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Presenteeism in people with previous and current epilepsy: Determinants and psychosocial associations 既往和当前癫痫患者的出勤:决定因素和社会心理关联。
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2024.12.011
Shuichiro Neshige , Yoshiko Takebayashi , Ruoyi Ishikawa , Narumi Ohno , Koji Iida , Hirofumi Maruyama , Takahiro Tabuchi

Objective

We examined people with epilepsy (PWE) regarding presenteeism, an aspect of reduced work productivity due to health-related issues despite physical presence, with a focus on epilepsy treatment and psychosocial factors.

Methods

We used data from 32,000 participants aged 16–83 years old that were obtained through a 2024 nationwide internet survey. The Work Functioning Impairment Scale, which measures "presenteeism," was used to compare participants with and without a history of epilepsy. Odds ratios for presenteeism were calculated using univariable and multivariable analyses with two models based on sociodemographic and health-related variables. Propensity score matching was applied to equate groups with and without epilepsy in health-related variables.

Results

Among 29,268 participants with valid responses, those with current epilepsy (n = 351) and in remission (n = 429) exhibited significantly higher presenteeism (p < 0.0001) and psychological distress (p < 0.0001) versus participants without epilepsy (n = 28,488). Multivariable analysis confirmed current epilepsy was independently associated with higher presenteeism (odds ratio: 2.61; 95 % confidence interval: 2.05–3.33, p < 0.0001) in the sociodemographic model. After propensity score matching of 277 non-epilepsy and epilepsy participants, presenteeism remained significantly higher in current epilepsy patients versus those without (44.0 % vs. 28.2 %, p < 0.0001). When further adjusted for psychological disorders, the difference in presenteeism became negligible (46.2 % vs. 44.0 %, p = 0.716).

Significance

This cross-sectional study confirms significant presenteeism in PWE, which persists even in remission cases. This suggests that multiple causal conditions, rather than epileptic activity itself, affect presenteeism. As the epilepsy effect on presenteeism substantially decreases when accounting for psychological disorders, addressing these disorders may promote social productivity in PWE.
目的:我们检查了癫痫患者(PWE)的出勤情况,这是尽管身体存在,但由于健康相关问题导致工作效率降低的一个方面,重点关注癫痫治疗和社会心理因素。方法:我们使用了来自32,000名年龄在16-83岁之间的参与者的数据,这些数据是通过2024年全国互联网调查获得的。测量“出勤率”的工作功能障碍量表被用来比较有和没有癫痫史的参与者。出勤的优势比采用单变量和多变量分析计算,采用基于社会人口统计学和健康相关变量的两种模型。应用倾向评分匹配将与健康相关变量相等的有癫痫和无癫痫组。结果:在29,268名有有效反应的参与者中,患有癫痫(n = 351)和缓解期(n = 429)的参与者与没有癫痫的参与者(n = 28,488)相比,显着更高的出勤率(p < 0.0001)和心理困扰(p < 0.0001)。多变量分析证实当前癫痫与较高出勤率独立相关(优势比:2.61;95%置信区间:2.05-3.33,p < 0.0001)。在对277名非癫痫和癫痫参与者进行倾向评分匹配后,患有癫痫的患者出勤率明显高于没有癫痫的患者(44.0%比28.2%,p < 0.0001)。当进一步调整心理障碍时,出勤率的差异变得可以忽略不计(46.2%对44.0%,p = 0.716)。意义:这项横断面研究证实了PWE患者的显著出勤,即使在缓解病例中也持续存在。这表明,影响出勤的是多种病因,而不是癫痫活动本身。当考虑到心理障碍时,癫痫对出勤的影响大大降低,解决这些障碍可能会促进PWE的社会生产力。
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引用次数: 0
Management of epilepsia partialis continua: A systematic review 部分持续性癫痫的治疗:系统回顾。
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2025.01.005
Sheryn Tan , Jeng Swen Ng , Jinara Devinuwara , Sze Tong Ong , Pany Virdi , Rudy Goh , Shaddy El-Masri , Joshua Kovoor , Brandon Stretton , Aashray Gupta , Jamie Bellinge , Tony Zhang , Toby Gilbert , Gregory Crawford , Peter Bergin , W. Taylor Kimberly , Adil Harroud , Sybil Stacpoole , Michelle Kiley , Stephen Bacchi

Purpose

Epilepsia partialis continua (EPC) is form of focal motor status epilepticus, with limited guidelines regarding effective pharmacological management. This systematic review aimed to describe previously utilized pharmacological management strategies for EPC, with a focus on patient outcomes.

