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Fröscher W, Kirschstein T, Rösche J. Antiepileptikabehandlung bei Hirntumor-bedingten epileptischen Anfällen. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2014; 82:678-90. [DOI: 10.1055/s-0034-1385475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rösche J, Kampf C, Benecke R. Possible effect of perampanel on focal status epilepticus after generalized tonic-clonic status epilepticus. Acta Neurol Belg 2014; 114:243-4. [PMID: 23801431 DOI: 10.1007/s13760-013-0225-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 06/14/2013] [Indexed: 11/30/2022]
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Rösche J, Pohley I, Jung SU, Benecke R. Meropenem und Valproinsäure – Eine Kombination mit schwerwiegendem Interaktionspotenzial. AKTUELLE NEUROLOGIE 2014. [DOI: 10.1055/s-0034-1370964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Rühle N, Schley A, Pohley I, Kampf C, Benecke R, Rösche J. Neuropsychological deficits after a first unprovoked seizure and depressive symptoms in the week before. Epilepsy Behav 2014; 31:334-8. [PMID: 24262784 DOI: 10.1016/j.yebeh.2013.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 10/02/2013] [Accepted: 10/04/2013] [Indexed: 11/17/2022]
Abstract
This prospective study was performed to investigate whether verbal memory deficits are present in patients with a first unprovoked seizure irrespective of significant lesions in the brain and whether symptoms of depression were experienced by those patients in the week before the seizure. After having given informed consent, patients who presented with a first unprovoked seizure were investigated with a psychometric battery consisting of a verbal memory test, a figural memory test, a test following the Stroop paradigm, and a self-rating scale for depression in addition to the routine diagnostic work-up with EEG and MRI. The data of 53 patients aged 45years on average (33 males and 20 females) were available. Verbal memory deficits were present in 60% of the patients, and 21% of the patients delivered a self-rating that was suggestive of at least minor depression in the week before the seizure. Neither verbal memory deficits nor symptoms of depression were associated with a significant lesion of the brain. There was a significant negative correlation between immediate recall in the verbal memory test and the score in the self-rating scale for depression. Our data suggest that even at the time of the first unprovoked seizure, there is an epileptic condition of the brain, which facilitates the occurrence of verbal memory deficits and depression in the presence of an epileptogenic focus irrespective of its localization.
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Rantsch K, Walter U, Wittstock M, Benecke R, Rösche J. Treatment and course of different subtypes of status epilepticus. Epilepsy Res 2013; 107:156-62. [DOI: 10.1016/j.eplepsyres.2013.08.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 06/25/2013] [Accepted: 08/03/2013] [Indexed: 11/29/2022]
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Kampf C, Grossmann A, Benecke R, Rösche J. Disappearance of breach rhythm heralding recurrent tumor progression in a patient with astrocytoma. Clin EEG Neurosci 2013; 44:237-43. [PMID: 23820313 DOI: 10.1177/1550059412458263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The breach rhythm is sometimes considered the consequence of reduced resistance between the cortex and the scalp electrode in the region of a skull defect. On the other hand, the electroencephalographic (EEG) changes after craniotomy were attributed to an activation of EEG activity by meningocortical adhesions with admixed gliosis. We report changes of the breach rhythm in a patient with astrocytoma, which give further evidence that the breach rhythm is not merely the result of physical changes in the area of a skull defect. In our patient, the breach rhythm was no longer detectable before a new tumor progression took place, showed up again, and at the end changed into localized slowing before the deterioration of the patient's general medical condition. This case suggests that in patients with brain tumors, the loss or attenuation in frequency of an established breach rhythm might be considered as an indication of a new tumor progression.
