Jefry Winner George Stephen, Jesiha George Stephen, Mohammed Ali, Ashwin Kumar, Susanna Jose
Epilepsy is a common neurological disorder. Epilepsy has many therapeutic options, the popular one being antiseizure medications. A good proportion of patients always responds well to the existing treatment modalities. But some patients develop resistant epilepsy, and treating them can be challenging with the current treatment; such scenarios are encountered frequently in patients, especially those under treatment for long-term as well as specific syndromes and channelopathies. Resistant epilepsy warrants the need to develop newer therapeutics for better treatment outcomes, and antisense oligonucleotides (ASOs) are one among them. Our review discusses the more recent startups called ASOs in the context of epilepsy therapeutics.
{"title":"Antisense Molecules in Epilepsy—A Neuropharmacological Educational Review","authors":"Jefry Winner George Stephen, Jesiha George Stephen, Mohammed Ali, Ashwin Kumar, Susanna Jose","doi":"10.1055/s-0044-1779694","DOIUrl":"https://doi.org/10.1055/s-0044-1779694","url":null,"abstract":"Epilepsy is a common neurological disorder. Epilepsy has many therapeutic options, the popular one being antiseizure medications. A good proportion of patients always responds well to the existing treatment modalities. But some patients develop resistant epilepsy, and treating them can be challenging with the current treatment; such scenarios are encountered frequently in patients, especially those under treatment for long-term as well as specific syndromes and channelopathies. Resistant epilepsy warrants the need to develop newer therapeutics for better treatment outcomes, and antisense oligonucleotides (ASOs) are one among them. Our review discusses the more recent startups called ASOs in the context of epilepsy therapeutics.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140266226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Status epilepticus (SE) is a serious neurological emergency with a high mortality rate. Although levetiracetam is an effective antiepileptic drug for managing SE, its excessive cost may limit its accessibility. Focale, a more affordable generic version, is currently available and is more than 50% less expensive than the original version. However, there is currently no study on the efficacy and safety of Focale in pediatric patients with SE. Objective This study aimed to investigate the efficacy and safety of the antiepileptic drug, Focale, in pediatric patients. Materials and Methods This was a retrospective study that examined 131 pediatric patients younger than 18 years, who were treated with Focale for seizure control and prevention between June 2019 and November 2022. Results A total of 131 patients were included in the study, of which 73 (55.7%) were male. The age group with the highest frequency was 0 to 3 years old (28.2%). Focale was used with the following indications: (1) SE (45.04%), (2) acute repetitive convulsive seizures (22.14%), (3) primary prophylaxis (26.72%), (4) acute first seizure (1.52%), and (5) patients with epilepsy with nothing per oral (4.58%). Regarding the outcomes, the seizure-controlled rate in the seizure group was 81.1%, while the seizure prevention rate was 92.7% for those who received Focale as a seizure prophylaxis. Only 2 out of 131 patients had experienced adverse effects (1.5%). Conclusion The generic intravenous levetiracetam treatment had high seizure-controlled rate in patients with seizure attacks and seizure prevention rate in the seizure prophylaxis group in pediatric patients. Side effects of this regimen in pediatric patients were low.
