Epilepsy & behavior : E&B
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Epilepsy & behavior : E&B · Sep 2019
The association of serotonin reuptake inhibitors and benzodiazepines with ictal central apnea.
Ictal (ICA) and postconvulsive central apnea (PCCA) have been implicated in sudden unexpected death in epilepsy (SUDEP) pathomechanisms. Previous studies suggest that serotonin reuptake inhibitors (SRIs) and benzodiazepines (BZDs) may influence breathing. The aim of this study was to investigate if chronic use of these drugs alters central apnea occurrence in patients with epilepsy. ⋯ Seizures in patients taking SRIs have lower occurrence of ICA, and patients on chronic treatment with BZDs have shorter ICA and PGES durations. Preventing or shortening ICA duration by using SRIs and/or BZD in patients with epilepsy may play a possible role in SUDEP risk reduction.
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Epilepsy & behavior : E&B · Aug 2019
Measuring coordination of epilepsy care: A mixed methods evaluation of social network analysis versus relational coordination.
Coordination of multidisciplinary care is critical to address the complex needs of people with neurological disorders; however, quality improvement and research tools to measure coordination of neurological care are not well-developed. This study explored and compared the value of social network analysis (SNA) and relational coordination (RC) in measuring coordination of care in a neurology setting. The Department of Veterans Affairs Healthcare System (VA) established an Epilepsy Centers of Excellence (ECOE) hub and spoke model of care, which provides a setting to measure coordination of care across networks of providers. ⋯ For quality improvement and research purposes, SNA and RC can be used to measure coordination of neurological care; RC provides a detailed assessment of the quality of communication within and across healthcare teams but is difficult to administer and analyze; SNA provides large scale coordination of care maps and metrics to compare across large healthcare systems. The two measures provide complimentary coordination of care data at a local as well as population level. Interviews describe the mechanisms of developing and sustaining health professional networks that are not captured in either SNA or RC measures.
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Epilepsy & behavior : E&B · Jul 2019
Prediction of antiepileptic drug treatment outcomes of patients with newly diagnosed epilepsy by machine learning.
The objective of this study was to build a supervised machine learning-based classifier, which can accurately predict the outcomes of antiepileptic drug (AED) treatment of patients with newly diagnosed epilepsy. ⋯ Our XGBoost-based machine learning classifier accurately predicts the most probable AED treatment outcome of a patient after he/she finishes all the standard examinations for the epilepsy disease. The classifier's prediction result could help disease guide counseling and eventually improve treatment strategies.
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Epilepsy & behavior : E&B · Jul 2019
Comparative StudyQuality of life after switching to generic levetiracetam - A prospective comparative study.
Improved quality of life (QoL) is one of the most important objectives in the treatment of epilepsy. Recent prospective, clinical studies proved no significant differences between brand antiepileptic drugs (AEDs) and their generic equivalents in terms of seizure control, pharmacokinetics, or safety. In this study, we focused on possible changes in QoL and adverse events in connection with generic substitution of levetiracetam (LEV). ⋯ We found reduced seizure worries over time among people with epilepsy allocated to either generic switch or continued treatment with brand LEV. We hypothesize that the nurse-led structured follow-up had an impact on seizure worries and switchback rates because of reduced nocebo effects. Further studies on generic AED substitution, focusing on psychological outcome measures, are warranted to test this supposition.
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Epilepsy & behavior : E&B · Jun 2019
Seizure comorbidity boosts odds of 30-day readmission after an index hospitalization for sepsis.
The objective of this study was to evaluate the association between comorbid seizures and hospital readmissions within 30 days following an index hospitalization for sepsis. ⋯ Seizures are not uncommon, and patients with sepsis and comorbid seizures are 30% more likely to be readmitted within 30-days postdischarge, compared to those with sepsis and no comorbid seizures.