonstrated that confidence in responding to epileptic seizures and administering oral buccal midazolam significantly improved after the program. We concluded that this training program can help special needs <em>Yogo</em> teachers gain confidence in administering buccal midazolam and responding to epileptic seizures in the school setting.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110156"},"PeriodicalIF":2.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746333","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}
Pub Date : 2024-11-30DOI: 10.1016/j.yebeh.2024.110155
Zeynep YANCI, Eylem TOPBAŞ
Objective
To test the validity and reliability of the Turkish version of the Epilepsy-Related Apathy Scale (E-RAS) in adults with epilepsy.
Methods
In this methodological study, the E-RAS was translated into Turkish using standard procedures and assessed for content validity by a panel of 8 experts. The draft scale was piloted with 10 people to ensure comprehensibility of the questions. For psychometric validation, the Turkish version of the scale was administered to 209 native Turkish speakers over 18 years of age who had epilepsy for at least 1 year and had been using antiepileptic drugs for at least 1 year.
Results
Exploratory and confirmatory factor analysis was performed for construct validity. Internal consistency analysis yielded Cronbach’s alpha reliability coefficients of 0.813 for the whole scale and 0.802–0.864 for the subscales. In exploratory factor analysis, 9 of the original 24 items were removed (factor loadings < 0.30) and the 4 subscales were condensed to 2, called “Motivational and Emotional” and ”Self-Regulatory and Cognitive“.
Conclusion
The 15-item, 2-dimensional Turkish version of the E-RAS was determined to be valid and reliable for use in adults with epilepsy in the Turkish population.
{"title":"Adaptation of the Epilepsy-Related apathy scale to Turkish in adults with Epilepsy: Validity and reliability study","authors":"Zeynep YANCI, Eylem TOPBAŞ","doi":"10.1016/j.yebeh.2024.110155","DOIUrl":"10.1016/j.yebeh.2024.110155","url":null,"abstract":"<div><h3>Objective</h3><div>To test the validity and reliability of the Turkish version of the Epilepsy-Related Apathy Scale (E-RAS) in adults with epilepsy.</div></div><div><h3>Methods</h3><div>In this methodological study, the E-RAS was translated into Turkish using standard procedures and assessed for content validity by a panel of 8 experts. The draft scale was piloted with 10 people to ensure comprehensibility of the questions. For psychometric validation, the Turkish version of the scale was administered to 209 native Turkish speakers over 18 years of age who had epilepsy for at least 1 year and had been using antiepileptic drugs for at least 1 year.</div></div><div><h3>Results</h3><div>Exploratory and confirmatory factor analysis was performed for construct validity. Internal consistency analysis yielded Cronbach’s alpha reliability coefficients of 0.813 for the whole scale and 0.802–0.864 for the subscales. In exploratory factor analysis, 9 of the original 24 items were removed (factor loadings < 0.30) and the 4 subscales were condensed to 2, called “Motivational and Emotional” and ”Self-Regulatory and Cognitive“.</div></div><div><h3>Conclusion</h3><div>The 15-item, 2-dimensional Turkish version of the E-RAS was determined to be valid and reliable for use in adults with epilepsy in the Turkish population.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110155"},"PeriodicalIF":2.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746322","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}
Pub Date : 2024-11-30DOI: 10.1016/j.yebeh.2024.110173
Georgia Ramantani , Antonio Giulio Gennari , Hans Holthausen
Cerebral infections are a common cause of structural focal epilepsy, particularly in developing countries, where the risk of unprovoked seizures is higher and is related to brain lesions and status epilepticus during the acute phase. Despite the prevalence of pharmacoresistant epilepsy after cerebral infections, few patients are referred for epilepsy surgery. However, those with mesial temporal sclerosis (MTS), particularly linked to meningitis or encephalitis in early life, are excellent surgical candidates. Encephalitis before age four is associated with MTS, indicating a period of hippocampal vulnerability. Temporal resections are the most common procedures in these patients. In contrast, extratemporal resections are less common and generally less successful, especially in patients with multifocal epilepsy or parasitic infections. Patients with severe hemispheric damage from infections and contralateral hemiparesis may undergo hemispheric procedures, with overall favorable outcomes. Surgery for post-viral encephalitis, such as herpes simplex virus encephalitis, is often less effective due to widespread brain involvement, though younger patients with unilateral hippocampal atrophy fare better. Although neurocysticercosis is a leading cause of epilepsy in endemic regions, surgery is rarely performed. However, resecting MTS along with calcified lesions can improve seizure control in pharmacoresistant cases. This review emphasizes the importance of surgery for appropriately selected patients with postinfectious epilepsy.