{"title":"The Clinical Efficacy and Safety of Acute Care Setting for Intravenous Levetiracetam (Focale) in Children","authors":"Siriporn Tiamkao, Preechaya Ruangritkul, Nanthaphan Chainirun, Tarnthip Hutthawanichakornkul, Issara Bungtong, Pinjutha Thongjankaew, Sineenard Mungmanitmongkol, Somsak Tiamkao, Narong Auvichayapat, Kittisak Sawanyawisuth","doi":"10.1055/s-0043-1774744","DOIUrl":"https://doi.org/10.1055/s-0043-1774744","url":null,"abstract":"Abstract Background Status epilepticus (SE) is a serious neurological emergency with a high mortality rate. Although levetiracetam is an effective antiepileptic drug for managing SE, its excessive cost may limit its accessibility. Focale, a more affordable generic version, is currently available and is more than 50% less expensive than the original version. However, there is currently no study on the efficacy and safety of Focale in pediatric patients with SE. Objective This study aimed to investigate the efficacy and safety of the antiepileptic drug, Focale, in pediatric patients. Materials and Methods This was a retrospective study that examined 131 pediatric patients younger than 18 years, who were treated with Focale for seizure control and prevention between June 2019 and November 2022. Results A total of 131 patients were included in the study, of which 73 (55.7%) were male. The age group with the highest frequency was 0 to 3 years old (28.2%). Focale was used with the following indications: (1) SE (45.04%), (2) acute repetitive convulsive seizures (22.14%), (3) primary prophylaxis (26.72%), (4) acute first seizure (1.52%), and (5) patients with epilepsy with nothing per oral (4.58%). Regarding the outcomes, the seizure-controlled rate in the seizure group was 81.1%, while the seizure prevention rate was 92.7% for those who received Focale as a seizure prophylaxis. Only 2 out of 131 patients had experienced adverse effects (1.5%). Conclusion The generic intravenous levetiracetam treatment had high seizure-controlled rate in patients with seizure attacks and seizure prevention rate in the seizure prophylaxis group in pediatric patients. Side effects of this regimen in pediatric patients were low.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136294075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objectives Women with epilepsy (WWE) have special reproductive health needs. We compare menstrual disorders, obstetric outcomes, and patterns of contraceptive use among WWE in the reproductive age group to those without epilepsy. Methods Sixty WWE between the ages of 18 and 45 years were randomly selected from a hospital database, and 60 controls in the same age group were recruited from among their families or close contacts. A questionnaire adapted from the National Family Health Survey 5 (NFHS-5) was administered to collect data on menstrual patterns, obstetric outcomes, fertility preferences, and contraceptive use. Descriptive statistics were used. Graphical and cross-tabulations were used for comparisons. All statistics were performed on STATA version 14.2 (StataCorp, Texas, United States). Results The demographic characteristics including mean age, education, and occupational status were comparable. Dysmenorrhea requiring use of pain killers was more common among WWE (odds ratio [OR]: 3.01; 95% confidence interval [CI]: 1.11–8.72); other menstrual disorders were equally frequent. Spontaneous fetal loss was seen in 25 (21.9%) of 114 pregnancies in WWE and 22 (17.9%) of 123 among control women. Demand for family planning was satisfied in 21 (65.6%) of 32 eligible WWE and 23 (62.2%) of 37 controls with the most common method being female sterilization. WWE knew fewer methods of contraception compared with controls (median: 2; interquartile range [IQR]: 1.2 vs. 4; IQR: 2.5; p < 0.0001). Conclusion WWE had more dysmenorrhea and less knowledge of contraceptive methods compared with controls. Abnormal uterine bleeding, contraceptive use, and spontaneous fetal loss were similar in both groups.