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Hensler K, Uhlmann C, Porschen T, Benecke R, Rösche J. Generic substitution of antiepileptic drugs--a survey of patients' perspectives in Germany and other German-speaking countries. Epilepsy Behav 2013; 27:135-9. [PMID: 23416284 DOI: 10.1016/j.yebeh.2012.12.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 12/03/2012] [Accepted: 12/28/2012] [Indexed: 11/28/2022]
Abstract
In this study, we sought to determine the patients' attitudes towards generic substitution of antiepileptic drugs (AEDs) and their experiences with the usage of generic antiepileptic drugs in Germany and other German-speaking countries. A questionnaire was designed for a cross-sectional study. Two thousand copies of the questionnaire were delivered with a magazine edited by a patients' organization. Additionally, the questionnaire was placed on the internet platform of another patients' organization. Thirty-two percent of the patients who already experienced a switch to generic AEDs complained of problems with the switch. Patients who answered the magazine survey worried significantly more about generic substitution of AEDs than patients who answered the internet version. Patients who had never switched were more concerned about generic substitution than those who had already switched. Moreover, patients' beliefs differed between the use of generic drugs in acute medical conditions such as pain and infections and the use of generic AEDs in epilepsy.
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Rösche J, Pohley I, Rantsch K, Walter U, Benecke R. [Experience with levetiracetam in the treatment of status epilepticus]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2012; 81:21-7. [PMID: 22890440 DOI: 10.1055/s-0032-1312951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Non-convulsive status epilepticus and epilepsia partialis continua are common epileptic conditions for which straightforward recommendations based on controlled randomised trials for treatment of therapy refractory courses are lacking. Therefore in these conditions sometimes antiepileptic drugs that are not approved by governmental authorities for the treatment of status epilepticus (SE) are used. Here we review all case reports and case series concerning the treatment of SE with levetiracetam (LEV), that had been listed in pub-med up to December 12th 2011. Additionally we analysed abstracts and papers in peer reviewed journals, that were listed in the references of the primarily reviewed papers. Furthermore we looked for LEV treatments in papers on the use of lacosamide (LCM) in SE. LEV was given in dosages ranging from 500 mg to 9000 mg per day. Side effects were especially sedation and irritability. Estimated on the basis of the case series the overall success-rate of LEV in terminating status epilepticus may be set in a range between 53.7% and 58.1%. Therefore LEV may be a useful alternative for the treatment of SE when the approved drugs are contraindicated or when these drugs have been taken without success.
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Rösche J, Kundt G, Weber R, Fröscher W, Uhlmann C. Memory deficits and depression in patients with chronic epilepsy. Acta Neuropsychiatr 2012; 24:230-5. [PMID: 25286816 DOI: 10.1111/j.1601-5215.2011.00625.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objective: In this retrospective study, we tested the hypothesis that patients with epilepsy (PWE) with moderate to major depression have more severe memory deficits than PWE with mild depression or no depression.Methods: Hundred and thirty-nine patients with chronic epilepsy were studied with the Self-Rating Depression Scale (SDS) and a neuropsychological-screening battery the day after admission on a specialised ward for PWE. For this study the data from the Memo-test for verbal memory and from the Benton-test for non-verbal memory were taken into account. For testing of the hypothesis of independence of memory deficits and grade of depression we performed a statistical analysis.Results: Eighty-three patients (59.7%) had a pathological score in the SDS, but only 36 (25.9%) scored in the range of a moderate to major depression. When all 83 patients with a pathological score in the SDS were taken into account, these patients did not differ on any cognitive measure from those without pathological score in SDS. The only significant association in our study was found between pathological results in immediate verbal recall and a score in the SDS for moderate to major depression (p = 0.038).Conclusion: Minor depressive symptoms may be a response to chronic illness without any impact on cognitive functioning. Nevertheless, a verbal memory deficit associated with major depression was observed in our study even in the presence of many confounding factors. This may be a hint for an association of severe depressive symptoms with left temporal dysfunction in PWE.
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Rantsch K, Pohley I, Benecke R, Rösche J. Erfahrungen mit Lacosamid in der Behandlung des Status epilepticus. AKTUELLE NEUROLOGIE 2012. [DOI: 10.1055/s-0032-1311558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fröscher W, Rösche J. [Combination therapy for epilepsy]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2012; 81:9-20. [PMID: 22450761 DOI: 10.1055/s-0031-1299361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Use of Monotherapy is acknowledged as the standard anticonvulsant therapy although no more than about 65% of patients become seizure-free with a single antiepileptic drug. Therefore, up to 50% of patients with epilepsy are treated at least intermittently with more than one antiepileptic drug. The percentage of patients achieving complete seizure control with combination therapy after ineffective monotherapy is small. Monotherapy and combination therapy are not always contrary to each other; many anticonvulsants have different modes of action and are effectively a combination therapy in one drug. Combinations of anticonvulsants with differing mechanisms of action are called "rational polypharmacy". A superior efficacy of these combinations over combinations of anticonvulsants with identical or similar mechanisms of action have not been proved by randomised trials. Add-on trials with lacosamide and the combination of lamotrigine and valproic acid, however, suggest a superior tolerability and/or efficacy of combinations with differing mechanisms of action. Treatment with drug combinations should take into account, above all, efficacy and safety, interactions, and costs of each antiepileptic drug as well as comorbidity.
