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Tatum WO, Mani J, Jin K, Halford JJ, Gloss D, Fahoum F, Maillard L, Mothersill I, Beniczky S. Minimum standards for inpatient long-term video-EEG monitoring: A clinical practice guideline of the international league against epilepsy and international federation of clinical neurophysiology. Clin Neurophysiol 2021; 134:111-128. [PMID: 34955428 DOI: 10.1016/j.clinph.2021.07.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The objective of this clinical practice guideline is to provide recommendations on the indications and minimum standards for inpatient long-term video-electroencephalographic monitoring (LTVEM). The Working Group of the International League Against Epilepsy and the International Federation of Clinical Neurophysiology develop guidelines aligned with the Epilepsy Guidelines Task Force. We reviewed published evidence using The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. We found limited high-level evidence aimed at specific aspects of diagnosis for LTVEM performed to evaluate patients with seizures and nonepileptic events (see Table S1). For classification of evidence, we used the Clinical Practice Guideline Process Manual of the American Academy of Neurology. We formulated recommendations for the indications, technical requirements, and essential practice elements of LTVEM to derive minimum standards used in the evaluation of patients with suspected epilepsy using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Further research is needed to obtain evidence about long-term outcome effects of LTVEM and establish its clinical utility.
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Affiliation(s)
- William O Tatum
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA.
| | - Jayanti Mani
- Department of Neurology, Kokilaben Dhirubai Ambani Hospital, Mumbai, India
| | - Kazutaka Jin
- Department of Epileptology, Tohoku University Graduate School of Medicine, Japan
| | - Jonathan J Halford
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA.
| | - David Gloss
- Department of Neurology, Charleston Area Medical Center, Charleston, WV, USA
| | - Firas Fahoum
- Department of Neurology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Louis Maillard
- Department of Neurology, University of Nancy, UMR7039, University of Lorraine, France.
| | - Ian Mothersill
- Department of Clinical Neurophysiology, Swiss Epilepsy Center, Zurich Switzerland.
| | - Sandor Beniczky
- Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark; Danish Epilepsy Center, Dianalund, Denmark.
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Tatum WO, Mani J, Jin K, Halford JJ, Gloss D, Fahoum F, Maillard L, Mothersill I, Beniczky S. Minimum standards for inpatient long-term video-electroencephalographic monitoring: A clinical practice guideline of the International League Against Epilepsy and International Federation of Clinical Neurophysiology. Epilepsia 2021; 63:290-315. [PMID: 34897662 DOI: 10.1111/epi.16977] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 01/02/2023]
Abstract
The objective of this clinical practice guideline is to provide recommendations on the indications and minimum standards for inpatient long-term video-electroencephalographic monitoring (LTVEM). The Working Group of the International League Against Epilepsy and the International Federation of Clinical Neurophysiology develop guidelines aligned with the Epilepsy Guidelines Task Force. We reviewed published evidence using the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) statement. We found limited high-level evidence aimed at specific aspects of diagnosis for LTVEM performed to evaluate patients with seizures and nonepileptic events. For classification of evidence, we used the Clinical Practice Guideline Process Manual of the American Academy of Neurology. We formulated recommendations for the indications, technical requirements, and essential practice elements of LTVEM to derive minimum standards used in the evaluation of patients with suspected epilepsy using GRADE (Grading of Recommendations Assessment, Development, and Evaluation). Further research is needed to obtain evidence about long-term outcome effects of LTVEM and to establish its clinical utility.