摘要目的女性癫痫患者有特殊的生殖健康需求。我们比较了生育年龄组WWE患者与非癫痫患者的月经紊乱、产科结局和避孕药具使用模式。方法从医院数据库中随机抽取60例年龄在18 ~ 45岁之间的WWE患者，并从其家属或密切接触者中抽取同年龄组的对照组60例。根据国家家庭健康调查5 (NFHS-5)进行问卷调查，收集有关月经模式、产科结果、生育偏好和避孕药具使用的数据。采用描述性统计。图表和交叉表用于比较。所有统计数据均在STATA 14.2版本(StataCorp, Texas, United States)上执行。结果人口统计学特征包括平均年龄、教育程度和职业状况具有可比性。需要使用止痛药的痛经在WWE中更为常见(优势比[OR]: 3.01;95%置信区间[CI]: 1.11-8.72);其他月经紊乱也同样频繁。WWE组114例妊娠中有25例(21.9%)发生自然流产，对照组123例中有22例(17.9%)发生自然流产。32名符合条件的WWE中有21名(65.6%)满足计划生育需求，37名对照中有23名(62.2%)满足计划生育需求，最常见的方法是女性绝育。与对照组相比，WWE组知道的避孕方法更少(中位数:2;四分位间距[IQR]: 1.2 vs. 4;差:2.5;p & lt;0.0001)。结论与对照组相比，WWE患者痛经较多，对避孕方法的了解较少。两组子宫异常出血、使用避孕药具和自发性胎儿丢失的情况相似。
{"title":"Reproductive Health of Women with Epilepsy in India: An Observational Study","authors":"Aadithya Narayan Sunil Kumar, Rajeswari Aghoram, Aneesh Keepanasseril, Pradeep P. Nair","doi":"10.1055/s-0043-1772709","DOIUrl":"https://doi.org/10.1055/s-0043-1772709","url":null,"abstract":"Abstract Objectives Women with epilepsy (WWE) have special reproductive health needs. We compare menstrual disorders, obstetric outcomes, and patterns of contraceptive use among WWE in the reproductive age group to those without epilepsy. Methods Sixty WWE between the ages of 18 and 45 years were randomly selected from a hospital database, and 60 controls in the same age group were recruited from among their families or close contacts. A questionnaire adapted from the National Family Health Survey 5 (NFHS-5) was administered to collect data on menstrual patterns, obstetric outcomes, fertility preferences, and contraceptive use. Descriptive statistics were used. Graphical and cross-tabulations were used for comparisons. All statistics were performed on STATA version 14.2 (StataCorp, Texas, United States). Results The demographic characteristics including mean age, education, and occupational status were comparable. Dysmenorrhea requiring use of pain killers was more common among WWE (odds ratio [OR]: 3.01; 95% confidence interval [CI]: 1.11–8.72); other menstrual disorders were equally frequent. Spontaneous fetal loss was seen in 25 (21.9%) of 114 pregnancies in WWE and 22 (17.9%) of 123 among control women. Demand for family planning was satisfied in 21 (65.6%) of 32 eligible WWE and 23 (62.2%) of 37 controls with the most common method being female sterilization. WWE knew fewer methods of contraception compared with controls (median: 2; interquartile range [IQR]: 1.2 vs. 4; IQR: 2.5; p < 0.0001). Conclusion WWE had more dysmenorrhea and less knowledge of contraceptive methods compared with controls. Abnormal uterine bleeding, contraceptive use, and spontaneous fetal loss were similar in both groups.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135771017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christin Berjaoui, S. Atrouni, H. Doumiati, H. Mezher, L. Sinno, Hania ElJarkass
Abstract Background Several studies addressed the awareness and knowledge of epilepsy among students and teachers that indicated unfavorable levels of awareness, but none in Lebanon. Aim The aim of this study is to determine the level of awareness and attitude toward epilepsy among nonmedical university students. Methods A survey-based questionnaire was conducted among 1,000 nonmedical students. SPSS was used for data analysis. Results Participants claimed 78.5% having some knowledge about epilepsy (78.5%), with only 20.1% of the participants attaining their knowledge through university courses. Alarmingly, negative beliefs were noticed in our study such as considering person with epilepsy (PWE) as disabled (34.9%), epilepsy is a genetic disorder (40.9%), and it would lead to insanity (43.1%). Moreover, participants think that a PWE is unable to get married (29.5%), nor have children (25.2%), and they would even refuse to marry someone with epilepsy (35.7%). On the other hand, participants showed some positive behaviors such as the fact that epilepsy is not contagious (81%), would accept to accompany a colleague with epilepsy (72.1%), and believing that PWE can succeed at jobs (82.2%). When it comes to providing first aid, wrong practices were reported such as believing that something should be placed in the mouth during a seizure to avoid biting their tongue (58.1%). Conclusion Lack of knowledge, acceptance, and first aid practices have been observed in our study. Thus, efforts in including epilepsy within university curriculums, as well as raising awareness different platforms and campaigns should be done, as the social burden is even higher on PWE.