{"title":"Epilepsy surgery for postinfectious lesions: A review","authors":"Georgia Ramantani , Antonio Giulio Gennari , Hans Holthausen","doi":"10.1016/j.yebeh.2024.110173","DOIUrl":"10.1016/j.yebeh.2024.110173","url":null,"abstract":"<div><div>Cerebral infections are a common cause of structural focal epilepsy, particularly in developing countries, where the risk of unprovoked seizures is higher and is related to brain lesions and status epilepticus during the acute phase. Despite the prevalence of pharmacoresistant epilepsy after cerebral infections, few patients are referred for epilepsy surgery. However, those with mesial temporal sclerosis (MTS), particularly linked to meningitis or encephalitis in early life, are excellent surgical candidates. Encephalitis before age four is associated with MTS, indicating a period of hippocampal vulnerability. Temporal resections are the most common procedures in these patients. In contrast, extratemporal resections are less common and generally less successful, especially in patients with multifocal epilepsy or parasitic infections. Patients with severe hemispheric damage from infections and contralateral hemiparesis may undergo hemispheric procedures, with overall favorable outcomes. Surgery for post-viral encephalitis, such as herpes simplex virus encephalitis, is often less effective due to widespread brain involvement, though younger patients with unilateral hippocampal atrophy fare better. Although neurocysticercosis is a leading cause of epilepsy in endemic regions, surgery is rarely performed. However, resecting MTS along with calcified lesions can improve seizure control in pharmacoresistant cases. This review emphasizes the importance of surgery for appropriately selected patients with postinfectious epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110173"},"PeriodicalIF":2.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744488","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}
Pub Date : 2024-11-30DOI: 10.1016/j.yebeh.2024.110167
Amy C. Lang , Kirby-Estar Laguerre , Stacy Buschhaus , Constance A. Mara , Susan L. Fong , Christina L. Duncan , Avani C. Modi
Background
At least 30% of youth with epilepsy will require transition from pediatric to adult neurology care. Many adolescents and young adults (AYAs) with epilepsy are inadequately prepared for health care transition, which may contribute to health care disruptions and decreased quality of life. The current study aimed to add to the growing body of literature on health care transition in epilepsy by characterizing a sample of AYAs with epilepsy and assessing the relationship between pre-existing and behaviorally modifiable factors and epilepsy-specific transition readiness.
Methods
103 AYAs (Mage = 17.56; range = 14–21; 54% female; 85% White) with epilepsy and 84 of their caregivers were enrolled from two pediatric hospitals in the United States. Participants provided sociodemographic and medical information and completed questionnaires assessing functioning, epilepsy management, and transition readiness. Data were analyzed using a two-step hierarchical multiple linear regression model with epilepsy-specific transition readiness as the outcome: 1) pre-existing factors (i.e., age, insurance, seizure severity); and 2) behaviorally modifiable factors (i.e., cognitive functioning, medication self-management, epilepsy self-efficacy).
Results
Only 44% of AYAs had discussed health care transition with their pediatric neurologist. The final model was significant, ΔF (3, 90) = 13.45, p < 0.001. Older age and greater epilepsy self-efficacy were associated with greater epilepsy-specific transition readiness.
Conclusion
AYAs with greater epilepsy self-efficacy may be better prepared for the transition from pediatric to adult neurology care. Routine assessment of epilepsy self-efficacy and transition readiness starting in early adolescence may help to identify individuals who could benefit from targeted interventions.