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Affiliation(s)
- William O Tatum
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - Jayanti Mani
- Department of Neurology, Kokilaben Dhirubai Ambani Hospital, Mumbai, India
| | - Kazutaka Jin
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jonathan J Halford
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - David Gloss
- Department of Neurology, Charleston Area Medical Center, Charleston, West Virginia, USA
| | - Firas Fahoum
- Department of Neurology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Louis Maillard
- Department of Neurology, University of Nancy, UMR7039, University of Lorraine, Nancy, France
| | - Ian Mothersill
- Department of Clinical Neurophysiology, Swiss Epilepsy Center, Zurich,, Switzerland
| | - Sandor Beniczky
- Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.,Danish Epilepsy Center, Dianalund, Denmark
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Zhao H, Li S, He L, Tang F, Han X, Deng W, Lin Z, Huang R, Li Z. Ameliorating Effect of Umbilical Cord Mesenchymal Stem Cells in a Human Induced Pluripotent Stem Cell Model of Dravet Syndrome. Mol Neurobiol 2021; 59:748-761. [PMID: 34766239 DOI: 10.1007/s12035-021-02633-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 11/02/2021] [Indexed: 01/01/2023]
Abstract
Dravet syndrome (DS) is a form of severe childhood-onset refractory epilepsy typically caused by a heterozygous loss-of-function mutation. DS patient-derived induced pluripotent stem cells (iPSCs) are appropriate human cells for exploring disease mechanisms and testing new therapeutic strategies in vitro. Repeated spontaneous seizures can cause neuroinflammatory reactions and oxidative stress, resulting in neuronal toxicity, neuronal dysfunction, blood-brain barrier disruption, and hippocampal inflammation. Antiepileptic drug therapy does not delay the development of chronic epilepsy. The application of mesenchymal stem cells (MSCs) is one therapeutic strategy for thwarting epilepsy development. This study evaluated the effects of human umbilical cord mesenchymal stem cell-conditioned medium (HUMSC-CM) in a new in vitro model of neurons differentiated from DS patient-derived iPSCs. In the presence of HUMSC-CM, increases in superoxide dismutase 1 (SOD1), superoxide dismutase 2 (SOD2), glutathione peroxidase (GPX), and glutathione (GSH) levels were found to contribute to a reduction in reactive oxygen species (ROS) levels. In parallel, inflammation was rescued in DS patient-derived neuronal cells via increased expression of anti-inflammatory cytokines (TGF-β, IL-6, and IL-10) and significant downregulation of tumor necrosis factor-α and interleukin-1β expression. The intracellular calcium concentration ([Ca2+]i) and malondialdehyde (MDA) and ROS levels were decreased in DS patient-derived cells. In addition, action potential (AP) firing ability was enhanced by HUMSC-CM. In conclusion, HUMSC-CM can effectively eliminate ROS, affect migration and neurogenesis, and promote neurons to enter a highly functional state. Therefore, HUMSC-CM is a promising therapeutic strategy for the clinical treatment of refractory epilepsy such as DS.
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Affiliation(s)
- Huifang Zhao
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
| | - Shuai Li
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Lang He
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Feng Tang
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xiaobo Han
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
- CAS Key Laboratory of Regenerative Biology, Joint School of Life Sciences, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
- Guangzhou Medical University, Guangzhou, 511436, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Weiyue Deng
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Zuoxian Lin
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
| | - Rongqi Huang
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
| | - Zhiyuan Li
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China.
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China.
- Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510005, China.
- CAS Key Laboratory of Regenerative Biology, Joint School of Life Sciences, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China.
- Guangzhou Medical University, Guangzhou, 511436, China.
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Assessment of Quality of Life of Epileptic Patients in Ethiopia. Int J Chronic Dis 2020; 2020:8714768. [PMID: 31976314 PMCID: PMC6961609 DOI: 10.1155/2020/8714768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/26/2019] [Accepted: 10/10/2019] [Indexed: 01/26/2023] Open
Abstract
Background Patients with epilepsy are at an increased risk of poor quality of life. Purpose We aimed at assessing the quality of life and its determinants among epileptic patients at University of Gondar Referral Hospital (UoGRH), Ethiopia. Methods Institution based cross-sectional study was conducted on epileptic patients on follow up at UoGRH from January 15 to April 15, 2017. Information including socio-demographic profile and diagnosis was extracted from medical records and patients. Quality Of Life In Epilepsy-10 (QOLIE-10) tool was used to measure the quality of life. Independent t-test and one-way analysis of variance were used to look for factors associated with quality of life. The level of statistical significance was declared at P-value ≤ 0.05. Results A total of 354 patients were included in the study and mean age was 29.1 ± 11.7 years. The mean QOLIE-10 score was 19.85. One hundred ninety-four (54.8%) of participants had a good quality of life. Being illiterate, unemployment, and presence of co-morbid medical condition were associated with poorer quality of life. Conclusion Nearly half of the participants had a poor quality of life. Patients with co-morbidity, illiteracy, and unemployment should be given special emphasis in order to improve their quality of life.
