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1.
Ideggyogy Sz ; 72(7-8): 257-263, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31517458

RESUMO

Background and purpose: Nonconvulsive status epilepticus (NCSE) is a heterogeneous, severe neurological disorder of different etiologies. In this study, the outcomes of NCSE episodes was assessed in a large series of adult patients. Our objective was to evaluate relationship between Status Epilepticus Severity Score (STESS) and etiology and the role of etiological factors on predicting the outcomes. Methods: In this retrospective study, the medical records of 95 patients over 18 years of age who were diagnosed with NCSE between June 2011 and December 2015 were reviewed. Their treatment and follow-up for NCSE was performed at the Epilepsy Unit in Department of Neurology, Antalya Research and Training Hospital. Etiological factors thought to be responsible for NCSE episodes as well as the prognostic data were retrieved. The etiological factors were classified into three groups as those with a known history of epilepsy (Group 1), primary neurological disorder (Group 2), or systemic/unknown etiology (Group 3). STESS was retrospectively applied to patients. Results: There were 95 participants, 59 of whom were female. Group 1, Group 2, and Group 3 consisted of 11 (7 female), 54 (33 female), and 30 (19 female) patients, respectively. Of the 18 total deaths, 12 occurred in Group 2, and 6 in Group 3. The negative predictive value for a STESS score of ≤ 2 was 93.88% (+LR 2.05 95% CI: 1.44-2.9 and -LR 0.3 95% CI 0.10-0.84 ) in the overall study group. While the corresponding values for Group 1 (patients with epilepsy), Group 2 (patients with primary neurological disorder), and group 3 (patients with systemic or unknown etiology) were 100%, 92.59% (+LR 2.06 95%CI: 1.32-3.21 and -LR 0.28 95% CI 0.08-1.02 ) 83.33% (+LR 1.14 95%CI: 0.59-2.9 and -LR 0.80 95% CI 0.23-2.73). Conclusion: This study included the one of the largest patients series ever reported in whom STESS, a clinical scoring system proposed for use in patients with status epilepticus, has been implemented. Although STESS appeared to be quite useful for predicting a favorable outcome in NCSE patients with epilepsy and primary neurological disorders, its predictive value in patients with systemic or unknown etiology was lower. Further prospective studies including larger NCSE samples are warranted.


Assuntos
Eletroencefalografia/estatística & dados numéricos , Estado Epiléptico/diagnóstico , Estado Epiléptico/etiologia , Adolescente , Adulto , Área Sob a Curva , Epilepsia/diagnóstico , Epilepsia/epidemiologia , Feminino , Humanos , Avaliação de Resultados (Cuidados de Saúde) , Prognóstico , Curva ROC , Estudos Retrospectivos , Índice de Gravidade de Doença , Estado Epiléptico/epidemiologia
2.
Artigo em Alemão | MEDLINE | ID: mdl-31529181

RESUMO

Trends of frequent chronic diseases and health problems, e.g. allergic diseases, have already been published based on the KiGGS Wave 2 study as part of the health monitoring of children and adolescents in Germany. The present work complements these findings with results on less frequent noncommunicable diseases and the trend of communicable, vaccine-preventable diseases.Information from parents about diagnoses and diseases of their 0­ to 17-year-old children from the representative cross-sectional survey KiGGS Wave 2 (2014-2017) are compared with those from the KiGGS baseline survey (2003-2006) and KiGGS Wave 1 (2009-2012).The current KiGGS results show almost unchanged prevalences for the noncommunicable diseases epilepsy, migraine, and heart disease. However, the data from KiGGS Wave 2 are supportive of an increased prevalence of diabetes mellitus, which nevertheless continues to be relatively rare and predominantly type 1 diabetes in children and adolescents.The decline in measles, chicken pox, and whooping cough diseases related to changes in vaccination recommendations shows that preventive measures can effectively benefit children and adolescents.However, the data on vaccine-preventable diseases indicate regionally varying immunity gaps in certain age groups, so the prevention potential of the vaccination recommendations of the Standing Vaccination Commission (STIKO) at the Robert Koch Institute does not seem to have been sufficiently exploited.