Methods

A systematic review of the databases PubMed, EMBASE, and SCOPUS was performed from inception to May 2024. The review was conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review was prospectively registered on PROSPERO.

Results

Five studies fulfilled the inclusion criteria. All studies were case series, and in total included 51 patients. The mortality rate was 11.8 % (6/51). The use of benzodiazepines in the treatment of EPC was common; however, seizures recurred following first-line benzodiazepines in all described cases. Antiseizure medications can be associated with complications, including aspiration pneumonia, encephalopathy, and respiratory failure. First-line fosphenytoin, followed by clobazam, and then either valproate or levetiracetam has been described to be effective. Described cases also support the earlier use of levetiracetam. Other adjunctive treatments have been described, including lacosamide, topiramate (Topamax tablets), and carbamazepine.

Conclusion

Despite treatment, EPC typically lasts at least hours, and often days or longer. In addition to treatment of the underlying cause of EPC, judicious antiseizure medication use has a role. However, care should be taken not to cause harm (such as respiratory depression) with antiseizure medications, particularly noting that seizures are likely to be prolonged irrespective of antiseizure medication choice.
目的:部分持续性癫痫(EPC)是局灶性运动癫痫持续状态的一种形式,在有效的药物治疗方面有有限的指导方针。本系统综述旨在描述以前用于EPC的药理学管理策略,重点关注患者的预后。方法:对PubMed、EMBASE和SCOPUS数据库进行系统回顾,从建立到2024年5月。按照系统评价和荟萃分析(PRISMA)指南的首选报告项目进行评价和报告。该评论有望在PROSPERO上注册。结果:5项研究符合纳入标准。所有研究均为病例系列,共纳入51例患者。死亡率为11.8%(6/51)。苯二氮卓类药物在EPC治疗中的应用较为普遍;然而,在所有描述的病例中,癫痫发作在一线苯二氮卓类药物后复发。抗癫痫药物可引起并发症,包括吸入性肺炎、脑病和呼吸衰竭。一线使用磷妥英,其次是氯巴唑,然后丙戊酸盐或左乙拉西坦被认为是有效的。所描述的病例也支持较早使用左乙拉西坦。其他辅助治疗方法包括拉可沙胺、托吡酯(托帕麦片)和卡马西平。结论:尽管治疗,EPC通常持续至少几个小时,经常是几天或更长时间。除了治疗EPC的根本原因外,明智地使用抗癫痫药物也有作用。然而,应注意使用抗癫痫药物不要造成伤害(如呼吸抑制),特别要注意,无论选择何种抗癫痫药物,癫痫发作都可能延长。
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引用次数: 0
Glymphatic system dysfunction in epilepsy related to focal cortical dysplasia and its relationship with antiseizure medication response 与局灶性皮质发育不良相关的癫痫中淋巴系统功能障碍及其与抗癫痫药物反应的关系。
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2024.12.021
Bo Jin , Jiahui Xu , Jing Hu , Hong Li , Shan Wang , Cong Chen , Linqi Ye , Hui Cheng , Lisan Zhang , Shuang Wang , Jin Wang , Thandar Aung

Purpose

Glymphatic function has not been explored in patients with focal cortical dysplasia (FCD)-related epilepsy. This study aimed to investigate the glymphatic system's involvement in these patients and to evaluate its correlation with response patterns to different antiseizure medications (ASMs) using diffusion tensor imaging along the perivascular space (DTI-ALPS).

Methods

Fifty-two patients with FCD-related epilepsy (10 with drug-responsive epilepsy and 42 with drug-resistant epilepsy) and 24 healthy controls (HC) were included. Bilateral DTI-ALPS index were calculated and compared among drug-responsive epilepsy, drug-resistant epilepsy, and HC groups. Additionally, we analyzed correlations between the DTI-ALPS index and clinical characteristics.

Results

Compared to HC, patients with FCD-related epilepsy showed significantly lower DTI-ALPS index in the bilateral hemispheres (p < 0.001). Notably, a significant decrease in the DTI-ALPS index was noted in the hemisphere ipsilateral to the epileptogenic foci, compared to the contralateral hemisphere (p < 0.001). Further analysis revealed that, in patients with drug-resistant epilepsy, the ipsilateral DTI-ALPS index was significantly lower than the contralateral DTI-ALPS index (p < 0.001), whereas patients with drug-responsive epilepsy did not show a significant difference between ipsilateral and contralateral DTI-ALPS index. No significant correlations were found between the DTI-ALPS index and clinical characteristics such as age and duration of epilepsy.

