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Hemorrhagic complication due to vascular side branch injury from a distant site in stereoelectroencephalography: A case report and proposed rules for safer electrode implantation 立体脑电图中远处血管侧支损伤引起的出血并发症:病例报告和更安全的电极植入规则建议。
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2024.12.019
Takahiro Suzuki , Tomotaka Ishizaki , Satoshi Maesawa , Miki Hashida , Yoshiki Ito , Takafumi Tanei , Ryuta Saito
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引用次数: 0
First clinical post-approval, observational study to assess clinical safety and effectiveness of brivaracetam sustained-release formulation in real-life settings of India: BEAM study 首个临床批准后的观察性研究,评估布瓦西坦缓释制剂在印度现实环境中的临床安全性和有效性:BEAM研究。
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2025.01.011
Lakshmi Narasimhan Ranganathan , Girish Kulkarni , Ashutosh Kakkad , Krishnaprasad Korukonda , Narendra Chouksey

Purpose

Brivaracetam (BRV) sustained-release (SR) tablets have recently been approved to treat focal seizures in India. SR formulations enhance patient adherence and quality of life (QoL). We assessed safety and effectiveness of BRV-SR for epilepsy management in Indian real-life settings.

Methods

A post-approval observational study involving 1989 patients receiving BRV-SR from 181 centres were analysed. Primary endpoints are efficacy variables derived from seizure-related changes, and secondary endpoints include responder rate (≥50% reduction in focal-onset seizures [FoS]/focal-to-bilateral tonic-clonic seizures [FBTCS] frequency), usage pattern data, clinician's global impression on efficacy index (CGI-EI) and safety variables.

Results

Patients’ mean age was 42.33±12.33 years, and 1441 (72.44%) were men. Psychiatric comorbidities included depression (21.97%), sleep disturbance (15.54%), and anxiety (9.60%). The predominant seizure types were FoS (71.44%) and FBTCS (28.56%). BRV-SR 100 mg once-daily was most prescribed dose (57.37%) at baseline and follow-up visits (51.94%). Median seizure frequency decreased from 2 at baseline to 1 at follow-up visit. At follow-up, 72.1% patients were responders, and 63.75% were seizure-free. BRV-SR showed “marked” to “moderate” improvement in 92.99% of patients according to CGI-EI. Subgroup-analysis revealed a positive correlation between BRV-SR use in patients with drug-resistant epilepsy, psychiatric co-morbidities, and behavioural adverse events (AEs) with past anti-seizure medications. AEs were rare, with none reported in 97.39% patients during study period.

Conclusion

The BEAM study findings provide first real-world evidence on effectiveness and safety of BRV-SR in Indian real-life settings. Furthermore, BRV-SR is a feasible option for focal epilepsy management with good retention rates and improved QoL.
目的:布瓦西坦(BRV)缓释片最近被批准用于治疗局灶性癫痫发作在印度。SR制剂可提高患者依从性和生活质量(QoL)。我们评估了BRV-SR在印度现实环境中用于癫痫管理的安全性和有效性。方法:对来自181个中心接受BRV-SR治疗的1989例患者的批准后观察性研究进行分析。主要终点是源于癫痫相关变化的疗效变量,次要终点包括反应率(局灶性癫痫发作[FoS]减少≥50% /局灶-双侧强直-阵挛性癫痫发作[FBTCS]频率)、使用模式数据、临床医生对疗效指数(CGI-EI)的总体印象和安全性变量。结果:患者平均年龄42.33±12.33岁,男性1441例(72.44%)。精神病学合并症包括抑郁(21.97%)、睡眠障碍(15.54%)和焦虑(9.60%)。主要癫痫类型为FoS(71.44%)和FBTCS(28.56%)。BRV-SR 100mg每日一次是基线和随访时的最大处方剂量(57.37%)。中位发作频率从基线时的2次降至随访时的1次。随访时,72.1%的患者有反应,63.75%的患者无癫痫发作。根据CGI-EI, 92.99%的患者BRV-SR表现为“显著”至“中度”改善。亚组分析显示,BRV-SR在耐药癫痫、精神共病和行为不良事件(ae)患者中的使用与既往抗癫痫药物呈正相关。研究期间,97.39%的患者未报告不良事件。结论:BEAM研究结果为BRV-SR在印度现实生活中的有效性和安全性提供了第一个真实世界的证据。此外,BRV-SR是局灶性癫痫治疗的可行选择,具有良好的保留率和改善的生活质量。
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引用次数: 0
Prevalence of and risk factors for sarcopenia in patients with epilepsy
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2025.01.003
Yu-Shiue Chen , Hung-Ling Huang , Huai-Hsien Huang , Tzu-Hsin Huang , Ming-Chi Lai , Chin-Wei Huang