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Chen B, Kessi M, Chen S, Xiong J, Wu L, Deng X, Yang L, He F, Yin F, Peng J. The Recommendations for the Management of Chinese Children With Epilepsy During the COVID-19 Outbreak. Front Pediatr 2020; 8:495. [PMID: 32984209 PMCID: PMC7477110 DOI: 10.3389/fped.2020.00495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/14/2020] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease (COVID-19) is the most severe public health problem facing the world currently. Social distancing and avoidance of unnecessary movements are preventive strategies that are being advocated to prevent the spread of the causative virus [severe acute respiratory syndrome (SARS)-CoV2]. It is known that epileptic children need long term treatments (antiepileptic drugs and/or immunosuppressive agents) as well as close follow up due to the nature of the disease. In addition, it is clear that epilepsy can concur with other chronic illnesses which can lower body immunity. As a result, epileptic children have high risk of acquiring this novel disease due to weak/immature immune system. Of concern, the management of children with epilepsy has become more challenging during this outbreak due to the prevention measures that are being taken. Although children with controlled seizures can be managed at home, it is challenging for pediatricians when it comes to cases with uncontrolled seizures/severe cases. To this end, we provide recommendations for the management of epileptic children at home, outpatient and inpatient settings.
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Affiliation(s)
- Baiyu Chen
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Miriam Kessi
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Shimeng Chen
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Juan Xiong
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Liwen Wu
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Xiaolu Deng
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Lifen Yang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Fang He
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Fei Yin
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Jing Peng
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
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Jiang LW, Qian RB, Fu XM, Zhang D, Peng N, Niu CS, Wang YH. Altered attention networks and DMN in refractory epilepsy: A resting-state functional and causal connectivity study. Epilepsy Behav 2018; 88:81-86. [PMID: 30243110 DOI: 10.1016/j.yebeh.2018.06.045] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Epilepsy is considered a disorder of neural networks. Patients diagnosed with refractory epilepsy frequently experience attention impairments. Seizure activity in epilepsy may disturb brain networks and damage the brain function of attention. The aims of this study were to assess functional and causal connectivities of the attention networks and default mode network using resting-state functional magnetic resonance imaging (fMRI). METHOD Resting-state fMRI data were gathered from 19 patients with refractory epilepsy (mixed localization and aetiologies) and 21 healthy people. The fMRI data were analyzed by group independent component analysis (ICA) fMRI toolbox to extract dorsal attention network (DAN), ventral attention network (VAN), and default mode network (DMN). The components of the selected networks were compared between patients and healthy controls to explore the change in functional connectivity (FC). Granger causality analysis was performed by taking the aforementioned significant brain areas as regions of interest (ROIs) to calculate autoregression coefficients of each pair of ROIs. Comparisons were done to find the significantly different causal connectivity when FC was changed between patients and healthy controls. RESULTS In DAN, the FC values of the bilateral frontal eye field (FEF) and left intraparietal sulcus (IPS) were decreased. In VAN, the FC values of the double-side ventral prefrontal cortex (vPFC) and the temporoparietal junction (TPJ) were reduced. As for DMN, the FC values of the bilateral medial prefrontal cortices (mPFC) were decreased whereas those for the bilateral precuneus (PCUN) were increased. Granger causal connectivity values were correlated: causal influence was decreased significantly from the left IPS (in DAN) to the double side of the vPFC but remained the same for the right FEF (in DAN) to the right TPJ. The value was decreased from the left PCUN (in DMN) to the right TPJ and FEF, and the causal flow from the right PCUN to the right TPJ and bilateral vPFC was also significantly inhibited (p < 0.05). CONCLUSION Frequent seizures in patients with refractory epilepsy may damage the cortex and disturb DAN, VAN, and DMN, leading to functional and causal connectivity alteration. In addition, epileptic activity may disrupt network interactions and further influence information communication.
