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Epilepsy Arabic renaming to cerebroelectric disorder could minimize the stigma 癫痫病阿拉伯语更名为脑电障碍可以减少耻辱。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.eplepsyres.2024.107495
Doaa A. Mekkawy , Nirmeen kishk , Noha T abokrysha , Gihan M Ramzy , Reham Mohamed Shamloul , Rehab Magdy , Alshimaa S. Othman , Amr Mohamed Fouad , Osama Yacoub , Maged Abdel-Naseer , Hatem S. Shehata , Nevin M. Shalaby , Amr Hassan , Amal S. Ashour , Ahmed Dahshan , Mona Hussein , Mohamed khodery , Hazem Kamal Alhewag , Dalia Abdelfatah , Nesma Mounir

Background

Naming is an important part of human communication. The precision of medical terms greatly influences the patients and their caregivers. "Alsara’الصرع " is the Arabic term defining epilepsy. However, it has a highly negative impact on patients, as reported by many caring physicians.

Methods

A multiple-choice face-to-face questionnaire was designed to assess stigma among patients with epilepsy (PwE), causes, impact on quality of life, impression of PwE about the Arabic terminology of epilepsy Alsara’, and their opinion regarding changing it to precise term "itrab fi kahrabeit el mokh" اضطراب في كهربية المخ” which means disturbance of the electrical brain activity. Stigma was assessed using a three-item stigma scale.The interviewed subjects were recruited from Cairo, Beni Suef, and Sohag University hospitals consecutively during a period from 15 August 2023 to 30 December 2023.

Results

Three hundred seventy-two PwE responded to the survey. Three hundred fifty-one (94.4 %) PwE felt a disease stigma. About 50 % of them attributed this stigma to the Arabic name of the disease. Eighty-four percent accepted changing the name Alsara’ into “itrab fi kahrabeit el mokh” and 77.2 % suspected a positive impact of this amendment on society. The occurrence of generalized tonic-clonic seizures was found to be an independent risk factor for epilepsy-associated stigma.

Conclusion

The Arabic nomenclature of epilepsy "Alsara’" is not an accurate term for epilepsy. In addition to being associated with many poor misconceptions and stigma. We hope this study will pave the way to replace it with a more appropriate and less defaming term.
背景:命名是人类交流的重要组成部分。医学术语的准确性对患者及其护理人员影响很大。“Alsara'الصرع”是定义癫痫的阿拉伯语术语。然而,正如许多有爱心的医生所报告的那样,它对患者有非常负面的影响。方法:采用面对面的多项选择问卷,评估癫痫患者(PwE)的耻辱感、原因、对生活质量的影响、PwE对阿拉伯语“癫痫Alsara”术语的印象,以及他们对将其改为精确术语“itrab fi kahrabeit el mokh”اضطراب في كهربية المخ(意为脑电活动紊乱)的意见。污名采用三项污名量表进行评估。受访对象是在2023年8月15日至2023年12月30日期间从开罗、贝尼苏夫和索哈格大学医院连续招募的。结果:372名PwE回应了调查。351名PwE(94.4 %)有疾病耻辱感。大约50% 他们将这种耻辱归因于这种疾病的阿拉伯名称。84%的人同意将“Alsara”更名为“itrab fi kahrabeit el mokh”,77.2%的人怀疑这一修正案会对社会产生积极影响 。发现全身性强直-阵挛性发作的发生是癫痫相关病耻感的独立危险因素。结论:阿拉伯语对癫痫的命名“Alsara”不是一个准确的癫痫术语。除了与许多糟糕的误解和耻辱联系在一起。我们希望这项研究将铺平道路,用一个更合适、更少诽谤的术语来取代它。
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引用次数: 0
Long-term efficacy and tolerability of brivaracetam in pediatric patients with focal-onset seizures and cognitive or learning comorbidities: Post hoc analysis of an open-label trial 布瓦西坦治疗局灶性癫痫和认知或学习合并症患儿的长期疗效和耐受性:一项开放标签试验的事后分析
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.eplepsyres.2024.107482
Dimitrios Bourikas , Juliane Koch , Christine de la Loge , Svetlana Dimova , Sami Elmoufti , Brian Moseley , Lieven Lagae

Objective

Efficacy, tolerability, and behavioral/executive functioning during long-term adjunctive brivaracetam treatment were assessed in pediatric patients with focal-onset seizures (FOS) with/without cognitive/learning comorbidities (CLC).