{"title":"Awareness and Attitude among Nonmedical University Students on Epilepsy in Lebanon: A Cross-Sectional Study","authors":"Christin Berjaoui, S. Atrouni, H. Doumiati, H. Mezher, L. Sinno, Hania ElJarkass","doi":"10.1055/s-0043-1771205","DOIUrl":"https://doi.org/10.1055/s-0043-1771205","url":null,"abstract":"Abstract Background Several studies addressed the awareness and knowledge of epilepsy among students and teachers that indicated unfavorable levels of awareness, but none in Lebanon. Aim The aim of this study is to determine the level of awareness and attitude toward epilepsy among nonmedical university students. Methods A survey-based questionnaire was conducted among 1,000 nonmedical students. SPSS was used for data analysis. Results Participants claimed 78.5% having some knowledge about epilepsy (78.5%), with only 20.1% of the participants attaining their knowledge through university courses. Alarmingly, negative beliefs were noticed in our study such as considering person with epilepsy (PWE) as disabled (34.9%), epilepsy is a genetic disorder (40.9%), and it would lead to insanity (43.1%). Moreover, participants think that a PWE is unable to get married (29.5%), nor have children (25.2%), and they would even refuse to marry someone with epilepsy (35.7%). On the other hand, participants showed some positive behaviors such as the fact that epilepsy is not contagious (81%), would accept to accompany a colleague with epilepsy (72.1%), and believing that PWE can succeed at jobs (82.2%). When it comes to providing first aid, wrong practices were reported such as believing that something should be placed in the mouth during a seizure to avoid biting their tongue (58.1%). Conclusion Lack of knowledge, acceptance, and first aid practices have been observed in our study. Thus, efforts in including epilepsy within university curriculums, as well as raising awareness different platforms and campaigns should be done, as the social burden is even higher on PWE.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47269620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Aims The study aimed to examine the nature and outcomes of social support for the well-being and quality of life (QoL) of adults with epilepsy. Methods The Australian Epilepsy Longitudinal Survey's 5 th Wave included the Medical Outcomes Study Modified Social Support Survey on four dimensions of social support and the QOLIE-31. Both numerical data and open-ended responses were analyzed quantitatively and qualitatively. A mixed method was used where quantitative analysis used t -tests, analysis of variance and block recursive regression, and qualitative analysis identified themes. Results Three-hundred thirty-two people with epilepsy (PWE) participated. The quantitative component showed that for emotional/informational support being older and living alone were key factors. These as well as household income were important in tangible support. For affectionate support living alone and household income were factors, but only income was a factor for positive social interaction. In addition, only positive social interaction predicted increased QoL. In the qualitative component of the study both positive and negative supports were identified for the emotional/informational supports. Many reported the benefits of having information, although some reported failure to have their needs taken seriously by health professionals or epilepsy associations. Inability to drive was an important feature of negative tangible support as was finding some assistive services unaffordable. Reports of positive social interaction identified being accepted as a person with epilepsy that is the primary concern. Peer support plays a role here. Discussion The findings of factors affecting the four dimensions of support in this study have supported a number of studies. This includes the effects of positive social interaction on QoL. The qualitative analysis supports these results, but it also contributes to deeper understanding of support in the lives of PWE. Conclusion Social support is a particularly important issue for PWE. The results of this study demonstrate the complexities and benefits of obtaining the appropriate forms of support. This survey took place before the coronavirus disease 2019 pandemic and it may well be that this phenomenon affects PWE's support needs.
{"title":"Reassures Me There Are People Around Who Care about Me: Analyzing Meanings of Support for People with Epilepsy","authors":"C. Walker, C. Peterson","doi":"10.1055/s-0043-1764396","DOIUrl":"https://doi.org/10.1055/s-0043-1764396","url":null,"abstract":"Abstract Aims The study aimed to examine the nature and outcomes of social support for the well-being and quality of life (QoL) of adults with epilepsy. Methods The Australian Epilepsy Longitudinal Survey's 5 th Wave included the Medical Outcomes Study Modified Social Support Survey on four dimensions of social support and the QOLIE-31. Both numerical data and open-ended responses were analyzed quantitatively and qualitatively. A mixed method was used where quantitative analysis used t -tests, analysis of variance and block recursive regression, and qualitative analysis identified themes. Results Three-hundred thirty-two people with epilepsy (PWE) participated. The quantitative component showed that for emotional/informational support being older and living alone were key factors. These as well as household income were important in tangible support. For affectionate support living alone and household income were factors, but only income was a factor for positive social interaction. In addition, only positive social interaction predicted increased QoL. In the qualitative component of the study both positive and negative supports were identified for the emotional/informational supports. Many reported the benefits of having information, although some reported failure to have their needs taken seriously by health professionals or epilepsy associations. Inability to drive was an important feature of negative tangible support as was finding some assistive services unaffordable. Reports of positive social interaction identified being accepted as a person with epilepsy that is the primary concern. Peer support plays a role here. Discussion The findings of factors affecting the four dimensions of support in this study have supported a number of studies. This includes the effects of positive social interaction on QoL. The qualitative analysis supports these results, but it also contributes to deeper understanding of support in the lives of PWE. Conclusion Social support is a particularly important issue for PWE. The results of this study demonstrate the complexities and benefits of obtaining the appropriate forms of support. This survey took place before the coronavirus disease 2019 pandemic and it may well be that this phenomenon affects PWE's support needs.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44839635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yahya Naji, Hasna Bentaher, Assma Boudanga, N. Kissani
Abstract Objectives Epilepsy remains a public health problem in developing countries, especially in Morocco. This prospective study was performed to expose new data about the time required to diagnose epilepsy in a tertiary hospital center and the main reasons behind its delay. Methods From January 2018 to December 2019, time from first seizure to diagnosis was acquired from 300 patients using face-to-face interview with pre-established sheet at the neurology department in tertiary hospital center (Marrakech, Morocco). Results Of the 300 patients, the mean epilepsy diagnosis delay was about 5 years, ranging from 1 month to over 40 years, with an 18 months difference between urban and rural habitation. About 36.4% had a delayed diagnosis of 1 year, 34% delayed by more than 5 years, and 26% delayed above 10 years. The main type of seizures was focal, mainly affecting young male patients. Rural habitation and seizure type impact significantly the delay of diagnosis. Conclusion This study revealed considerable epilepsy diagnosis delay with a statistically significant impact of rural habitation and seizure type. New and efficient strategies are needed to be developed to reduce the delay in epilepsy diagnosis and improve epilepsy care.