{"title":"Preparing adolescents and young adults with epilepsy for transitioning health care (PATH) study: The important role of age and self-efficacy","authors":"Amy C. Lang , Kirby-Estar Laguerre , Stacy Buschhaus , Constance A. Mara , Susan L. Fong , Christina L. Duncan , Avani C. Modi","doi":"10.1016/j.yebeh.2024.110167","DOIUrl":"10.1016/j.yebeh.2024.110167","url":null,"abstract":"<div><h3>Background</h3><div>At least 30% of youth with epilepsy will require transition from pediatric to adult neurology care. Many adolescents and young adults (AYAs) with epilepsy are inadequately prepared for health care transition, which may contribute to health care disruptions and decreased quality of life. The current study aimed to add to the growing body of literature on health care transition in epilepsy by characterizing a sample of AYAs with epilepsy and assessing the relationship between pre-existing and behaviorally modifiable factors and epilepsy-specific transition readiness.</div></div><div><h3>Methods</h3><div>103 AYAs (<em>M<sub>age</sub></em> = 17.56; range = 14–21; 54% female; 85% White) with epilepsy and 84 of their caregivers were enrolled from two pediatric hospitals in the United States. Participants provided sociodemographic and medical information and completed questionnaires assessing functioning, epilepsy management, and transition readiness. Data were analyzed using a two-step hierarchical multiple linear regression model with epilepsy-specific transition readiness as the outcome: 1) pre-existing factors (i.e., age, insurance, seizure severity); and 2) behaviorally modifiable factors (i.e., cognitive functioning, medication self-management, epilepsy self-efficacy).</div></div><div><h3>Results</h3><div>Only 44% of AYAs had discussed health care transition with their pediatric neurologist. The final model was significant, Δ<em>F</em> (3, 90) = 13.45<em>, p</em> < 0.001. Older age and greater epilepsy self-efficacy were associated with greater epilepsy-specific transition readiness.</div></div><div><h3>Conclusion</h3><div>AYAs with greater epilepsy self-efficacy may be better prepared for the transition from pediatric to adult neurology care. Routine assessment of epilepsy self-efficacy and transition readiness starting in early adolescence may help to identify individuals who could benefit from targeted interventions.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110167"},"PeriodicalIF":2.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744391","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}
Pub Date : 2024-11-29DOI: 10.1016/j.yebeh.2024.110151
Sara Joelsson , Klara Andersson , Petra Brannefors , Samuel Klemetz , Lovisa Gärdesmed , Elisabet Wennberg , Anders Hedström , Fredrik Asztely , Johan Zelano , Joakim Strandberg
Objective
Electroencephalography (EEG) is a standard investigation after a first unprovoked seizure but the diagnostic value in adults remains unclear. Our objective was to investigate the diagnostic value of EEG after a first unprovoked seizure in a population-based cohort in Gothenburg, Sweden.
Methods
This retrospective population-based study included adult patients referred by a neurologist for EEG after a first unprovoked seizure from August 2016 - December 2019 in the greater Gothenburg catchment area. In total 520 patients were included and followed in medical records for a median of 4.42 years (range 0.33–6.93). Primary outcome measures were epileptiform activity. Medical records were reviewed for the influence of EEG on clinical management. The frequency of epileptiform activity was calculated and compared in different subgroup analyses.
Results
EEGs were recorded after a median of 70 days from the seizure. In total, 7.7 % had epileptiform activity, and 27.9 % had pathological slowing on their EEG. Seizure recurrence occurred in 33.7 % (29.6–37.8). Epileptiform activity predicted seizure recurrence with a recurrence risk of 82.5 % (70.7–94.3). The sensitivity of epileptiform activity was only 19.2 % (13.6–25.9) but the specificity was 98.0 % (95.9–99.2) and the relative risk of recurrence in presence of such activity was 2.8 (2.3–3.5). The EEG findings resulted in an alteration of diagnosis and/or medication in 4.4 % of the patients. Factors associated with epileptiform activity on EEG were younger age, EEG including sleep recording, generalized onset seizure, shorter time from seizure to EEG and longer duration of EEG recording.
Significance
The yield of EEG recorded with a longer latency after a first unprovoked seizure in adults was low. However, epileptiform activity highly predicted seizure recurrence and our results suggest that epileptiform activity on EEG could be explored further as a biomarker for defining epilepsy already after a first seizure.