Assuntos
Saúde do Adolescente/estatística & dados numéricos , Doença Crônica/epidemiologia , Viroses/epidemiologia , Adolescente , Varicela/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Epilepsia/epidemiologia , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Cardiopatias/epidemiologia , Humanos , Lactente , Recém-Nascido , Sarampo/epidemiologia , Transtornos de Enxaqueca/epidemiologia , Convulsões Febris/epidemiologia , Coqueluche/epidemiologia
3.
Pan Afr Med J ; 33: 10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31303955

RESUMO

Epilepsy in Sudan accounts for 1.6 annual mortality rates and 238.7 disability adjusted life years per 100 000. These figures are higher among females; children and young adults. It is associated with notable stigma and social burdens. Patients of epilepsy are subjected to various forms of social discrimination that affect their quality of life. They are isolated, neglected and deprived of their education and employments rights and not able to achieve normal social and family life. Aiming at highlighting social implications of epilepsy among Sudanese patients, this study found that social encumbrances due to epilepsy in Sudan are more prevalent among highly vulnerable groups like women, children and poor populations living in remote areas. Lack of trained medical personnel in neurology and the medical equipment's required for proper diagnosis and treatment of epilepsy in Sudan are key reasons aggravating social and health burden of epilepsy both among patients and their caregivers.


Assuntos
Epilepsia/terapia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Qualidade de Vida , Serviços Urbanos de Saúde/normas , Criança , Epilepsia/economia , Epilepsia/epidemiologia , Feminino , Disparidades em Assistência à Saúde/economia , Humanos , Masculino , Pobreza , Discriminação Social , Sudão/epidemiologia , Serviços Urbanos de Saúde/economia , População Urbana/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos , Adulto Jovem
4.
Medicine (Baltimore) ; 98(27): e16156, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277117

RESUMO

The occurrence of seizures during pregnancy is really a challenging situation which risks the health of both mothers and fetuses. However, new onset epilepsy is unpredictable in pregnancy, and its clinic feature is barely known. This study aimed to explore the clinical characteristics and pregnancy outcomes of new onset epilepsy during pregnancy.We screened consecutive women with epilepsy and reproductive history from June 2013 to November 2018 from 3 hospitals in West China. Detailed demographics, clinical features, neurological status, related tests, managements, seizure and pregnancy outcomes were recorded and followed-up. Within them, patients with first seizure during pregnancy and spontaneous recurrent seizures after delivery or abortion were defined as new onset epilepsy during pregnancy.We screened a total of 1041 consecutive women with epilepsy and reproductive history. Twenty-two of them (2.1%) had new onset epilepsy during pregnancy. The average age at seizure onset was 22.7 ± 3.0 years. All their first seizures occurred in pregnancy period, including 4 (18.2%) in the first trimester, ten (45.4%) in the second trimester and eight (36.4%) in the third trimester. Most patients delivered healthy babies, except one patient had to choose induced abortion because of the disappearance of fetal heart rate, one child was diagnosed with mild harelip and one was diagnosed with trisomy 21 syndrome, tetralogy of Fallot and congenital duodenal atresia. All 3 complications happened in patients with their first seizures in first trimester.Although the risk of new onset epilepsy during pregnancy was relatively low, accurate diagnosis and appropriate treatment were required to reduce the damage to both mothers and fetuses. New onset epilepsy during pregnancy mostly began in middle and late pregnancy. However, seizures occurred from early pregnancy had bad effects on the embryo or fetus.


Assuntos
Epilepsia/epidemiologia , Complicações na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Adulto , Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Feminino , Humanos , Gravidez , Adulto Jovem
5.
Int J Equity Health ; 18(1): 102, 2019 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266472

RESUMO

BACKGROUND: For a large part of the prisoners population, the prevalence of many diseases and the number of risk factors are greater than for the general population. In this work, we present an analysis of the prevalence of epilepsy and its co-occurrence with alcohol dependence among prisoners in a Polish penitentiary. METHODS: One and multidimensional logistic regression was used to present the relationship between epilepsy and the co-occurrence of alcohol dependence and of other variables like: the prisoners' age, their classification, the unit type, the length of the stay in the penitentiary, and professional activity. RESULTS: More than 7% of the prisoners had epilepsy. The prevalence was significantly higher in the 40-49 age group and among prisoners aged 50 and older. For prisoners suffering from alcohol dependence, the probability of epilepsy was over four times higher than for prisoners who did not suffer from that condition (OR [95%CI] = 4.09 [1.82-9.17], p = 0.001]. CONCLUSIONS: The obtained results show that the prevalence of epilepsy and alcohol dependence in the studied prisoner population was much higher than in the general population of Poles and that alcohol dependence was strongly correlated with epilepsy, independent from other variables. The research allowed to assess the size of the analyzed problem among convicts, however, bearing in mind the multifactorial etiology of epilepsy, the cause and effect relationship between exposure to alcohol and its occurrence would require further in-depth analytical studies taking into account other etiological factors of this disease.