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Kampf C, Benecke R, Rösche J. Veränderungen des Narbenrhythmus (Breach Rhythm, BR) im Krankheitsverlauf eines Patienten mit Astrozytom. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Rantsch K, Walter U, Wittstock M, Benecke R, Rösche J. Efficacy of intravenous lacosamide in refractory nonconvulsive status epilepticus and simple partial status epilepticus. Seizure 2011; 20:529-32. [DOI: 10.1016/j.seizure.2011.03.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 03/12/2011] [Accepted: 03/18/2011] [Indexed: 11/16/2022] Open
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Rösche J, Kundt G, Weber R, Fröscher W, Uhlmann C. The impact of antiepileptic polytherapy on mood and cognitive function. Acta Neurol Belg 2011; 111:29-32. [PMID: 21510230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This retrospective study was performed to reevaluate the effect of polytherapy on mood and cognitive function. 139 patients with refractory epilepsy were screened with a neuropsychological test battery and a depression score. Our regression model with age at admission, duration of the disorder and number of antiepileptic drugs as independent variables had a significant influence on 10 out of 11 neuropsychological parameters but not on depression. Looking at the significance of each predictor variable the number of antiepileptic drugs had a significant effect only on the estimation of the fluid intelligence. A significant effect on five neuropsychological parameters was found for the predictor variable duration of the disorder. Therefore our data do not support the commonly reported hypothesis that antiepileptic polytherapy itself is a substantial risk factor for cognitive deficits or depression in patients with refractory epilepsy. But there may be an influence of accumulative drug load during the course of the disorder as reflected by the effect of the duration of the disorder on five neuropsychological parameters.
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Rösche J, Schley A, Schwesinger A, Grossmann A, Mach H, Benecke R, Walter U. Recurrent aphasic status epilepticus after prolonged generalized tonic-clonic seizures versus a special feature of Todd's paralysis. Epilepsy Behav 2011; 20:132-7. [PMID: 21131238 DOI: 10.1016/j.yebeh.2010.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 10/30/2010] [Accepted: 11/01/2010] [Indexed: 10/18/2022]
Abstract
Postictal aphasia may be a feature of Todd's paralysis or the presentation of aphasic nonconvulsive status epilepticus (NCSE). We describe a 74-year-old woman with three episodes of aphasic status epilepticus after prolonged generalized tonic-clonic seizures. In the first episode, the NCSE was not definitively diagnosed, but an increase in the epileptic medication led to resolution of the epileptic activity within 2 weeks. During the second episode, NCSE was terminated within 7 days under intensified antiepileptic treatment. In the third episode, phenytoin treatment led to intoxication and resulted in further treatment on an intensive care unit. The patient required several months to recover from this episode. NCSE in the elderly is difficult to recognize, especially when it presents as a prolonged postictal deficit like aphasia. Once diagnosed it has to be treated carefully, because in the elderly, aggressive treatment strategies may be associated with a high risk of adverse events.
