scholarly journals P.069 The predictive factors of electroencephalograms with epileptiform activity in psychiatric patients

2016 ◽  
Vol 43 (S2) ◽  
pp. S37-S37
Author(s):  
C Dash ◽  
BJ Mischuk ◽  
S Almubarak ◽  
F Moien-Afshari
Keyword(s):  
Predictive Factors ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Epileptiform Activity ◽  
Febrile Seizures ◽  
University Hospital ◽  
Brain Infection ◽  
Essentially Normal ◽  
Epileptiform Discharges ◽  
Abnormal Eegs

Background: Psychiatrists commonly use electroencephalogram (EEG) to rule out epilepsy as a cause of psychiatric symptoms. A large number of these studies are normal. Our study aims to identify the predictive factors of an EEG with epileptiform activity in these patients. Methods: We performed a retrospective study of the EEG results and chart reviews of the 208 psychiatric patients at Royal University Hospital in Saskatoon, Saskatchewan from 2013-2015. The EEG results were correlated with several factors known to increase the probability of an abnormal recording including history of seizures, previously abnormal EEGs, imaging abnormalities, medications known to cause epileptiform discharges, electroconvulsive therapy, prematurity, brain infection, childhood febrile seizures, head trauma, and family history. Results: Of the 208 EEGs performed, 176 (84%) were normal (77%) or essentially normal (7%). Epileptiform activity was found in 13 EEGs (6.3%), of which 9 (4.3%) had a previous EEG with epileptiform activity. Focal slowing appeared in 12 EEGs (5.8%), two of which had previous abnormal EEGs. Generalized slowing was found in 7 EEGs (3.4%). Conclusions: We conclude that the majority of EEGs in patients with psychiatric manifestations are normal. The most predictive factor for epileptiform activity in this population is a previous EEG with epileptiform discharges. Other predictive factors are under review.

scholarly journals Relationship of Anxiety and Depression with Respiratory Symptoms: Comparison between Depressed and Non-Depressed Smokers in Singapore

2019 ◽  
Vol 16 (1) ◽  
pp. 163 ◽  
Author(s):  
Cyrus SH Ho ◽  
Elysia LY Tan ◽  
Roger CM Ho ◽  
Marcus YL Chiu
Keyword(s):  
Smoking Cessation ◽  
Lung Disease ◽  
Multiple Regression ◽  
Respiratory Symptoms ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Anxiety Symptoms ◽  
University Hospital ◽  
Cross Sectional Survey ◽  
Cross Sectional

The rising prevalence of smokers in the community, specifically psychiatric patients, necessitates smoking cessation as an important strategy for reducing the harmful effects of tobacco. This study aims to compare the profiles of depressed and non-depressed smokers and evaluate how psychiatric symptoms influence respiratory symptoms. A cross-sectional survey was administered to 276 non-depressed adult smokers in the community and 69 adult smokers who had been formally diagnosed with depression in the outpatient clinic of a University Hospital in Singapore. Participants were administered questionnaires on smoking attitudes and perceptions, psychiatric symptoms, and respiratory symptoms. Correlations and multiple regression analyses were conducted. The mean age of smokers in the study was 35.32 ± 13.05 years. Smokers in the community and psychiatric samples were largely similar on all of the sociodemographic factors, except that fewer depressed people were employed (χ2 = 8.35, p < 0.01). Smokers with depression also reported more attempts to quit smoking (χ2 = 7.14, p < 0.05), higher mean depressive, anxiety, and stress symptom (DASS) scores (t = −10.04, p < 0.01), and endorsed more respiratory symptoms than smokers in the community (t = −2.40, p < 0.05). The DASS scores, number of cigarettes smoked daily, years of smoking, general perception of smokers getting heart disease, and presence of lung disease were positively and significantly correlated with respiratory symptoms. On multiple regression, only anxiety symptoms (β = 0.26, p < 0.05) and the presence of lung disease (β = 0.22, p < 0.001) were significantly correlated with respiratory symptoms. Depressed smokers reported greater difficulty in quitting tobacco use, and they perceived more severe respiratory symptoms compared to non-depressed counterparts. Anxiety symptoms were positively associated with the severity of respiratory symptoms. Smoking cessation campaigns need to specifically target psychological symptoms in smokers and focus more psychoeducation on the risk of cardiovascular disease in the middle-aged population.