Background

Epilepsy is a chronic neurological disorder with a burden of comorbidities. Knowledge regarding sarcopenia prevalence and associated risk factors in patients with epilepsy remains limited, which prompted us to conduct the present study.

Methods

This cross-sectional study enrolled patients with epilepsy from our epilepsy clinic and controls from the staff at National Cheng Kung University Hospital, Tainan, Taiwan. Sarcopenia was defined using the criteria outlined by the 2019 Asian Working Group for Sarcopenia and the 2010 European Working Group on Sarcopenia in Older People. Muscle mass (skeletal muscle mass index) was measured through bioelectrical impedance, muscle strength was assessed using hand grip tests, and physical performance was evaluated using the 6-m walk test. Hormone (testosterone, growth hormone, and insulin-like growth factor-1) and vitamin D levels were measured. Descriptive statistics and logistic regression models were used to estimate the prevalence of sarcopenia and identify sarcopenia risk factors in patients with epilepsy.

Results

This study enrolled 300 adults (mean age: 42.9 ± 14.7 years; women: 53.7 %). The epilepsy and control groups comprised 200 and 100 participants, respectively. The overall prevalence of sarcopenia was 31.3 % and it was significantly higher (p = 0.004) in women (20.7 %) than in men (10.6 %). The prevalence was higher in the epilepsy group than in the control group (36.0 % vs. 22.0 %, p = 0.014). Logistic regression revealed female, age (≥ 65 year) and low body mass index (BMI) were influenced the risk of sarcopenia in all participants. Importantly, epilepsy is significantly associated sarcopenia. The BMI, protein level, calf circumference, and use of enzyme-inducing antiseizure medications (EIASM) influenced the risk of sarcopenia in the epilepsy group.

Conclusion

The prevalence of sarcopenia is significantly higher in patients with epilepsy than in the control participants. Low BMI, protein level, calf circumference, and the use of EIASM may increase the risk of sarcopenia in this population. Our findings underscore the need for mitigating sarcopenia risk in patients with epilepsy.
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引用次数: 0
Illuminating the Safety, Tolerability, and Efficacy of Different Ketogenic Diets for Individuals with Epilepsy: A Scoping Meta-Review
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2025.01.018
Mohammad Mehdi Abbasi , Ali Jafari , Mahshad Mohtadi , Mahshad Shahabi , Farnush Bakhshimoghaddam , Hamid Abbasi , Ghazaleh Eslamian

Background

Diet therapies for epilepsy, including the ketogenic diets (KDs), have been used as a treatment for both pediatric and adult populations. Recent studies have focused on the safety, efficacy, and tolerability of various diet therapies for epilepsy. The objective of this scoping meta- review was to evaluate the evidence regarding different ketogenic diets for epilepsy.

Methods

This study followed the Arksey and O'Malley framework and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR) reporting standards. The research question was formulated using the Population, Concept, Context (PCC) framework. A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science up to August 14, 2024.

Results

Out of the 152 papers identified, 38 systematic reviews and meta-analyses were included. The review examined the safety, tolerability, and efficacy of diet therapies for epilepsy, particularly in drug-resistant cases. The findings underscore the significant benefits of classic ketogenic diet (CKD) in reducing seizure frequency. The Modified Atkins Diet (MAD) and Medium-Chain Triglyceride (MCT) KD were found to be effective with improved tolerability. The Low Glycemic Index Diet (LGID) may be less effective. Further research is needed to refine these dietary approaches.