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Rösche J, Schwesinger A, Greim B, Benecke R. Temporale intermittierende Delta-Aktivität (TIRDA) und neuropsychologische Defizite bei familiärer mesialer Temporallappen-Epilepsie (FMTLE). KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1249088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rösche J, Uhlmann C, Fröscher W. Kognitive Defizite und psychiatrische Störungen in Frühstadien epileptischer Erkrankungen. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2010; 78:18-26. [DOI: 10.1055/s-0028-1109887] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rösche J. [Research and quality control at a neuropsychiatric epilepsy clinic]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2009; 77 Suppl 1:S58-S60. [PMID: 19685396 DOI: 10.1055/s-0028-1109603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Quality management in German health care services is demanded by law. If a monitoring of treatment results using scientifically established scores is performed as a part of quality management, the data may also be used for research on the course and the outcome of chronic disease and even for basic research. Using a multimodal therapy monitoring on a neuropsychiatric ward for patients with refractory epilepsy it could be shown that comprehensive treatment strategies were able to enhance cognitive abilities, mood and coping-strategies. The introduction of selective serotonin reuptake inhibitors (e. g. citalopram, sertraline) did not result in an increased burden of seizures. Interesting for understanding the multiple causes of depression was the finding that folic acid serum levels in the lower normal range or below were associated with a higher risk of depressive mood.
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Fröscher W, Raape J, Rösche J. Reversibler GGT-Anstieg bei einer Levetiracetam-Kombinationstherapie. AKTUELLE NEUROLOGIE 2005. [DOI: 10.1055/s-2005-866928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Fröscher W, Schier KR, Hoffmann M, Meyer A, May TW, Rambeck B, Rösche J. Topiramate: a prospective study on the relationship between concentration, dosage and adverse events in epileptic patients on combination therapy. Epileptic Disord 2005; 7:237-48. [PMID: 16162434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2004] [Accepted: 02/14/2005] [Indexed: 05/04/2023]
Abstract
RATIONALE The relationship between topiramate (TPM) concentration, dosage and adverse events in patients with epilepsy is still controversial. We therefore performed a prospective study in patients with poorly controlled epilepsy treated with TPM, predominantly in combination with other antiepileptic drugs. The goal of the study was to investigate the relationship between the occurrence of adverse events due to TPM and its serum concentration or dosage, respectively. METHODS The relationship between the occurrence of adverse events and TPM serum concentration or dosage, respectively, was examined in a group of 42 young adult and adult patients with poorly controlled epilepsy. Within 22 months, all patients treated with TPM had been included in the study. The 8 adverse events occurring most frequently (difference > or = 10%) in TPM-treated patients in 5, double-blind, placebo-controlled, parallel group studies, were checked regularly. This side effect profile has been presented by Reife et al. (1995a). Other possible or probable adverse events were also documented. RESULTS The difference in TPM serum concentrations and TPM dosages (mg/kg) for patients without an adverse event, and patients with a given adverse event was statistically significant for "abnormal thinking, impaired concentration, weight loss, dizziness, speech problems, somnolence, ataxia, increased seizure frequency and paresthesia". To avoid adverse events, we recommend an initial "maintenance serum concentration" of below 4 microg/mL. As regards the TPM dosage, our results suggest initial maintenance dosages of 100 TPM or lower, 1.5 mg/kg or lower, respectively. These conclusions are limited by the relatively small number of patients.
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Rösche J, Uhlmann C, Fröscher W. [On the value of neuropsychological short tests in epileptology]. DER NERVENARZT 2004; 75:1204-8. [PMID: 15349735 DOI: 10.1007/s00115-004-1777-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Cognitive deficits are common in patients with epilepsy refractive to therapy and have considerable influence on the quality of life in this group of patients. Therefore, neuropsychological investigations should play an important role in the comprehensive evaluation of patients with chronic epilepsy. The aim of this study was to examine whether a reliable screening for cognitive deficits in these patients may be reduced to the assessment of two bedside tests. In a prospective study we analyzed the results of 40 patients with epilepsy refractive to therapy subjected to a 45-min neuropsychological screening battery and compared them with the results of a short battery consisting of two bedside tests. Using the screening battery as the gold standard, the short battery had a sensitivity of 50% and a specificity of 100%. Changing the criteria for pathological results in the short battery, sensitivity could be raised to 81.25% but specificity fell to 50%. Therefore, bedside tests instead of longer neuropsychological testing cannot be recommended as a screening method for cognitive deficits in patients with chronic epilepsy.