scholarly journals Incidence of SUDEP in a cohort of patients with refractory epilepsy: the role of surgery and lesion localization

2010 ◽  
Vol 68 (6) ◽  
pp. 898-902 ◽  
Author(s):  
Andrea Garcia de Almeida ◽  
Magda Lahorgue Nunes ◽  
André Luis Fernandes Palmini ◽  
Jaderson Costa da Costa
Keyword(s):  
Refractory Epilepsy ◽  
Epileptiform Activity ◽  
University Hospital ◽  
Seizure Type ◽  
Mri Findings ◽  
Unexpected Death ◽  
Cross Sectional ◽  
Epileptiform Discharges ◽  
Significant Difference ◽  
Lesion Localization

OBJECTIVE: The aim of this study was to verify incidence and characteristics of sudden unexpected death in patients (SUDEP) with refractory epilepsy and its relation to previous surgery and lesion localization. METHOD: A cross sectional study was carried out in a cohort of 550 patients with refractory epilepsy followed up by the Epilepsy Surgery Program of the University Hospital of PUCRS, Porto Alegre, Brazil, between January, 1992 and July, 2002. Patients were allocated in two groups (operated and non operated). Seizure type, distribution of interictal spikes and MRI findings were correlated with the SUDEP outcome. RESULTS: The estimated incidence of probable SUDEP amounted to 29:1000 individuals. Probable SUDEP occurred in 1.2% of the 166 patients of the non operated group and in 3.7% of the 384 patients who were operated (OR=3.02, 95% CI 0.69-13.16) (p=0.11). Comparing patients who died to patients alive in the operated group a significant difference was observed concerning the following variables: SUDEP patients had a predominance of generalized seizures (p=0.002), extratemporal lesion on MRI (p<0.001) and epileptiform activity over extratemporal regions (p=0.001). CONCLUSION: In surgically treated patients with refractory epilepsy, an extratemporal location of the lesion and of the epileptiform discharges significantly correlated to SUDEP. Thus it is possible that in those patients; the underlying disease may play a role in the pathogenesis of SUDEP.

scholarly journals Succinic Semialdehyde Dehydrogenase Deficiency: Review of the Natural History Study

2021 ◽  
pp. 088307382098126
Author(s):  
Phillip L. Pearl ◽  
Melissa L. DiBacco ◽  
Christos Papadelis ◽  
Thomas Opladen ◽  
Ellen Hanson ◽  
...  
Keyword(s):  
Natural History ◽  
Psychiatric Symptoms ◽  
Epileptiform Activity ◽  
Laboratory Data ◽  
Standard Of Care ◽  
Succinic Semialdehyde ◽  
Succinic Semialdehyde Dehydrogenase ◽  
Natural History Study ◽  
Semialdehyde Dehydrogenase ◽  
Verbal Score

Objective: The SSADHD Natural History Study was initiated in 2019 to define the natural course and identify biomarkers correlating with severity. Methods: The study is conducted by 4 institutions: BCH (US clinical), WSU (bioanalytical core), USF (biostatistical core), and Heidelberg (iNTD), with support from the family advocacy group (SSADH Association). Recruitment goals were to study 20 patients on-site at BCH, 10 with iNTD, and 25 as a standard-of care cohort. Results: At this half-way point of this longitudinal study, 28 subjects have been recruited (57% female, mean 9 years, range 18 months–40 years). Epilepsy is present in half and increases in incidence and severity, as do psychiatric symptoms, in adolescence and adulthood. The average Full Scale IQ (FSIQ) was 53 (Verbal score of 56, Non Verbal score of 49), and half scored as having ASD. Although there was no correlation between gene variant and phenotypic severity, there were extreme cases of lowest functioning in one individual and highest in another that may have genotype-phenotype correlation. The most common EEG finding was mild background slowing with rare epileptiform activity, whereas high-density EEG and magnetoencephalography showed reduction in the gamma frequency band consistent with GABAergic dysfunction. MR spectroscopy showed elevations in the GABA/NAA ratio in all regions studied with no crossover between subjects and controls. Conclusions: The SSADH Natural History Study is providing a unique opportunity to study the complex pathophysiology longitudinally and derive electrophysiologic, neuroimaging, and laboratory data for correlation and to serve as biomarkers for clinical trials and prognostic assessments in this ultra-rare inherited disorder of GABA metabolism.