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Affiliation(s)
- Lu-Wei Jiang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Anhui Provincial Hospital Affiliated to Anhui Medical University, 17 Lujiang Road, Hefei, Anhui Province 230001, China; School of Neurosurgery, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province 230032, China
| | - Ruo-Bing Qian
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Anhui Provincial Hospital Affiliated to Anhui Medical University, 17 Lujiang Road, Hefei, Anhui Province 230001, China; Anhui Provincial Institute of Stereotactic Neurosurgery, 9 Lujiang Road, Hefei, Anhui Province 230001, China.
| | - Xian-Ming Fu
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Anhui Provincial Hospital Affiliated to Anhui Medical University, 17 Lujiang Road, Hefei, Anhui Province 230001, China; Anhui Provincial Institute of Stereotactic Neurosurgery, 9 Lujiang Road, Hefei, Anhui Province 230001, China
| | - Dong Zhang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Anhui Provincial Hospital Affiliated to Anhui Medical University, 17 Lujiang Road, Hefei, Anhui Province 230001, China
| | - Nan Peng
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Anhui Provincial Hospital Affiliated to Anhui Medical University, 17 Lujiang Road, Hefei, Anhui Province 230001, China
| | - Chao-Shi Niu
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Anhui Provincial Hospital Affiliated to Anhui Medical University, 17 Lujiang Road, Hefei, Anhui Province 230001, China; Anhui Provincial Institute of Stereotactic Neurosurgery, 9 Lujiang Road, Hefei, Anhui Province 230001, China
| | - Ye-Han Wang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Anhui Provincial Hospital Affiliated to Anhui Medical University, 17 Lujiang Road, Hefei, Anhui Province 230001, China; Anhui Provincial Institute of Stereotactic Neurosurgery, 9 Lujiang Road, Hefei, Anhui Province 230001, China
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Tatum W, Rubboli G, Kaplan P, Mirsatari S, Radhakrishnan K, Gloss D, Caboclo L, Drislane F, Koutroumanidis M, Schomer D, Kasteleijn-Nolst Trenite D, Cook M, Beniczky S. Clinical utility of EEG in diagnosing and monitoring epilepsy in adults. Clin Neurophysiol 2018; 129:1056-1082. [DOI: 10.1016/j.clinph.2018.01.019] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 12/28/2017] [Accepted: 01/09/2018] [Indexed: 12/20/2022]
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Hu CY, Gao X, Long L, Long X, Liu C, Chen Y, Xie Y, Liu C, Xiao B, Hu ZY. Altered DMN functional connectivity and regional homogeneity in partial epilepsy patients: a seventy cases study. Oncotarget 2017; 8:81475-81484. [PMID: 29113406 PMCID: PMC5655301 DOI: 10.18632/oncotarget.20575] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/06/2017] [Indexed: 12/30/2022] Open
Abstract
Purpose Clinically diagnosed partial epilepsy is hard to be functionally diagnosed by regular electroencephalograph (EEG) and conventional magnetic resonance imaging (MRI). By collecting transient brain regional signals, blood oxygenation level-dependent (BOLD) function MRI (BOLD-fMRI) can provide brain function change information with high accuracy. By using resting state BOLD-fMRI technique, we aim to investigate the changes of brain function in partial epilepsy patients. Methods BOLD-fMRI scanning was performed in 70 partial epilepsy and 70 healthy people. BOLD-fMRI data was analyzed by using the Regional Homogeneity (ReHo) method and functional connectivity of Default Mode Network (DMN) methods. The abnormal brain functional connectivity in partial epilepsy patients was detected by Statistical Parametric Mapping 8 (SPM8) analysis. Results Compared to healthy group, epilepsy patients showed significant decreased ReHo in left inferior parietal lobule/pre- and post-central gyrus, right thalamus/paracentral lobule/Cerebellum anterior and posterior Lobe, bilateral insula. The DMN functional connectivity regions decreased significantly in right uncus, left Inferior parietal lobule, left supramarginal gyrus, left uncus, left parahippocampa gyrus, and left superior temporal gyrus, in epilepsy patients, compared to healthy controls. Significance This study clarified that both ReHo and functional connectivity of DMN decreased in partial epilepsy patients compared to healthy controls. While left inferior parietal lobule was detected in both ReHo and DMN, many other identified regions were different by using these two BOLD-fMRI techniques. We propose that both ReHo and DMN patterns in BOLD-fMRI may suggest networks responsible for partial epilepsy genesis or progression.
