1Aix Marseille University, INSERM, INS, Inst Neurosci Syst, Marseille, France 2Department of Clinical Neurophysiology, CHU Timone, AP-HM, Marseille, France 3Department of Psychiatry, Psychotherapeutic Center of Nancy, CPN, Laxou, France 4Department of Neurology, University Hospital of Nancy, Nancy Cedex, France 5Academic Department of Neurosciences, Royal Hallamshire Hospital and University of Sheffield, Sheffield, United Kingdom 6Contributing members of the ILAE PNES Task Force: Ali AsadiPooya (Iran), Rod Duncan (New Zealand), David Gigineishvili (Georgia), Kousuke Kanemoto (Japan), Lady Ladino Maladon (Colombia), Curt William LaFrance junior (USA), Chrisma Pretorius (South Africa), Dong Zhou (China)
{"title":"Correct Diagnosis of Psychogenic Nonepileptic Seizures","authors":"A. McGonigal, C. Hingray, M. Reuber","doi":"10.1055/s-0038-1675548","DOIUrl":"https://doi.org/10.1055/s-0038-1675548","url":null,"abstract":"1Aix Marseille University, INSERM, INS, Inst Neurosci Syst, Marseille, France 2Department of Clinical Neurophysiology, CHU Timone, AP-HM, Marseille, France 3Department of Psychiatry, Psychotherapeutic Center of Nancy, CPN, Laxou, France 4Department of Neurology, University Hospital of Nancy, Nancy Cedex, France 5Academic Department of Neurosciences, Royal Hallamshire Hospital and University of Sheffield, Sheffield, United Kingdom 6Contributing members of the ILAE PNES Task Force: Ali AsadiPooya (Iran), Rod Duncan (New Zealand), David Gigineishvili (Georgia), Kousuke Kanemoto (Japan), Lady Ladino Maladon (Colombia), Curt William LaFrance junior (USA), Chrisma Pretorius (South Africa), Dong Zhou (China)","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0038-1675548","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41547077","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}
Bhargava K., M. N., Shishir D., R. K, R. M., Bharath D., S. S, S. Sinha
{"title":"Network Changes in Eating Epilepsy: An MEG Study","authors":"Bhargava K., M. N., Shishir D., R. K, R. M., Bharath D., S. S, S. Sinha","doi":"10.1055/S-0039-1694868","DOIUrl":"https://doi.org/10.1055/S-0039-1694868","url":null,"abstract":"","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/S-0039-1694868","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43893876","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 Pulmonary arterial hypertension (PAH) is a progressive pulmonary vasculopathy. A 29-year-old female patient presenting with dyspnea and syncope within 6 hours of onset was admitted to our hospital. The patient stated that she looked for a neurologist months ago because she experienced abrupt shaking limbs occurring during physical activity. She was diagnosed with focal seizure, and carbamazepine (CBZ) was started. On admission, she reported that the dyspnea had started in the last week and recurrent episodes of syncope in the last few hours. A right heart catheterization was diagnostic of PAH. She was started on spironolactone, furosemide, sildenafil, warfarin, and supplemental oxygen. On 10th admission day, the patient was seizure free and the dose of CBZ was tapered. In the follow-up, the patient remained seizure free. An investigation to search for a chronic lung disease or hypoxemia, systemic disorder, hematological disorder, and metabolic disorder was negative.