scholarly journals Induction of Tertiary Phase Epileptiform Discharges after Postasphyxial Infusion of a Toll-Like Receptor 7 Agonist in Preterm Fetal Sheep

2021 ◽  
Vol 22 (12) ◽  
pp. 6593
Author(s):  
Kenta H.T. Cho ◽  
Mhoyra Fraser ◽  
Bing Xu ◽  
Justin M. Dean ◽  
Alistair J. Gunn ◽  
...  
Keyword(s):  
Moderate Hypertension ◽  
Epileptiform Activity ◽  
Ischemic Brain Injury ◽  
Toll Like Receptor ◽  
Fetal Sheep ◽  
Ischemic Brain ◽  
Tlr Agonists ◽  
Epileptiform Discharges ◽  
Subcortical Regions ◽  
Total Burden

Background: Toll-like receptor (TLR) agonists are key immunomodulatory factors that can markedly ameliorate or exacerbate hypoxic–ischemic brain injury. We recently demonstrated that central infusion of the TLR7 agonist Gardiquimod (GDQ) following asphyxia was highly neuroprotective after 3 days but not 7 days of recovery. We hypothesize that this apparent transient neuroprotection is associated with modulation of seizure-genic processes and hemodynamic control. Methods: Fetuses received sham asphyxia or asphyxia induced by umbilical cord occlusion (20.9 ± 0.5 min) and were monitored continuously for 7 days. GDQ 3.34 mg or vehicle were infused intracerebroventricularly from 1 to 4 h after asphyxia. Results: GDQ infusion was associated with sustained moderate hypertension that resolved after 72 h recovery. Electrophysiologically, GDQ infusion was associated with reduced number and burden of postasphyxial seizures in the first 18 h of recovery (p < 0.05). Subsequently, GDQ was associated with induction of slow rhythmic epileptiform discharges (EDs) from 72 to 96 h of recovery (p < 0.05 vs asphyxia + vehicle). The total burden of EDs was associated with reduced numbers of neurons in the caudate nucleus (r2 = 0.61, p < 0.05) and CA1/2 hippocampal region (r2 = 0.66, p < 0.05). Conclusion: These data demonstrate that TLR7 activation by GDQ modulated blood pressure and suppressed seizures in the early phase of postasphyxial recovery, with subsequent prolonged induction of epileptiform activity. Speculatively, this may reflect delayed loss of early protection or contribute to differential neuronal survival in subcortical regions.

The Practice of Community Psychiatric Nursing and Mental Health Social Work in Salford Some Implications for Community Care

1988 ◽  
Vol 152 (6) ◽  
pp. 783-792 ◽  
Author(s):  
K. Wooff ◽  
D. P. Goldberg ◽  
T. Fryers
Keyword(s):  
Mental Health ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Psychiatric Nurses ◽  
Health Staff ◽  
Mental Health Staff ◽  
Term Care ◽  
Community Psychiatric ◽  
Wide Range

The context and content of work undertaken with individual clients by community psychiatric nurses (CPNs) and mental health social workers (MHSWs) in Salford were found to be significantly different. Although there were some areas of overlap, the ways in which the two professions worked were quite distinct. MHSWs discussed a wide range of topics and were as concerned with clients' interactions with family and community networks as they were with symptoms. Their interviews with schizophrenic clients followed a similar pattern to those with other groups, and they worked closely with psychiatrists and other mental health staff. CPNs, on the other hand, focused mainly on psychiatric symptoms, treatment arrangements, and medications, and spent significantly less time with individual psychotic clients than they did with patients suffering from neuroses. They were as likely to be in contact with general practitioners as they were with psychiatrists, and had fewer contacts with other mental health staff than the MHSWs. There was evidence that the long-term care of chronic psychiatric patients living outside hospital required more co-ordinated long-term multidisciplinary input.