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Affiliation(s)
- Chong-Yu Hu
- Department of Neurology, Hunan Provincial People's Hospital, Changsha, Hunan, China
| | - Xiaoping Gao
- Department of Neurology, Hunan Provincial People's Hospital, Changsha, Hunan, China
| | - Lili Long
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaoyan Long
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chaorong Liu
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yayu Chen
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yuanyuan Xie
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chujuan Liu
- Department of Rehabilitation, Hunan Provincial People's Hospital, Changsha, Hunan, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zhe-Yu Hu
- Department of Clinical Research and Teaching, The First Hospital of Changsha, Changsha, Hunan, China
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Novotná I, Rektor I. The long-term development of public attitudes towards people with epilepsy in the Czech Republic: 1981, 1984, 1998 and 2009 studies. Acta Neurol Scand 2017; 135:454-458. [PMID: 27273139 DOI: 10.1111/ane.12619] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The long-term development of public attitudes towards people with epilepsy (PWE) was studied. METHODS Four questions (Q) used in Czech questionnaires for studies in 1981, 1984, 1998 and 2009 concerned: Q1, familiarity with the concept of epilepsy; Q2, tolerance towards children with epilepsy; Q3, whether epilepsy is considered to be a mental disease; and Q4, attitudes towards employment of PWE. RESULTS The quality of information about epilepsy increased significantly between 1981 and 1998, 1981 and 2009, and 1998 and 2009. The 1981 and 1984 studies reflected a level of information inferior to the levels seen in Germany and the USA, and the difference had almost disappeared in 1998 and 2009. CONCLUSIONS The long-term follow-up studies in Czech Republic displayed a permanent increase in knowledge about epilepsy. This may reflect the progress in the spread of information, the efforts of patient associations and specialists and perhaps also a change in general attitudes towards people with disabilities. The dramatic change of information levels in Czech surveys could also reflect the change of the political system in 1989. A question that remains to be answered is the extent to which the positive trend reflects positive attitudes in real life. The answers to questions concerning whether people would be willing to help a person having a seizure remain unsatisfactory. Greater efforts should be made to improve the situation of PWE and to minimize their stigmatization.
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Affiliation(s)
- I. Novotná
- Brno Epilepsy Centre; Masaryk University First Department of Neurology; St. Anne's Hospital; Brno Czech Republic
| | - I. Rektor
- Brno Epilepsy Centre; Masaryk University First Department of Neurology; St. Anne's Hospital; Brno Czech Republic
- Centre of Neuroscience; Central European Institute of Technology (CEITEC); Masaryk University; Brno Czech Republic
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10
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Bollo RJ. Surgical advancements in pediatric epilepsy surgery: from the mysterious to the minimally invasive. Transl Pediatr 2016; 5:180-182. [PMID: 27709100 PMCID: PMC5035754 DOI: 10.21037/tp.2016.05.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Robert J Bollo
- Division of Pediatric Neurosurgery, Department of Neurosurgery, Primary Children's Hospital, University of Utah School of Medicine, Salt Lake City, UT, USA
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11
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Fischer W, Franke H, Krügel U, Müller H, Dinkel K, Lord B, Letavic MA, Henshall DC, Engel T. Critical Evaluation of P2X7 Receptor Antagonists in Selected Seizure Models. PLoS One 2016; 11:e0156468. [PMID: 27281030 PMCID: PMC4900628 DOI: 10.1371/journal.pone.0156468] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 05/13/2016] [Indexed: 01/03/2023] Open
Abstract
The ATP-gated P2X7 receptor (P2X7R) is a non-selective cation channel which senses high extracellular ATP concentrations and has been suggested as a target for the treatment of neuroinflammation and neurodegenerative diseases. The use of P2X7R antagonists may therefore be a viable approach for treating CNS pathologies, including epileptic disorders. Recent studies showed anticonvulsant potential of P2X7R antagonists in certain animal models. To extend this work, we tested three CNS-permeable P2X7R blocker (Brilliant Blue G, AFC-5128, JNJ-47965567) and a natural compound derivative (tanshinone IIA sulfonate) in four well-characterized animal seizure models. In the maximal electroshock seizure threshold test and the pentylenetetrazol (PTZ) seizure threshold test in mice, none of the four compounds demonstrated anticonvulsant effects when given alone. Notably, in combination with carbamazepine, both AFC-5128 and JNJ-47965567 increased the threshold in the maximal electroshock seizure test. In the PTZ-kindling model in rats, useful for testing antiepileptogenic activities, Brilliant Blue G and tanshinone exhibited a moderate retarding effect, whereas the potent P2X7R blocker AFC-5128 and JNJ-47965567 showed a significant and long-lasting delay in kindling development. In fully kindled rats, the investigated compounds revealed modest effects to reduce the mean seizure stage. Furthermore, AFC-5128- and JNJ-47965567-treated animals displayed strongly reduced Iba 1 and GFAP immunoreactivity in the hippocampal CA3 region. In summary, our results show that P2X7R antagonists possess no remarkable anticonvulsant effects in the used acute screening tests, but can attenuate chemically-induced kindling. Further studies would be of interest to support the concept that P2X7R signalling plays a crucial role in the pathogenesis of epileptic disorders.