Assuntos
Alcoolismo/epidemiologia , Comorbidade , Epilepsia/epidemiologia , Prisioneiros/estatística & dados numéricos , Prisões/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Prevalência , Fatores de Risco
6.
Nat Commun ; 10(1): 3043, 2019 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-31292440

RESUMO

There are established associations between advanced paternal age and offspring risk for psychiatric and developmental disorders. These are commonly attributed to genetic mutations, especially de novo single nucleotide variants (dnSNVs), that accumulate with increasing paternal age. However, the actual magnitude of risk from such mutations in the male germline is unknown. Quantifying this risk would clarify the clinical significance of delayed paternity. Using parent-child trio whole-exome-sequencing data, we estimate the relationship between paternal-age-related dnSNVs and risk for five disorders: autism spectrum disorder (ASD), congenital heart disease, neurodevelopmental disorders with epilepsy, intellectual disability and schizophrenia (SCZ). Using Danish registry data, we investigate whether epidemiologic associations between each disorder and older fatherhood are consistent with the estimated role of dnSNVs. We find that paternal-age-related dnSNVs confer a small amount of risk for these disorders. For ASD and SCZ, epidemiologic associations with delayed paternity reflect factors that may not increase with age.


Assuntos
Testes Genéticos , Modelos Genéticos , Idade Paterna , Adulto , Fatores Etários , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/genética , Criança , Dinamarca/epidemiologia , Epilepsia/epidemiologia , Epilepsia/genética , Feminino , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/genética , Humanos , Incidência , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/genética , Masculino , Pessoa de Meia-Idade , Mutação , Polimorfismo de Nucleotídeo Único , Prevalência , Sistema de Registros/estatística & dados numéricos , Medição de Risco/métodos , Esquizofrenia/epidemiologia , Esquizofrenia/genética , Sequenciamento Completo do Exoma
7.
J Headache Pain ; 20(1): 64, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31146673

RESUMO

BACKGROUND: Migraine aura (MA) is a common and disabling neurological condition, characterized by transient visual, and less frequently sensory and dysphasic aura disturbances. MA is associated with an increased risk of cardiovascular disorders and is often clinically difficult to distinguish from other serious neurological disorders such as transient ischemic attacks and epilepsy. Optimal clinical classification of MA symptoms is important for more accurate diagnosis and improved understanding of the pathophysiology of MA through clinical studies. MAIN BODY: A systematic review of previous prospective and retrospective systematic recordings of visual aura symptoms (VASs) was performed to provide an overview of the different types of visual phenomena occurring during MA and their respective frequencies in patients. We found 11 retrospective studies and three prospective studies systematically describing VASs. The number of different types of VASs reported by patients in the studies ranged from two to 23. The most common were flashes of bright light, "foggy" vision, zigzag lines, scotoma, small bright dots and 'like looking through heat waves or water'. CONCLUSIONS: We created a comprehensive list of VAS types reported by migraine patients based on all currently available data from clinical studies, which can be used for testing and validation in future studies. We propose that, based on this work, an official list of VAS types should be developed, preferably within the context of the International Classification of Headache Disorders of the International Headache Society.


Assuntos
Enxaqueca com Aura/diagnóstico , Enxaqueca com Aura/fisiopatologia , Visão Ocular/fisiologia , Adulto , Epilepsia/diagnóstico , Epilepsia/epidemiologia , Epilepsia/fisiopatologia , Feminino , Alucinações/diagnóstico , Alucinações/epidemiologia , Alucinações/fisiopatologia , Humanos , Ataque Isquêmico Transitório/diagnóstico , Ataque Isquêmico Transitório/epidemiologia , Ataque Isquêmico Transitório/fisiopatologia , Masculino , Enxaqueca com Aura/epidemiologia , Estudos Prospectivos , Estudos Retrospectivos
8.
Pan Afr Med J ; 32: 69, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31231452

RESUMO

Introduction: Cerebrovascular accidents (strokes) are one of the main acquired causes of epilepsy in adults, but little data are available on the incidence of epilepsy after a stroke in Africa. This study aims to estimate the impact of epilepsy in stroke patients in Parakou. Methods: We conducted a dynamic cohort study including 203 stroke patients hospitalized in the Department of Neurology at the University Hospital of Parakou. Patients with a history of epilepsy were excluded from the follow-up. Patients were monitored over a 21-month period from 1 January 2013 to 30 September 2014. Epilepsy was defined according to the International League Against Epilepsy criteria. Results: Patients were aged 18-99 years, with an average age of 58.4 ± 14.2 years. The median of consultation time after symptoms was 54,3 h (+/-112,9h). Ischemic strokes accounted for 45.8%, haemorrhagic strokes 31% and indeterminate strokes 23.2%. The cumulative impact of epilepsy was 17. The incidence density rate of epilepsy was 9.8 per 100 person-years. Factors associated with the occurrence of epilepsy were the educational level, the duration of hospitalization and Barthel score. Conclusion: The incidence of epilepsy is very high; hence, taking into consideration the factors associated with it during the implementation of a treatment strategy may reduce its overall load.


