Epilepsy research
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Ubiquitin carboxy-terminal hydrolase (UCH-L1) has been established as a reliable and potential biomarker of neuronal damage after acute neurologic insults such as ischemic stroke, subarachnoid hemorrhage, and traumatic brain injury. The effects of seizures on UCH-L1 levels in cerebrospinal fluid (CSF) has not been investigated in epileptic patients. The aim of the present study was to evaluate whether CSF UCH-L1 levels are a reliable marker of brain damage from epileptic seizures. ⋯ Our results suggest that UCH-L1 may serve as a novel biomarker for neuronal damage after epileptic seizure.
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To investigate the connectivity associated with the reorganized language network in patients with temporal lobe epilepsy (TLE) using cortico-cortical evoked potential (CCEP), which reveals the brain networks. ⋯ Our results suggest that language reorganization might be associated with a functional shift from the termination of anterior-posterior language connection to the surrounding cortices. It should be noted that language areas can be identified outside the anterior-posterior language connection.
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The objective of this study was to develop and validate coding algorithms for epilepsy using ICD-coded inpatient claims, physician claims, and emergency room (ER) visits. 720/2049 charts from 2003 and 1533/3252 charts from 2006 were randomly selected for review from 13 neurologists' practices as the "gold standard" for diagnosis. Epilepsy status in each chart was determined by 2 trained physicians. ⋯ Accepting chart review data as the gold standard, we calculated sensitivity, specificity, positive, and negative predictive value for each ICD-9 and ICD-10 administrative data algorithm (case definitions). Of 18 algorithms assessed, the most accurate algorithm to identify epilepsy cases was "2 physician claims or 1 hospitalization in 2 years coded" (ICD-9 345 or G40/G41) and the most sensitive algorithm was "1 physician clam or 1 hospitalization or 1 ER visit in 2 years." Accurate and sensitive case definitions are available for research requiring the identification of epilepsy cases in administrative health data.
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Comparative Study
Costs, work absence, and adherence in patients with partial onset seizures prescribed gabapentin or pregabalin.
Few studies have examined cost of illness of epileptic partial onset seizures (POS) from the employer perspective or compared users of gabapentin and pregabalin in treatment of POS. This study compares pharmacotherapy, direct/indirect costs, and work absences of patients with POS newly started on gabapentin or pregabalin. ⋯ Despite higher acquisition costs for branded pregabalin over generic gabapentin, overall direct and indirect costs trended lower for pregabalin users. Additionally, pregabalin users had significantly fewer sick leave days and significantly higher adherence rates than gabapentin users.