{"title":"Seizures in Idiopathic Pulmonary Arterial Hypertension","authors":"J. Rissardo, A. Caprara","doi":"10.1055/s-0039-1688528","DOIUrl":"https://doi.org/10.1055/s-0039-1688528","url":null,"abstract":"Abstract Pulmonary arterial hypertension (PAH) is a progressive pulmonary vasculopathy. A 29-year-old female patient presenting with dyspnea and syncope within 6 hours of onset was admitted to our hospital. The patient stated that she looked for a neurologist months ago because she experienced abrupt shaking limbs occurring during physical activity. She was diagnosed with focal seizure, and carbamazepine (CBZ) was started. On admission, she reported that the dyspnea had started in the last week and recurrent episodes of syncope in the last few hours. A right heart catheterization was diagnostic of PAH. She was started on spironolactone, furosemide, sildenafil, warfarin, and supplemental oxygen. On 10th admission day, the patient was seizure free and the dose of CBZ was tapered. In the follow-up, the patient remained seizure free. An investigation to search for a chronic lung disease or hypoxemia, systemic disorder, hematological disorder, and metabolic disorder was negative.","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1688528","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44601474","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}
{"title":"Clinical and Demographic Profile of Epilepsy Patients in Rural Rajasthan","authors":"S. Chaturvedi, R. Sureka, A. Agarwal","doi":"10.1055/S-0039-1694900","DOIUrl":"https://doi.org/10.1055/S-0039-1694900","url":null,"abstract":"","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/S-0039-1694900","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45910902","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}
{"title":"Repeated stages of fugue in patients with epilepsy: case series","authors":"Y. S, Srivstava S., Y. Jyoti, Chaurasia N.","doi":"10.1055/S-0039-1694873","DOIUrl":"https://doi.org/10.1055/S-0039-1694873","url":null,"abstract":"","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/S-0039-1694873","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45175204","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 Introduction Periodic discharges are now known as the ictal–interictal continuum and represent ongoing injury in acute or chronic neurological illnesses. Objective The aim of our study was to identify periodic discharges in patients who have undergone continuous bedside electroencephalography (EEG) monitoring and to classify the EEG according to the current American Clinical Neurophysiology Society terminology. Materials and Methods The continuous bedside EEG records of intensive care patients admitted from August 2017 to July 2018 were analyzed. The clinical spectrum, the treatment, and outcome of each of these patients were monitored. Results Fifty cases of periodic discharges (11 children, 39 adults) were identified over 1 year from 2017 to 2018. The clinical presentation included 32% seizures, 16% status epilepticus, 20% coma, 16% fever with altered sensorium, 8% abnormal behavior, 4% strokes, and 4% traumatic brain injury. The diagnosis was 20% autoimmune encephalitis, 8% herpes encephalitis, 20% multiorgan failure, 4% traumatic brain injury, 16% status epilepticus, 16% posthypoxic encephalopathy, 4% strokes, 4% intracerebral bleeds, 4% meningitis, and 4% severe dementia. Lateralized periodic discharges were identified in 20%, bilateral independent periodic discharges in 20%, and generalized periodic discharges in 60%. Fifty-six percent patients recovered with residual neurological deficits and 44% succumbed to their illness. Conclusions Continuous bedside EEG monitoring has revolutionized the approach to seizures in critically ill patients. Despite a vigilant approach and diligent diagnosis of these abnormal rhythms, the mortality rate was 20% in patients with lateralized periodic discharges and 60% with bilateral and generalized periodic discharges (p ≤ 0.05).