{"title":"Diagnostic value of EEG after a first unprovoked seizure in adults – A population-based study","authors":"Sara Joelsson , Klara Andersson , Petra Brannefors , Samuel Klemetz , Lovisa Gärdesmed , Elisabet Wennberg , Anders Hedström , Fredrik Asztely , Johan Zelano , Joakim Strandberg","doi":"10.1016/j.yebeh.2024.110151","DOIUrl":"10.1016/j.yebeh.2024.110151","url":null,"abstract":"<div><h3>Objective</h3><div>Electroencephalography (EEG) is a standard investigation after a first unprovoked seizure but the diagnostic value in adults remains unclear. Our objective was to investigate the diagnostic value of EEG after a first unprovoked seizure in a population-based cohort in Gothenburg, Sweden.</div></div><div><h3>Methods</h3><div>This retrospective population-based study included adult patients referred by a neurologist for EEG after a first unprovoked seizure from August 2016 - December 2019 in the greater Gothenburg catchment area. In total 520 patients were included and followed in medical records for a median of 4.42 years (range 0.33–6.93). Primary outcome measures were epileptiform activity. Medical records were reviewed for the influence of EEG on clinical management. The frequency of epileptiform activity was calculated and compared in different subgroup analyses.</div></div><div><h3>Results</h3><div>EEGs were recorded after a median of 70 days from the seizure. In total, 7.7 % had epileptiform activity, and 27.9 % had pathological slowing on their EEG. Seizure recurrence occurred in 33.7 % (29.6–37.8). Epileptiform activity predicted seizure recurrence with a recurrence risk of 82.5 % (70.7–94.3). The sensitivity of epileptiform activity was only 19.2 % (13.6–25.9) but the specificity was 98.0 % (95.9–99.2) and the relative risk of recurrence in presence of such activity was 2.8 (2.3–3.5). The EEG findings resulted in an alteration of diagnosis and/or medication in 4.4 % of the patients. Factors associated with epileptiform activity on EEG were younger age, EEG including sleep recording, generalized onset seizure, shorter time from seizure to EEG and longer duration of EEG recording.</div></div><div><h3>Significance</h3><div>The yield of EEG recorded with a longer latency after a first unprovoked seizure in adults was low. However, epileptiform activity highly predicted seizure recurrence and our results suggest that epileptiform activity on EEG could be explored further as a biomarker for defining epilepsy already after a first seizure.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110151"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744399","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}
Pub Date : 2024-11-29DOI: 10.1016/j.yebeh.2024.110166
Sofia Kasradze , Giorgi Lomidze , Nino Gogatishvili , Salome Mgeliashvili , Tamara Antia , Josemir W Sander
Objective
One of the most significant challenges faced by people with epilepsy is the stigma imposed by the broader community. We aim to assess the dynamics of stigma and the level of misconceptions towards individuals with epilepsy by comparing two studies conducted decades apart.
Methods
Awareness-raising campaigns and professional skill development activities were conducted. We utilised a Georgian-adapted structured questionnaire and the Stigma Scale of Epilepsy (SSE) questionnaire, which had previously been validated in Georgian. A cross-sectional study was conducted. We used multivariable logistic regression analysis to develop a predictive model for stigma perception. To compare the two studies, we used the Chi-squared test to examine differences in proportions between the two populations, including the 95% Confidence Interval (CI) for the difference in proportions. A p-value of less than 0.05 was considered statistically significant.
Results
Of the 1,146 participants, 502 (43.8%) were female, and 207 (18.1%) had a medical education. Higher levels of stigma were observed more frequently among individuals without a medical background. Participants who perceived epilepsy as a psychiatric disorder, a hereditary condition, or a congenital disability exhibited higher levels of stigma. Comparisons between the two studies reveal a significant decrease in the number of individuals who would oppose their child marrying or playing with someone who has epilepsy.
Conclusions
Respondents with medical backgrounds were less likely to express stigma and misconceptions. A comparison of the two studies indicates a statistically significant improvement over the past decade, likely to be partly attributable to regular awareness-raising campaigns.