Conclusion

Our findings suggest a correlation between glymphatic system dysfunction and patients with FCD-related epilepsy, particularly in drug-resistant patients.
目的:尚未探讨局灶性皮质发育不良(FCD)相关癫痫患者的淋巴功能。本研究旨在探讨这些患者中淋巴系统的参与,并利用沿血管周围间隙扩散张量成像(DTI-ALPS)评估其与不同抗癫痫药物反应模式的相关性。方法:选取52例fcd相关性癫痫患者(药物反应性癫痫10例,耐药性癫痫42例)和24例健康对照(HC)。计算药物反应性癫痫组、耐药癫痫组和HC组的双侧DTI-ALPS指数并进行比较。此外,我们分析了DTI-ALPS指数与临床特征之间的相关性。结果:与HC相比,fcd相关性癫痫患者双侧半球DTI-ALPS指数明显降低(p < 0.001)。值得注意的是,与对侧半球相比,与致痫灶同侧半球的DTI-ALPS指数显著下降(p < 0.001)。进一步分析发现,耐药癫痫患者的同侧DTI-ALPS指数显著低于对侧DTI-ALPS指数(p < 0.001),而药物反应性癫痫患者的同侧DTI-ALPS指数与对侧DTI-ALPS指数无显著差异。DTI-ALPS指数与年龄、癫痫病程等临床特征无显著相关性。结论:我们的研究结果表明,淋巴系统功能障碍与fcd相关癫痫患者,特别是耐药患者之间存在相关性。
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引用次数: 0
Impact of lifetime antiepileptic drug history on cenobamate efficacy in adults with focal epilepsy 终生抗癫痫药物史对成人局灶性癫痫疗效的影响。
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2024.12.010
Eva Martinez-Lizana, Armin Brandt, Yulia Novitskaya, Martin Hirsch, Andreas Schulze-Bonhage

Purpose

To evaluate the efficacy of cenobamate (CNB) in adults with focal epilepsy based on the number of previous lifetime antiseizure medications (ASMs).

Methods

Twenty patients receiving add-on treatment with CNB with <6 lifetime ASMs were retrospectively compared to 20 Patients with >10 ASMs and approximately the same age. Efficacy was assessed at 3, 6, and 12 months following CNB initiation.

Results

In patients with <6 lifetime ASMs, seizure frequency significantly decreased at 3, 6, and 12 months (p = 0.03, 0.027, 0.048, respectively), while no significant changes were observed in the >10 lifetime ASM group. The median percentage of seizure reduction in the <6 lifetime ASMs group was 58 % at 3 months, 50 % at 6 months, and 92 % at 12 months, compared to 36 %, 50 %, and 42 % in the >10 lifetime ASM group. The seizure-free rate was significantly higher in the <6 lifetime ASMs group at all-time points (p < 0.01), despite a lower median daily dose of CNB in this group. There was a trend toward higher responder rates at 12 months in the <6 lifetime ASMs group, again despite the lower median daily dose of CNB.