Enhanced NMDAR-dependent epileptiform activity is controlled by oxidizing agents in a chronic model of temporal lobe epilepsy

1996 ◽  
Vol 76 (6) ◽  
pp. 4185-4189 ◽  
Author(s):  
J. C. Hirsch ◽  
O. Quesada ◽  
M. Esclapez ◽  
H. Gozlan ◽  
Y. Ben-Ari ◽  
...  
Keyword(s):  
Synaptic Transmission ◽  
Ex Vivo ◽  
Epileptiform Activity ◽  
Hippocampal Slices ◽  
Nmda Antagonist ◽  
Pyramidal Cells ◽  
Resting Membrane Potential ◽  
Postsynaptic Potentials ◽  
Epileptiform Discharges ◽  
Late Part

1. Graded N-methyl-D-aspartate receptor (NMDAR)-dependent epileptiform discharges were recorded from ex vivo hippocampal slices obtained from rats injected a week earlier with an intracerebroventricular dose of kainic acid. Intracellular recordings from pyramidal cells of the CA1 area showed that glutamate NMDAR actively participated in synaptic transmission, even at resting membrane potential. When NMDAR were pharmacologically isolated, graded burst discharges could still be evoked. 2. The oxidizing reagent 5,5'-dithiobis(2-nitrobenzoic acid) (DTNB, 200 microM, 15 min) suppressed the late part of the epileptiform burst that did not recover after wash but could be reinstated by the reducing agent tris (2-carboxyethyl) phosphine (TCEP, 200 microM, 15 min) and again abolished with the NMDA antagonist D-2-amino-5-phosphonovaleric acid (D-APV). 3. Pharmacologically isolated NMDAR-mediated responses were decreased by DTNB (56 +/- 10%, mean +/- SD, n = 6), an effect reversed by TCEP. 4. When only the fast glutamateric synaptic component was blocked, NMDA-dependent excitatory postsynaptic potentials (EPSPs) could be evoked despite the presence of underlying fast and slow inhibitory postsynaptic potentials (IPSPs). DTNB decreased EPSPs to 48 +/- 12% (n = 5) of control. 5. Since a decrease of the NMDAR-mediated response by +/- 50% is sufficient to suppress the late part of the burst, we suggest that epileptiform activity can be controlled by manipulation of the redox sites of NMDAR. Our observations raise the possibility of developing new anticonvulsant drugs that would spare alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid-R (AMPAR)-mediated synaptic responses and decrease NMDAR-mediated synaptic transmission without blocking it completely.

scholarly journals Epileptiform Discharges With In-Vivo-Like Features in Slices of Rat Piriform Cortex With Longitudinal Association Fibers

2001 ◽  
Vol 86 (5) ◽  
pp. 2445-2460 ◽  
Author(s):  
Rezan Demir ◽  
Lewis B. Haberly ◽  
Meyer B. Jackson
Keyword(s):  
Seizure Activity ◽  
Epileptiform Activity ◽  
Piriform Cortex ◽  
Brain Slices ◽  
Epileptiform Discharges ◽  
Local Circuitry ◽  
Association Fibers ◽  
Discharge Propagation

