Epilepsy & Behavior最新文献

{"title":"Development of a rapid screener to elicit patient preferences for antiseizure medication discontinuation","authors":"Samuel W. Terman ,&nbsp;Jordan M. Silva ,&nbsp;Max Kuster ,&nbsp;Jasper Lee ,&nbsp;Amanda Brand ,&nbsp;Kara Manuel ,&nbsp;Navya Kalia ,&nbsp;Micaela Dugan ,&nbsp;Marla Reid ,&nbsp;Katherine Mortati ,&nbsp;Alexandra Tolmasov ,&nbsp;Palak S. Patel ,&nbsp;James F. Burke ,&nbsp;Arthur C. Grant ,&nbsp;Susanna S. O’Kula ,&nbsp;Chloe E. Hill","doi":"10.1016/j.yebeh.2024.110240","DOIUrl":"10.1016/j.yebeh.2024.110240","url":null,"abstract":"<div><h3>Objective</h3><div>While guidelines encourage individualized discussions of the risks and benefits of antiseizure medication (ASM) withdrawal after a period of seizure-freedom, no formal methods exist for assessing patient preferences. We report the initial development of a rapid patient preferences screener.</div></div><div><h3>Methods</h3><div>We conducted a mixed-methods study of adults who were ≥1 year seizure-free and seen for epilepsy across three institutions. We reviewed existing questionnaires and adapted three questions measuring core constructs influencing ASM decisions – views about ASMs, driving restrictions, and seizures. We added one additional “global” question, for 4 total questions. Participants rated question clarity and utility from 1 (low) to 7 (high).</div></div><div><h3>Results</h3><div>Of 32 participants, the median patient age was 46 (interquartile range [IQR] 33–56), with a median 3 years since their last seizure (IQR 2–11). Median responses were: 2 (IQR 1–5) for being bothered by ASMs, 2 (IQR 1–6) for feeling that a driving restriction would be disruptive, and 5 (IQR 4–7) for feeling that another seizure would be serious. Respondents tended to disagree that ASMs are doing more harm than good (median 1, IQR 1–2). Participants rated question clarity (median 6, IQR 6–7) and utility (median 7, IQR 6–7) highly.</div></div><div><h3>Conclusions</h3><div>We report the initial development of a pre-visit rapid screener of patient preferences pertinent to ASM withdrawal in well-controlled epilepsy. Patients endorsed the utility of such a screener and provided guidance to improve items. We hope that this work will ultimately improve shared decision-making.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110240"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerometer-measured physical activity patterns in daily life and their association with factors of sedentary behavior in people with epilepsy","authors":"Burcin Aktar ,&nbsp;Birgul Balci ,&nbsp;Hatice Eraslan Boz ,&nbsp;Sevgi Ferik Ozalan ,&nbsp;Ibrahim Oztura ,&nbsp;Baris Baklan","doi":"10.1016/j.yebeh.2024.110198","DOIUrl":"10.1016/j.yebeh.2024.110198","url":null,"abstract":"<div><h3>Objectives</h3><div>Being physically active is important, but people with epilepsy (PWE) tend to have a sedentary lifestyle. There is limited evidence about physical activity patterns in PWE using objective measures. The aims of this study were: (1) to examine the physical activity patterns of PWE, (2) compare activity patterns between PWE in terms of drug-resistant epilepsy and medically controlled epilepsy with age- and sex-matched healthy controls; and (3) explore the association between physical activity patterns and body function and structure, activity and participation, and quality of life of PWE.</div></div><div><h3>Methods</h3><div>Seventy-three PWE and 74 healthy controls were enrolled. Physical activity data were collected prospectively over a 7-day period using a SenseWear Arm Band. Body function and structure in PWE were evaluated using the Fatigue Severity Scale, 30-second Chair Stand (30CST), Biodex-Fall Risk, Generalized Anxiety Disorder, Beck Depression Inventory, Pittsburg Sleep Quality Index, and Montreal Cognitive Assessment (MoCA). Activity and participation in PWE were measured using Activities-specific Balance Confidence, Timed Up and Go Test, Six-Minute Walk Test, and Tinetti-Balance and Tinetti-Gait. The quality of life of PWE was evaluated using the Quality of Life in Epilepsy Inventory-31.