Conclusion

The KDs are effective in reducing seizure frequency in epilepsy, especially in drug-resistant cases. The results highlight the valuable advantages of the CKD in decreasing the frequency of seizures. The MCT KD and the MAD are also effective options and are generally better tolerated. The LGID shows potential but may be less effective. Further research is needed to enhance these dietary treatments and investigate their long-term impact.
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引用次数: 0
Alterations in white matter integrity and correlations with clinical characteristics in children with non-lesional temporal lobe epilepsy 非病变性颞叶癫痫患儿白质完整性的改变及其与临床特征的相关性。
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2024.12.017
Siqi Luo , Yaqin Xia , Chaogang Lu , Yi Wang , Zhongwei Qiao

Purpose

To complement the current research on altered white matter integrity in children with non-lesional temporal lobe epilepsy (NL-TLE), especially the correlation between diffusion metrics and clinical characteristics, so as to provide imaging evidence for clinical practice.

Methods

Children with temporal lobe epilepsy and no lesions on magnetic resonance imaging (MRI) were retrospectively collected from 2016.01.01 to 2022.12.31, and typically developing children (TDC) with normal MRI were collected as control group. Tract-based spatial statistics (TBSS) was used to compare the fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) between the two groups. Twenty fiber bundles were used as regions of interest (ROIs) to extract and compare the diffusion metrics. Partial correlation analysis was performed to assess the association between diffusion parameters within ROIs and clinical characteristics.

Results

TBSS and ROI analysis showed that FA values decreased and MD and RD values increased in the NL-TLE compared with the TDC, without significant differences in AD values. FA values in all ROIs increased with age, while the MD and RD values decreased in all ROIs, and the AD values decreased in most ROIs. Epilepsy duration was negatively correlated with FA values and positively correlated with MD and RD values in specific fibers. Frequency of seizures was negatively correlated with the FA values in a few trats. Full-scale intelligence quotient (FSIQ) was positively correlated with FA values and negatively with RD value in a few tracts.

Conclusion

Children with NL-TLE showed widespread alterations in white matter integrity, which were correlated with clinical characteristics.
目的:补充目前关于非病变性颞叶癫痫(NL-TLE)患儿白质完整性改变的研究,特别是弥散指标与临床特征的相关性,为临床实践提供影像学依据。方法:回顾性收集2016.01.01 ~ 2022.12.31年MRI未见病变的颞叶癫痫患儿,以MRI正常的典型发育患儿(TDC)为对照组。采用基于束的空间统计(TBSS)方法比较两组的分数各向异性(FA)、平均扩散率(MD)、轴向扩散率(AD)和径向扩散率(RD)。用20束纤维作为感兴趣区域(roi)提取和比较扩散指标。采用偏相关分析评估roi内扩散参数与临床特征之间的关系。结果:TBSS和ROI分析显示,与TDC相比,NL-TLE的FA值降低,MD和RD值升高,AD值无显著差异。所有roi的FA值随着年龄的增长而增加,而MD和RD值在所有roi中都下降,AD值在大多数roi中都下降。癫痫持续时间与特定纤维FA值呈负相关,与MD和RD值呈正相关。癫痫发作频率与FA值呈负相关。全量表智商(FSIQ)与FA值呈显著正相关,与RD值呈显著负相关。结论:NL-TLE患儿表现出广泛的白质完整性改变,与临床特征相关。
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引用次数: 0
Post-marketing safety of antiseizure medications: Focus on serious adverse effects including drug reaction with eosinophilia and systemic symptoms (DRESS) 抗癫痫药物上市后的安全性:重点关注严重的不良反应,包括药物反应与嗜酸性粒细胞增多和全身症状(DRESS)。
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2025.01.002
Jingjing Qian , Xiangzhong Xue , Lotanna Ezeja , Zachary Boxx , Cherry W. Jackson

Purpose

On November 28, 2023, the U.S. FDA issued a Drug Safety Communication, warning that antiseizure medications (ASMs) levetiracetam and clobazam can cause a rare but serious reaction, drug reaction with eosinophilia and systemic symptoms (DRESS). However, the risk of DRESS from other ASMs remains unclear. This observational study examined post-marketing safety of ASMs focusing on serious adverse events (AEs) reporting including DRESS.