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Rösche J, Uhlmann C, Weber R. [Changes of coping strategies in patients with therapy refractory epilepsy in the course of a ward based treatment with a holistic therapeutic approach]. Psychother Psychosom Med Psychol 2004; 54:4-8. [PMID: 14722833 DOI: 10.1055/s-2003-812588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In this study we examined whether individual coping strategies improve in the course of a ward based treatment with a holistic therapeutic approach. An increase in problem-focussed coping and a decrease in emotion-focussed coping or avoidance-oriented coping were considered as improvement. As a part of a comprehensive therapy monitoring 65 patients with therapy refractory epilepsy were studied with the Freiburg Questionnaire of coping with Illness (FKV) on the day after admittance to a specialized epilepsy ward. A second investigation with the FKV was performed on the day before discharge. A decrease in depressive coping and cognitive avoidance and an increase in problem focussed coping could be documented. These changes could not be interpreted as an effect of better seizure control or antidepressive drugs. This may be a hint for the efficacy of a holistic treatment approach to increase the patient's resources for a successful psychosocial adjustment to therapy refractory epilepsy.
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Rösche J, Uhlmann C, Weber R. Der Einfluss von Erkrankungsalter, Lebensalter und Krankheitsdauer auf die kognitiven Leistungen bei Patienten mit therapierefraktärer Epilepsie. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2003; 71:595-9. [PMID: 14608511 DOI: 10.1055/s-2003-43466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This retrospective study was performed as part of the controversial discussion whether increasing cognitive deficits in patients with refractory epilepsy are mainly an effect of normal aging or caused by epilepsy related noxious events during the course of an intractable epilepsy. Neuropsychological data and information about the course of the disease from 146 patients with refractory epilepsy were available. There were significant correlations between the age at onset and premorbid intelligence, duration of disease and fluid intelligence and age and difference between premorbid intelligence and fluid intelligence as a measure of cognitive deterioration. Discussing these results we conclude that beneath a clear effect of normal aging on cognitive deterioration there is probably a small effect of the refractory course of the epilepsy, which might be mediated by the number of seizures. Additionally we would like to encourage early cognitive screening and rehabilitation programmes for patients with epilepsy to minimize the effect of the age of onset on the level of education or premorbid intelligence.
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Rösche J, Uhlmann C, Fröscher W. Low serum folate levels as a risk factor for depressive mood in patients with chronic epilepsy. J Neuropsychiatry Clin Neurosci 2003; 15:64-6. [PMID: 12556573 DOI: 10.1176/jnp.15.1.64] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study takes into consideration whether low serum folate levels may contribute to depressive mood in patients with chronic epilepsy. The serum folate levels and the score on the Self-Rating Depression Scale (SDS) were examined in 46 patients with chronic epilepsy. Patients with a score indicating at least minor depression on the SDS had a significantly lower serum folate level than patients with a normal score on SDS. There was a significant negative correlation between the serum folate levels and the SDS score. A serum folate level below 7.5 ng/ml was significantly associated with a pathological score on SDS. Because a serum folate level of 7.5 ng/ml is in the normal range for many laboratories, further studies using total plasma homocysteine as a sensitive measure of functional folate deficiency are required to elucidate the impact of folate metabolism on depressive mood in patients with chronic epilepsy.
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Rösche J, Uhlmann C, Weber R, Fröscher W. The influence of folate serum levels on depressive mood and mental processing in patients with epilepsy treated with enzyme-inducing anti-epileptic drugs. Acta Neuropsychiatr 2003; 15:63-7. [PMID: 26984794 DOI: 10.1034/j.1601-5215.2003.00009.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Folate deficiency is common in patients with epilepsy and also occurs in patients with depression or cognitive deficits. OBJECTIVE This study investigates whether low serum folate levels may contribute to depressive mood and difficulties in mental processing in patients with epilepsy treated with anti-epileptic drugs inducing the cytochrome P450. METHODS We analysed the serum folate levels, the score in the Self Rating Depression Scale (SDS) and the results of a bedside test in mental processing in 54 patients with epilepsy. RESULTS There was a significant negative correlation between the serum folate levels and the score in SDS and significant positive correlations between the score in SDS and the time needed to process an interference task or a letter-reading task. CONCLUSIONS Low serum folate levels may contribute to depressive mood and therefore to difficulties in mental processing. Further studies utilizing total plasma homocysteine as a sensitive measure of functional folate deficiency and more elaborate tests of mental processing are required to elucidate the impact of folate metabolism on depressive mood and cognitive function in patients with epilepsy.
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