Methods

Post hoc analysis of a phase 3 open-label follow-up trial (N01266/NCT01364597). Patients with FOS (<16 years at core trial entry; direct enrollers ≥4–<17 years) received ≤5 mg/kg/day brivaracetam (≤200 mg/day). Subgroup analyses were performed for patients with and without ongoing CLC at baseline.

Results

Patients with CLC (84/185 [45.4 %]) had longer epilepsy duration and higher number of prior antiseizure medications. Kaplan-Meier–estimated brivaracetam retention at 1, 3, and 5 years was 75.0 %/78.2 %, 61.9 %/61.9 %, and 52.2 %/53.3 % in patients with/without CLC. Efficacy assessments (patients >2 years of age) showed numerically lower median percent reduction in FOS frequency/28 days (43.8 %/74.1 % [n = 63/60]), 50 % responder rates for FOS (46.0 %/61.7 % [n = 63/60]), and ≥12-month continuous freedom from all seizures (31.7 %/55.9 % [n = 60/68 patients with ≥12 months treatment]) in patients with/without CLC. Treatment-emergent adverse events were reported in 94.0 %/95.0 % of patients with/without CLC (serious: 33.3 %/27.7 %; drug-related: 31.0 %/33.7 %). From baseline to last evaluation, most patients with/without CLC had no shift in T-score category for each Achenbach Child Behavior Checklist (CBCL) 1.5–5 syndrome (≥50.0 %/≥72.2 %), CBCL 6–18 syndrome (≥66.0 %/≥69.1 %), and Behavior Rating Inventory of Executive Function scale (≥66.7 %/≥69.0 %).