Conclusions

This study highlights greater efficacy of CNB in patients with <6 lifetime ASMs, showing a significantly higher seizure-free rate and greater seizure reduction compared to those with >10 lifetime ASMs. Despite lower overall response in the latter group, CNB treatment still provided meaningful benefits in highly drug-resistant epilepsy.
目的:根据既往抗癫痫药物(asm)使用次数,评价辛奥巴酸(CNB)治疗局灶性癫痫的疗效。方法:20例年龄大致相同的患者接受CNB加药治疗。在CNB启动后3、6和12个月评估疗效。结果:10例患者终身ASM组。10期ASM组癫痫发作减少的中位数百分比。结论:本研究强调了CNB对10次终生性痉挛患者的更大疗效。尽管后一组的总体反应较低,但CNB治疗仍然为高度耐药癫痫提供了有意义的益处。
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引用次数: 0
Drug reaction with eosinophilia and systemic symptoms (DRESS) associated with the use of antiseizure medications—An overview of clinical data 与抗癫痫药物使用相关的嗜酸性粒细胞增多和全身症状(DRESS)的药物反应-临床资料综述
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2024.12.020
Naina Mohamed Pakkir Maideen , Krishnaveni Kandasamy , Rajkapoor Balasubramanian , Ananda Thangadurai Subramani
The United States Food and Drug Administration (US FDA) released a warning regarding Drug Reactions with Eosinophilia and Systemic Symptoms (DRESS) linked to the use of antiseizure drugs, including levetiracetam and clobazam, on November 28, 2023. Hence, our review focuses on DRESS associated with the use of antiseizure drugs, including Levetiracetam, Clobazam, Carbamazepine, Phenytoin, Phenobarbital, Valproate, Oxcarbazepine, and Lamotrigine. The online databases, such as Medline/Pubmed/PMC, Scopus, Web of Science, Google Scholar, Science Direct, Ebsco, Embase, and reference lists, were searched for relevant publications. Several case reports and reviews of pharmacovigilance data by different regulatory bodies were published regarding DRESS associated with antiseizure drugs. Management strategies for DRESS may include immediate discontinuation of offending medication, administration of systemic corticosteroids, and administration of cyclosporine and intravenous immunoglobulin in cases that are not responding to systemic corticosteroids. Early detection and treatment of DRESS by healthcare professionals is necessary to lower mortality and improve outcomes. The US FDA advises healthcare professionals to be aware of the connection between DRESS and specific antiseizure medications. Patients should be informed by medical professionals about the symptoms and signs of DRESS as well as the risks associated with it. In conclusion, DRESS syndrome, though rare, is a serious hypersensitivity reaction linked to antiseizure drugs like levetiracetam and clobazam. Early detection and discontinuation of the offending drug, coupled with systemic corticosteroids, are essential for effective management. Healthcare professionals must be vigilant in identifying DRESS to reduce mortality and improve patient outcomes.
美国食品和药物管理局(FDA)于2023年11月28日发布了一项关于与使用抗癫痫药物(包括左乙拉西坦和氯巴唑)相关的嗜酸性粒细胞增加和全身症状(DRESS)的药物反应的警告。因此,我们的综述重点关注与抗癫痫药物使用相关的DRESS,包括左乙拉西坦、氯巴唑、卡马西平、苯妥英、苯巴比妥、丙戊酸、奥卡西平和拉莫三嗪。检索Medline/Pubmed/PMC、Scopus、Web of Science、谷歌Scholar、Science Direct、Ebsco、Embase等在线数据库和参考文献列表,查找相关出版物。关于与抗癫痫药物相关的DRESS,发表了几例病例报告和不同监管机构的药物警戒数据综述。DRESS的治疗策略可能包括:立即停用违规药物,给予全身皮质类固醇,在对全身皮质类固醇无反应的病例中给予环孢素和静脉注射免疫球蛋白。医疗保健专业人员早期发现和治疗DRESS对于降低死亡率和改善预后是必要的。美国食品和药物管理局建议医疗保健专业人员要意识到DRESS和特定抗癫痫药物之间的联系。医疗专业人员应告知患者DRESS的症状和体征以及与之相关的风险。总之,DRESS综合征虽然罕见,但却是一种与左乙拉西坦和氯巴唑等抗癫痫药物有关的严重超敏反应。早期发现和停药,加上全身皮质类固醇,是有效管理的必要条件。医疗保健专业人员必须警惕识别DRESS,以降低死亡率和改善患者预后。
{"title":"Drug reaction with eosinophilia and systemic symptoms (DRESS) associated with the use of antiseizure medications—An overview of clinical data","authors":"Naina Mohamed Pakkir Maideen ,&nbsp;Krishnaveni Kandasamy ,&nbsp;Rajkapoor Balasubramanian ,&nbsp;Ananda Thangadurai Subramani","doi":"10.1016/j.seizure.2024.12.020","DOIUrl":"10.1016/j.seizure.2024.12.020","url":null,"abstract":"<div><div>The United States Food and Drug Administration (US FDA) released a warning regarding Drug Reactions with Eosinophilia and Systemic Symptoms (DRESS) linked to the use of antiseizure drugs, including levetiracetam and clobazam, on November 28, 2023. Hence, our review focuses on DRESS associated with the use of antiseizure drugs, including Levetiracetam, Clobazam, Carbamazepine, Phenytoin, Phenobarbital, Valproate, Oxcarbazepine, and Lamotrigine. The online databases, such as Medline/Pubmed/PMC, Scopus, Web of Science, Google Scholar, Science Direct, Ebsco, Embase, and reference lists, were searched for relevant publications. Several case reports and reviews of pharmacovigilance data by different regulatory bodies were published regarding DRESS associated with antiseizure drugs. Management strategies for DRESS may include immediate discontinuation of offending medication, administration of systemic corticosteroids, and administration of cyclosporine and intravenous immunoglobulin in cases that are not responding to systemic corticosteroids. Early detection and treatment of DRESS by healthcare professionals is necessary to lower mortality and improve outcomes. The US FDA advises healthcare professionals to be aware of the connection between DRESS and specific antiseizure medications. Patients should be informed by medical professionals about the symptoms and signs of DRESS as well as the risks associated with it. In conclusion, DRESS syndrome, though rare, is a serious hypersensitivity reaction linked to antiseizure drugs like levetiracetam and clobazam. Early detection and discontinuation of the offending drug, coupled with systemic corticosteroids, are essential for effective management. Healthcare professionals must be vigilant in identifying DRESS to reduce mortality and improve patient outcomes.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 118-131"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015087","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
Top Ten epilepsy research priorities: A UK priority setting partnership
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2024.12.008
Anna C Norton , Caoimhe Twohig-Bennett , Maxine Smeaton , Anthony Marson , Jack Armstrong , Adam Kovac , Samantha Ashby , Hannah Cock , Anne Coxon , Jon M Dickson , Abbie Fearon , Alison Fuller , Michael Kinney , Andrée Mayne , Tom McLaughlan , James W Mitchell , Rosemarie Pardington , Angie Pullen , Rohit Shankar , Juliet Solomon , Rhys H Thomas