Methods

This retrospective, cross-sectional study analyzed the U.S. FDA Adverse Event Reporting System (FAERS) data from January 1, 2004, to March 31, 2024. Ten older (valproic acid, carbamazepine, oxcarbazepine, phenytoin, and phenobarbital) and newer (zonisamide, topiramate, lamotrigine, lacosamide, and brivaracetam) frequently used ASMs and three benzodiazepines (lorazepam, chlordiazepoxide, and diazepam) in clinical practice as alternative treatments were examined together with levetiracetam and clobazam, respectively. Disproportionality analysis, reporting odds ratio (ROR), was used to detect reporting risk signals of DRESS along with serious AE, hospitalization, death, and Stevens-Johnson Syndrome (SJS) for levetiracetam/clobazam and alternative treatments. A statistically significant reporting risk signal was detected when the lower boundary of the 95 % confidence interval for the RORs exceeded 1.

Results

Levetiracetam had significant reporting risks of serious AE, hospitalization, DRESS, and SJS. Older ASMs including valproic acid, carbamazepine, oxcarbazepine, phenytoin, and phenobarbital all had significant reporting risks of DRESS and SJS. Newer ASMs including zonisamide and lamotrigine had significant reporting risks of DRESS and SJS, while topiramate, lacosamide, and brivaracetam did not exhibit reporting risk for DRESS. Clobazam had significant reporting risks of serious AE, DRESS, and SJS. Lorazepam, chlordiazepoxide, and diazepam did not exhibit reporting risks for DRESS or SJS.

Conclusions

Findings highlighted reporting risk signals of DRESS for levetiracetam/clobazam and alternative ASMs. Given the limitations from passive surveillance nature of FAERS, further surveillance and longitudinal studies are essential to evaluate and confirm our findings.
目的:2023年11月28日,美国FDA发布了一份药物安全通报,警告抗癫痫药物左乙拉西坦和氯巴唑可引起罕见但严重的反应,药物反应伴有嗜酸性粒细胞增多和全身症状(DRESS)。然而,其他asm引起DRESS的风险尚不清楚。本观察性研究考察了asm上市后的安全性,重点关注包括DRESS在内的严重不良事件(ae)报告。方法:本回顾性横断面研究分析了2004年1月1日至2024年3月31日美国FDA不良事件报告系统(FAERS)的数据。10种较老的(丙戊酸、卡马西平、奥卡西平、苯妥英和苯巴比妥)和较新的(唑尼沙胺、托吡酯、拉莫三嗪、拉科沙胺和布瓦西坦)在临床实践中作为替代治疗方法,分别与左乙拉西坦和氯巴赞一起检查了三种苯二氮卓类药物(劳拉西泮、氯二氮环氧化合物和地西泮)。歧化分析,报告优势比(ROR),用于检测左乙拉西坦/氯巴唑和替代治疗的DRESS报告风险信号以及严重AE、住院、死亡和史蒂文斯-约翰逊综合征(SJS)。当RORs 95%置信区间的下限超过1时,检测到具有统计学意义的报告风险信号。结果:左乙拉西坦有严重AE、住院、DRESS和SJS的显著报告风险。包括丙戊酸、卡马西平、奥卡西平、苯妥英和苯巴比妥在内的老年sm患者均有显著的DRESS和SJS风险报告。较新的asm包括唑尼沙胺和拉莫三嗪具有显著的DRESS和SJS报告风险,而托吡酯、拉科沙胺和布瓦西坦没有DRESS报告风险。氯巴唑有严重AE、DRESS和SJS的显著报告风险。劳拉西泮、氯二氮环氧化物和地西泮没有DRESS或SJS的风险报告。结论:研究结果强调了左乙拉西坦/氯巴赞和替代asm的DRESS风险信号报告。鉴于FAERS被动监测的局限性,进一步的监测和纵向研究对于评估和证实我们的发现是必要的。
{"title":"Post-marketing safety of antiseizure medications: Focus on serious adverse effects including drug reaction with eosinophilia and systemic symptoms (DRESS)","authors":"Jingjing Qian ,&nbsp;Xiangzhong Xue ,&nbsp;Lotanna Ezeja ,&nbsp;Zachary Boxx ,&nbsp;Cherry W. Jackson","doi":"10.1016/j.seizure.2025.01.002","DOIUrl":"10.1016/j.seizure.2025.01.002","url":null,"abstract":"<div><h3>Purpose</h3><div>On November 28, 2023, the U.S. FDA issued a Drug Safety Communication, warning that antiseizure medications (ASMs) levetiracetam and clobazam can cause a rare but serious reaction, drug reaction with eosinophilia and systemic symptoms (DRESS). However, the risk of DRESS from other ASMs remains unclear. This observational study examined post-marketing safety of ASMs focusing on serious adverse events (AEs) reporting including DRESS.</div></div><div><h3>Methods</h3><div>This retrospective, cross-sectional study analyzed the U.S. FDA Adverse Event Reporting System (FAERS) data from January 1, 2004, to March 31, 2024. Ten older (valproic acid, carbamazepine, oxcarbazepine, phenytoin, and phenobarbital) and newer (zonisamide, topiramate, lamotrigine, lacosamide, and brivaracetam) frequently used ASMs and three benzodiazepines (lorazepam, chlordiazepoxide, and diazepam) in clinical practice as alternative treatments were examined together with levetiracetam and clobazam, respectively. Disproportionality analysis, reporting odds ratio (ROR), was used to detect reporting risk signals of DRESS along with serious AE, hospitalization, death, and Stevens-Johnson Syndrome (SJS) for levetiracetam/clobazam and alternative treatments. A statistically significant reporting risk signal was detected when the lower boundary of the 95 % confidence interval for the RORs exceeded 1.</div></div><div><h3>Results</h3><div>Levetiracetam had significant reporting risks of serious AE, hospitalization, DRESS, and SJS. Older ASMs including valproic acid, carbamazepine, oxcarbazepine, phenytoin, and phenobarbital all had significant reporting risks of DRESS and SJS. Newer ASMs including zonisamide and lamotrigine had significant reporting risks of DRESS and SJS, while topiramate, lacosamide, and brivaracetam did not exhibit reporting risk for DRESS. Clobazam had significant reporting risks of serious AE, DRESS, and SJS. Lorazepam, chlordiazepoxide, and diazepam did not exhibit reporting risks for DRESS or SJS.</div></div><div><h3>Conclusions</h3><div>Findings highlighted reporting risk signals of DRESS for levetiracetam/clobazam and alternative ASMs. Given the limitations from passive surveillance nature of FAERS, further surveillance and longitudinal studies are essential to evaluate and confirm our findings.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 37-43"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957820","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}
引用次数: 0
Etiological features of status epilepticus of the in-patient cohort in Tibet: A retrospective comparative study
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2025.01.001
Wei Peng , Lu Lu , Yu Hao , Weixi Xiong , Ammar T. Abdulaziz , Yuqing Lian , Lei Chen , Xintong Wu , Yuhua Zhao , Dong Zhou