Conclusions

These data indicate that brivaracetam could be an efficacious and well-tolerated treatment option for pediatric patients with FOS with and without CLC. Behavior and executive functioning were generally stable or slightly improved in patients with and without CLC.
目的:评估伴有/不伴有认知/学习合并症(CLC)的局灶性癫痫(FOS)患儿长期辅助布伐西坦治疗期间的疗效、耐受性和行为/执行功能。方法:对一项3期开放标签随访试验(N01266/NCT01364597)进行事后分析。结果:CLC患者(84/185[45.4 %])癫痫持续时间较长,既往抗癫痫药物使用次数较多。kaplan - meier估计,布伐西坦在1、3和5年的保留率分别为75.0 %/ 78.2% %、61.9 %/61.9 %和52.2 %/53.3 %。疗效评估(患者年龄为bb0 ~ 2岁)显示,在有/无CLC患者中,FOS频率/28天降低的中位数百分比较低(43.8 %/74.1 % [n = 63/60]), FOS的应答率为50 %(46.0 %/61.7 % [n = 63/60]),所有癫痫发作持续自由≥12个月(31.7 %/55.9 % [n = 60/68例治疗≥12个月的患者])。94.0 %/95.0 %的CLC /非CLC患者报告了治疗中出现的不良事件(严重:33.3% %/27.7 %;毒品:31.0 % / 33.7 %)。从基线到最后一次评估,大多数患有/未患有CLC的患者在每个Achenbach儿童行为检查表(CBCL) 1.5-5综合征(≥50.0 %/≥72.2 %),CBCL 6-18综合征(≥66.0 %/≥69.1 %)和执行功能量表行为评定量表(≥66.7 %/≥69.0 %)的t评分类别上没有变化。结论:这些数据表明布瓦西坦可能是一种有效且耐受性良好的治疗方案,适用于伴有或不伴有CLC的小儿FOS患者。无论有无CLC,患者的行为和执行功能总体稳定或略有改善。
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引用次数: 0
The characterization of psychosis and response to antipsychotic therapy in monogenic forms of familial focal epilepsy: A systematic review 家族性局灶性癫痫单基因形式的精神病特征和对抗精神病治疗的反应:系统回顾。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.eplepsyres.2024.107493
Mark Ainsley Colijn
While the genetic architecture of epilepsy is complex and presumably polygenic in many cases, pathogenic variants have increasingly been identified, and this is perhaps best exemplified by the monogenic familial focal epilepsies. Although individuals with epilepsy (particularly focal epilepsy) are at increased risk of developing psychosis, little has been written on this topic in relation to monogenic familial focal epilepsy, specifically. As such, this systematic review aimed to characterize the phenomenology of psychosis (and response to antipsychotic therapy) in affected individuals. Only eight articles were identified and minimal information with respect to psychiatric phenotyping was provided in most cases. As such, although no firm conclusions can be drawn, it is notable that none of the reports described a temporal relationship between seizure and psychosis onset; the typical convention used in epilepsy. As most reports also did not include primary psychotic disorder diagnoses, it remains unclear if the individuals’ presentations were understood to represent epileptic psychoses or schizophrenia, and to what degree (if at all) their genetic variants were thought to have contributed directly to psychosis risk. More robust case descriptions are needed to better characterize the nature of psychotic symptoms (and their response to treatment) in monogenic familial focal epilepsy.
虽然癫痫的遗传结构很复杂,而且在许多情况下可能是多基因遗传,但致病变异体已被越来越多地发现,单基因家族性局灶性癫痫可能就是最好的例证。虽然癫痫(尤其是局灶性癫痫)患者罹患精神病的风险会增加,但有关单基因家族性局灶性癫痫的研究却很少。因此,本系统综述旨在描述受影响患者的精神病现象(以及对抗精神病药物治疗的反应)。结果只发现了八篇文章,而且大多数文章都只提供了极少的精神病表型方面的信息。因此,虽然无法得出肯定的结论,但值得注意的是,没有一篇报告描述了癫痫发作与精神病发病之间的时间关系;这是癫痫中使用的典型惯例。由于大多数报告也没有包括原发性精神病的诊断,因此目前仍不清楚这些人的表现是代表癫痫性精神病还是精神分裂症,也不清楚他们的基因变异在多大程度上(如果有的话)被认为直接导致了精神病风险。要更好地描述单基因家族性局灶性癫痫患者精神病症状(及其对治疗的反应)的性质,还需要更有力的病例描述。
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引用次数: 0
Late onset epilepsy findings in a developmental country, a report of first results 在一个发展中国家发现的晚发性癫痫,初步结果报告。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.eplepsyres.2024.107496
Hasan Saad Hosny, Mahmoud Salah Adly, Sarah Sherif Abdo, Sarah Khalil, Amr Mohamed Fouad

Introduction

Older patients with Late onset epilepsy (LOE) provide a special set of difficulties for both the treating doctors and the patients.

Objectives

To address the characteristics and treatment outcomes of LOE in a cohort of Egyptian population at a tertiary center and to assess factors affecting seizure freedom in this age group.

Methods

From December 1, 1995, to November 30, 2020, we analysed all patients with newly diagnosed epilepsy above the age of 50 at Cairo University's neurology department. The term "seizure freedom" was used to refer to the absence of seizures or auras for at least 12 months. Patients were classified as either having achieved seizure freedom or not.

Results

One hundred and twenty-one patients were included. The median follow-up time was 24 months. 69.4 % attain seizure freedom. 52.1 % of our patients had symptomatic epilepsy. Among this group, 31.4 % (n = 38) had epilepsy caused by cerebrovascular disease (ischemic or hemorrhagic). Patients with epileptogenic lesions in neuroimaging, and those who are receiving ≥ 2 ASMs had significantly higher probability of not achieving seizure freedom for 12 months compared to those with normal or non-epileptogenic lesions in neuroimaging and receiving ≤ 1 ASMs with significant trends a trend toward lower seizure freedom in both.