{"title":"Epilepsy Diagnosis Delay in a Tertiary Hospital Center: What Facts, for What Reasons?","authors":"Yahya Naji, Hasna Bentaher, Assma Boudanga, N. Kissani","doi":"10.1055/s-0043-1761630","DOIUrl":"https://doi.org/10.1055/s-0043-1761630","url":null,"abstract":"Abstract Objectives Epilepsy remains a public health problem in developing countries, especially in Morocco. This prospective study was performed to expose new data about the time required to diagnose epilepsy in a tertiary hospital center and the main reasons behind its delay. Methods From January 2018 to December 2019, time from first seizure to diagnosis was acquired from 300 patients using face-to-face interview with pre-established sheet at the neurology department in tertiary hospital center (Marrakech, Morocco). Results Of the 300 patients, the mean epilepsy diagnosis delay was about 5 years, ranging from 1 month to over 40 years, with an 18 months difference between urban and rural habitation. About 36.4% had a delayed diagnosis of 1 year, 34% delayed by more than 5 years, and 26% delayed above 10 years. The main type of seizures was focal, mainly affecting young male patients. Rural habitation and seizure type impact significantly the delay of diagnosis. Conclusion This study revealed considerable epilepsy diagnosis delay with a statistically significant impact of rural habitation and seizure type. New and efficient strategies are needed to be developed to reduce the delay in epilepsy diagnosis and improve epilepsy care.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47614321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Srikanth, M. Vranda, P. Thomas, Kenchaiah Raghvendra
Abstract Introduction Epilepsy is a neurological disorder that causes neurobiological, cognitive, and psychosocial consequences. Such impairments lead to substantial social influence on women across their life cycle stages, mostly connected with stigma, the severity of illness, quality of life, and other psychosocial issues in adding to reproductive decision-making associated to risk perception. This study aimed to assess the knowledge, risk perception, and reproductive decision-making factors among women with epilepsy. Materials and Methods A cross-sectional descriptive study was carried out to assess the knowledge, risk perception, and reproductive decision-making factors among women with epilepsy. A semistructured questionnaire was prepared to collect the sociodemographic and clinical characteristics of 49 women who sought treatment for epilepsy from a national tertiary referral care center for neuropsychiatry in South India. The researcher developed a 24-item questionnaire, including three open-ended questions to assess the knowledge about reproductive health issues and epilepsy. Results The participants' mean age was 24.67 ± 3.72, where 51% had secondary education, 63.3% were married, and 46.9% were homemakers. Women with epilepsy have reported lower knowledge about the illness and about the pregnancy, childbearing practices, breastfeeding, and epilepsy-related factors. Content analysis of responses to open-ended questions brought out the presence of marriage-related concerns, epilepsy and pregnancy, misconceptions about the pregnancy outcomes, and general misconceptions about the illness factors that play a role in reproductive decision-making among women living with epilepsy. Conclusion The study reveals that women with poor knowledge about epilepsy and pregnancy have difficulty in reproductive decision-making, thereby increasing risk perception of childbearing. This places interest on the necessity for health care professionals to address the above psychosocial problems as part of their intervention plan.