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Affiliation(s)
- Wolfgang Fischer
- Rudolf-Boehm-Institute of Pharmacology and Toxicology, Medical Faculty, University of Leipzig, Leipzig, Germany
- * E-mail:
| | - Heike Franke
- Rudolf-Boehm-Institute of Pharmacology and Toxicology, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Ute Krügel
- Rudolf-Boehm-Institute of Pharmacology and Toxicology, Medical Faculty, University of Leipzig, Leipzig, Germany
| | | | - Klaus Dinkel
- Lead Discovery Center GmbH, Dortmund, Germany
- Affectis Pharmaceutical AG, Dortmund, Germany
| | - Brian Lord
- Neuroscience Therapeutic Area, Janssen Research & Development, LLC, San Diego, California, United States of America
| | - Michael A. Letavic
- Neuroscience Therapeutic Area, Janssen Research & Development, LLC, San Diego, California, United States of America
| | - David C. Henshall
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Tobias Engel
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin 2, Ireland
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Bhalla D, Lotfalinezhad E, Timalsina U, Kapoor S, Kumar KS, Abdelrahman A, Giagante B, Tripathi M, Srivastava K, Irmansyah I. A comprehensive review of epilepsy in the Arab world. Seizure 2015; 34:54-9. [PMID: 26724591 DOI: 10.1016/j.seizure.2015.12.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 12/05/2015] [Accepted: 12/08/2015] [Indexed: 11/26/2022] Open
Abstract
PURPOSE We conducted a comprehensive review of the epidemiology of epilepsy in the Arab world. METHODS Epidemiological literature about epilepsy from 22 countries of the Arab League was searched in French and English using several keywords (specific and wider) and combinations, individually for each country. The search was conducted on Google first and then on PubMed. The results are presented as counts, proportions, and medians along with 95% confidence intervals (CI). Unpaired t-test with unequal variance and regressions were performed, altogether and individually, for lifetime and active epilepsy prevalence as well as incidence. RESULTS Google provided 21 prevalence, four camp and nine incidence estimates while PubMed provided ten such estimates; none of them was identified by Google. No epidemiological data about epilepsy was found from 10/22 countries. Excluding pediatric studies, 13 prevalence estimates from six countries were identified. Including pediatric studies, 21 estimates from nine countries were found. Median lifetime and active epilepsy prevalence were 7.5/1000 (95% CI 2.6-12.3, range 1.9-12.9) and 4.4/1000 (95% CI 2.1-9.3, range 2.1-9.3), respectively, excluding pediatric studies (1984-2014, N=244081). Median incidence was 56.0/100,000 (n=9, N=122484, 95% CI 13.7-147.9, range 10.4-190). CONCLUSION The fact that no epidemiological data about epilepsy is available in the public domain for almost one half of all Arab countries offers opportunities for future research. This thorough review of existing literature demonstrates a prevalence of epilepsy three times higher than previously reported for this region. The median incidence is similar to other regions of the world, e.g. North America. Google yielded additional valuable sources not indexed in PubMed and provided pertinent references more quickly.
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Affiliation(s)
- Devender Bhalla
- Nepal Interest Group of Epilepsy and Neurology, Kathmandu, Nepal; Faculté de Medecine, Université de Limoges, Limoges, France; Iranian Epilepsy Association, Tehran, Iran.
| | - Elham Lotfalinezhad
- Iranian Epilepsy Association, Tehran, Iran; University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Saloni Kapoor
- All India Institute of Medical Sciences, Delhi, India
| | | | | | - Brenda Giagante
- Department of Neurosciences, El Cruce Hospital, Buenos Aires, Argentina
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