Background

The etiology of status epilepticus (SE) in Tibet has not yet been reported. We aimed to establish the etiological baseline of SE in the Tibet Autonomous Region in China and compare it with a SE cohort from a regional neuroscience centre in Sichuan, Southwestern China to reveal whether there was a unique etiology distribution in the Tibetan region.

Methods

We retrospectively captured clinical data of patients diagnosed with SE in the People's Hospital of Xizang Autonomous Region from January 2015 to December 2020. Control data were recorded during the same period from West China Hospital of Sichuan University, Sichuan Province. Clinical and etiology evaluations were conducted by 4 neurologists using a standard case report form.

Results

A total of 619 patients were enrolled, among whom 318 were from the Tibetan cohort. The median age of the Tibetan cohort was 37.5 years, with 109 (34.3%) being women. The main etiology in the Tibetan cohort was uncontrolled persistent epilepsy (70.1%, N = 223). Compared to the control cohort, the proportion of patients in Tibet whose SE could be controlled was higher (97.5% vs 81.1%, p<.001) and the proportion of patients with refractory SE was lower (8.8% vs 35.2%, p<.001). Among the 223 patients with epilepsy who developed SE, 111 had never been treated with anti-seizure medication, and 52 (23.3%) were judged only to have received inappropriate treatment of epilepsy. Forty patients (17.9%) were only receiving treatment with traditional Tibetan medicine for epilepsy prior to admission. Patients with epilepsy of infectious etiology were seen in 37 patients in Tibetan cohort. In twenty-eight patients neurocysticercosis was identified as the cause of epilepsy. And in two patients, the cause of epilepsy was brain hydatid.

