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Mountain A, Patrice Lindsay M, Teasell R, Salbach NM, de Jong A, Foley N, Bhogal S, Bains N, Bowes R, Cheung D, Corriveau H, Joseph L, Lesko D, Millar A, Parappilly B, Pikula A, Scarfone D, Rochette A, Taylor T, Vallentin T, Dowlatshahi D, Gubitz G, Casaubon LK, Cameron JI. Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Community Participation following Stroke. Part Two: Transitions and Community Participation Following Stroke. Int J Stroke 2020; 15:789-806. [DOI: 10.1177/1747493019897847] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The sixth update of the Canadian Stroke Best Practice Recommendations for Transitions and Community Participation following Stroke is a comprehensive set of evidence-based guidelines addressing issues faced by people following an acute stroke event. Establishing a coordinated and seamless system of care that supports progress achieved during the initial recovery stages throughout the transition to the community is more essential than ever as the medical complexity of people with stroke is also on the rise. All members of the health-care team engaged with people with stroke, their families, and caregivers are responsible for partnerships and collaborations to ensure successful transitions and return to the community following stroke. These guidelines reinforce the growing and changing body of research evidence available to guide ongoing screening, assessment, and management of individuals following stroke as they move from one phase and stage of care to the next without “falling through the cracks.” It also recognizes the growing role of family and informal caregivers in providing significant hours of support that disrupt their own lives and responsibilities and addresses their support and educational needs. According to Statistics Canada, in 2012, eight million Canadians provided care to family members or friends with a long-term health condition, disability, or problems associated with aging. These recommendations incorporate aspects that were previously in the rehabilitation module for the purposes of streamlining, and both modules should be reviewed in order to provide comprehensive care addressing recovery and community reintegration and participation. These recommendations cover topics related to support and education of people with stroke, families, and caregivers during transitions and community reintegration. They include interprofessional planning and communication, return to driving, vocational roles, leisure activities and relationships and sexuality, and transition to long-term care.
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Affiliation(s)
- Anita Mountain
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada
- Nova Scotia Rehabilitation Centre Site, Queen Elizabeth II Health Sciences Centre, Halifax, Canada
| | | | - Robert Teasell
- Western University, London, Canada
- Stroke Rehabilitation Program, Parkwood Hospital, London, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, University of Toronto, Canada
