Previous studies have shown that Khyber Pakhtunkhwa, Pakistan has a high incidence of epilepsy and a high proportion of low socioeconomic background and high treatment gap. Considering the changes ...over the past 20 years little is known about the current epidemiological characteristics of epilepsy in Khyber Pakhtunkhwa, Pakistan. The current study was focused to find the impact of various contributing factors on the clinical response to anti-epileptic drugs in the KP population, Pakistan. A total of 315 participants aged 19.1 ± 8.6 years were examined. Mean age of the patients was 18 ± 8.1 year. Epilepsy was high in male patients (64.39%) and urban areas (60.1%). Mostly, 88.6% of patients were belonging to low socioeconomic status background. 42.4% patients have positive family history for epilepsy and 42.8% patients had consanguineous marriages. Middle SES class patients (OR, 2.22 CI, 0.54-9.1) were slightly associated with controlled response to CBZ and VPA therapy. Absence seizure (OR, 1.16 CI, 0.59-2.3), and Complex partial seizure (OR, 1.29 CI, 0.58-6.3) showed good response to CBZ therapy while, Myoclonic seizure (OR, 2.23 CI, 0.05-8.8) was responsive to VPA therapy. However, non-compliance (
0.82,
< 0.0001) and nature of seizures (
0.83,
< 0.0001) were associated with the high risk for poor response to both CBZ and VPA therapy. Epilepsy was high in male patients and in urban areas. Most patients were belonging to low socioeconomic status. Non-compliance, low socioeconomic and nature of seizures strongly predict poor clinical response of anti-epileptic drugs therapy.
Abstract We report on inter-rater agreement in assessing the types of seizures exhibited by one hundred mothers ascertained in a study of the teratogenicity of maternal epilepsy and antiepileptic ...drugs. A summary of each woman's medical record and a one-page report of her responses to questions about her epilepsy were reviewed independently by six neurologists, three in pediatric neurology and three in adult neurology. Agreement was measured by the kappa statistic and log-linear modeling techniques. The adult neurologists agreed with each other 59% of the time, with the agreement higher when all three used information from the patients' records, such as an EEG, rather than when depending on the patients' responses to questions about their epilepsy. The pediatric neurologists agreed with each other 44% of the time and tended to rely more heavily on information in the patients' records, such as an EEG or a prior diagnosis, compared with the adult neurologists.
Purpose The aim was to study the influence of patients' age, frequency and type of seizures, disease duration, number of AEDs and use of benzodiazepines on the quality of life of patients with ...epilepsy. Patients and methods We consecutively identified 223 patients with epilepsy who attended the epilepsy outpatient clinics at three university hospitals in Greece. Quality of life was evaluated by QOLIE-31. One-way analysis was used to assess the association of the studied factors and QOLIE-31 subscales. After checking for co-linearity, we performed multivariate stepwise linear regression analysis with all the variables that on univariate analysis showed a statistically significant effect on each subscale of QOLIE-31 to explore which of the studied factors affect independently on QOLIE-31 scores. Results Of a total of 223 patients, 118 (52.95%) were men; mean age was 35.18 ± 13.22; mean duration of the disease was 13 years; 58 (26%) patients had generalized seizures, 93 (41.7%) had PS, and 72 (32.3%) of the patients had PsG; 85 (38.1%) were on polytherapy and 38 (17%) were taking benzodiazepines. Independent factors affecting QoL were: seizure frequency (Overall QoL P = 0.0001, Seizure worry and Emotional well-being P< 0.0001, Energy/fatigue and Social functioning P = 0.01); duration of the disease (Overall QoL and Energy/fatigue P = 0.01, Seizure worry P = 0.008, Cognitive functioning P < 0.0001); polytherapy only for the Emotional well-being PΎ< 0.0001; and use of benzodiazepines (Overall QoL, Energy/fatigue, Social functioning P = 0.002, Cognitive functioning P < 0.0001). Conclusion Our findings suggest that QoL in epileptic patients might be affected, in addition to the other established factors (high frequency of seizures and polytherapy), by the daily use of benzodiazepines as adjunctive therapy. Change of medical strategy concerning this medication may lead to improving the QoL of these patients.
Recent data indicate that the prevalence and incidence of epilepsy are high among the elderly, many of whom will have concomitant neurodegenerative, cerebrovascular, or neoplastic disease. The aim of ...this study is to evaluate the clinical characteristics of elderly patients with epilepsy in China. We retrospectively reviewed the clinical records of 104 outpatients over 50 years of age (average: 63.8 years). The results showed that in the total 104 outpatients, 53 men and 51 women were studied. Twenty-seven (26.0%) patients had idiopathic epilepsy syndromes, and 15 (14.4%) patients were considered cryptogenic. Sixty-two (59.6%) patients had remote symptomatic epilepsy. According to the known etiological factors, cerebrovascular disease (53.2%) is the most common underlying cause, followed by craniocerebral trauma (16.1%), primary or metastatic neoplastic disease (16.1%), and others (14.5%). The most common type of seizure in the group studied was partial seizures (51.9%), followed by generalized seizures (37.5%). Forty-three patients (41.3%) were used combination medication and 61 patients (58.7%) were used single medication. In conclusions, this study provides important data for clinical and research purposes in China. Further research is indicated to confirm the clinical findings of the elderly people with epilepsy by a larger epidemiological study.
To explore the value of video-electroencephalography plus surface electromyography (VEEG+SEMG) in providing theoretic rationales for clinical diagnosis of different motor seizure types and ...differentiating the application value of paroxysmal diseases.
A total of 116 suspected and repetitive motion epileptics underwent VEEG+SEMG from 2009 to 2012. According to their clinical features, different muscles were selected to record electromyography (EMG) under different activations and stimulations (bodily movement and posture activation, touching, sound stimulus, tapping tendons and arms straight test, etc) and monitor their seizure states.
Among 68 patients, 567 attacks were recorded, including 443 epileptic seizures in 41 patients (229 epileptic mycological seizures in 22 patients, 95 tonic seizures in 8, 118 epileptic spasms in 10 and 1 atonic seizure in 1). The average durations of different epileptic motor seizures were (0.16 ± 0.04), (2.9 ± 2.4), (1.4 ± 0.8) and 2 s respectively. Their features of ictal EEG an
An analysis of the medical documentation and investigation of 130 cases of epilepsy diagnosed in a group of people over 50 years of age (average: 65.4 years) revealed that the most common type of ...seizure in the group studied was partial (66.2%), followed by seizures with secondary generalization (33.8%). Epilepsy was caused by cerebrovascular disease (50.8%) considerably more often in patients over 74 years of age, craniocerebral trauma in patients addicted to alcohol (13.1%), especially those under 65 years of age, primary or metastatic neoplastic disease (10.7%), and others. The authors wish to draw attention to the leukoaraiosis factor, which might be the proepileptogenic cause of epilepsy recognized in the group of patients over 74 years of age (56.5%) and is much more frequent in this group than in the group of patients under 65 years of age (1.6%). Moreover, some drugs, such as L-dopa and Baclofen, might have been related to the epileptic seizures. In 29 patients (22.3%) the definite cause of late-onset epilepsy was unknown. The authors suggest in such cases, both follow-up tomographic examination and careful clinical examinations. In the study group of patients with initially unknown seizure etiology, some diseases, such as cerebral tumor or colon and pancreatic neoplasm, were diagnosed during follow-up examination. These processes were revealed several months after the first epileptic seizure.
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