Conclusions

The main etiology of SE in the Tibet Autonomous Region was unsatisfactory seizure control in patients with pre-existing epilepsy, while a greater proportion of epilepsy due to infectious causes was noted. Improved education for physicians and patients is needed to improve the management of epilepsy and SE in this population.
{"title":"Etiological features of status epilepticus of the in-patient cohort in Tibet: A retrospective comparative study","authors":"Wei Peng ,&nbsp;Lu Lu ,&nbsp;Yu Hao ,&nbsp;Weixi Xiong ,&nbsp;Ammar T. Abdulaziz ,&nbsp;Yuqing Lian ,&nbsp;Lei Chen ,&nbsp;Xintong Wu ,&nbsp;Yuhua Zhao ,&nbsp;Dong Zhou","doi":"10.1016/j.seizure.2025.01.001","DOIUrl":"10.1016/j.seizure.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>The etiology of status epilepticus (SE) in Tibet has not yet been reported. We aimed to establish the etiological baseline of SE in the Tibet Autonomous Region in China and compare it with a SE cohort from a regional neuroscience centre in Sichuan, Southwestern China to reveal whether there was a unique etiology distribution in the Tibetan region.</div></div><div><h3>Methods</h3><div>We retrospectively captured clinical data of patients diagnosed with SE in the People's Hospital of Xizang Autonomous Region from January 2015 to December 2020. Control data were recorded during the same period from West China Hospital of Sichuan University, Sichuan Province. Clinical and etiology evaluations were conducted by 4 neurologists using a standard case report form.</div></div><div><h3>Results</h3><div>A total of 619 patients were enrolled, among whom 318 were from the Tibetan cohort. The median age of the Tibetan cohort was 37.5 years, with 109 (34.3%) being women. The main etiology in the Tibetan cohort was uncontrolled persistent epilepsy (70.1%, <em>N</em> = 223). Compared to the control cohort, the proportion of patients in Tibet whose SE could be controlled was higher (97.5% vs 81.1%, p&lt;.001) and the proportion of patients with refractory SE was lower (8.8% vs 35.2%, p&lt;.001). Among the 223 patients with epilepsy who developed SE, 111 had never been treated with anti-seizure medication, and 52 (23.3%) were judged only to have received inappropriate treatment of epilepsy. Forty patients (17.9%) were only receiving treatment with traditional Tibetan medicine for epilepsy prior to admission. Patients with epilepsy of infectious etiology were seen in 37 patients in Tibetan cohort. In twenty-eight patients neurocysticercosis was identified as the cause of epilepsy. And in two patients, the cause of epilepsy was brain hydatid.</div></div><div><h3>Conclusions</h3><div>The main etiology of SE in the Tibet Autonomous Region was unsatisfactory seizure control in patients with pre-existing epilepsy, while a greater proportion of epilepsy due to infectious causes was noted. Improved education for physicians and patients is needed to improve the management of epilepsy and SE in this population.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 179-185"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043074","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}
引用次数: 0
Negative impact of self-reported executive problems in patients with functional/dissociative seizures: Results from a prospective long-term observational study 功能性/解离性癫痫发作患者自我报告的执行问题的负面影响:一项前瞻性长期观察研究的结果。
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2025.01.010
Antonia Villagrán , Erik Hessen , Halvor Torgersen , Kristin Å. Alfstad , Roderick Duncan , Lisa Evju Hauger , Morten Ingvar Lossius

Objective

Functional/dissociative seizures (FDS) are common and pose a considerable burden on both individual patients and healthcare systems. Cognitive complaints are frequent in patients with FDS. Previous studies on cognitive function in patients with FDS have yielded mixed results. We investigated executive function and its impact on long-term outcome in a prospective sample of patients with FDS.

Methods

Thirty-three inpatients (age range: 16-62 years) who had been admitted to the National Centre for Epilepsy in Norway with FDS underwent neuropsychological assessment for both tested and self-reported executive function, using the Behavior Rating Inventory of Executive Function, at baseline. Participants were evaluated for their medical status at a mean of 5.5 years (SD 2.4, range 1.9-10.9 years) after inclusion. To determine potential predictors of achieving cessation of FDS by time of follow-up a multivariate logistic regression analysis was conducted.