{"title":"Concepts in Periodic Discharges: A Descriptive Study","authors":"L. Khanna, N. Agarwal, S. Kandel","doi":"10.1055/s-0039-1692732","DOIUrl":"https://doi.org/10.1055/s-0039-1692732","url":null,"abstract":"Abstract Introduction Periodic discharges are now known as the ictal–interictal continuum and represent ongoing injury in acute or chronic neurological illnesses. Objective The aim of our study was to identify periodic discharges in patients who have undergone continuous bedside electroencephalography (EEG) monitoring and to classify the EEG according to the current American Clinical Neurophysiology Society terminology. Materials and Methods The continuous bedside EEG records of intensive care patients admitted from August 2017 to July 2018 were analyzed. The clinical spectrum, the treatment, and outcome of each of these patients were monitored. Results Fifty cases of periodic discharges (11 children, 39 adults) were identified over 1 year from 2017 to 2018. The clinical presentation included 32% seizures, 16% status epilepticus, 20% coma, 16% fever with altered sensorium, 8% abnormal behavior, 4% strokes, and 4% traumatic brain injury. The diagnosis was 20% autoimmune encephalitis, 8% herpes encephalitis, 20% multiorgan failure, 4% traumatic brain injury, 16% status epilepticus, 16% posthypoxic encephalopathy, 4% strokes, 4% intracerebral bleeds, 4% meningitis, and 4% severe dementia. Lateralized periodic discharges were identified in 20%, bilateral independent periodic discharges in 20%, and generalized periodic discharges in 60%. Fifty-six percent patients recovered with residual neurological deficits and 44% succumbed to their illness. Conclusions Continuous bedside EEG monitoring has revolutionized the approach to seizures in critically ill patients. Despite a vigilant approach and diligent diagnosis of these abnormal rhythms, the mortality rate was 20% in patients with lateralized periodic discharges and 60% with bilateral and generalized periodic discharges (p ≤ 0.05).","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1692732","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44533308","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}
{"title":"Awareness and Attitudes of General Physicians’ toward Epilepsy Surgery","authors":"Natesan D., P. Ravindran","doi":"10.1055/S-0039-1694886","DOIUrl":"https://doi.org/10.1055/S-0039-1694886","url":null,"abstract":"","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/S-0039-1694886","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48373460","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}
A. Srivastava, A. Dixit, Ramesh Dodamanni, Jyotirmoy Banerjee, M. Thipathi, P. Chandra
Background: Epileptic encephalopathy (EE), associated with ESES, with its associated impact on cognition and language, is an important cause of morbidity in children. The effects of various treatment modalities and the factors affect-ing treatment response are not fully understood. Methods: Case records of patients admitted in the institute and diagnosed to have EE with ESES pattern on EEG were accessed. Spike and wave index (SWI) was calculated from sleep records. Language development was assessed using Receptive-Expressive Emergent Language Scale and seizure outcome using the modified Engel seizure score. Results: Fifty-two children with age ranging from 1 to 19 years were included (idiopathic ESES, n = 19 and symptomatic ESES with pre-existing developmental delay and/or structural brain lesions, n = 33). The two groups differed in terms of younger age at seizure onset in symptomatic ESES ( p = 0.006), early age at language regression ( p = 0.046), history of neonatal seizures ( p = 0.038) and slowing of background on EEG ( p = 0.024). Language regression was noted in 63.5% of the cohort. Twenty-five (48%) patients received steroids alone and showed improvement in seizure ( p ≤ 0.001) and language outcomes at 1 year ( p = 0.021), while 21 (40.3%) received steroids + IVIgG and showed improvement in seizure outcome ( p = 0.002) at 1 year. On 1- year follow-up, seizure remission was noted in 13 (25%) patients with improvement in seizure score in 32/39 (82%) patients and language improvement in 60.8%. Patients with normal background on EEG ( p = 0.03), generalized spikes ( p = 0.05), no Fz negative spikes ( p = 0.01), and SWI < 1.70 ( p = 0.004) were found to have favorable cognitive outcomes on follow-up. 31/45 (68.9%) patients had persistent ESES at 1-year follow-up. ( p = 0.006). In multivariate analysis, ethnic origin, family income, and other socio- economic status were completely associated with treatment acceptance; verbal autopsy find-ings on the nine people who died will be presented. Conclusion: People with epilepsy who do not accept treatment are more likely to be of ethnic origin and from lower income strata. Failure to accept treatment is associated with high mortality. in HS patients, providing a rationale for conducting further exploratory studies. Objective: Long-term treatment by antiepileptic drugs (AEDs) is vital for effective control of seizures in patients with epilepsy ( p WE). The present study was per-formed to measure extent and factors influencing adherence to AEDs. Methods: The present study was a prospective, cross-sectional study, involving PWE reporting at a tertiary care hospital. The extent of adherence to AEDs was measured using Morisky Medication Adherence Scale (MMAS). Data from 451 patients with confirmed diagnosis of epilepsy were subjected to univariate analysis using Chi-square test to observe association between AED adherence and different variables. Further the predictors of adherence were analyzed using bin
