ObjectiveThe risk factors of relapse in 133 epileptic children after withdrawal were analyzed retrospectively and provide reference for clinical withdrawal.MethodsFrom January 2017 to March 2019, 133 children with withdrawal epilepsy were selected as the study object. According to whether there was recurrence during the follow-up period, the children with epilepsy were divided into recurrence group (42 cases) and non recurrence group (91 cases). The gender, age of onset, history of trauma, frequency of seizure before treatment, EEG before drug reduction, imaging, type of medication, family history, time of reaching control, course of disease before treatment, comorbidity, multiple attack types, withdrawal speed and EEG before treatment were observed and compared between the two groups. ResultsThere were significant differences in EEG (χ2 =7.621), medication type (χ2=8.760), time to control (χ2=6.618), course before treatment (χ2=6.435), multiple seizure types (χ2=5.443) and epilepsy comorbidity (χ2=42.795) between the two groups (P < 0.05). The results of Logistic multiple regression analysis showed that the recurrence of epileptic children after drug reduction / withdrawal was correlated with abnormal EEG before drug reduction [OR=9.268, 95%CI (2.255, 38.092)], combined drug treatment [OR=3.205, 95%CI (1.159, 8.866)] and course of disease > 1 year before treatment [OR=5.363, 95%CI (1.781, 16.150)] (P < 0.05).ConclusionsIn order to reduce the possibility of recurrence of epileptic children, the treatment time of epileptic children with abnormal EEG, combined medication and long course before treatment should be prolonged properly.
ObjectiveTo explore the clinical characteristics of epilepsy and depression patients, and provide guidance for clinical intervention of epilepsy and depression patients.MethodsPatients with epilepsy (epilepsy group) were prospectively enrolled in Emeishan People’s Hospital from 2015 to 2017, and healthy controls (control group) were enrolled in the same period. Clinical assessment of depression was conducted and compared between the two groups. In the epilepsy group, the severity and incidence of depression were analyzed and compared among different subgroups according to the epileptic seizure type, frequency and course.ResultsA total of 120 patients and 70 healthy controls were enrolled. The Hamilton Depression Scale score of epilepsy group was higher than that of the control group (t=7.430, P<0.001), and the depression degree of epilepsy group was significantly higher than that of the control group (Z=?4.371, P< 0.001). There was no significant difference in depression rating between convulsive epilepsy patients and partial epilepsy patients (Z=?1.591, P=0.112); there was no significant difference in depression rating among patients with different epilepsy course (χ2=1.943, P=0.584); there was significant difference in depression rating among patients with different seizure frequency (χ2=27.575, P<0.001). Patients with high frequency of seizures were more likely to suffer from depression and severe depression, with the lowest proportion of normal neuropsychological state. Conversely, patients with low frequency of epileptic seizures had a lower proportion of depression and severe depression.ConclusionsThe incidence of depression in epilepsy patients is higher than that in normal people. Timely detection and treatment of depression in clinical work have a positive impact on the prognosis of patients.
ObjectiveTo investigate the anxious level of people with epilepsy (PWE) during the outbreak of 2019 Novel Coronavirus Diseases (COVID-19) and explore the reasons of anxiety.MethodsAn internet questionnaire survey were conducted on the anxiety state of PWE and health controls (HC) aged 18 to 45 years old between Feb 9, 2020 and Feb 17, 2020. The questionnaire included demographic information, general status and the State-Trait Anxiety Inventory (STAI).ResultsIn all, 148 PWE and 300 HC were included in this study. The total SAI score (46.72±9.98 vs. 41.77±10.20, P<0.001) and the total TAI score (44.18±8.88 vs. 31.27±17.44, P<0.001) were significantly higher in PWE than in HC. PWE concerned most (69.9%) about the difficulty of obtaining antiepileptic drugs (AEDs) while HC concerned most about the lack of face masks (73.3%).ConclusionHigh anxious level in PWE during the outbreak of COVID is probably due to the difficulty of obtaining AEDs. Thus, the society should strengthen the solution of the problem of purchasing AEDs and conduct timely psychological counseling.