</div></div><div><h3>Results</h3><div>PWE took fewer steps per day and were sedentary for more time compared with healthy controls (7826 vs. 10,564 steps, <em>P</em> = 0.01; 534 min/day vs. 463 min/day, <em>P</em> &lt; 0.001), especially PWE with drug-resistant epilepsy. 30CST, MoCA, and Biodex-Fall Risk were associated with sedentary behavior, with Biodex-Fall Risk explaining 7.2 % of the variance.</div></div><div><h3>Conclusions</h3><div>PWE demonstrated lower physical activity levels compared with healthy individuals, especially those with drug-resistant epilepsy. Our study highlights the need to tailor strategies including postural stability exercises for the enhancement of physical activity levels in PWE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110198"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of temporal changes in cognitive effects induced by antiseizure medications in epilepsy patients","authors":"Ömer Karadaş ,&nbsp;Javid Shafiyev ,&nbsp;Akçay Övünç Karadaş ,&nbsp;Uğur Burak Şimşek ,&nbsp;Betül Özenç ,&nbsp;Özlem Aksoy Özmenek","doi":"10.1016/j.yebeh.2024.110199","DOIUrl":"10.1016/j.yebeh.2024.110199","url":null,"abstract":"<div><h3>Objective</h3><div>Numerous studies have been conducted investigating the effects of antiseizure medications (ASMs) on cognitive functions, and the cognitive side effects of some ASMs have been demonstrated. However, data on whether tolerance to these side effects develops over time is insufficient. The aim of this study is to evaluate the reversibility of cognitive impairments caused by ASMs in patients, utilizing event-related potentials (ERPs) and the Montreal Cognitive Assessment (MoCA) test.</div></div><div><h3>Materials and Methods</h3><div>The single-center prospective study was conducted from July 2022 to August 2023. This study enrolled participants aged 18 to 50 who had been diagnosed with epilepsy and were planning to commence treatment with an antiseizure medication (ASM). The inclusion criteria comprised individuals aged between 18 and 50 years, with a diagnosis of epilepsy, and who were intending to initiate a new ASM as monotherapy. Exclusion criteria encompassed individuals younger than 18 or older than 50 years, those diagnosed with psychogenic non-epileptic seizures, those currently on antiepileptic drugs, and those with cognitive dysfunction or dementia. Before starting treatment, patients were subjected to the MoCA test and ERP measurements by a neurologist. These tests and measurements were repeated at the second and sixth months of treatment.</div></div><div><h3>Result</h3><div>The study included a cohort of 254 participants with a mean age of 32.6 (±14) years. At the second month after starting treatment with carbamazepine (CBZ), zonisamide (ZNS), valproic acid (VPA), and topiramate (TPM), both MoCA and ERP values showed significantly worse cognitive impairment compared to before treatment (p &lt; 0.05). This impairment showed a significant improvement by the sixth month for CBZ, ZNS, and VPA (p &lt; 0.05). Although there was improvement in MoCA and ERP values in patients using TPM, the changes remained statistically significant compared to baseline values (p &lt; 0.05). In patients using levetiracetam, lamotrigine, oxcarbazepine, and lacosamide, cognitive impairment was not statistically significant at either the second or sixth month.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that the detrimental cognitive effects associated with CBZ, VPA, and ZNS could be reversible. Although some improvement was observed over time with TPM, the absence of significant recovery suggests that additional time may be required for a substantial reversal of these effects.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110199"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Animal welfare assessment after controlled cortical impact in CD-1 mice – A model of posttraumatic epilepsy","authors":"Ricardo Schmidt ,&nbsp;Björn Welzel ,&nbsp;Wolfgang Löscher","doi":"10.1016/j.yebeh.2024.110214","DOIUrl":"10.1016/j.yebeh.2024.110214","url":null,"abstract":"<div><div>The ethical use of laboratory animals requires that the benefits of an experimental study are carefully weighed against potential harm to the animals. In traumatic brain injury (TBI) research, ethical concerns are especially relevant to