| | | | | | | | - Naresh Bains
- Department of Neurosciences, University of Alberta Hospital, Edmonton, Canada
| | - Rebecca Bowes
- ICAN Independence Centre and Network, Sudbury, Canada
| | - Donna Cheung
- South East Toronto Stroke Network, Toronto, Canada
| | - Helene Corriveau
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
| | | | - Dana Lesko
- West GTA Stroke Network, Trillium Health Partners, Mississauga, Canada
| | | | | | | | | | - Annie Rochette
- School of Rehabilitation, University of Montreal, Montreal, Canada
| | - Trudy Taylor
- Carewest Dr. Vernon Fanning Centre, Calgary, Canada
| | - Tina Vallentin
- Stroke Program, Hamilton Health Sciences, Hamilton, Canada
| | | | - Gord Gubitz
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada
- Stroke Program, Queen Elizabeth II Health Sciences Centre, Halifax, Canada
| | - Leanne K Casaubon
- Toronto Western Hospital, University Health Network, Toronto, Canada
| | - Jill I Cameron
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
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Philippsen T, Orini M, Martin C, Volkova E, Ormerod J, Sohaib S, Elamin N, Blake S, Sawhney V, Ahmad S, Waring O, Bowers R, Raiman L, Hazelwood T, Mills R, Corrado C, Honarbakhsh S, Von Maydell A, Norrish G, Chubb H, Chubb H, Chubb H, Toledano M, Ruiz A, van Zalen J, Foley P, Pearman C, Rehal O, Foley P, Wong L, Foley P, Pearman C, Brahmbhatt D, Khan H, Wardley J, Akbar S, Christensen L, Hansen M, Brandes A, Tinker A, Munroe P, Lambiase P, Honarbakhsh S, McLean A, Lambiase P, Schilling R, Lane J, Chow A, Earley M, Hunter R, Khan F, Lambiase P, Schilling R, Sporton S, Dhinoja M, Camm C, Xavier R, de Sousa M, Betts T, Shun-Shin M, Wright I, Lim E, Lim P, Koawing M, Lefroy D, Linton N, Davies D, Peters N, Kanagaratnam P, Francis D, Whinnett Z, Khan M, Bowes R, Sahu J, Sheridan P, Rogers D, Kyriacou A, Kelland N, Lewis N, Lee J, Segall E, Diab I, Breitenstein A, Ullah W, Sporton S, Earley M, Finlay M, Dhinoja M, Schilling R, Hunter R, Ahmed M, Petkar S, Davidson N, Stout M, Pearce KP, Leo M, Ginks M, Rajappan K, Bashir Y, Balasubramaniam R, Sopher S, Betts T, Paisey J, Cheong J, Roy D, Adhya S, Williams S, O'Neill M, Niederer S, Providencia R, Srinivasan N, Ahsan S, Lowe M, Segal O, Hunter R, Finlay M, Earley M, Schilling R, Lambiase P, Stella S, Cantwell C, Chowdhury R, Kim S, Linton N, Whinnett Z, Koa-Wing M, Lefroy D, Davies DW, Kanagaratnam P, Lim PB, Qureshi N, Peters N, Cantarutti N, Limongelli G, Elliott P, Kaski J, Williams S, Lal K, Harrison J, Whitaker J, Kiedrowicz R, Wright M, O'Neill M, Harrison J, Whitaker J, Williams S, Wright M, Schaeffter T, Razavi R, O'Neill M, Karim R, Williams S, Harrison J, Whitaker J, Wright M, Schaeffter T, Razavi R, O'Neill M, Montanes M, Ella Field E, Walsh H, Callaghan N, Till J, Mangat J, Lowe M, Kaski J, Ruiz Duthil A, Li A, Saba M, Patel N, Beale L, Brickley G, Lloyd G, French A, Khavandi A, McCrea