Assuntos
Isquemia Encefálica/complicações , Epilepsia/epidemiologia , Hospitalização/estatística & dados numéricos , Acidente Vascular Cerebral/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Benin/epidemiologia , Isquemia Encefálica/epidemiologia , Estudos de Coortes , Epilepsia/etiologia , Feminino , Seguimentos , Hospitais Universitários , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Adulto Jovem
9.
BMC Public Health ; 19(1): 595, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101093

RESUMO

BACKGROUND: Childhood epilepsy can adversely affect education and employment in addition to health. Previous studies are small or highly selective producing conflicting results. This retrospective cohort study aims to compare educational and health outcomes of children receiving antiepileptic medication versus peers. METHODS: Record linkage of Scotland-wide databases covering dispensed prescriptions, acute and psychiatric hospitalisations, maternity records, deaths, annual pupil census, school absences/exclusions, special educational needs, school examinations, and (un)employment provided data on 766,244 children attending Scottish schools between 2009 and 2013. Outcomes were adjusted for sociodemographic and maternity confounders and comorbid conditions. RESULTS: Compared with peers, children on antiepileptic medication were more likely to experience school absence (Incidence Rate Ratio [IRR] 1.43, 95% CI: 1.38, 1.48), special educational needs (Odds ratio [OR] 9.60, 95% CI: 9.02, 10.23), achieve the lowest level of attainment (OR 3.43, 95% CI: 2.74, 4.29) be unemployed (OR 1.82, 95% CI: 1.60, 2.07), be admitted to hospital (Hazard Ratio [HR] 3.56, 95% CI: 3.42, 3.70), and die (HR 22.02, 95% CI: 17.00, 28.53). Absenteeism partly explained poorer attainment and higher unemployment. Girls and younger children on antiepileptic medication had higher risk of poor outcomes. CONCLUSIONS: Children on antiepileptic medication fare worse than peers across educational and health outcomes. In order to reduce school absenteeism and mitigate its effects, children with epilepsy should receive integrated care from a multidisciplinary team that spans education and healthcare.


Assuntos
Anticonvulsivantes/uso terapêutico , Epilepsia/epidemiologia , Hospitalização/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Desemprego/estatística & dados numéricos , Absenteísmo , Adolescente , Adulto , Criança , Bases de Dados Factuais , Prescrições de Medicamentos/estatística & dados numéricos , Escolaridade , Epilepsia/tratamento farmacológico , Feminino , Humanos , Masculino , Registro Médico Coordenado , Razão de Chances , Gravidez , Estudos Retrospectivos , Escócia/epidemiologia , Adulto Jovem
10.
Neurologist ; 24(3): 84-86, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045717

RESUMO

BACKGROUND AND PURPOSE: Data regarding the incidence of seizures in patients diagnosed with fat embolism syndrome (FES) are lacking. We examined the incidence of seizures in patients with FES, and the impact of seizures on outcomes over a 10-year period. METHODS: Using the National Inpatient Sample data set we identified adults (age 18 y old or above) with a diagnosis of FES (ICD-9 958.1) between 2005 and 2014, and categorized them according to the presence or absence of seizures. We excluded patients with a history of epilepsy or traumatic brain injury RESULTS:: Of the 66,227,531 discharges, we identified 1888 patients (0.003%) with FES of which 53% were male and mean age of 56 (±57.45). Seizure or epilepsy rate in patients with FES was 2.86% (1.69% with seizures and 1.16% with epilepsy), as compared with 3.6% in all hospitalized patients without FES. The Charlson Comorbidity Index for all FES patients was 2.38 (±5.28) and was similar for those with and without seizures. Hospital length of stay was higher in patients with FES and seizures versus those without seizures (14.59 vs. 10.82 d, P=0.09). No statistically significant difference in mortality was observed between the 2 groups. CONCLUSIONS: The rate of seizure and epilepsy in patients with FES is low when compared with rates in all hospitalized patients or in patients with other causes of acute neurological injury such as intracerebral hemorrhage, subarachnoid hemorrhage, and traumatic brain injury. Further studies are needed to provide recommendations for antiepileptic medication use in FES.