severe TBI, after which animals may experience suffering, depending on the implementation of refinement measures such as (1) postsurgical analgesia during the initial period following TBI and (2) humane endpoints. However, despite the frequent use of rodent models such as fluid percussion injury (FPI) and controlled cortical impact (CCI) in rats or mice, there is only one recent study that applied assessment of welfare to a severe TBI model, the FPI model in rats. In the present pilot study in a CCI mouse model of posttraumatic epilepsy, we assessed animal welfare by a brain injury-specific severity scoresheet. Furthermore, nest building was used as a sensitive indicator of health and welfare in laboratory mice. Sham mice that underwent craniotomy but not CCI were used for comparison. Craniotomy and CCI were performed under anesthesia with isoflurane, followed by 3 days of postsurgical analgesia with the opioid l-methadone. Mannitol was used to prevent the head pain caused by increased intracranial pressure. Using the TBI-specific scoresheet to describe and monitor potential distress in animals, moderately increased scores were determined in CCI mice only over the first 2 days after surgery, indicating that animal suffering in this model is transitory. Similarly, significantly impaired nest building was observed at 1 but not 7 days after CCI. We conclude that with effective postsurgical analgesia and mannitol behavioral recovery is rapid in mice after CCI.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110214"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of an epilepsy peer education program on knowledge, attitudes, and first aid approaches: A quasi-experimental design","authors":"Yasemin Şahin Yıldız ,&nbsp;Büşra Kurtuluş","doi":"10.1016/j.yebeh.2024.110224","DOIUrl":"10.1016/j.yebeh.2024.110224","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the effect of a peer education program on students’ epilepsy knowledge, attitudes, and seizure first aid approaches.</div></div><div><h3>Methods</h3><div>This study utilized a one-group pretest/posttest quasi-experimental design. Peer educators provided training to 1343 peer students. The program consisted of two face-to-face sessions, each lasting 60 min. Data were collected using a demographic questionnaire, first aid management information form, The Epilepsy Knowledge Level Scale, and The Epilepsy Attitude Scale. Descriptive statistics, paired samples <em>t</em>-test, and Pearson correlation analysis were used to analyze the data. The significance level was set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>The Epilepsy Knowledge Scale score increased from 8.17(±3.46) to 12.50(±2.41), and The Epilepsy Attitude Scale score increased from 59.39(±7.32) to 61.01(±6.95) after the training. There was a significant positive correlation between students’ knowledge and attitudes both before training (r = 0.305, p &lt; 0.05) and after training (r = 0.344, p &lt; 0.05). After the training, the percentage of students who felt competent for seizure first aid intervention increased from 20.5 % to 54.4 % (p &lt; 0.001). After the training, the results regarding recognizing seizure symptoms and what to do during a seizure were statistically significant (p &lt; 0.05).</div></div><div><h3>Significance</h3><div>Our results show that peer-mediated learning is highly acceptable and that the training improves students’ knowledge, positive attitudes, and seizure first aid approaches. Given these results, it is suggested that school-based epilepsy peer education programs be developed and implemented for students who will become future health professionals.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110224"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating life after New-onset refractory status epilepticus (NORSE) and Febrile infection-related epilepsy syndrome (FIRES): Insights from caregiver and patient interviews","authors":"Krista Eschbach ,&nbsp;Julia Reedy ,&nbsp;Teneille Gofton ,&nbsp;Margaret Gopaul ,&nbsp;Raquel Farias-Moeller ,&nbsp;Marissa Kellogg ,&nbsp;Kelly Knupp ,&nbsp;Lawrence J. Hirsch ,&nbsp;Nora Wong ,&nbsp;Brook Dorsey Holliman","doi":"10.1016/j.yebeh.2024.110236","DOIUrl":"10.1016/j.yebeh.2024.110236","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the lived experience of patients with NORSE and explore quality of life (QOL) for patients and their caregivers.