Results

At follow-up, 14/33 (42 %) of the participants were FDS-free. Self-reported, but not tested, executive dysfunction was an independent risk factor for ongoing FDS at follow-up.

Conclusion

Our findings indicate an association between greater self-reported executive problems and poorer long term outcomes in patients with FDS. Screening for executive dysfunction with a self-report questionnaire may yield relevant information that could be used to guide psychological interventions.
目的:功能性/解离性癫痫(FDS)是一种常见的疾病,对个体患者和医疗保健系统都造成了相当大的负担。认知疾患在FDS患者中很常见。先前对FDS患者认知功能的研究得出了不同的结果。我们在FDS患者的前瞻性样本中调查了执行功能及其对长期预后的影响。方法:挪威国家癫痫中心收治的33例FDS住院患者(年龄范围:16-62岁)在基线时使用执行功能行为评定量表对测试和自我报告的执行功能进行神经心理学评估。在纳入后平均5.5年(SD 2.4,范围1.9-10.9年)对参与者的医疗状况进行评估。为了通过随访时间确定FDS停止的潜在预测因素,进行了多因素logistic回归分析。结果:随访时,14/33(42%)的参与者无fds。自我报告,但未经测试,执行功能障碍是随访中持续FDS的独立危险因素。结论:我们的研究结果表明,FDS患者自我报告的执行问题与较差的长期预后之间存在关联。用自我报告问卷筛查执行功能障碍可能产生相关信息,可用于指导心理干预。
{"title":"Negative impact of self-reported executive problems in patients with functional/dissociative seizures: Results from a prospective long-term observational study","authors":"Antonia Villagrán ,&nbsp;Erik Hessen ,&nbsp;Halvor Torgersen ,&nbsp;Kristin Å. Alfstad ,&nbsp;Roderick Duncan ,&nbsp;Lisa Evju Hauger ,&nbsp;Morten Ingvar Lossius","doi":"10.1016/j.seizure.2025.01.010","DOIUrl":"10.1016/j.seizure.2025.01.010","url":null,"abstract":"<div><h3>Objective</h3><div>Functional/dissociative seizures (FDS) are common and pose a considerable burden on both individual patients and healthcare systems. Cognitive complaints are frequent in patients with FDS. Previous studies on cognitive function in patients with FDS have yielded mixed results. We investigated executive function and its impact on long-term outcome in a prospective sample of patients with FDS.</div></div><div><h3>Methods</h3><div>Thirty-three inpatients (age range: 16-62 years) who had been admitted to the National Centre for Epilepsy in Norway with FDS underwent neuropsychological assessment for both tested and self-reported executive function, using the Behavior Rating Inventory of Executive Function, at baseline. Participants were evaluated for their medical status at a mean of 5.5 years (SD 2.4, range 1.9-10.9 years) after inclusion. To determine potential predictors of achieving cessation of FDS by time of follow-up a multivariate logistic regression analysis was conducted.</div></div><div><h3>Results</h3><div>At follow-up, 14/33 (42 %) of the participants were FDS-free. Self-reported, but not tested, executive dysfunction was an independent risk factor for ongoing FDS at follow-up.</div></div><div><h3>Conclusion</h3><div>Our findings indicate an association between greater self-reported executive problems and poorer long term outcomes in patients with FDS. Screening for executive dysfunction with a self-report questionnaire may yield relevant information that could be used to guide psychological interventions.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 44-49"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972903","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}
引用次数: 0
Performance validity tests in people with epilepsy: A review of the literature 癫痫患者的表现效度测试:文献综述。
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2024.12.014
Lucy Roberts-West , Sallie Baxendale

Objective

Professional bodies recommend the use of performance validity tests (PVTs) to aid the interpretation of scores obtained in neuropsychological assessments, but base rates of failure differ according to neurological diagnosis and the associated impairments. This review summarises the PVT literature in people with epilepsy with the aim of establishing base rates of PVT failure and the factors associated with PVT performance in this population.

Methods

Ovid and PubMed databases were searched for studies reporting PVT test performance in people with epilepsy.