Conclusion

Patients with Late- onset epilepsy have an excellent chance of achieving seizure freedom, especially those controlled on 1 ASM and those with normal neuroimaging.
老年晚发性癫痫(LOE)患者给治疗医生和患者带来了一系列特殊的困难。目的:探讨在埃及某三级中心的一组人群中LOE的特点和治疗结果,并评估影响该年龄组癫痫发作自由的因素。方法:对1995年12月1日至2020年11月30日在开罗大学神经内科新诊断的50岁以上癫痫患者进行分析。“无癫痫发作”一词是指至少12个月没有癫痫发作或先兆。患者被分为癫痫发作自由和未发作自由两类。结果:纳入121例患者。中位随访时间为24个月。69.4 %患者癫痫发作自由。52.1 %的患者有症状性癫痫。其中31.4% % (n = 38)为脑血管病(缺血性或出血性)所致癫痫。与神经影像学显示为正常或非癫痫性病变且接受≤ 1 asm的患者相比,神经影像学显示为癫痫性病变且接受≥ 2 asm的患者在12个月内无法实现癫痫发作自由的概率明显更高,且两者均有明显的降低癫痫发作自由的趋势。结论:迟发性癫痫患者有极好的机会实现癫痫发作自由,特别是在1 ASM控制和神经影像学正常的患者。
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引用次数: 0
The relationship between disease self-management and internalized stigmatization in individuals with epilepsy: A sample in eastern Turkey
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.eplepsyres.2024.107497
Eda Ay , Emrah Ay , Nuray Bingol

Background

Epilepsy is often misunderstood, leading to fear, stigmatization of patients and the risk of social discrimination. For some patients, social stigma can be an even bigger problem than epilepsy itself.

Aim

This study examined the relationship between self-management and internalized stigma levels in individuals diagnosed with epilepsy.

Methods

This descriptive and cross-sectional study was conducted in the Neurology Outpatient Clinic of a Training and Research Hospital and 128 epilepsy patients were included in the sample based on various inclusion criteria such as having a diagnosis of epilepsy for at least six months, being over the age of 18, not having any psychiatric disorder that would prevent reading and comprehension.The Sociodemographic Data Form, Internalized Stigma in Epilepsy Scale, and Epilepsy Self-Management Scale were used to collect the data.

Results

The mean age at disease onset was 19.5 ± 11.7 years. In terms of the demographics of the patients, 55.5 % were female, 46 % were aged 18–22 years, 53.9 % were single, 30 % were at least university graduates, 85.2 % had income equal to their expenses, 75.8 % had a seizure frequency of more than one per year, 58.6 % had generalized onset seizures, and 73.4 % used one drug. The patients’ Self-Management Scale total score was 111.01 ± 13.22, and their Internalized Stigma Scale total score was 49.9 ± 12.9. The correlation analysis indicated a high significant negative correlation between the Self-Management Scale total score and the Internalized Stigma Scale total score (p < 0.001).

Conclusions

The patients’ self-management levels were above average, and their internalized stigma levels were moderate. The patients were most stigmatized in the areas of isolation and discrimination. Generally, as the self-management skills of patients increased, their internalized stigma levels decreased. In this context, it is recommended that intervention studies be conducted to increase the self-management levels and reduce stigma for individuals diagnosed with epilepsy.
{"title":"The relationship between disease self-management and internalized stigmatization in individuals with epilepsy: A sample in eastern Turkey","authors":"Eda Ay ,&nbsp;Emrah Ay ,&nbsp;Nuray Bingol","doi":"10.1016/j.eplepsyres.2024.107497","DOIUrl":"10.1016/j.eplepsyres.2024.107497","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is often misunderstood, leading to fear, stigmatization of patients and the risk of social discrimination. For some patients, social stigma can be an even bigger problem than epilepsy itself.</div></div><div><h3>Aim</h3><div>This study examined the relationship between self-management and internalized stigma levels in individuals diagnosed with epilepsy.</div></div><div><h3>Methods</h3><div>This descriptive and cross-sectional study was conducted in the Neurology Outpatient Clinic of a Training and Research Hospital and 128 epilepsy patients were included in the sample based on various inclusion criteria such as having a diagnosis of epilepsy for at least six months, being over the age of 18, not having any psychiatric disorder that would prevent reading and comprehension.The Sociodemographic Data Form, Internalized Stigma in Epilepsy Scale, and Epilepsy Self-Management Scale were used to collect the data.</div></div><div><h3>Results</h3><div>The mean age at disease onset was 19.5 ± 11.7 years. In terms of the demographics of the patients, 55.5 % were female, 46 % were aged 18–22 years, 53.9 % were single, 30 % were at least university graduates, 85.2 % had income equal to their expenses, 75.8 % had a seizure frequency of more than one per year, 58.6 % had generalized onset seizures, and 73.4 % used one drug. The patients’ Self-Management Scale total score was 111.01 ± 13.22, and their Internalized Stigma Scale total score was 49.9 ± 12.9. The correlation analysis indicated a high significant negative correlation between the Self-Management Scale total score and the Internalized Stigma Scale total score (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The patients’ self-management levels were above average, and their internalized stigma levels were moderate. The patients were most stigmatized in the areas of isolation and discrimination. Generally, as the self-management skills of patients increased, their internalized stigma levels decreased. In this context, it is recommended that intervention studies be conducted to increase the self-management levels and reduce stigma for individuals diagnosed with epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"209 ","pages":"Article 107497"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Plasma proteomics in epilepsy: Network-based identification of proteins associated with seizures 癫痫的血浆蛋白质组学:与癫痫发作相关的基于网络的蛋白质鉴定。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.eplepsyres.2024.107480
Saman Hosseini Ashtiani , Sarah Akel , Evelin Berger , Johan Zelano