W, Barnes E, Chandrasekaran B, Parry J, Garth L, Chapman J, Todd D, Hobbs J, Modi S, Waktare J, Hall M, Gupta D, Snowdon R, Papageorgiou N, Providência R, Falconer D, Sewart E, Ahsan S, Segal O, Ezzat V, Rowland E, Lowe M, Lambiase P, Chow A, Swift M, Charlton P, James J, Colling A, Barnes E, Starling L, Kontogeorgis A, Roses-Noguer F, Wong T, Jarman J, Clague J, Till J, Colling A, James J, Hawkins M, Burnell S, Chandrasekaran B, Coulson J, Smith L, Choudhury M, Oguguo E, Boyett M, Morris G, Flinn W, Chari A, Belham M, Pugh P, Somarakis K, Parasa R, Allata A, Hashim H, Mathew T, Kayasundar S, Venables P, Quinn J, Ivanova J, Brown S, Oliver R, Lyons M, Chuen M, Walsh J, Robinson T, Staniforth A, Ahsan A, Jamil-Copley S. POSTERS (2)96CONTINUOUS VERSUS INTERMITTENT MONITORING FOR DETECTION OF SUBCLINICAL ATRIAL FIBRILLATION IN HIGH-RISK PATIENTS97HIGH DAY-TO-DAY INTRA-INDIVIDUAL REPRODUCIBILITY OF THE HEART RATE RESPONSE TO EXERCISE IN THE UK BIOBANK DATA98USE OF NOVEL GLOBAL ULTRASOUND IMAGING AND CONTINUEOUS DIPOLE DENSITY MAPPING TO GUIDE ABLATION IN MACRO-REENTRANT TACHYCARDIAS99ANTICOAGULATION AND THE RISK OF COMPLICATIONS IN PATIENTS UNDERGOING VT AND PVC ABLATION100NON-SUSTAINED VENTRICULAR TACHYCARDIA FREQUENTLY PRECEDES CARDIAC ARREST IN PATIENTS WITH BRUGADA SYNDROME101USING HIGH PRECISION HAEMODYNAMIC MEASUREMENTS TO ASSESS DIFFERENCES IN AV OPTIMUM BETWEEN DIFFERENT LEFT VENTRICULAR LEAD POSITIONS IN BIVENTRICULAR PACING102CAN WE PREDICT MEDIUM TERM MORTALITY FROM TRANSVENOUS LEAD EXTRACTION PRE-OPERATIVELY?103PREVENTION OF UNECESSARY ADMISSIONS IN ATRIAL FIBRILLATION104EPICARDIAL CATHETER ABLATION FOR VENTRICULAR TACHYCARDIA ON UNINTERRUPTED WARFARIN: A SAFE APPROACH?105HOW WELL DOES THE NATIONAL INSTITUTE OF CLINICAL EXCELLENCE (NICE) GUIDENCE ON TRANSIENT LOSS OF CONSCIOUSNESS (T-LoC) WORK IN A REAL WORLD? AN AUDIT OF THE SECOND STAGE SPECIALIST CARDIOVASCULAT ASSESSMENT AND DIAGNOSIS106DETECTION OF ATRIAL FIBRILLATION IN COMMUNITY LOCATIONS USING NOVEL TECHNOLOGY'S AS A METHOD OF STROKE PREVENTION IN THE OVER 65'S ASYMPTOMATIC POPULATION - SHOULD IT BECOME STANDARD PRACTISE?107HIGH-DOSE ISOPRENALINE INFUSION AS A METHOD OF INDUCTION OF ATRIAL FIBRILLATION: A MULTI-CENTRE, PLACEBO CONTROLLED CLINICAL TRIAL IN PATIENTS WITH VARYING ARRHYTHMIC RISK108PACEMAKER COMPLICATIONS IN A DISTRICT GENERAL HOSPITAL109CARDIAC RESYNCHRONISATION THERAPY: A TRADE-OFF BETWEEN LEFT VENTRICULAR VOLTAGE OUTPUT AND EJECTION FRACTION?110RAPID DETERIORATION IN LEFT VENTRICULAR FUNCTION AND ACUTE HEART FAILURE AFTER DUAL CHAMBER PACEMAKER INSERTION WITH RESOLUTION FOLLOWING BIVENTRICULAR PACING111LOCALLY PERSONALISED ATRIAL ELECTROPHYSIOLOGY MODELS FROM PENTARAY CATHETER MEASUREMENTS112EVALUATION OF SUBCUTANEOUS ICD VERSUS TRANSVENOUS ICD- A PROPENSITY MATCHED COST-EFFICACY ANALYSIS OF COMPLICATIONS & OUTCOMES113LOCALISING DRIVERS USING ORGANISATIONAL INDEX IN CONTACT MAPPING OF HUMAN PERSISTENT ATRIAL FIBRILLATION114RISK FACTORS FOR SUDDEN CARDIAC DEATH IN PAEDIATRIC HYPERTROPHIC