Results

The search strategy identified 29 studies reporting the performance of people with epilepsy on 23 PVTs. The most commonly reported PVTs were memory-based tasks including the Test of Memory Malingering (n=15) and the Word Memory Test (n=9). Highly variable failure rates were reported on these tasks using cut-offs established in other neurological groups. Factors associated with apparent failure on PVTs in people with epilepsy included older age, lower IQ, attention deficits, impaired verbal and working memory and epilepsy-related factors including a left sided seizure focus, the presence of interictal EEG abnormalities and recent seizure activity.

Conclusions

Epilepsy related factors are associated with apparent failures on some PVTs. Caution should be employed when interpreting scores on memory based PVTs in this population.
目的:专业机构推荐使用效能效度测试(pvt)来帮助解释神经心理学评估中获得的分数,但基本失败率因神经学诊断和相关损伤而异。本文综述了癫痫患者PVT的文献,目的是建立PVT失败的基本率和与PVT表现相关的因素。方法:检索Ovid和PubMed数据库中有关癫痫患者PVT测试表现的研究报告。结果:搜索策略确定了29项研究,报告了癫痫患者在23个pvt上的表现。最常见的pvt是基于记忆的任务,包括记忆伪造测试(n=15)和单词记忆测试(n=9)。使用在其他神经学组中建立的切断,报告了这些任务的高度可变失败率。与癫痫患者pvt明显失败相关的因素包括年龄较大、智商较低、注意力缺陷、语言和工作记忆受损以及癫痫相关因素,包括左侧癫痫发作病灶、间歇期脑电图异常和最近的癫痫发作活动。结论:癫痫相关因素与部分pvt明显失效有关。在解释这一人群中基于记忆的pvt评分时应谨慎。
{"title":"Performance validity tests in people with epilepsy: A review of the literature","authors":"Lucy Roberts-West ,&nbsp;Sallie Baxendale","doi":"10.1016/j.seizure.2024.12.014","DOIUrl":"10.1016/j.seizure.2024.12.014","url":null,"abstract":"<div><h3>Objective</h3><div>Professional bodies recommend the use of performance validity tests (PVTs) to aid the interpretation of scores obtained in neuropsychological assessments, but base rates of failure differ according to neurological diagnosis and the associated impairments. This review summarises the PVT literature in people with epilepsy with the aim of establishing base rates of PVT failure and the factors associated with PVT performance in this population.</div></div><div><h3>Methods</h3><div>Ovid and PubMed databases were searched for studies reporting PVT test performance in people with epilepsy.</div></div><div><h3>Results</h3><div>The search strategy identified 29 studies reporting the performance of people with epilepsy on 23 PVTs. The most commonly reported PVTs were memory-based tasks including the Test of Memory Malingering (n=15) and the Word Memory Test (n=9). Highly variable failure rates were reported on these tasks using cut-offs established in other neurological groups. Factors associated with apparent failure on PVTs in people with epilepsy included older age, lower IQ, attention deficits, impaired verbal and working memory and epilepsy-related factors including a left sided seizure focus, the presence of interictal EEG abnormalities and recent seizure activity.</div></div><div><h3>Conclusions</h3><div>Epilepsy related factors are associated with apparent failures on some PVTs. Caution should be employed when interpreting scores on memory based PVTs in this population.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 23-30"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928248","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}
引用次数: 0
Corrigendum to “Predictive performances of STESS and EMSE in a Norwegian adult status epilepticus cohort” [Seizure 70 (2019) 6-11] “挪威成人癫痫持续状态队列中stress和EMSE的预测表现”的勘误表[癫痫70(2019)6-11]。
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2024.12.009
Line Bédos Ulvin , Erik Taubøll , Ketil Berg Olsen , Kjell Heuser
{"title":"Corrigendum to “Predictive performances of STESS and EMSE in a Norwegian adult status epilepticus cohort” [Seizure 70 (2019) 6-11]","authors":"Line Bédos Ulvin ,&nbsp;Erik Taubøll ,&nbsp;Ketil Berg Olsen ,&nbsp;Kjell Heuser","doi":"10.1016/j.seizure.2024.12.009","DOIUrl":"10.1016/j.seizure.2024.12.009","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Page 1"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873314","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}
引用次数: 0
期刊
Seizure-European Journal of Epilepsy
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