Objective
To understand the status quo of medical staffs engaged in epilepsy and EEG in Shanxi Province, analyze the existing problems, and summarize the improvement and development direction of epilepsy and EEG in Shanxi Province.
Methods
A questionnaire survey was conducted among medical staff of epilepsy and electroencephalogram specialty in public hospitals at or above county level in whole province and municipalities.
Results
① Generally speaking, there are 17 males and 473 females in this study, with an average age of 38.7 years, the youngest was 23 years-old and the oldest was 70 years-old; ② The regional distribution has a tendency of decrease from Taiyuan in Shanxi Province to the remote areas of southeast, northwest and northwest China, and the epilepsy treatment in some poverty-stricken areas have not even been carried out; ③ The shortest time of working is 3 months and the longest is more than 40 years. The proportion of junior collage students, undergraduates, masters and doctors is 24%, 50%, 25% and 1% respectivel. The professional titles of primary, medium-level, vice-senior and senior are 24%, 39%, 26% and 11% respectively.
Conclusion
The number of medical workers engaged in EEG specialty in Shanxi Province is insufficient, the regional development is not balanced, and the number of junior and medium-level professional titles is large. We can formulate a mobile policy to encourage experienced medical personnel to communicate with weak areas, so as to improve the overall level of epilepsy and EEG professional development in Shanxi Province.
ObjectiveTo provide the possibility to explain the relationship between genotype and phenotype, and to provide reference for the clinical treatment of Sleep-related hypermotor epilepsy (SHE). MethodsWe retrospectively analyzed the case data of the child (patient 1) diagnosed with SHE in the outpatient department of the Second Affiliated Hospital of Wenzhou Medical University in December 2017, and inquired about his family history and growth and development history. We learned that the father (patient 2) of the child had a history of epilepsy, and we also collected his medical history and growth and development history of patient 2. We carried out the basic physical examination for the two patients, and basic blood routine and blood biochemical indicators have also been done. In addition, electroencephalogram, Wechsler intelligence assessment and cranial magnetic resonance imaging were performed. After the diagnosis of patients 1 and 2, we treated them with antiepileptic drugs and make them long-term follow-up. What’more, we collected the peripheral blood of patient 1 and his father and mother, sequenced the gene, established phylogenetic tree for the mutation gene, and compared the homologous protein sequence to judge the conservation of the mutation. Moreover, in silico analysis was used to analyze the pathogenicity of the mutant gene. ResultsWe find a family with epilepsy, of whom patient 1 and his father are with epilepsy. Their clinical manifestations are atypical, and their seizures are all in sleep. After a long-term follow-up of two patients' drug treatments, it is found that patient 1 and patient 2 respond well to the drugs. Gene test shows that the mutations of DEPDC5 (c.484-1del c.484_485del) and KCNQ2 (c.1164A> T) are at the same site in both patient 1 and patient 2, and the mutation sites are first reported. What’more, the homologous protein alignment shows that the amino acids corresponding to the two mutant genes are highly conserved. ConclusionThis study mainly reports a family with sleep-related hypermotor epilepsy. Patients 1 and patient 2 have novel mutations of DEPDC5 and KCNQ2 genes. In the long-term follow-up of this study, it is found that the patients are effective the antiepileptic drugs.
ObjectiveThe aim of this meta-analysis and systematic review is to assess the effectiveness of microRNAs as a diagnostic tool for individuals with epilepsy. MethodsA systematic search of PubMed, EMBASE, the Cochrane Library, and Web of Science databases was performed to collect literature on miRNA diagnosis of epilepsy up to January 1, 2024. Two researchers independently screened and extracted the literature and resolved discrepancies by negotiation. The QUADAS-2 evaluation tool was used to assess the quality of the included studies. Statistical analysis was performed using Review Manager 5.4, Meta-Disc 1.4, and Stata 17.0. Results A total of 17 papers were included, including 942 patients with epilepsy and 932 healthy controls. miRNA in the diagnosis of epilepsy had a combined sensitivity of 0.76 [95%CI (0.71, 0.79)], combined specificity of 0.78 [95%CI (0.74, 0.82)], and area under the SROC curve of 0.84 [95%CI (0.80, 0.87)]. Subgroup analysis showed that miRNA had higher diagnostic value for temporal lobe epilepsy, especially medial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). ConclusionThe study suggests that miRNA may be a promising tool for the diagnosis of epilepsy, especially temporal lobe epilepsy, but more high-quality studies are needed to support it.