{"title":"Revisiting knowledge, attitudes and perceptions towards epilepsy after a decade of interventions: The case of Tbilisi, Georgia","authors":"Sofia Kasradze , Giorgi Lomidze , Nino Gogatishvili , Salome Mgeliashvili , Tamara Antia , Josemir W Sander","doi":"10.1016/j.yebeh.2024.110166","DOIUrl":"10.1016/j.yebeh.2024.110166","url":null,"abstract":"<div><h3>Objective</h3><div>One of the most significant challenges faced by people with epilepsy is the stigma imposed by the broader community. We aim to assess the dynamics of stigma and the level of misconceptions towards individuals with epilepsy by comparing two studies conducted decades apart.</div></div><div><h3>Methods</h3><div>Awareness-raising campaigns and professional skill development activities were conducted. We utilised a Georgian-adapted structured questionnaire and the Stigma Scale of Epilepsy (SSE) questionnaire, which had previously been validated in Georgian. A cross-sectional study was conducted. We used multivariable logistic regression analysis to develop a predictive model for stigma perception. To compare the two studies, we used the Chi-squared test to examine differences in proportions between the two populations, including the 95% Confidence Interval (CI) for the difference in proportions. A p-value of less than 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Of the 1,146 participants, 502 (43.8%) were female, and 207 (18.1%) had a medical education. Higher levels of stigma were observed more frequently among individuals without a medical background. Participants who perceived epilepsy as a psychiatric disorder, a hereditary condition, or a congenital disability exhibited higher levels of stigma. Comparisons between the two studies reveal a significant decrease in the number of individuals who would oppose their child marrying or playing with someone who has epilepsy.</div></div><div><h3>Conclusions</h3><div>Respondents with medical backgrounds were less likely to express stigma and misconceptions. A comparison of the two studies indicates a statistically significant improvement over the past decade, likely to be partly attributable to regular awareness-raising campaigns.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110166"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744400","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}
Pub Date : 2024-11-29DOI: 10.1016/j.yebeh.2024.110161
J.G. Burneo , D.A. Steven , D. Englot , J.E. Bender del Busto , K. Lin , S. Wiebe , J.M. Wilmshurst , A. Cukiert , F. Cendes , for the Epilepsy Surgery in low resource settings Task Force
A large proportion of those affected by epilepsy live in resource-poor areas. The Epilepsy surgery in low-resource settings Task Force from the ILAE undertook a survey in Africa and Latin America to identify fellowships in Epilepsy and EEG as well as in Epilepsy Surgery. The results revealed a significant shortage of training programs in these two regions of the globe.
{"title":"Fellowship education in epilepsy in Latin America and Africa: Results of a survey","authors":"J.G. Burneo , D.A. Steven , D. Englot , J.E. Bender del Busto , K. Lin , S. Wiebe , J.M. Wilmshurst , A. Cukiert , F. Cendes , for the Epilepsy Surgery in low resource settings Task Force","doi":"10.1016/j.yebeh.2024.110161","DOIUrl":"10.1016/j.yebeh.2024.110161","url":null,"abstract":"<div><div>A large proportion of those affected by epilepsy live in resource-poor areas. The Epilepsy surgery in low-resource settings Task Force from the ILAE undertook a survey in Africa and Latin America to identify fellowships in Epilepsy and EEG as well as in Epilepsy Surgery. The results revealed a significant shortage of training programs in these two regions of the globe.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110161"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142747626","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}
Pub Date : 2024-11-29DOI: 10.1016/j.yebeh.2024.110148
Esin Kavuran
Objective
This study aimed to investigate the impact of fatalism, self-management, and self-esteem on the quality of life of individuals with multiple sclerosis and epilepsy.
Methods
A cross-sectional study was conducted between February and May 2024 with 122 MS patients and 108 epilepsy patients. Participants completed questionnaires measuring fatalistic beliefs, self-management, self-esteem, and quality of life. Data were collected through face-to-face interviews during hospital visits. Statistical analyses included t-tests, Mann-Whitney U tests, and hierarchical regression.
Results
MS patients reported significantly higher levels of fatalism and lower levels of self-esteem compared to epilepsy patients. However, both groups reported statistically significant relationships between fatalism, self-management, self-esteem, and quality of life. Hierarchical regression analyses revealed that the factor of fatalism negatively impacted quality of life in both groups, while self-management and self-esteem were positively associated with quality of life. Although these variables consistently impacted the quality of life for both groups, the magnitude of these effects and the amount of variance explained differed.
Conclusions
These findings highlight the importance of addressing fatalistic beliefs, promoting self-management skills, and enhancing self-esteem in both MS and epilepsy patients. Intervention programs focusing on these psychosocial factors could significantly improve the quality of life for individuals living with these chronic neurological conditions.