Assuntos
Embolia Gordurosa/epidemiologia , Convulsões/epidemiologia , Bases de Dados Factuais , Embolia Gordurosa/complicações , Epilepsia/complicações , Epilepsia/epidemiologia , Feminino , Humanos , Incidência , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Convulsões/complicações
11.
Expert Opin Pharmacother ; 20(12): 1449-1456, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31099271

RESUMO

Introduction: Sodium valproate is a widely used anti-epileptic drug with a broad spectrum of activity and mechanism of action. It has consequently been the first-line drug for most seizure types in children for the past fifty years. A wide range of side effects come along with these exceptional properties, including teratogenicity and neuro-cognitive impairments in offspring. Therefore, epilepsy treatment in children and adolescents should be reassessed in light of newer antiepileptic drugs as well as a more targeted-approach with older drugs. Areas covered: The authors review the main concerns of valproate use in terms of adverse effects on different systems and drug interactions. The current alternatives to valproate in absence, myoclonic, tonic-clonic and focal onset seizures in children/adolescents are also reviewed. Expert opinion: There are several issues that research should address in antiepileptic therapy and in clinical studies with children, given the peculiarity of this population. Future perspectives in epilepsy therapy should now lead towards an individualized treatment.


Assuntos
Anticonvulsivantes/uso terapêutico , Comportamento de Escolha , Epilepsia/tratamento farmacológico , Ácido Valproico/uso terapêutico , Adolescente , Criança , Epilepsia/epidemiologia , Epilepsia Generalizada/tratamento farmacológico , Humanos , Medicina de Precisão/métodos , Medicina de Precisão/tendências , Convulsões/tratamento farmacológico , Convulsões/epidemiologia , Ácido Valproico/efeitos adversos
12.
Infect Dis Poverty ; 8(1): 34, 2019 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-31109376

RESUMO

BACKGROUND: In onchocerciasis-endemic areas, particularly in those with a sub-optimal onchocerciasis control programme, a high prevalence of epilepsy is observed. Both onchocerciasis and epilepsy are stigmatizing conditions. The first international workshop on onchocerciasis-associated epilepsy (OAE) was held in Antwerp, Belgium (12-14 October 2017) and during this meeting, an OAE alliance was established. In this paper, we review what is known about epilepsy-associated stigma in onchocerciasis-endemic regions, and present the recommendations of the OAE alliance working group on stigma. MAIN BODY: For this scoping review, literature searches were performed on the electronic databases PubMed, Scopus and Science Direct using the search terms "epilepsy AND onchocerciasis AND stigma". Hand searches were also undertaken using Google Scholar, and in total seven papers were identified that addressed epilepsy-related stigma in an onchocercisasis-endemic area. Due to the limited number of published research papers on epilepsy-associated stigma in onchocerciasis-endemic areas, other relevant literature that describes important aspects related to stigma is discussed. The thematic presentation of this scoping review follows key insights on the barriers to alleviating the social consequences of stigma in highly affected onchocerciasis-endemic areas, which were established by experts during the working group on stigma and discrimination at the first international workshop on OAE. These themes are: knowledge gaps, perceived disease aetiology, access to education, marriage restrictions, psycho-social well-being, burden on the care-giver and treatment seeking behaviour. Based on the literature and expert discussions during the OAE working group on stigma, this paper describes important issues regarding epilepsy-related stigma in onchocerciasis-endemic regions and recommends interventions that are needed to reduce stigma and discrimination for the improvement of the psycho-social well-being of persons with epilepsy. CONCLUSIONS: Educating healthcare workers and communities about OAE, strengthening onchocerciasis elimination programs, decreasing the anti-epileptic treatment gap, improving the care of epilepsy-related injuries, and prioritising epilepsy research is the way forward to decreasing the stigma associated with epilepsy in onchocerciasis-endemic regions.


Assuntos
Epilepsia/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Estigma Social , Comitês Consultivos , África/epidemiologia , Bélgica , Cuidadores , Doenças Endêmicas , Epilepsia/complicações , Epilepsia/epidemiologia , Humanos , Oncocercose/complicações , Oncocercose/epidemiologia
13.
Infect Dis Poverty ; 8(1): 35, 2019 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-31122275

RESUMO

In a study from the onchocerciasis-endemic area of Mahenge in southern Tanzania, Mmbando et al. [Inf Dis Poverty. 2018;7:64] demonstrate that in four selected villages the overall epilepsy prevalence was high, and significantly more elevated in the two villages of higher onchocerciasis endemicity compared to those of lower endemicity. This is replicating earlier findings from many other areas of tropical Africa. The authors are also providing data indicating that in the Mahenge focus, the prevalence of nodding syndrome may be related to that of onchocerciasis in the same way as epilepsy in general. The application of a clinical case definition for onchocerciasis-associated epilepsy (OAE) as used in the study of Mmbando et al. [Inf Dis Poverty. 2018;7:64] faces some difficulties; indeed, its precision in discerning cases of OAE from epilepsy due to other etiologies is not known, and it does not allow for a specific diagnosis in the individual patient. Because an operational surveillance tool for assessing the number of patients in the population could mean substantial advance for better estimating the burden of OAE, the proposed definition should be tried in different settings and its performance reviewed in the process.