Purpose

Identification of potential biomarkers of seizures.

Methods

In this exploratory study, we quantified plasma protein intensities in 15 patients with recent seizures compared to 15 patients with long-standing seizure freedom. Using TMT-based proteomics we found fifty-one differentially expressed proteins.

Results

Network analyses including co-expression networks and protein-protein interaction networks, using the STRING database, followed by network centrality and modularity analyses revealed 22 protein modules, with one module showing a significant association with seizures. The protein-protein interaction network centered around this module identified a subnetwork of 125 proteins, grouped into four clusters. Notably, one cluster (mainly enriching inflammatory pathways and Gene Ontology terms) demonstrated the highest enrichment of known epilepsy-related genes.

Conclusion

Overall, our network-based approach identified a protein module linked with seizures. The module contained known markers of epilepsy and inflammation. The results also demonstrate the potential of network analysis in discovering new biomarkers for improved epilepsy management.
目的:鉴定癫痫发作的潜在生物标志物。方法:在这项探索性研究中,我们量化了15例近期癫痫发作患者和15例长期癫痫发作无发作患者的血浆蛋白强度。利用基于tmt的蛋白质组学,我们发现了51个差异表达蛋白。结果:使用STRING数据库进行网络分析,包括共表达网络和蛋白质相互作用网络,随后进行网络中心性和模块化分析,发现22个蛋白质模块,其中一个模块显示与癫痫发作显著相关。以该模块为中心的蛋白质-蛋白质相互作用网络确定了125个蛋白质的子网络,分为四个簇。值得注意的是,一个簇(主要富集炎症途径和基因本体术语)显示已知癫痫相关基因的富集程度最高。结论:总的来说,我们基于网络的方法确定了与癫痫发作相关的蛋白质模块。该模块包含已知的癫痫和炎症标志物。研究结果还表明,网络分析在发现改善癫痫管理的新生物标志物方面具有潜力。
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引用次数: 0
Epilepsy core outcome set for effectiveness trials (EPSET): A systematic review of outcomes measured in registered phase III and IV clinical trials for adults with epilepsy 癫痫有效性试验的核心结局集(EPSET):对成人癫痫患者注册的III期和IV期临床试验的结果进行系统回顾。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.eplepsyres.2024.107481
James W. Mitchell , Rachel Batchelor , Guleed Adan , Adam Noble , Paula R. Williamson , Tony Marson
At present, little is known about the outcomes measured in studies assessing the effectiveness of treatments for adults with epilepsy. As part of a wider project developing a Core Outcome Set for clinical trials for adults with epilepsy, we summarised the current outcomes and measurement instruments used in completed phase III and IV clinical trials registered in the clinicaltrials.gov and International Standard Randomised Controlled Trial Number (ISRCTN) databases. Of the reviewed studies 104 were deemed eligible. The outcomes that were measured were recorded, and trial registry entries cross referenced against associated peer review publications. In total, 374 unique granular outcome terms were identified, which grouped into 45 outcome concepts across the following domains: seizures, cognitive/behavioural/psychiatric, sleep, general symptom, functional status / disability, emotional functioning, social functioning, delivery of care, life impact, trial processes, side effects / adverse events, pregnancy / offspring, and death. We identified evidence of outcome measurement heterogeneity, with just 10/45 outcome concepts measured in more than half of the identified studies. This association remained when assessing studies grouped by epilepsy chronicity (newly diagnosed vs. chronic/treatment refractory) and epilepsy classification (focal vs. other). These findings highlight the need for a Core Outcome Set for interventional studies for adults with epilepsy to improve consistency of outcome measurement and reporting.
目前,对评估成人癫痫治疗有效性的研究结果所知甚少。作为开发成人癫痫临床试验核心结果集的更广泛项目的一部分,我们总结了在clinicaltrials.gov和国际标准随机对照试验编号(ISRCTN)数据库中注册的已完成的III期和IV期临床试验的当前结果和测量工具。在审查的研究中,104项被认为是合格的。测量的结果被记录下来,试验注册条目与相关的同行评审出版物交叉引用。总共确定了374个独特的颗粒结局术语,分为以下领域的45个结局概念:癫痫发作、认知/行为/精神、睡眠、一般症状、功能状态/残疾、情感功能、社会功能、护理交付、生活影响、试验过程、副作用/不良事件、怀孕/后代和死亡。我们发现了结果测量异质性的证据,在超过一半的研究中,只有10/45个结果概念被测量。在评估癫痫慢性性(新诊断与慢性/治疗难治性)和癫痫分类(局灶性与其他)分组的研究时,这种关联仍然存在。这些发现强调了为成人癫痫患者的介入研究制定核心结果集的必要性,以提高结果测量和报告的一致性。
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引用次数: 0
Effectiveness and tolerability of cenobamate: A single center experience cenobamate的有效性和耐受性:单中心经验。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.eplepsyres.2024.107498
Christopher Saouda, Omar Nofal, Yamane Makke, Alexandra Eid, Victoria Vinarsky, Helen Edelberg, Sean M. Lee, Mohamad Koubeissi