Currently, about one-third of patients with anti-epilepsy drug or resective surgery continue to have sezure, the mechanism remin unknown. Up to date, the main target for presurgical evaluation is to determene the EZ and SOZ. Since the early nineties of the last century network theory was introduct into neurology, provide new insights into understanding the onset, propagation and termination. Focal seizure can impact the function of whole brain, but the abnormal pattern is differet to generalized seizure. Brain network is a conception of mathematics. According to the epilepsy, network node and hub are related to the treatment. Graphy theory and connectivity are main algorithms. Understanding the mechanism of epilepsy deeply, since study the theory of epilepsy network, can improve the planning of surgery, resection epileptogenesis zone, seizure onset zone and abnormal node of hub simultaneously, increase the effect of resectiv surgery and predict the surgery outcome. Eventually, develop new drugs for correct the abnormal network and increase the effect. Nowadays, there are many algorithms for the brain network. Cooperative study by the clinicans and biophysicists instituted standard and extensively applied algorithms is the precondition of widely used clinically.
Childhood is the key period of psychological and behavioral development of children. The changes of children's psychological behavior during this period have an impact on the psychological and behavioral patterns of adolescents and even adults. Epilepsy is a chronic and recurrent disease, which affect the development emotional behavior problem of children with epilepsy seriously. This paper reviewed the influencing factors, measuring methods and intervention of emotional behavior problems in children with epilepsy so as to alleviate the negative emotion and behavior problems and provide quality of life in children with epilepsy.
ObjectiveTo develop Knowledge attitude behavior and practice (KABP) health education path table, and to explore its application in health education of physician-nurse collaboration for children with epilepsy, and provide practical reference for health education of children with epilepsy.MethodsA convenient sampling method was used to select 94 family units of children with epilepsy and their main caregivers from the Department of Neurology in Hunan Children’s Hospital from September 2018 to March 2019. Divided into observation group and control group, 47 cases in each group. In the control group, the health care education was carried out by the conventional method of medical personnel’s one-way input of knowledge. The observation group conducted health education through interactive participation in the path of the health education path of KABP on the basis of regular health education. Then compared the effect of the health education between the two groups.ResultsAfter the intervention, the quality of life scores of the observation group were significantly higher than the control group (P<0.01). The relevant knowledge scores of main caregivers at 1 and 3 months after discharge were significant higher than those in the control group (P=0.008, P=0.001). The medication compliance scores of children with epilepsy at 1 and 3 months after discharge were significant higher than those in the control group (P=0.010, P=0.006).ConclusionsThe KABP health education pathway can improve the knowledge level of caregivers, as well as the medication compliance and quality of life of children with epilepsy.
Objective To study the correlation of changes in liver function during long-term treatment with sodium valproate (VPA) in children with epilepsy in Putian, and to explore individualized administration to improve the compliance of children with medication. Methods The blood concentration of VPA and related biochemical test data of 350 children with epilepsy from June 1, 2018 to March 1, 2021 were collected in our hospital. According to the results of VPA blood concentration, they were classified as low Blood concentration group (<50 μg/mL), therapeutic blood concentration group (50 ~ 100 μg/mL) and high blood concentration group (>100 μg/mL). Results There was no significant difference in liver function indexes between the VPA treatment group and the control group (P>0.05). There were significant differences in liver function ALT, AST, AST/ALT, TBIL and DBIL among the groups of VPA blood concentration range (P<0.05). The abnormal incidence of liver function indexes of high blood drug concentration was lower in the concentration group and higher in the treatment concentration group, and there were differences (P<0.05). Conclusion Abnormal liver function in the high blood drug concentration treatment groupis quite common, and the dose of the drug should be adjusted in time to avoid liver damage caused by the VPA.