Assuntos
Epilepsia/epidemiologia , Síndrome do Cabeceio , Oncocercose , Humanos , Prevalência , Tanzânia/epidemiologia
14.
Artigo em Inglês | MEDLINE | ID: mdl-31022891

RESUMO

This meta-analysis aimed to evaluate the association between epilepsy and suicide. We systematically searched PubMed, PsycINFO, Embase and Web of Science for studies that reported the prevalence of suicidality in the form of suicide ideation, attempts and deaths among people with epilepsy (PWE). Studies were included if they reported the numbers of patients who died by suicide and concurrently suffered from epilepsy, assessed suicide ideation, or studied suicide attempts in PWE by validated instruments or diagnostic interviews. We used the random effects model to calculate the pooled odds ratios (OR) and standard mean differences (SMDs). We performed subgroup analyses. Seven case-control studies were included in the comparison of rates of suicide attempts between PWE and controls, with a total of 821,594 participants. Our analyses demonstrated a positive association between epilepsy and suicide attempts (pooled OR = 3.25, 95% confidence interval (CI): 2.69-3.92, p < 0.001), indicating that PWE have an elevated risk of suicide. The pooled prevalence for suicide ideation (24 studies) and suicide attempts (18 studies) were 23.2% (95% CI: 0.176-0.301) and 7.4% (95% CI: 0.031-0.169) respectively. The pooled rate of death due to suicide (10 studies) was 0.5% (95% CI: 0.002-0.016). Meta-regression showed that mean age and proportion of male gender were significant moderators for prevalence of suicide attempts and death due to suicide in PWE. Young PWE could be triggered by relationship problems and male PWE might use more lethal methods to attempt suicide. This meta-analysis provides the most up-to-date information on the prevalence of suicide among people with epilepsy and guidance on strategies to improve current psychiatric services provided for this population.


Assuntos
Epilepsia/epidemiologia , Ideação Suicida , Tentativa de Suicídio , Estudos de Casos e Controles , Humanos , Prevalência
15.
Int J Mol Sci ; 20(8)2019 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-31018519

RESUMO

Epilepsy is a common neurological disorder associated with increased morbidity and mortality. Sudden unexpected death in epilepsy, also known as SUDEP, is the main cause of death in patients with epilepsy. SUDEP has an incidence of 1.2 per 1000 person-years in adults and 0.2 per 1000 person-years in children. SUDEP accounts for 8-17% of deaths in patients with epilepsy. It is commonly associated with a history of generalized tonic-clonic seizures, and its risk may be increased by other factors such as postictal electroencephalographic suppression, prone sleeping position, altered heart rate variability, conduction abnormalities, gender, or antiepileptic medications. Recently, electrocardiograms, electroencephalograms, and imaging markers have helped clinicians stratify SUDEP risk and identify patients in need of close monitoring. However, the pathophysiology of SUDEP is likely multifactorial and still unknown. Improving the knowledge of SUDEP incidence, risk factors, and biomarkers can help design and implement effective prevention strategies.


Assuntos
Morte Súbita/epidemiologia , Epilepsia/genética , Animais , Arritmias Cardíacas/complicações , Arritmias Cardíacas/genética , Arritmias Cardíacas/patologia , Arritmias Cardíacas/fisiopatologia , Morte Súbita/patologia , Epilepsia/epidemiologia , Epilepsia/patologia , Epilepsia/fisiopatologia , Predisposição Genética para Doença , Humanos , Fatores de Risco
16.
Ideggyogy Sz ; 72(3-4): 115-122, 2019 Mar 30.
Artigo em Húngaro | MEDLINE | ID: mdl-30957466

RESUMO

Background and purpose: The purpose of our communication was to determine the total cost of cerebral paretic patients in Hungary between 0 and 18 years and to assess their impact on the national budget. Methods: Based on the data of Borsod county we calculated the CP characteristics. The cost of CP was determined by routine care of individuals. Lost Parental Income and Tax were calculated on the basis of average earnings. The ratio of GDP, Health and Social Budget and Health Budget to CP is based on CP annual average cost and frequency. We have developed a repeatable computational model. Results: Of the risk groups, premature birth (30.97%), low birth weight (29.64%), perinatal asphyxia (19.47%) were the most common. Source is unknown of 37.61% of the cases. CP prevalence was 2.1‰. The two-sided (59.7%) and the one-sided (19.0%) spastic pareses dominated. The most serious form is the two-sided spastic paresis (42.5% GMFCS 3-5 degrees). Epilepsy was 22.0%, incontinence was 27%, mental involvement was 46%. Care for one child up to 18 years of age costs an average of 73 million HUF (€ 251,724). The lost family income was 27.36 million HUF (€ 94,345), and lost tax and health care contributions were 14.46 million HUF (€ 49,862). Additionally, 0.525% of the GDP, 0.88% of the full health and social budget and 1.83% of direct medical costs were spent for CP families. Conclusion: The cost of CP disease is significant. Costs can be reduced by improving primary prevention. From the perspective of the family and government, it is better to care for families so they can take care of their disabled children.


