Epilepsy & behavior : E&B
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Epilepsy & behavior : E&B · Feb 2006
Case ReportsRecurrent status epilepticus as the main feature of Hashimoto's encephalopathy.
Hashimoto's encephalopathy (HE) is a severe but treatable condition that rarely complicates Hashimoto's thyroiditis. Clinically it is characterized by progressive or relapsing symptoms, including tremor, myoclonus, stroke-like episodes, seizures, impairment of consciousness, and dementia. ⋯ Our observation confirms that the clinical spectrum of HE at presentation is heterogeneous and diagnosis is often difficult. This case highlights the crucial importance of antithyroid antibody measurement in patients presenting with otherwise unexplained episodes of GCSE with or without adjunctive signs of encephalopathy or thyroiditis.
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Epilepsy & behavior : E&B · Feb 2006
Posttraumatic stress disorder and major depressive disorder is common in parents of children with epilepsy.
The purpose of the study was to determine the prevalence of posttraumatic stress disorder (PTSD), posttraumatic stress symptoms (PTSS), and major depressive disorder (MDD) in parents of children with epilepsy. ⋯ These findings suggest that a significant proportion of parents of children with epilepsy experience PTSD and MDD. Increased awareness of the clinical presentations of these disorders may help clinicians to develop preventive and intervention strategies for parents of children with epilepsy.
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Epilepsy & behavior : E&B · Feb 2006
ReviewVagus nerve stimulation use and effect in epilepsy: what have we learned?
Vagus nerve stimulation (VNS) for epilepsy has been available in the United States for 8 years. Pivotal randomized, blinded clinical trials leading to FDA approval in patients age 12 and older with refractory partial seizures have not been performed for other age groups or epilepsy syndromes. This practical review takes stock of the current information about VNS use and efficacy in various types of epilepsy. ⋯ We review adverse events and VNS effects on respiratory patterns, cardiac function, and mood and behavior. With the recent U. S. approval of VNS for treatment-resistant depression, we anticipate that lessons learned from treating patients with epilepsy will be useful to physicians using VNS to treat patients with depression and possibly other conditions.
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Epilepsy & behavior : E&B · Dec 2005
ReviewAntiepileptic drugs and neuroprotection: current status and future roles.
There has been a growing interest in the use of antiepileptic drugs (AEDs) for neuroprotection, and in the possible role of AEDs in disease modification (i.e., antiepileptogenesis). Increased understanding of the mechanisms underlying brain injury has led to advances in the study of neuroprotection. However, defining the clinical paradigm and selecting appropriate outcomes to detect neuroprotective effects present challenges to clinicians studying the neuroprotective properties of drugs. ⋯ Animal model studies also have suggested that newer AEDs, such as levetiracetam, topiramate, and zonisamide, may have neuroprotective or antiepileptogenic properties. However, the prevention of epileptogenesis by an AED has yet to be demonstrated in clinical trials. The future of neuroprotection may involve established and newer AEDs, as well as other compounds, such as immunophilins, caspase inhibitors, endocannabinoids, and antioxidants.