Introduction

Medication-resistant epilepsy (MRE) is characterized by the failure of adequate trials of two antiseizure medications (ASMs). Numerous studies have shown that once two ASMs fail to control seizures, the likelihood of subsequent ASM regimens providing seizure control diminishes significantly. Recent clinical data on cenobamate (CNB) suggest it may offer higher rates of seizure freedom in MRE patients. This study aims to report real-world, single-center findings on the effectiveness and tolerability of CNB in treating MRE.

Methods

This retrospective study includes adult patients diagnosed with MRE and treated with CNB between 2020 and 2023 at The George Washington University (GWU). Data were collected from electronic medical records. Statistical analyses were conducted to evaluate CNB's impact on seizure control and patient outcomes.

Results

121 patients with medication-resistant epilepsy (MRE) were prescribed cenobamate (CNB). After exclusions, 104 patients were included in the effectiveness analysis and 111 in the tolerability analysis. Results showed that 34.6 % of patients achieved seizure freedom for at least three months, with a mean duration of seizure freedom of 11 ( ± 7.9) months.

Significance

CNB use in a large population of more than 100 patients demonstrated impressive anti-seizure activity with a good proportion of patients with MRE achieving seizure freedom despite having failed multiple prior ASMs.
前言:药物抵抗性癫痫(MRE)的特点是两种抗癫痫药物(asm)的充分试验失败。大量研究表明,一旦两种ASM不能控制癫痫发作,后续ASM方案提供癫痫发作控制的可能性显著降低。最近的临床数据表明,cenobamate (CNB)可以提高MRE患者的癫痫发作自由率。本研究旨在报道CNB治疗MRE的有效性和耐受性的真实单中心研究结果。方法:本回顾性研究纳入了2020年至2023年在乔治华盛顿大学(GWU)诊断为MRE并接受CNB治疗的成年患者。数据是从电子病历中收集的。统计分析评估CNB对癫痫发作控制和患者预后的影响。结果:121例难治性癫痫(MRE)患者使用了辛奥巴酸(CNB)。排除后,104例患者纳入疗效分析,111例患者纳入耐受性分析。结果34.6% %患者癫痫发作自由持续时间至少3个月,平均癫痫发作自由持续时间为11( ± 7.9)个月。意义:在100多例患者中使用CNB显示出令人印象深刻的抗癫痫活动,很大比例的MRE患者在多次asm失败的情况下实现了癫痫发作自由。
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引用次数: 0
Surgical outcome and contributing presurgical evaluations in children with magnetic resonance imaging-negative epilepsy and periodic seizure cycles 磁共振成像阴性癫痫和周期性发作周期儿童的手术结果和术前评估
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-27 DOI: 10.1016/j.eplepsyres.2024.107492
Yoshihiko Saito , Kenji Sugai , Masaki Iwasaki , Noriko Sato , Akiyoshi Kakita , Yuko Saito , Taisuke Ohtsuki , Masayuki Sasaki