{"title":"Fatalism, self-management and self-esteem: How do they shape the quality of life in MS and epilepsy Patients?","authors":"Esin Kavuran","doi":"10.1016/j.yebeh.2024.110148","DOIUrl":"10.1016/j.yebeh.2024.110148","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the impact of fatalism, self-management, and self-esteem on the quality of life of individuals with multiple sclerosis and epilepsy.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted between February and May 2024 with 122 MS patients and 108 epilepsy patients. Participants completed questionnaires measuring fatalistic beliefs, self-management, self-esteem, and quality of life. Data were collected through face-to-face interviews during hospital visits. Statistical analyses included t-tests, Mann-Whitney U tests, and hierarchical regression.</div></div><div><h3>Results</h3><div>MS patients reported significantly higher levels of fatalism and lower levels of self-esteem compared to epilepsy patients. However, both groups reported statistically significant relationships between fatalism, self-management, self-esteem, and quality of life. Hierarchical regression analyses revealed that the factor of fatalism negatively impacted quality of life in both groups, while self-management and self-esteem were positively associated with quality of life. Although these variables consistently impacted the quality of life for both groups, the magnitude of these effects and the amount of variance explained differed.</div></div><div><h3>Conclusions</h3><div>These findings highlight the importance of addressing fatalistic beliefs, promoting self-management skills, and enhancing self-esteem in both MS and epilepsy patients. Intervention programs focusing on these psychosocial factors could significantly improve the quality of life for individuals living with these chronic neurological conditions.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110148"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744491","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}
Pub Date : 2024-11-29DOI: 10.1016/j.yebeh.2024.110171
Debopam Samanta
Dravet syndrome (DS) is a severe genetic developmental and epileptic encephalopathy, primarily caused by SCN1A gene mutations. Historically, treatments like clobazam and valproate have been used without evidence from randomized controlled trials (RCTs). However, the therapeutic landscape of DS has evolved with multiple RCTs demonstrating the efficacy and safety of three antiseizure medications (ASMs): stiripentol, cannabidiol (CBD), and fenfluramine. In the absence of direct comparisons between these therapies, several network meta-analyses have been conducted to compare the ASMs, while expert consensus has independently been developed to formulate treatment guidelines. While these three ASMs show promise in reducing seizures, increasing awareness of non-seizure outcomes—such as cognitive development and quality of life—has shifted the focus of evaluation. Some recent real-world studies of these ASMs have reported improvements in these non-seizure outcomes, alongside sustained efficacy and safety. However, natural history studies continue to underscore persistent deficits in these areas and highlight suboptimal long-term seizure control despite the use of these therapies. This review addresses these gaps by first discussing network meta-analyses and treatment guidelines, along with the practical limitations of these approaches. It then examines the long-term efficacy, safety, non-seizure effects, and cost-effectiveness from real-world studies of these ASMs. Finally, emerging research on novel therapeutic approaches, including genetic and serotonergic modulation, is explored. By evaluating these developments, this review aims to guide clinical decision-making and propose future directions for optimizing DS care.