CARDIOMYOPATHY: A SYSTEMATIC REVIEW AND META-ANALYSIS115EFFECT OF CATHETER STABILITY AND CONTACT FORCE ON VISITAG DENSITY DURING PULMONARY VEIN ISOLATION116HEPATIC CAPSULE ENHANCEMENT IS COMMONLY SEEN DURING MR-GUIDED ABLATION OF ATRIAL FLUTTER: A MECHANISTIC INSIGHT INTO PROCEDURAL PAIN117DOES HIGHER CONTACT FORCE IMPAIR LESION FORMATION AT THE CAVOTRICUSPID ISTHMUS? INSIGHTS FROM MR-GUIDED ABLATION OF ATRIAL FLUTTER118CLINICAL CHARACTERISATION OF A MALIGNANT SCN5A MUTATION IN CHILDHOOD119RADIOFREQUENCY ASSOCIATED VENTRICULAR FIBRILLATION120CONTRACTILE RESERVE EXPRESSED AS SYSTOLIC VELOCITY DOES NOT PREDICT RESPONSE TO CRT121DAY-CASE DEVICES - A RETROSPECTIVE STUDY USING PATIENT CODING DATA122PATIENTS UNDERGOING SVT ABLATION HAVE A HIGH INCIDENCE OF SECONDARY ARRHYTHMIA ON FOLLOW UP: IMPLICATIONS FOR PRE-PROCEDURE COUNSELLING123PROGNOSTIC ROLE OF HAEMOGLOBINN AND RED BLOOD CELL DITRIBUTION WIDTH IN PATIENTS WITH HEART FAILURE UNDERGOING CARDIAC RESYNCHRONIZATION THERAPY124REMOTE MONITORING AND FOLLOW UP DEVICES125A 20-YEAR, SINGLE-CENTRE EXPERIENCE OF IMPLANTABLE CARDIOVERTER DEFIBRILLATORS (ICD) IN CHILDREN: TIME TO CONSIDER THE SUBCUTANEOUS ICD?126EXPERIENCE OF MAGNETIC REASONANCE IMAGING (MEI) IN PATIENTS WITH MRI CONDITIONAL DEVICES127THE SINUS BRADYCARDIA SEEN IN ATHLETES IS NOT CAUSED BY ENHANCED VAGAL TONE BUT INSTEAD REFLECTS INTRINSIC CHANGES IN THE SINUS NODE REVEALED BY
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(F) BLOCKADE128SUCCESSFUL DAY-CASE PACEMAKER IMPLANTATION - AN EIGHT YEAR SINGLE-CENTRE EXPERIENCE129LEFT VENTRICULAR INDEX MASS ASSOCIATED WITH ESC HYPERTROPHIC CARDIOMYOPATHY RISK SCORE IN PATIENTS WITH ICDs: A TERTIARY CENTRE HCM REGISTRY130A DGH EXPERIENCE OF DAY-CASE CARDIAC PACEMAKER IMPLANTATION131IS PRE-PROCEDURAL FASTING A NECESSITY FOR SAFE PACEMAKER IMPLANTATION? Europace 2016. [DOI: 10.1093/europace/euw274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
An evaluation of domestic assaultive ( n = 46), general assaultive ( n = 23) and nonassaultive (19 property offenders) groups was performed to compare cognitive (Test of Nonverbal Intelligence), personality (Minnesota Multiphasic Personality Inventory), aggression (Buss-Durkee Hostility Inventory), and criminal sentiments (Carlson Psychological Survey). Analysis showed minimal significant differences amongst the groups. A significant difference was found for the Verbal Hostility subscale of the Buss-Durkee Hostility Inventory. The domestic assaultive offenders were similar to the general assaultive and nonviolent offenders, with a greater disparity for the control group. Furthermore, a significant difference was noted for the Hypochondriasis scale of the Minnesota Multiphasic Personality Inventory. The general assaultive and control ( n = 15) groups had similar scores, with the greatest difference found for nonviolent offenders who were least anxious. Discriminant analysis showed group membership could be identified for 89.1% of the domestic assaultive group.