</div></div><div><h3>Background</h3><div>NORSE is a rare condition characterized by refractory status epilepticus, often of unknown cause, in a previously neurologically healthy individual. Febrile infection-related epilepsy syndrome (FIRES) is a subset of NORSE. NORSE is associated with a risk of mortality, acute morbidity, and neurocognitive sequela with limited data about the long-term impacts.</div></div><div><h3>Methods</h3><div>We conducted in-depth individual or dyadic semi-structured interviews with patients and caregivers. Interviews explored the long-term experiences after NORSE and its impacts on patient and caregiver QOL. Data were analyzed using a thematic content analysis approach.</div></div><div><h3>Results</h3><div>Fourteen interviews, comprising 5 patients and 15 caregivers, were completed between April 2023 – February 2024. The median age at NORSE onset was 17 years (IQR: 11.00 – 20.25) with a median of 5.60 years (IQR: 3.88 – 8.50) since onset. While experiences varied based on NORSE outcomes and time since onset, we identified the following themes: 1) Seizures, medication side effects, and comorbid health concerns impact patient independence and QOL; 2) Mental and behavioral health concerns compounded by loneliness and isolation impact patient QOL; 3) Friend and family relationship changes impact patient social and emotional QOL; 4) Family members take on care of the patient and experience significant life changes.</div></div><div><h3>Conclusion</h3><div>NORSE has significant life-altering impacts on patients and caregivers. These findings highlight a need to evaluate outcomes and provide support that extends beyond seizure management.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110236"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child with epilepsy in school environment – The development of a conceptual model","authors":"Dana Brabcová Buršíková ,&nbsp;Jiří Kohout ,&nbsp;Martina Komzáková ,&nbsp;Alena Nohavová ,&nbsp;Vendula Tegelová","doi":"10.1016/j.yebeh.2024.110246","DOIUrl":"10.1016/j.yebeh.2024.110246","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this qualitative study is to develop a conceptual model for the school life of the children with epilepsy based on grounded theory methodological framework.</div></div><div><h3>Methodology</h3><div>A total of 20 children with epilepsy participated in the semi-structured interviews. Inclusion criteria were age of 8–15 years, IQ higher than 70, duration of epilepsy of at least of two years and attendance of mainstream schools. 15 children had never seizure in school and 16 of them have not had a seizure in last 12 months. Qualitative research data was processed based on grounded theory with open coding leading consecutively to several main categories, axial coding establishing connections between individual categories, and finally selective coding resulting in one central category which was the core of the developed conceptual model.</div></div><div><h3>Results</h3><div>Eight main categories were identified during open coding: type of epilepsy and its management, sources of stress at school, adaptive responses to stressors, safe school environment in relation to (a) epilepsy and (b) learning, family support, stability of experience and behavior, and positive self-concept. Axial and selective coding resulted in establishment of Adaptive responses to stressors as the central category which is in the developed conceptual model determined by relevant external and internal factors as well as the sources enabling effective adaptation.</div></div><div><h3>Conclusions</h3><div>The presented research emphasize the importance of adaptive responses to stressors in the school environment among children with epilepsy which may be useful in counselling focused on how to avoid or successfully manage possible traumatizing experience related with epilepsy in this group.