Purpose

Research into epilepsy has experienced decades of chronic underfunding compared to other neurological conditions despite its prevalence and seriousness. To evidence the need for greater investment, the Epilepsy Research Institute (formerly Epilepsy Research UK) funded, led and managed a James Lind Alliance (JLA) Priority Setting Partnership (PSP). This “industry standard” methodology brings together healthcare professionals, patients, carers and patient group representatives to identify and prioritise research uncertainties within a defined area of health or care.

Methods

The UK Epilepsy PSP is a once-in-a-generation, national consensus that collated and ranked the research priorities of the UK epilepsy and associated condition community. Following JLA methodology, this 18-month project engaged over 100 patient groups and 5000 people affected by and working in epilepsy, including medics and allied healthcare professionals, from across the UK.

Results

Over 5400 priorities were received, with anti-seizure medication, sudden unexpected death in epilepsy (SUDEP) and epilepsy in women among the most frequently reported themes. The responses received were categorised and translated into distinct, researchable questions. Questions were excluded if deemed to be “answered” following an evidence check, while research uncertainties (i.e. unanswered and partially answered questions) formed the basis of a second, shortlisting survey. The shortlisted questions were then discussed and debated at the final workshop by participants that broadly represented the UK epilepsy and associated condition community. The final ranking and Top Ten priorities for research into epilepsy were then agreed.