{"title":"Expression Profile of Histone Deacetylases in Patients with Hippocampal Sclerosis","authors":"A. Srivastava, A. Dixit, Ramesh Dodamanni, Jyotirmoy Banerjee, M. Thipathi, P. Chandra","doi":"10.1055/S-0039-1694861","DOIUrl":"https://doi.org/10.1055/S-0039-1694861","url":null,"abstract":"Background: Epileptic encephalopathy (EE), associated with ESES, with its associated impact on cognition and language, is an important cause of morbidity in children. The effects of various treatment modalities and the factors affect-ing treatment response are not fully understood. Methods: Case records of patients admitted in the institute and diagnosed to have EE with ESES pattern on EEG were accessed. Spike and wave index (SWI) was calculated from sleep records. Language development was assessed using Receptive-Expressive Emergent Language Scale and seizure outcome using the modified Engel seizure score. Results: Fifty-two children with age ranging from 1 to 19 years were included (idiopathic ESES, n = 19 and symptomatic ESES with pre-existing developmental delay and/or structural brain lesions, n = 33). The two groups differed in terms of younger age at seizure onset in symptomatic ESES ( p = 0.006), early age at language regression ( p = 0.046), history of neonatal seizures ( p = 0.038) and slowing of background on EEG ( p = 0.024). Language regression was noted in 63.5% of the cohort. Twenty-five (48%) patients received steroids alone and showed improvement in seizure ( p ≤ 0.001) and language outcomes at 1 year ( p = 0.021), while 21 (40.3%) received steroids + IVIgG and showed improvement in seizure outcome ( p = 0.002) at 1 year. On 1- year follow-up, seizure remission was noted in 13 (25%) patients with improvement in seizure score in 32/39 (82%) patients and language improvement in 60.8%. Patients with normal background on EEG ( p = 0.03), generalized spikes ( p = 0.05), no Fz negative spikes ( p = 0.01), and SWI < 1.70 ( p = 0.004) were found to have favorable cognitive outcomes on follow-up. 31/45 (68.9%) patients had persistent ESES at 1-year follow-up. ( p = 0.006). In multivariate analysis, ethnic origin, family income, and other socio- economic status were completely associated with treatment acceptance; verbal autopsy find-ings on the nine people who died will be presented. Conclusion: People with epilepsy who do not accept treatment are more likely to be of ethnic origin and from lower income strata. Failure to accept treatment is associated with high mortality. in HS patients, providing a rationale for conducting further exploratory studies. Objective: Long-term treatment by antiepileptic drugs (AEDs) is vital for effective control of seizures in patients with epilepsy ( p WE). The present study was per-formed to measure extent and factors influencing adherence to AEDs. Methods: The present study was a prospective, cross-sectional study, involving PWE reporting at a tertiary care hospital. The extent of adherence to AEDs was measured using Morisky Medication Adherence Scale (MMAS). Data from 451 patients with confirmed diagnosis of epilepsy were subjected to univariate analysis using Chi-square test to observe association between AED adherence and different variables. Further the predictors of adherence were analyzed using bin","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/S-0039-1694861","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43946321","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}
{"title":"Na+-K+-2Cl– Cotransport Inhibitors and their Effect on Induced Seizure Tests in Experimental Models","authors":"C. D., Karamthoti B., Kurra B.","doi":"10.1055/s-0039-1694864","DOIUrl":"https://doi.org/10.1055/s-0039-1694864","url":null,"abstract":"","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1694864","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58113033","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}
Haroon Rashid, J. Katyal, M. Tripathi, M. Sood, Y. Gupta
{"title":"Depression in Persons with Epilepsy: A Comparative Study of Different Screening Tools in Indian Population","authors":"Haroon Rashid, J. Katyal, M. Tripathi, M. Sood, Y. Gupta","doi":"10.1055/S-0039-1694871","DOIUrl":"https://doi.org/10.1055/S-0039-1694871","url":null,"abstract":"","PeriodicalId":38086,"journal":{"name":"International Journal of Epilepsy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/S-0039-1694871","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46855431","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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