{"title":"Knowledge, Risk Perception, and Reproductive Decision Making among Women with Epilepsy","authors":"P. Srikanth, M. Vranda, P. Thomas, Kenchaiah Raghvendra","doi":"10.1055/s-0043-1768584","DOIUrl":"https://doi.org/10.1055/s-0043-1768584","url":null,"abstract":"Abstract Introduction Epilepsy is a neurological disorder that causes neurobiological, cognitive, and psychosocial consequences. Such impairments lead to substantial social influence on women across their life cycle stages, mostly connected with stigma, the severity of illness, quality of life, and other psychosocial issues in adding to reproductive decision-making associated to risk perception. This study aimed to assess the knowledge, risk perception, and reproductive decision-making factors among women with epilepsy. Materials and Methods A cross-sectional descriptive study was carried out to assess the knowledge, risk perception, and reproductive decision-making factors among women with epilepsy. A semistructured questionnaire was prepared to collect the sociodemographic and clinical characteristics of 49 women who sought treatment for epilepsy from a national tertiary referral care center for neuropsychiatry in South India. The researcher developed a 24-item questionnaire, including three open-ended questions to assess the knowledge about reproductive health issues and epilepsy. Results The participants' mean age was 24.67 ± 3.72, where 51% had secondary education, 63.3% were married, and 46.9% were homemakers. Women with epilepsy have reported lower knowledge about the illness and about the pregnancy, childbearing practices, breastfeeding, and epilepsy-related factors. Content analysis of responses to open-ended questions brought out the presence of marriage-related concerns, epilepsy and pregnancy, misconceptions about the pregnancy outcomes, and general misconceptions about the illness factors that play a role in reproductive decision-making among women living with epilepsy. Conclusion The study reveals that women with poor knowledge about epilepsy and pregnancy have difficulty in reproductive decision-making, thereby increasing risk perception of childbearing. This places interest on the necessity for health care professionals to address the above psychosocial problems as part of their intervention plan.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45237009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objective Self-Limited Epilepsy with Autonomic Seizures (SeLEAS), previously known by the eponymous Panayiotopoulos syndrome, is a benign focal epilepsy of the pediatric age group. It is characterized by nocturnal seizures with dominant autonomic features. Limited data from India exists on SeLEAS. We aimed to describe the clinical, demographic, and treatment-related features of SeLEAS. Methods In this descriptive retrospective cohort study, we reviewed record of children who met criteria for SeLEAS. Each patient's clinical, demographic, electroencephalographic, neuroimaging, and treatment details were reviewed. Response to antiseizure medications was also recorded. Results Twenty-three children with SeLEAS were enrolled (males = 18; 78.2%). Median age at onset was 4 (interquartile range: 2.5–10) years and median age at presentation was 6 (2.5–11) years. Focal seizures were observed in 65.2% ( n = 15) and 30% ( n = 7) had history of status epilepticus. Ictal/postictal emesis was observed in all patients. Occipital spikes on electroencephalography were seen in 78% ( n = 17). Four children had poor scholastic performance. Most (70%) of patients were well controlled on monotherapy, even with older antiseizure medications. Conclusion This cohort shows the spectrum of clinical heterogeneity associated with SeLEAS. Although considered benign, occurrence of status epilepticus and poor scholastic performance among some of our patients suggests that some caution may be appropriate while prognosticating such patients. Seizures were well controlled with monotherapy.