{"title":"A comprehensive review of evolving treatment strategies for Dravet syndrome: Insights from randomized trials, meta-analyses, real-world evidence, and emerging therapeutic approaches","authors":"Debopam Samanta","doi":"10.1016/j.yebeh.2024.110171","DOIUrl":"10.1016/j.yebeh.2024.110171","url":null,"abstract":"<div><div>Dravet syndrome (DS) is a severe genetic developmental and epileptic encephalopathy, primarily caused by SCN1A gene mutations. Historically, treatments like clobazam and valproate have been used without evidence from randomized controlled trials (RCTs). However, the therapeutic landscape of DS has evolved with multiple RCTs demonstrating the efficacy and safety of three antiseizure medications (ASMs): stiripentol, cannabidiol (CBD), and fenfluramine. In the absence of direct comparisons between these therapies, several network <em>meta</em>-analyses have been conducted to compare the ASMs, while expert consensus has independently been developed to formulate treatment guidelines. While these three ASMs show promise in reducing seizures, increasing awareness of non-seizure outcomes—such as cognitive development and quality of life—has shifted the focus of evaluation. Some recent real-world studies of these ASMs have reported improvements in these non-seizure outcomes, alongside sustained efficacy and safety. However, natural history studies continue to underscore persistent deficits in these areas and highlight suboptimal long-term seizure control despite the use of these therapies. This review addresses these gaps by first discussing network <em>meta</em>-analyses and treatment guidelines, along with the practical limitations of these approaches. It then examines the long-term efficacy, safety, non-seizure effects, and cost-effectiveness from real-world studies of these ASMs. Finally, emerging research on novel therapeutic approaches, including genetic and serotonergic modulation, is explored. By evaluating these developments, this review aims to guide clinical decision-making and propose future directions for optimizing DS care.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110171"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744382","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}
Pub Date : 2024-11-29DOI: 10.1016/j.yebeh.2024.110164
Ricardo Mario Arida , Amanda Cristina Mosini , Sarah Collard , Maria Alice Susemihl , Heitor Franco Santos , Lavínia Teixeira-Machado
This survey evaluated the Brazilian population’s physical exercise habits and compared them with those from two decades ago. In this cross-sectional study, 432 people with epilepsy (PWE) assessed the questionnaire. Of these, 387 (age: 33 ± 10.58, 81.4 % women) completed the questionnaire. Among them, 60.5 % were involved in regular physical activities. Among those who exercise regularly, the majority (96.5 %) exercised between 2 and 5 times weekly and had been physically active for at least two years. Only 23.3 % were prohibited by their doctors from participating in physical activities. Only 10 % reported that seizures occur during exercise, and about half of them (55.8 %) believed that exercise improves or has no effect on seizure frequency. Most (79.06 %) did not or rarely believe exercise can trigger seizures. More than half (57.3 %) were not afraid to have seizures during exercise or were not afraid of injury during exercise due to a seizure (69 %). Most believed exercise improves cognition (80.9 %), depression, and anxiety (93.8 %). We visited this scenario two decades early. In our previous study, only 15 % exercised regularly, while in this survey, 58.4 % routinely exercised. Our findings also align with our initial survey, indicating a low seizure frequency during regular exercise, a belief that physical activity reduces seizure frequency, and a reduction in the fear that exercise might trigger seizures. In conclusion, our results show that after two decades, there have been several improvements in physical and sports activity participation among PWE. Implementing strategies to reduce barriers to exercise for PWE and educating them on the benefits of physical activity can help improve this scenario.
{"title":"Physical exercise habits in people with epilepsy: A survey from Brazilian population","authors":"Ricardo Mario Arida , Amanda Cristina Mosini , Sarah Collard , Maria Alice Susemihl , Heitor Franco Santos , Lavínia Teixeira-Machado","doi":"10.1016/j.yebeh.2024.110164","DOIUrl":"10.1016/j.yebeh.2024.110164","url":null,"abstract":"<div><div>This survey evaluated the Brazilian population’s physical exercise habits and compared them with those from two decades ago. In this cross-sectional study, 432 people with epilepsy (PWE) assessed the questionnaire. Of these, 387 (age: 33 ± 10.58, 81.4 % women) completed the questionnaire. Among them, 60.5 % were involved in regular physical activities. Among those who exercise regularly, the majority (96.5 %) exercised between 2 and 5 times weekly and had been physically active for at least two years. Only 23.3 % were prohibited by their doctors from participating in physical activities. Only 10 % reported that seizures occur during exercise, and about half of them (55.8 %) believed that exercise improves or has no effect on seizure frequency. Most (79.06 %) did not or rarely believe exercise can trigger seizures. More than half (57.3 %) were not afraid to have seizures during exercise or were not afraid of injury during exercise due to a seizure (69 %). Most believed exercise improves cognition (80.9 %), depression, and anxiety (93.8 %). We visited this scenario two decades early. In our previous study, only 15 % exercised regularly, while in this survey, 58.4 % routinely exercised. Our findings also align with our initial survey, indicating a low seizure frequency during regular exercise, a belief that physical activity reduces seizure frequency, and a reduction in the fear that exercise might trigger seizures. In conclusion, our results show that after two decades, there have been several improvements in physical and sports activity participation among PWE. Implementing strategies to reduce barriers to exercise for PWE and educating them on the benefits of physical activity can help improve this scenario.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110164"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744489","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}
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