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110246"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the impact of etiology, lead time to treatment, and parental awareness on outcomes in infantile epileptic spasm syndrome?","authors":"Deniz Menderes ,&nbsp;Esra Serdaroğlu ,&nbsp;Tuğba Hırfanoğlu ,&nbsp;Ayşe Serdaroğlu ,&nbsp;Ebru Arhan","doi":"10.1016/j.yebeh.2024.110178","DOIUrl":"10.1016/j.yebeh.2024.110178","url":null,"abstract":"<div><h3>Objective</h3><div>Infantile epileptic spasm syndrome (IESS) is a kind of developmental epileptic encephalopathy that can lead to severe outcomes, including drug-resistant epilepsy and impaired neurodevelopment. The underlying etiology, early diagnosis, and adequate treatment impact the outcome. Our study focused on examining the factors that influence the prognosis and the level of knowledge among families regarding IESS.</div></div><div><h3>Methods</h3><div>In the Department of Pediatric Neurology at Gazi University Hospital, we examined 62 IESS children’s demographics, neuroimaging, metabolic and genetic findings, seizure characteristics, treatment choices, and long-term outcomes. Our study examined family awareness of seizures, lead time to treatment<!--> <!-->(LTT), and their impact on prognosis.</div></div><div><h3>Results</h3><div>Forty-two (67.8 %) patients presented with a symptomatic cause, with over half experiencing intraventricular hemorrhage and/or periventricular leukomalacia attributable to prematurity. The hormonal therapy (tetracosactide or oral prednisolone) was the preferred treatment. Treatment was effective for two-thirds of the patients. Nevertheless, hardly 50 % of the families acknowledged the “event” as a seizure. However, 34 (61 %) individuals had sought medical advice from a doctor during the first seven days. The mean time from the start of seizures to seeking medical care was 9.2 ± 5.7 days.</div></div><div><h3>Conclusion</h3><div>Our research revealed that the etiology was the most significant factor influencing the long-term outcomes of IESS. Additionally, we demonstrated that the clinicians who initially encountered the patients promptly referred them to pediatric neurology departments, despite the fact that the families’ seizure awareness was poor. To help prevent this circumstance, it is important to provide information about infantile spasms to the families of high-risk infants.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110178"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double Stigma: Reluctance to be referred to a psychiatrist among people with epilepsy and psychiatric comorbidities","authors":"Si-Lei Fong ,&nbsp;Aminath Shauna ,&nbsp;Kheng-Seang Lim ,&nbsp;Chong-Guan Ng ,&nbsp;Xuen Yu ,&nbsp;Siew-Tim Lai ,&nbsp;Hui-Jan Tan ,&nbsp;Juen-Kiem Tan ,&nbsp;Venus Tang ,&nbsp;Chong-Tin Tan","doi":"10.1016/j.yebeh.2024.110196","DOIUrl":"10.1016/j.yebeh.2024.110196","url":null,"abstract":"<div><h3>Introduction</h3><div>Psychiatric comorbidities such as depression and anxiety disorders are highly prevalent among people with epilepsy (PWE). These two co-occurring chronic illnesses could lead to double stigma and negatively impact every aspect of psychiatric and epilepsy care for PWE, especially in help-seeking behavior. We aimed to identify the socio-demographic and clinical factors contributing to reluctance to be referred to a psychiatrist among PWE.</div></div><div><h3>Methods</h3><div>A prospective cross-sectional study was conducted at a tertiary teaching hospital in Kuala Lumpur, Malaysia. Psychological screening was done using the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and General Anxiety Disorder (GAD-7) questionnaire. Patients screened positive were offered psychiatric referrals and given an early psychiatric clinic appointment if they agreed to the referral. The reasons for those who refused the referral were noted.