{"title":"Self-Limited Epilepsy with Autonomic Seizures (SeLEAS): A Retrospective Case Series","authors":"Aakanksha Anand, Ashna Kumar, D. Garg, Bhavya Kansal, Simar Saluja, Suvasini Sharma","doi":"10.1055/s-0043-57246","DOIUrl":"https://doi.org/10.1055/s-0043-57246","url":null,"abstract":"Abstract Objective Self-Limited Epilepsy with Autonomic Seizures (SeLEAS), previously known by the eponymous Panayiotopoulos syndrome, is a benign focal epilepsy of the pediatric age group. It is characterized by nocturnal seizures with dominant autonomic features. Limited data from India exists on SeLEAS. We aimed to describe the clinical, demographic, and treatment-related features of SeLEAS. Methods In this descriptive retrospective cohort study, we reviewed record of children who met criteria for SeLEAS. Each patient's clinical, demographic, electroencephalographic, neuroimaging, and treatment details were reviewed. Response to antiseizure medications was also recorded. Results Twenty-three children with SeLEAS were enrolled (males = 18; 78.2%). Median age at onset was 4 (interquartile range: 2.5–10) years and median age at presentation was 6 (2.5–11) years. Focal seizures were observed in 65.2% ( n = 15) and 30% ( n = 7) had history of status epilepticus. Ictal/postictal emesis was observed in all patients. Occipital spikes on electroencephalography were seen in 78% ( n = 17). Four children had poor scholastic performance. Most (70%) of patients were well controlled on monotherapy, even with older antiseizure medications. Conclusion This cohort shows the spectrum of clinical heterogeneity associated with SeLEAS. Although considered benign, occurrence of status epilepticus and poor scholastic performance among some of our patients suggests that some caution may be appropriate while prognosticating such patients. Seizures were well controlled with monotherapy.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45754844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Extreme sleep spindles have fast activity and high amplitude, unlike normal sleep spindles. We report a case series of six children with autism and related disorders who had extreme spindles as noted on the sleep electroencephalogram recording at our center. We examine the types of extreme spindles, describe the clinical profiles of the 6 children, and discuss similar clinical and neurophysiological conditions.
{"title":"Extreme Sleep Spindles in Children with Autism Spectrum Disorder and Related Disorders—A Case Series","authors":"S. Kaku, M. James, G. Sarma","doi":"10.1055/s-0043-1764397","DOIUrl":"https://doi.org/10.1055/s-0043-1764397","url":null,"abstract":"Abstract Extreme sleep spindles have fast activity and high amplitude, unlike normal sleep spindles. We report a case series of six children with autism and related disorders who had extreme spindles as noted on the sleep electroencephalogram recording at our center. We examine the types of extreme spindles, describe the clinical profiles of the 6 children, and discuss similar clinical and neurophysiological conditions.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47407132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Nonconvulsive status epilepticus is defined as a state of impaired consciousness with subtle motor manifestations and ongoing seizure activity in the electroencephalogram (EEG) for at least 30 minutes. Objectives and Methods This study of nonconvulsive status epilepticus and its outcomes was a retrospective analysis of the continuous bedside EEG recordings of 100 patients over 2 years (Aug 2017–July 2019) at the Neurophysiology Department in Sir Ganga Ram Hospital, New Delhi. There were two groups of patients in the study comprising of adults (72) and children (28). A comparison between the two groups was made based on the clinical presentation, etiology, EEG, MRI findings, treatment, and the consequences. Results and Conclusions In adults, nonconvulsive status had a high mortality rate, while in children, the associated comorbidities dominated and contributed to residual neurological sequelae. Early diagnosis and treatment at any age is essential to prevent cognitive decline and psychomotor retardation. Presently, bedside and ambulatory EEG recordings are used to capture the dynamic and rhythmic features of the ictal EEG. Continuous EEG monitoring enables bedside assessment of the effectiveness of treatment.
{"title":"Nonconvulsive Status Epilepticus: Current Status and Future Perspectives","authors":"L. Khanna, N. Agarwal","doi":"10.1055/s-0042-1744156","DOIUrl":"https://doi.org/10.1055/s-0042-1744156","url":null,"abstract":"\u0000 Introduction Nonconvulsive status epilepticus is defined as a state of impaired consciousness with subtle motor manifestations and ongoing seizure activity in the electroencephalogram (EEG) for at least 30 minutes.\u0000 Objectives and Methods This study of nonconvulsive status epilepticus and its outcomes was a retrospective analysis of the continuous bedside EEG recordings of 100 patients over 2 years (Aug 2017–July 2019) at the Neurophysiology Department in Sir Ganga Ram Hospital, New Delhi. There were two groups of patients in the study comprising of adults (72) and children (28). A comparison between the two groups was made based on the clinical presentation, etiology, EEG, MRI findings, treatment, and the consequences.\u0000 Results and Conclusions In adults, nonconvulsive status had a high mortality rate, while in children, the associated comorbidities dominated and contributed to residual neurological sequelae. Early diagnosis and treatment at any age is essential to prevent cognitive decline and psychomotor retardation. Presently, bedside and ambulatory EEG recordings are used to capture the dynamic and rhythmic features of the ictal EEG. Continuous EEG monitoring enables bedside assessment of the effectiveness of treatment.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46221975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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