Background

The identification of surgical candidates is a critical issue in patients with magnetic resonance imaging (MRI)-negative drug-resistant focal epilepsy and latent accompanying resectable lesions, such as focal cortical dysplasia (FCD). Recently, periodic seizure cycles have been associated with FCD in both patients with MRI-positive and MRI-negative epilepsy. We investigated the presurgical evaluation and postsurgical outcome of patients with MRI-negative epilepsy with FCD and a history of periodic seizure cycles.

Methods

We retrospectively reviewed the characteristics of presurgical evaluation and postsurgical seizure outcome in 14 children with MRI-negative drug-resistant focal epilepsy and a history of periodic seizure cycles. All the patients had FCD histopathologically.

Results

The mean age at epilepsy surgery was 7.7 ± 4.7 years (0.7–16.1 years). Favorable postsurgical seizure outcome (ILAE classes 1–3) was obtained in 10 (71 %) patients five years after surgery. The relative risk of the complete concordance between imaging findings and resected area for five-year seizure freedom was 2.25 in positron emission tomography (PET) and 2.22 in subtraction ictal single-photon emission computed tomography co-registered to MRI (SISCOM), and 1.86 in magnetoencephalography (MEG).

Conclusion

All the children with MRI-negative focal epilepsy and a history of periodic seizure cycles were turned out to have FCD pathologically, and are good surgical candidates. Favorable seizure outcome can be expected in such patients when resective epilepsy surgery is planned based on presurgical evaluation with PET or SISCOM.
背景:对于核磁共振成像(MRI)阴性的耐药局灶性癫痫和潜在的可切除病变(如局灶性皮质发育不良(FCD))患者,确定手术候选人是一个关键问题。最近,周期性发作周期与mri阳性和mri阴性癫痫患者的FCD有关。我们研究了mri阴性癫痫患者伴有FCD和周期性发作周期的术前评估和术后结果。方法回顾性分析14例mri阴性且有周期性癫痫发作史的耐药局灶性癫痫患儿的术前评价及术后癫痫结局特点。所有患者病理组织学均为FCD。结果癫痫手术平均年龄为7.7±4.7岁(0.7 ~ 16.1岁)。10例(71% %)患者术后5年获得良好的术后癫痫发作结果(ILAE等级1-3)。正电子发射断层扫描(PET)和磁共振成像(SISCOM)的减影单光子发射计算机断层扫描(SISCOM)与脑磁图(MEG)的成像结果完全一致的相对风险分别为2.25和2.22。结论所有mri阴性局灶性癫痫且有周期性发作史的患儿病理均证实为FCD,适合手术治疗。在术前PET或SISCOM评估的基础上计划切除性癫痫手术时,这类患者的癫痫发作预后良好。
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引用次数: 0
Cannabis use, sleep and mood disturbances among persons with epilepsy – A clinical and polysomnography study from a Canadian tertiary care epilepsy center 癫痫患者吸食大麻、睡眠和情绪障碍--加拿大一家三级护理癫痫中心的临床和多导睡眠图研究
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-20 DOI: 10.1016/j.eplepsyres.2024.107479
Garima Shukla , Rishabh Sablok , Zaitoon Shivji , Stuart Fogel , Gavin P. Winston , Lysa Boissé Lomax , Ana Johnson , Helen Driver

Objective

Interest in anti-seizure properties of cannabinoids is increasing, with the rise in prevalence of recreational and medical cannabis use, especially across Canada. In a recent study on people with epilepsy (PWE), cannabis use showed a strong association with poor psychosocial health. Sleep and mood comorbidities are highly prevalent in epilepsy, and are common motivations for cannabis use. The primary objective of this study was to assess demographic, subjective and objectively assessed sleep quality and mood related differences among PWE who regularly use cannabis compared to those who do not.

