Epilepsy & behavior : E&B
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Epilepsy & behavior : E&B · Mar 2005
Review Historical ArticleDid all those famous people really have epilepsy?
Many famous individuals are said to have had epilepsy, and these names often find their way into books and lectures on epilepsy. The goal of this study was to investigate in detail the histories of 43 of those people who had various kinds of attacks, but not epilepsy. They range chronologically from Pythagorus, born in 582 bc, to the actor Richard Burton, born in 1925 AD. ⋯ In some instances no evidence of any episodic symptom could be found. One unexpected finding was that 40% of these well-known, individuals had serious, often life-threatening, physical conditions as infants or very young children. This article is an attempt to correct the record with respect to these people and also to remind us of the many reasons similar misdiagnoses are being made today.
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Epilepsy & behavior : E&B · Dec 2004
Comparative StudyAnxiety and depression in children with epilepsy and their mothers.
Children with epilepsy have high rates of depression and anxiety. The majority of studies concentrate on the children with epilepsy, but the emotional impact of epilepsy on family members is of clinical concern. In this cross-sectional study we aimed to examine the association between epilepsy in childhood and adolescence, and anxiety and depression in these patients and their mothers. ⋯ These results support findings from previous studies that children and adolescents with epilepsy have a higher frequency of depressive but not anxiety symptoms than the general population of healthy children and that this is independent of their mothers' symptoms.
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Epilepsy & behavior : E&B · Dec 2004
Comparative StudyEffects of antiepileptic drugs on working memory as assessed by spatial alternation performance in rats.
Patients with epilepsy can have impaired cognitive abilities. Many factors contribute to this impairment, including the adverse effects of antiepileptic drugs (AEDs). However, there are few systematic data on the effects of AEDs on specific cognitive domains, such as working memory. ⋯ In contrast, ethosuximide significantly disrupted working memory. The disruptions produced by triazolam and phenobarbital were similar in magnitude to the effects of the muscarinic antagonist scopolamine. The present results indicate that AEDs can disrupt working memory, but there are differences among AEDs in the magnitude of the disruption that do not appear to be correlated with mechanism of action.
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Epilepsy & behavior : E&B · Oct 2004
ReviewWhat is the evidence that oxcarbazepine and carbamazepine are distinctly different antiepileptic drugs?
Oxcarbazepine (OXC, Trileptal) is a modern antiepileptic drug (AED) used as both monotherapy and adjunctive therapy for the treatment of partial seizures with or without secondary generalization in adults and children above 4 years (USA) or 6 years (Europe) of age. Although OXC has been developed through structural variation of carbamazepine (CBZ) with the intent to avoid metabolites causing side effects, significant differences have emerged between the two drugs. The mechanism of action of OXC involves mainly blockade of sodium currents but differs from CBZ by modulating different types of calcium channels. ⋯ This constitutes compelling clinical evidence that OXC and CBZ are distinctly different medications. From postmarketing experience in over 1,000,000 patient years, OXC had an advantageous risk-benefit balance also in comparison to other new AEDs. OXC should be preferred over CBZ and other older AEDs because of its proven efficacy and excellent side effect profile in children, adolescents, and adults with partial seizures.
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Epilepsy & behavior : E&B · Oct 2004
Case ReportsNow we lay them down to sleep: ethical issues with the use of pharmacologic coma for adult status epilepticus.
The use of pharmacologic coma (PC) to treat status epilepticus (SE) is not always successful, and there are no guidelines for the duration of PC in an attempt to achieve seizure control. Using clinical cases, we explore three concepts: (1) SE as a terminal condition; (2) PC resulting in permanent unconsciousness; and (3) use of PC for extended periods. ⋯ We argue that when PC therapy is not reversing the patient's clinical course and only offering to sustain organic life, it is ethically appropriate to discontinue such therapy and provide the patient comfort care. If PC therapy is only expected to sustain organic life, it is ethically appropriate not to offer it.