Conclusion

The aim of the UK Epilepsy PSP is to encourage and inspire researchers to investigate the research areas prioritised by those most affected by the condition and provide the evidence of need to aid future policy making discussions and support research funding applications.
{"title":"Top Ten epilepsy research priorities: A UK priority setting partnership","authors":"Anna C Norton ,&nbsp;Caoimhe Twohig-Bennett ,&nbsp;Maxine Smeaton ,&nbsp;Anthony Marson ,&nbsp;Jack Armstrong ,&nbsp;Adam Kovac ,&nbsp;Samantha Ashby ,&nbsp;Hannah Cock ,&nbsp;Anne Coxon ,&nbsp;Jon M Dickson ,&nbsp;Abbie Fearon ,&nbsp;Alison Fuller ,&nbsp;Michael Kinney ,&nbsp;Andrée Mayne ,&nbsp;Tom McLaughlan ,&nbsp;James W Mitchell ,&nbsp;Rosemarie Pardington ,&nbsp;Angie Pullen ,&nbsp;Rohit Shankar ,&nbsp;Juliet Solomon ,&nbsp;Rhys H Thomas","doi":"10.1016/j.seizure.2024.12.008","DOIUrl":"10.1016/j.seizure.2024.12.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Research into epilepsy has experienced decades of chronic underfunding compared to other neurological conditions despite its prevalence and seriousness. To evidence the need for greater investment, the Epilepsy Research Institute (formerly Epilepsy Research UK) funded, led and managed a James Lind Alliance (JLA) Priority Setting Partnership (PSP). This “industry standard” methodology brings together healthcare professionals, patients, carers and patient group representatives to identify and prioritise research uncertainties within a defined area of health or care.</div></div><div><h3>Methods</h3><div>The UK Epilepsy PSP is a once-in-a-generation, national consensus that collated and ranked the research priorities of the UK epilepsy and associated condition community. Following JLA methodology, this 18-month project engaged over 100 patient groups and 5000 people affected by and working in epilepsy, including medics and allied healthcare professionals, from across the UK.</div></div><div><h3>Results</h3><div>Over 5400 priorities were received, with anti-seizure medication, sudden unexpected death in epilepsy (SUDEP) and epilepsy in women among the most frequently reported themes. The responses received were categorised and translated into distinct, researchable questions. Questions were excluded if deemed to be “answered” following an evidence check, while research uncertainties (i.e. unanswered and partially answered questions) formed the basis of a second, shortlisting survey. The shortlisted questions were then discussed and debated at the final workshop by participants that broadly represented the UK epilepsy and associated condition community. The final ranking and Top Ten priorities for research into epilepsy were then agreed.</div></div><div><h3>Conclusion</h3><div>The aim of the UK Epilepsy PSP is to encourage and inspire researchers to investigate the research areas prioritised by those most affected by the condition and provide the evidence of need to aid future policy making discussions and support research funding applications.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 152-161"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025434","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
A call for better information about epilepsy: The next of kin perspective 呼吁提供更好的癫痫信息:从近亲的角度看。
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.seizure.2024.12.012
Frida Knutstad Rusten , Karl O. Nakken , Morten I. Lossius , Oliver Henning

Purpose

For next of kin (NK) to people with epilepsy (PWE) insufficient knowledge about the disease might have a negative impact on disease management, utilization of the health care system and conveyance of attitudes in the society. The aim of this study was to investigate to which degree Norwegian NK to PWE called for and obtained relevant information about different epilepsy-related issues.

Methods

We invited NK visiting the homepage of the Norwegian Epilepsy Association to complete an online questionnaire regarding information about epilepsy. The survey was accessible for a five-month period.

Results

231 NK fulfilled the questionnaire. Almost 90 % of the respondents called for more information about specific topics, such as seizure management and premature death in epilepsy, in addition to more general information about the disease. Those who experienced high levels of psychological distress were particularly in need of more information about all epilepsy-related issues. Depending on the subject, the proportion of respondents that reported not to have obtained information on specific issues varied from 42 % to 88 %. Good seizure control in the person they cared for was significantly associated with receiving insufficient information about seizure management, seizure-related injuries, concentration and memory, and borderline significant about depression and anxiety.

Significans

The majority of Norwegian NK to PWE call for more and better information about the disease. Perceived lack of information among close relatives was associated with high levels of emotional stress. This should be a wake-up call for healthcare professionals working with this patient group.
目的:癫痫患者的近亲属(NK)对该病的认识不足可能会对疾病管理、卫生保健系统的利用和社会态度的传递产生负面影响。本研究的目的是调查挪威NK对PWE的要求程度,并获得不同癫痫相关问题的相关信息。方法:我们邀请NK访问挪威癫痫协会主页,填写一份关于癫痫信息的在线问卷。这项调查为期五个月。结果:231名NK满足问卷要求。几乎90%的答复者要求除了提供更多关于该病的一般信息外,还提供更多关于癫痫发作管理和癫痫过早死亡等具体主题的信息。那些经历过高度心理困扰的人尤其需要更多关于所有癫痫相关问题的信息。根据主题的不同,报告未获得具体问题信息的答复者比例从42%到88%不等。在他们所照顾的人身上,良好的癫痫控制与接收到的癫痫管理、癫痫相关损伤、注意力和记忆力的信息不足以及抑郁和焦虑的边缘性显著相关。意义:大多数挪威NK到PWE呼吁更多更好的疾病信息。近亲之间缺乏信息的感知与高水平的情绪压力有关。这应该为与该患者群体一起工作的医疗保健专业人员敲响警钟。
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引用次数: 0
Utilizing machine learning techniques for EEG assessment in the diagnosis of epileptic seizures in the brain: A systematic review and meta-analysis
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-01-27 DOI: 10.1016/j.seizure.2025.01.021
Dikshit Chawla , Eshita Sharma , Numa Rajab , Paweł Łajczak , Yasmin P. Silva , João Marcelo Baptista , Beatriz W. Pomianoski , Aisha R. Ahmed , Mir wajid Majeed , Yan G. de Sousa , Manoela L. Pinto , Oğuz K. Sahin , Muhaison H. Ibrahim , Idrys H.L. Guedes , Anoushka Chatterjee , Ramon Guerra Barbosa , Walter Fagundes