Methods

Consecutive consenting patients with a confirmed epilepsy diagnosis, admitted to our Epilepsy Monitoring Unit, over a 3-year period (2019–2022) were enrolled. Detailed epilepsy-related data and self-reported sleep [Pittsburgh Sleep quality index (PSQI)], Epworth Sleepiness Scale (ESS)], mood [(Beck’s Depression Inventory (BDI) and Beck’s Anxiety inventory (BAI)] and cannabis use related data were collected. Overnight polysomnography (PSG) was conducted on the first night of admission, with simultaneous 18-channel video-EEG. Sleep (PSG) scoring followed American Academy of Sleep Medicine guidelines by a scorer blinded to clinical details.

Results

Among 51 patients with similar seizure control, 25 (13 F) reported cannabis use (mean age 36.3+14.8 years) and were significantly younger than 26 (18 F) non-users (mean age 48.3+15 years). Cannabis users had significantly better subjective sleep quality (mean PSQI scores 7.2+2.9 vs 10.2+5.2 respectively). Most patients endorsed sleepiness (Cannabis users with ESS scores greater than 10; 91.3 %, 77.3 % in non-users) and moderate to extreme depression (BDI) scores. No significant differences were observed in objective sleep parameters. BDI score significantly predicted PSQI and ESS scores on multiple logistic regression analysis.

Significance

Despite a significant age difference, self-reported sleep quality is better among PWE who report regular cannabis use compared to non-users. However, there is no significant difference in objective sleep quantity and quality from PSG between the two groups. Additionally, severity of depressive symptoms is a significant predictor of sleep quality and of excessive daytime sleepiness among PWE.
目的随着娱乐性和医用大麻使用率的上升,人们对大麻素抗癫痫特性的兴趣与日俱增,尤其是在加拿大。在最近一项针对癫痫患者(PWE)的研究中,大麻的使用与不良的社会心理健康密切相关。睡眠和情绪并发症在癫痫患者中非常普遍,也是吸食大麻的常见动机。本研究的主要目的是评估经常使用大麻的癫痫患者与不使用大麻的癫痫患者在人口统计学、主观和客观评估的睡眠质量和情绪方面的差异。收集了详细的癫痫相关数据和自我报告的睡眠[匹兹堡睡眠质量指数(PSQI)]、埃普沃斯嗜睡量表(ESS)]、情绪[贝克抑郁量表(BDI)和贝克焦虑量表(BAI)]以及大麻使用相关数据。入院第一晚进行了夜间多导睡眠图(PSG)检查,并同时进行了 18 通道视频脑电图检查。结果在 51 名发作控制情况相似的患者中,有 25 人(13 名女性)报告吸食大麻(平均年龄为 36.3+14.8 岁),他们的年龄明显小于 26 名(18 名女性)非吸食者(平均年龄为 48.3+15 岁)。吸食大麻者的主观睡眠质量明显更好(平均 PSQI 分数分别为 7.2+2.9 与 10.2+5.2)。大多数患者都认可嗜睡(吸食大麻者的ESS评分大于10;91.3%,非吸食者为77.3%)和中度至极度抑郁(BDI)评分。在客观睡眠参数方面没有观察到明显差异。在多重逻辑回归分析中,BDI 分数可明显预测 PSQI 和 ESS 分数。意义尽管存在明显的年龄差异,但与不吸食大麻者相比,报告经常吸食大麻的残疾人自我报告的睡眠质量更好。然而,根据 PSG 的客观睡眠数量和质量,两组之间没有明显差异。此外,抑郁症状的严重程度也是影响残疾人睡眠质量和白天过度嗜睡的一个重要预测因素。
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Epilepsy Research
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