Assuntos
Paralisia Cerebral/economia , Paralisia Cerebral/epidemiologia , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Paralisia Cerebral/psicologia , Paralisia Cerebral/terapia , Criança , Pré-Escolar , Epilepsia/epidemiologia , Humanos , Hungria/epidemiologia , Lactente , Recém-Nascido , Prevalência , Qualidade de Vida , Convulsões/economia , Perfil de Impacto da Doença
17.
Rev. neurol. (Ed. impr.) ; 68(8): 321-325, 16 abr., 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-180665

RESUMO

Introducción. El descontrol de la epilepsia representa un potencial daño neurológico, por lo que deben investigarse sus causas. Objetivo. Explorar la epidemiología de pacientes mexicanos con descontrol agudo de epilepsia en un servicio de urgencias neurológicas. Pacientes y métodos. Análisis prospectivo descriptivo de pacientes con diagnóstico previo de epilepsia que acuden a un servicio de urgencias por descontrol de las crisis. Resultados. Se analizó a 100 pacientes entre agosto de 2016 y enero de 2017. Ochenta y seis fueron crisis focales, de las cuales 76 fueron focales a bilaterales tonicoclónicas, dos fueron con alteración de la consciencia de inicio motor y tres de inicio no motor, una sin alteración de la consciencia de inicio motor y cuatro de inicio no motor. Catorce fueron generalizadas de inicio generalizado motor. Las causas de descontrol fueron: 26 pacientes por falta de adhesión al tratamiento antiepiléptico, 21 de causa desconocida, 19 por infección, 13 por privación de sueño, 10 por ajuste de tratamiento, tres por estrés, tres por menstruación, dos por uso de alcohol y tres por otras razones. En los 26 pacientes con falta de adhesión, 10 fueron por olvido de dosis, siete por negarse a tomar el medicamento, seis por causas económicas y tres por indicación de médico ajeno a la institución. Conclusiones. En México, la falta de adhesión al tratamiento representa un 25% de los casos de descontrol de la epilepsia, lo que es un área de oportunidad para incrementar la educación de higiene de crisis y disminuir la frecuencia de éstas


Introduction. Acute seizures in patients with epilepsy are a potential of source of neurological damage; their causes must be researched. Aim. To explore the epidemiology of acute seizure exacerbations in patients with epilepsy in a neurological emergency department in Mexico City. Patients and methods. Descriptive prospective study of patients with a previous diagnosis of epilepsy that receive medical care in an emergency department due to acute seizures. Results. 100 patients were analyzed between august 2016 and January 2017. 86 patients presented with focal seizures, of which 76 were focal to bilateral tonic-clonic, 2 with impaired awareness and motor onset, 3 with impaired awareness and non-motor onset, 1 without impaired awareness and motor onset, and 4 without impaired awareness and non-motor onset. 14 patients had generalized seizures with motor onset. The causes of exacerbation were as follows: 26 patients due to antiepileptic dose omission, 21 due to a unknown cause, 19 due to infection, 13 due to sleep deprivation, 3 due to stress, 3 were catamenial, 2 due to alcohol abuse and 3 due to other reasons. Of the 26 patients with dose omission, 10 were due to forgetfulness, 7 refused to comply with their prescription, 6 could not afford to buy their prescription and 3 had their prescription changed by another doctor. Conclusions. In Mexico, antiepileptic drug dose omission represents up to 25% of patients with acute seizure exacerbations; increased patient education on epilepsy hygiene measures may be an area of opportunity for reducing its frequency


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Serviços Médicos de Emergência , Epilepsia , Estudos Prospectivos , México/epidemiologia , Epilepsia/epidemiologia , Epilepsia/tratamento farmacológico , Epilepsia/etiologia
18.
Eur J Epidemiol ; 34(7): 651-660, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30868347

RESUMO

Recent studies have shown that certain pharmacological agents used by fathers before conception may increase the risk of adverse neonatal outcomes in offspring. However, little is known about the effect of paternal use of antiepileptic drugs (AEDs) on congenital anomalies in children. Based on Danish national registers, we conducted a cohort study of 733, 282 singletons born from 1997 to 2008, with follow-up throughout 2013. The children whose fathers used AEDs during the 3 months before conception were categorized as the exposed. Logistic regression model was used to examine association between paternal AEDs use before conception and the risk of congenital anomalies in offspring. Compared with unexposed children, the exposed had a 23% increased risk of congenital anomalies (odds ratios (OR) 1.23, 95% confidence interval [CI] 1.10-1.37) after adjusting for potential confounders. When extending the exposure window to 1 year before conception to the end of pregnancy, except for those using AEDs during 3 months before conception (the susceptible period of exposure), the increased risks were also observed in children whose fathers were former users (i.e., those using AEDs only from 1 year to 3 months before conception) (OR 1.29, 95%CI 1.03-1.61) and later users (i.e., those using AEDs only during pregnancy) (OR 1.35, 95%CI 1.12-1.65). This study suggested that the mildly increased risk of congenital anomalies in the offspring associated with paternal AEDs use before conception may be attributable to the underlying indications related to AEDs use.


