Epilepsy & behavior : E&B
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Epilepsy & behavior : E&B · Feb 2007
Seizures during intracarotid methohexital and amobarbital testing.
Methohexital and amobarbital have been used as agents for Wada testing in the presurgical evaluation of patients with epilepsy. Previous experience with methohexital as an anesthetic indicates that methohexital may decrease seizure threshold and may trigger seizures. ⋯ Patients with a previous history of epilepsy may be at higher risk for seizures after methohexital injection as compared with amobarbital injection.
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Epilepsy & behavior : E&B · Nov 2006
Clinical TrialDisfluent speech in patients with partial epilepsy: beneficial effect of levetiracetam.
The aim of this study was to evaluate the clinical effects of levetiracetam (LEV) in patients with partial epilepsy and disfluent speech. ⋯ As an add-on therapy, LEV seems to improve verbal fluency in patients with partial epilepsy and disfluent speech. This effect seems unrelated to the antiepileptic activity of the drug. A placebo-controlled trial of LEV in patients with this kind of verbal disfluency is warranted.
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Epilepsy & behavior : E&B · Sep 2006
Comparative StudyClinical characteristics of psychogenic nonepileptic seizure status in the long-term monitoring unit.
Patients with psychogenic nonepileptic seizures (PNES) mimicking status epilepticus (PNES-status) are at risk of iatrogenic complications. Our aim was to assess whether the population of patients with PNES who develop PNES-status are distinguishable. Retrospectively, we identified patients with PNES-status and compared them with patients with PNES without status and with patients with electroclinical status epilepticus (SE). ⋯ Use of fewer than three antiepileptic drugs and emergent admission were independent predictors of PNES-status classification on logistic regression. Of 154 patients with epilepsy, 8 had SE during LTM (5.2%), significantly fewer than the proportion with PNES-status relative to PNES (P=0.008); the only clinical variable distinguishing these two groups was a baseline lower seizure frequency among the patients with epileptic seizures (P=0.045). Our results suggest that patients with PNES-status have features that differentiate them from patients with PNES without status and, to a lesser extent, from patients with epileptic seizures.
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Epilepsy & behavior : E&B · Aug 2006
Internal consistency and test-retest reliability of the Chinese version of the self-report health-related quality of life measure for children and adolescents with epilepsy.
The aim of this validation study was to evaluate the internal consistency (internal reliability) and test-retest reliability (external reliability) of the Chinese version of the self-report health-related quality of life measure for children and adolescents with epilepsy. ⋯ The Chinese version of the health-related quality of life measure for children and adolescents with epilepsy demonstrated acceptable internal consistency and test-retest reliability. Further studies are required to study other psychometric properties such as construct validity and factor analysis.
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Epilepsy & behavior : E&B · Aug 2006
ReviewFinding the missing link between ictal bradyarrhythmia, ictal asystole, and sudden unexpected death in epilepsy.
Basic science studies of the human brain have supported the cortical representation of cardiovascular responses, including heart rate variability. Clinical observations of ictal bradyarrhythmia may be mechanistically explained by the influence of the central autonomic network, although the localization and lateralization issues need to be considered in the light of patterns of seizure spread, hand dominance, and presence of lesions. ⋯ The missing links are (1) clinical evidence of common factors shared by patients with ictal bradyarrhythmia and patients who die from SUDEP, (2) evidence of arrhythmia as a risk factor for SUDEP from epidemiological studies, and, (3) determination of the importance of ictal bradyarrhythmia in SUDEP with respect to other proposed mechanisms including apnea and intrinsic cardiac abnormalities. There remains a need to review the seizure mechanisms in cases of SUDEP and to step up the amount of concurrent ECG/intracranial EEG analysis in both ictal bradyarrhythmia and SUDEP cases.