</div></div><div><h3>Results</h3><div>Out of 585 patients, 91 (15.5 %) were screened positive for depression and/or anxiety. Eighteen patients were excluded from the study due to pre-existing psychiatric disorders. Of the remaining 73 patients, 23 (31.5 %) agreed to be referred to a psychiatrist. Only 17 (23.3 %) attended the psychiatrist appointment. A total of 11 (15.1 %) and one (1.4 %) patients were subsequently diagnosed with major depressive disorder and generalized anxiety disorder, respectively. Another 50 (68.5 %) patients were not referred to a psychiatrist, predominantly (n = 43, 58.9 %) due to reluctance to be referred to a psychiatrist. The reasons included avoidance of referral likely related to stigma (n = 22, 51.2 %), self-reliance, family and caregivers’ disapproval of referral, and logistic difficulty. The mean scores in NDDI-E and GAD-7 in the referred group were higher than the not-referred group but not statistically significant (NDDI-E: 17.8 ± 3.6 vs. 16.5 ± 2.5, <em>p</em> = 0.072; GAD-7: 12.4 ± 5.70 vs. 9.8 ± 5.4, <em>p</em> = 0.061).</div></div><div><h3>Conclusion</h3><div>A significant number of PWE were reluctant to receive psychiatric referrals predominantly due to self-avoidance or family and caregiver disapproval of referral likely related to stigma. An integrated epilepsy care management model is recommended.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110196"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The comparison of hand grip strength between healthy volunteers and individuals diagnosed with temporal lobe epilepsy","authors":"Ece Hilal ,&nbsp;Fatma Meltem Usteki ,&nbsp;Serkan Aksu ,&nbsp;Semai Bek ,&nbsp;Gulnihal Kutlu","doi":"10.1016/j.yebeh.2024.110201","DOIUrl":"10.1016/j.yebeh.2024.110201","url":null,"abstract":"<div><h3>Purpose</h3><div>Hand grip strength (HGS) is crucial for the performance of daily activities and has been linked to various clinical parameters, including morbidity, mortality, and both physical and cognitive functions. While HGS has been shown to decline in numerous diseases, it has not been previously examined in patients diagnosed with temporal lobe epilepsy. This study aims to investigate the differences in hand grip strength between individuals with temporal lobe epilepsy and healthy volunteers.</div></div><div><h3>Methods</h3><div>A total of forty-four patients diagnosed with temporal lobe epilepsy (22 with controlled epilepsy and 22 with drug-resistant epilepsy) and 22 healthy volunteers were followed up at the Epilepsy and Sleep Center. Maximum and mean hand grip strength measurements were obtained for both the dominant and non-dominant hands using a digital hand dynamometer. Based on the assumption of normality, data from healthy volunteers and all epilepsy patients were analyzed using independent samples t-tests or Mann-Whitney U tests. Comparisons among the resistant epilepsy group, controlled epilepsy group, and healthy volunteer group were conducted using one-way analysis of variance (ANOVA) or Kruskal-Wallis tests. Pairwise comparisons were performed using independent samples t-tests or Mann-Whitney U tests. Correlations were assessed using Spearman’s rank correlation tests.</div></div><div><h3>Results</h3><div>The mean age of the sample was 32.56 years (SD = ±1.29). The sample comprised 24 male and 42 female participants. The average duration of education was 11.68 ± 3.20 years, while the average age of onset of epilepsy among patients was 16.39 ± 10.95 years, with a disease duration of 16.45 ± 10.97 years. Significant differences were observed in all hand grip strength variables between healthy volunteers and individuals diagnosed with temporal lobe epilepsy. Notably, there were significant differences in hand grip strength between healthy volunteers and the patient group; however, no differences were found between subgroups with controlled seizures and those with drug-resistant epilepsy.</div></div><div><h3>Conclusion</h3><div>A significant reduction in hand grip strength has been observed in patients diagnosed with temporal lobe epilepsy, regardless of treatment resistance and disease severity. This decline may be attributed to several factors, including impaired motor coordination resulting from seizures, side effects of medications, and mood disturbances. Further comprehensive studies are necessary to explore the relationship between these underlying factors and hand grip strength, as well as its association with other clinical variables such as functionality and mortality.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110201"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812546","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}