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Affiliation(s)
- Paul M Valliant
- Department of Psychology, Laurentian University, Sudbury, ON, Canada
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Barr CJ, Patritti BL, Bowes R, Crotty M, McLoughlin JV. Orthotic and therapeutic effect of functional electrical stimulation on fatigue induced gait patterns in people with multiple sclerosis. Disabil Rehabil Assist Technol 2016; 12:560-572. [PMID: 28612678 DOI: 10.3109/17483107.2015.1136702] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess the orthotic and therapeutic effects of prolonged use of functional electrical stimulation (FES) on fatigue induced gait patterns in people with Multiple Sclerosis (MS). METHOD Thirteen people with MS completed 3D gait analysis with FES off and on, before and after a fatiguing 6-minute walk, at baseline and after 8 weeks of use of FES. RESULTS Eleven participants completed all testing. An orthotic effect on gait was not evident on first use of FES. However, therapeutic effects on gait after 8 weeks use were generally positive, including increases in walking speed due to improved neuromuscular control and power generated at the hip and ankle of the more affected limb. The action of FES alone was not sufficient to overcome all fatigue related deficits in gait but there was evidence 8 weeks use of FES can ameliorate some fatigue effects on lower limb kinetics, including benefits to ankle mechanics involved in generating power around push-off during stance. CONCLUSIONS Eight-weeks of FES can benefit the gait pattern of people with MS under non-fatigued and fatigued conditions. Implications for rehabilitation In some people with MS prolonged use of FES may be necessary before observing positive orthotic effects. Improvements in the neuromuscular control of the more affected lower limb may develop with prolonged use of FES in people with MS. Only some therapeutic benefits of FES are maintained during fatigued walking in people with MS. FES may be considered as a gait retraining device as well as an orthotic intervention for people with MS.
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Affiliation(s)
- Christopher J Barr
- a Department of Rehabilitation Aged and Extended Care, School of Health Sciences , Flinders University , Bedford Park , South Australia , Australia
| | | | - Rebecca Bowes
- b Repatriation General Hospital , Daw Park , South Australia , Australia
| | - Maria Crotty
- a Department of Rehabilitation Aged and Extended Care, School of Health Sciences , Flinders University , Bedford Park , South Australia , Australia.,b Repatriation General Hospital , Daw Park , South Australia , Australia
| | - James V McLoughlin
- a Department of Rehabilitation Aged and Extended Care, School of Health Sciences , Flinders University , Bedford Park , South Australia , Australia
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Robinson T, Oliver J, Sheridan P, Sahu J, Bowes R. Fragmentation and embolization of pacemaker leads as a complication of lead extraction. Europace 2010; 12:754-5. [DOI: 10.1093/europace/euq001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Treguer F, Mabo P, Tassin A, Prunier F, Furber A, Daubert JC, Solnon A, Dupuis JM, Jarverud K, Broome M, Noren K, Svensson T, Hjelm S, Bjorling A, Val-Mejias JE, Doshi S, Kroll M, Oza A, Shah S, Doshi SK, Val-Mejias JE, Pittaro M, Reeves R, Payne J, Kroll M, Graumann R, Oza A, Maury P, Raczka F, Pasquie JL, Beck L, Taieb J, Qu F, Shah R, Hallier B, Gutleben K, Brachmann J, Vogt J, Boriani G, Bowes R, Casset C, Krumel F, Johansson I, Blixt F, Andersson F, Stromberg A, Perzanowski C, Irnich W, Larsen P, Lever N, Wasniewski M, Mitkowski P, Baszko A, Ochotny R, Grajek S, Deering TF, Golman DS, Epstein A, Greenberg S, Gupta M, Lee K, Hero M, Magne I, Souques M, Moro E, Marcon C, Allocca G, Marras E, Sitta N, Da Soghe M, Varbaro A, Delise P, Chiladakis I, Kalogeropoulos A, Koutogiannis N, Arvanitis P, Zagli F, Nikokiris G, Alexopoulos D, Szydlo K, Wita K, Trusz-Gluza M, Tabor Z, Anichkov D, Shostak N, Platonova A, Polovina M, Potpara T, Grujic M, Mujovic N, Carmo P, Adragao P, Cavaco D, Parreira L, Santos K, Morgado F, Marcelino S, Silva A, Rumeau P, Maury P, Duparc A, Hebrard A, Mondoly P, Rollin A, Delay M, Mizutani N, Yonemoto T, Fukuta M, Ito T, Herrera Siklody C, Blum T, Schiebeling-Roemer J, Restle C, Weber R, Stockinger J, Kalusche D, Arentz T, Fouche R, Fromentin S, Lassabe G, Sager C. Poster Session 2: Sudden death and ICD: technical aspects. Europace 2009. [DOI: 10.1093/europace/euq217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mletzko R, Anselme F, Bowes R, Mabo P, Schoels W, Seidl K, Schwab J, Iscolo N, Sadoul N. 472 Incidence of inappropriate therapies in dual-chamber ICDs. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/eupace/7.supplement_1.111-b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- R. Mletzko
- Herz Kreislauf Klinik, Cardiology, Bad-Bevensen, Germany
| | - F. Anselme
- University hospital, Cardiology, Rouen, France
| | - R. Bowes
- Northern General Hospital, Cardiology, Sheffield, United Kingdom
| | - P. Mabo
- University hospital, Cardiology, Rennes, France
| | - W. Schoels
- University Hospital, Cardiology, Heidelberg, Germany
| | - K.H. Seidl
- University Hospital, Cardiology, Ludwigshafen, Germany
| | - J. Schwab
- University Hospital, Cardiology, Bonn, Germany
| | - N. Iscolo
- Sorin France, Le Plessis-Robinson, France
| | - N. Sadoul
- University Hospital, Cardilology, Nancy, France
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Schaeffer P, Mletzko R, Bowes R, Anselme F, Schoels W, Luise R, Davy JM, Kamouche N. P-159 First clinical experience with an ICD providing cardiac resynchronization therapy. Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b104-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - R. Mletzko
- Herz-Kreislauf-Klinik
,
Bad-Bevensen, Germany
| | - R. Bowes
- Northern General Hospital
,
Sheffield, UK
| | | | | | - R. Luise
- Villa Pini D Abruzzo
,
Chieti, Italy
| | - J.-M. Davy
- Montpellier University Hospital
,
France
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Abstract
BACKGROUND Previous reports have documented the coexistence of obstructive sleep apnea (OSA) and epilepsy and the therapeutic effects of treatment on seizure frequency and daytime sleepiness. The authors' objective was to determine the prevalence of OSA and its association with survey items in a group of patients with medically refractory epilepsy undergoing polysomnography (PSG). METHODS Thirty-nine candidates for epilepsy surgery without a history of OSA underwent PSG as part of a research protocol examining the relationship of interictal epileptiform discharges to sleep state. Subjects also completed questionnaires about their sleep, including validated measures of sleep-related breathing disorders (Sleep Apnea Scale of the Sleep Disorders Questionnaire [SA/SDQ]) and subjective daytime sleepiness (Epworth Sleepiness Scale [ESS]). RESULTS One-third of subjects had OSA, defined by a respiratory disturbance index (RDI) > or = 5. Five subjects (13%) had moderate to severe OSA (RDI > 20). Subjects with OSA were more likely to be older, male, have a higher SA/SDQ score, and more likely to have seizures during sleep than those without OSA (p < 0.05). Seizure frequency per month, the number or type of antiepileptic drugs (AED) prescribed, the localization of seizures (temporal versus extratemporal), and the ESS were not statistically different between the two groups. CONCLUSIONS In our sample, previously undiagnosed obstructive sleep apnea was common, especially among men, older subjects, and those with seizures during sleep. The impact of treating OSA on seizure frequency and daytime sleepiness in medically refractory epilepsy patients warrants further controlled study.
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Affiliation(s)
- B A Malow
- Department of Neurology, University of Michigan Medical School, Ann Arbor, USA.
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Abstract
A 65-year-old man with paroxysmal atrial flutter was treated with digoxin and flecainide. The atrial flutter rate was slowed to 190 beats per minute but at times 1:1 AV conduction occurred.
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Affiliation(s)
- A Ahsan
- Department of Cardiology, Northern General Hospital, Sheffield, UK
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