Purpose

Advancements in Machine Learning (ML) techniques have revolutionized diagnosing and monitoring epileptic seizures using Electroencephalogram (EEG) signals. This analysis aims to determine the effectiveness of ML techniques in recognizing patterns of epileptic seizures in the brain using EEG signals.

Methods

We searched PubMed, Scopus, and Google Scholar for relevant RCTs, cohort studies, and case-control studies involving patients with prior epileptic seizures who underwent EEG analysis aided by ML techniques. Using the STATA software, we evaluated the accuracy of predicting epileptic seizures, measured using metrics such as Area under the curve (AUC), Sensitivity, and Specificity.

Results

The random effects bivariate model of 4 studies with 214 patients revealed high diagnostic performance for ML techniques in detecting epileptic signals in EEGs. The estimated sensitivity was 0.97 (95 % CI: 0.92–0.99), indicating its ability to accurately detect the condition in 97 % of cases. Similarly, the estimated specificity was 0.99 (95 % CI: 0.98–0.99), demonstrating its ability to correctly identify the absence of the condition in 99 % of cases. There was also a high AUC (1.00, 95 % CI: 0.99–1.00), indicating ML techniques can distinguish epileptic seizures from no seizures in EEG signals 100 % of the time. These findings underscore the test's robust diagnostic utility in sensitivity and specificity. There was a significant between-study variability (heterogeneity) with a chi-square p-value <0.001 and an I2 value of 95 %. A bivariate box plot further confirmed the heterogeneity. Deek's test for publication bias showed a non-significant p-value (p = 0.06) indicating the absence of publication bias.

Conclusion

ML techniques can potentially enhance diagnostic accuracy in epilepsy detection, offering valuable insights into developing advanced diagnostic tools for clinical practice.
{"title":"Utilizing machine learning techniques for EEG assessment in the diagnosis of epileptic seizures in the brain: A systematic review and meta-analysis","authors":"Dikshit Chawla ,&nbsp;Eshita Sharma ,&nbsp;Numa Rajab ,&nbsp;Paweł Łajczak ,&nbsp;Yasmin P. Silva ,&nbsp;João Marcelo Baptista ,&nbsp;Beatriz W. Pomianoski ,&nbsp;Aisha R. Ahmed ,&nbsp;Mir wajid Majeed ,&nbsp;Yan G. de Sousa ,&nbsp;Manoela L. Pinto ,&nbsp;Oğuz K. Sahin ,&nbsp;Muhaison H. Ibrahim ,&nbsp;Idrys H.L. Guedes ,&nbsp;Anoushka Chatterjee ,&nbsp;Ramon Guerra Barbosa ,&nbsp;Walter Fagundes","doi":"10.1016/j.seizure.2025.01.021","DOIUrl":"10.1016/j.seizure.2025.01.021","url":null,"abstract":"<div><h3>Purpose</h3><div>Advancements in Machine Learning (ML) techniques have revolutionized diagnosing and monitoring epileptic seizures using Electroencephalogram (EEG) signals. This analysis aims to determine the effectiveness of ML techniques in recognizing patterns of epileptic seizures in the brain using EEG signals.</div></div><div><h3>Methods</h3><div>We searched PubMed, Scopus, and Google Scholar for relevant RCTs, cohort studies, and case-control studies involving patients with prior epileptic seizures who underwent EEG analysis aided by ML techniques. Using the STATA software, we evaluated the accuracy of predicting epileptic seizures, measured using metrics such as Area under the curve (AUC), Sensitivity, and Specificity.</div></div><div><h3>Results</h3><div>The random effects bivariate model of 4 studies with 214 patients revealed high diagnostic performance for ML techniques in detecting epileptic signals in EEGs. The estimated sensitivity was 0.97 (95 % CI: 0.92–0.99), indicating its ability to accurately detect the condition in 97 % of cases. Similarly, the estimated specificity was 0.99 (95 % CI: 0.98–0.99), demonstrating its ability to correctly identify the absence of the condition in 99 % of cases. There was also a high AUC (1.00, 95 % CI: 0.99–1.00), indicating ML techniques can distinguish epileptic seizures from no seizures in EEG signals 100 % of the time. These findings underscore the test's robust diagnostic utility in sensitivity and specificity. There was a significant between-study variability (heterogeneity) with a chi-square p-value &lt;0.001 and an I<sup>2</sup> value of 95 %. A bivariate box plot further confirmed the heterogeneity. Deek's test for publication bias showed a non-significant p-value (<em>p</em> = 0.06) indicating the absence of publication bias.</div></div><div><h3>Conclusion</h3><div>ML techniques can potentially enhance diagnostic accuracy in epilepsy detection, offering valuable insights into developing advanced diagnostic tools for clinical practice.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 16-23"},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143169714","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
Education and empathy through cinema: Lessons from seizure: The medical treatment and social problems of epilepsy (1951)
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-01-23 DOI: 10.1016/j.seizure.2025.01.020
Francesco Brigo
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引用次数: 0
Is lamotrigine a teratogen?
IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-01-21 DOI: 10.1016/j.seizure.2025.01.019
Frank JE Vajda , Simon R L Vajda , Mervyn J Eadie