Assuntos
Anticonvulsivantes/efeitos adversos , Epilepsia/tratamento farmacológico , Pai/psicologia , Exposição Paterna/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Adulto , Anticonvulsivantes/uso terapêutico , Carbamazepina/uso terapêutico , Criança , Pré-Escolar , Estudos de Coortes , Dinamarca/epidemiologia , Epilepsia/epidemiologia , Pai/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Vigilância da População , Cuidado Pré-Concepcional , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia
19.
Epilepsy Res ; 152: 52-58, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30909052

RESUMO

BACKGROUND: We aimed to study the short-term association between air pollutants and hospitalization for epilepsy in 47 hospitals from 10 cities in eastern China. METHOD: We identified hospital epilepsy admissions in 2014 and 2015. A conditional Poisson regression model was used to examine the association between air pollutants and hospital admission, with temperature and relative humidity adjusted using the natural spline (ns) function. Pollutants included sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and particulate matter (PM). The association was stratified by sex, age, and geographic region in single-pollutant and two-pollutant models. RESULTS: An interquartile (IQR) increase of NO2 and CO on the concurrent day is correlated with an increased admission of 2.0% (0.5%, 3.6%) and 1.1% (0.1%, 2.1%), respectively. The association is stronger in children (≤18 years) and in northern China, but did not vary with sex. A positive association was also observed on the previous day for CO [1.5%, 95% confidence interval (CI): 0.3%, 2.6%], NO2 (2.5%, 95% CI: 0.6%, 4.3%), and PM2.5 (1.32%, 95% CI: 0.16%, 2.48%). Moving average concentration of 7 days for all pollutants was associated with decreased admission (CO: -1.29%, NO2: -0.4.69%, SO2:-2.12%, PM2.5:-0.98%, PM10:-1.70%). CONCLUSION: Exposures to NO2 and CO on concurrent days, and PM2.5 on the previous day, are associated with increased epilepsy hospitalization, whereas cumulative exposure appeared protective.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Poluição do Ar/estatística & dados numéricos , Epilepsia/induzido quimicamente , Epilepsia/epidemiologia , Hospitalização/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Monóxido de Carbono/efeitos adversos , Monóxido de Carbono/análise , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Dióxido de Nitrogênio/análise , Dióxido de Nitrogênio/química , Estudos Retrospectivos , Dióxido de Enxofre/efeitos adversos , Dióxido de Enxofre/análise , Adulto Jovem
20.
Seizure ; 67: 23-26, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30856458

RESUMO

PURPOSE: To describe sociocultural representations of epilepsy in a sub-Saharan Africa rural community using a population-based approach. METHOD: A cross-sectional door-to-door survey was underway on a rural community of the Central African Republic in 2015. A two-stage stratified sampling was performed. Trained care personnel performed individual face-to-face interviews. A standardized questionnaire was used to assess epilepsy. We collected sociodemographic data and cultural representations toward epilepsy in general population. RESULTS: Overall, 1023 participants were interviewed. Epilepsy prevalence was 11.7 (95%CI 6.7-20.4) per 1000 people. In the rural community, epilepsy was identified as a supernatural disease related to bad luck (40.4%), witchcraft (31.3%) or a curse (28.3%). Epilepsy was confused with a mental disorder in 75.9% of subjects. Three quarters of participants (75.3%) considered epilepsy as a contagious disease. Saliva was mainly mentioned as a means of transmission in 63.8%. More than half of participants preferred or recommended traditional treatments. Only 24.8% believed in the efficacy of medical treatment for epilepsy. CONCLUSIONS: Epilepsy misconceptions are highly prevalent in rural sub-Saharan Africa. Understanding misrepresentations is an essential phase to develop culturally appropriate interventional programs in order to improve medical treatment adherence, quality of life, and to decrease stigma. Campaigns to raise awareness are needed in urban and rural population to reduce misconception and combat stigmatization.


Assuntos
Epilepsia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Adolescente , Adulto , República Centro-Africana , Criança , Estudos Transversais , Cultura , Epilepsia/epidemiologia , Epilepsia/etnologia , Epilepsia/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural , Estigma Social , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
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