Aim

To assess whether lamotrigine (Lamictal), when used in antiseizure medication (ASM) monotherapy, is a teratogen.

Materials/Methods

Analysis of data from 490 LTG monotherapy treated pregnancies and 214 pregnancies in women with epilepsy not exposed to any antiseizure medications during at least the first half of pregnancy.

Results

The LTG-treated and the untreated pregnancies were well matched in nearly all regards apart from ASM exposure. There was a foetal malformation (FM) occurrence rate of 4.49 % in the LTG-exposed pregnancies and 3.27 % in the untreated pregnancies (Risk Ratio = 1.37; 95 % C.I. 0.60, 3.16). Logistic regression produced no evidence that the extent of the LTG-associated malformation occurrence hazard was LTG dose related. However, the malformation-affected body regions tended to differ between the LTG-treated and untreated pregnancies.

Conclusion

The above findings do not reach a statistically significant level (P < 0.05) but, taken overall, they do not necessarily exclude the possibility that LTG may be a weak teratogen. If LTG monotherapy-associated foetal malformation occurrence rates are used as the comparator against which to evaluate the foetal malformation hazards associated with other ASMs, the findings may possibly be open to the risk of falsely reassuring outcomes.
{"title":"Is lamotrigine a teratogen?","authors":"Frank JE Vajda ,&nbsp;Simon R L Vajda ,&nbsp;Mervyn J Eadie","doi":"10.1016/j.seizure.2025.01.019","DOIUrl":"10.1016/j.seizure.2025.01.019","url":null,"abstract":"<div><h3>Aim</h3><div>To assess whether lamotrigine (Lamictal), when used in antiseizure medication (ASM) monotherapy, is a teratogen.</div></div><div><h3>Materials/Methods</h3><div>Analysis of data from 490 LTG monotherapy treated pregnancies and 214 pregnancies in women with epilepsy not exposed to any antiseizure medications during at least the first half of pregnancy.</div></div><div><h3>Results</h3><div>The LTG-treated and the untreated pregnancies were well matched in nearly all regards apart from ASM exposure. There was a foetal malformation (FM) occurrence rate of 4.49 % in the LTG-exposed pregnancies and 3.27 % in the untreated pregnancies (Risk Ratio = 1.37; 95 % C.I. 0.60, 3.16). Logistic regression produced no evidence that the extent of the LTG-associated malformation occurrence hazard was LTG dose related. However, the malformation-affected body regions tended to differ between the LTG-treated and untreated pregnancies.</div></div><div><h3>Conclusion</h3><div>The above findings do not reach a statistically significant level (<em>P</em> &lt; 0.05) but, taken overall, they do not necessarily exclude the possibility that LTG may be a weak teratogen. If LTG monotherapy-associated foetal malformation occurrence rates are used as the comparator against which to evaluate the foetal malformation hazards associated with other ASMs, the findings may possibly be open to the risk of falsely reassuring outcomes<strong>.</strong></div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 1-5"},"PeriodicalIF":2.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041396","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
期刊
Seizure-European Journal of Epilepsy
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