Brain slices serve as useful models for the investigation of epilepsy. However, the preparation of brain slices disrupts circuitry and severs axons, thus complicating efforts to relate epileptiform activity in vitro to seizure activity in vivo. This issue is relevant to studies in transverse slices of the piriform cortex (PC), the preparation of which disrupts extensive rostrocaudal fiber systems. In these slices, epileptiform discharges propagate slowly and in a wavelike manner, whereas such discharges in vivo propagate more rapidly and jump abruptly between layers. The objective of the present study was to identify fiber systems responsible for these differences. PC slices were prepared by cutting along three different nearly orthogonal planes (transverse, parasagittal, and longitudinal), and epileptiform discharges were imaged with a voltage-sensitive fluorescent dye. Interictal-like epileptiform activity was enabled by either a kindling-like induction process or disinhibition with bicuculline. The pattern of discharge onset was very similar in slices cut in different planes. As described previously in transverse PC slices, discharges were initiated in the endopiriform nucleus (En) and adjoining regions in a two-stage process, starting with low-amplitude “plateau activity” at one site and leading to an accelerating depolarization and discharge onset at another nearby site. The similar pattern of onset in slices of various orientations indicates that the local circuitry and neuronal properties in and around the En, rather than long-range fibers, assume dominant roles in the initiation of epileptiform activity. Subtle variations in the onset site indicate that interneurons can fine tune the site of discharge onset. In contrast to the mode of onset, discharge propagation showed striking variations. In longitudinal slices, where rostrocaudal association fibers are best preserved, discharge propagation resembled in vivo seizure activity in the following respects: propagation was as rapid as in vivo and about two to three times faster than in other slices; discharges jumped abruptly between the En and PC; and discharges had large amplitudes in superficial layers of the PC. Cuts in longitudinal slices that partially separated the PC from the En eliminated these unique features. These results help clarify why epileptiform activity differs between in vitro and in vivo experiments and suggest that rostrocaudal pyramidal cell association fibers play a major role in the propagation of discharges in the intact brain. The longitudinal PC slice, which best preserves these fibers, is ideally suited for the study their role.

scholarly journals Predictive Factors for Viral B and C Infection in Health Workers in a University Hospital in Ivory Cost

2018 ◽  
Vol 08 (10) ◽  
pp. 377-385
Author(s):  
Okon Anassi Jean-Baptiste ◽  
Koné Amadou ◽  
Diakité Mamadou ◽  
Aké Fabrice ◽  
Thot’o Amani Sroboua ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Health Workers ◽  
University Hospital

scholarly journals Predictors of Developing Hepatocellular Carcinoma in Treated HCV-Carriers in Morocco according to University Hospital Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Younès Cherradi ◽  
Rajaa Afifi ◽  
Hanaa Benbrahim ◽  
Wafaa Essamri ◽  
Imane Benelbarhdadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Predictive Factors ◽  
Antiviral Treatment ◽  
Significant Risk ◽  
University Hospital ◽  
Advanced Age ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
Severe Fibrosis

Introduction. Hepatitis C is the first major cause for HCC in Morocco. Antiviral treatment reduces the risk of developing HCC but few cases of HCC in HCV-treated patients were reported. We aimed to define this population’s features and to identify predictive factors of developing HCC. Patients and Methods. We included all HCV carriers who developed HCC after antiviral treatment from January 2002 to April 2010. We compare HCV-treated patients with no developed HCC to HCC population using khi-2 and Fisher Exact analysis. Results. 369 HVC-treated patients were considered, and 20 HCC were reported. The risk of HCC was not significant according to gender and genotypes (resp., P=0.63 and P=0.87). Advanced age and severe fibrosis were significant risk factors (resp., P=0.003 and P=0.0001). HCC was reported in 2.6% of sustained virological responders versus 12.5% of nonresponders (P=0.004). Conclusion. In our series, 5% of previously treated patients developed an HCC. Advanced age and severe fibrosis at HCV diagnosis are predictive factors of HCC occurrence. Sustained virological response reduces considerably the risk of HCC occurrence but screening is indicated even after SVR.

Spontaneous interictal-like activity originates in multiple areas of the CA2-CA3 region of hippocampal slices

1994 ◽  
Vol 71 (4) ◽  
pp. 1574-1585 ◽  
Author(s):  
L. V. Colom ◽  
P. Saggau
Keyword(s):  
Guinea Pig ◽  
Epileptiform Activity ◽  
Hippocampal Slices ◽  
Optical Recording ◽  
Objective Lens ◽  
Gamma Aminobutyric Acid ◽  
Subsequent Increase ◽  
Epileptiform Discharges ◽  
High K ◽  
Ca3 Region

1. The sites of origin of spontaneous interictal-like epileptiform activity in hippocampal slices from guinea pig, mouse, and rat were determined. A multisite fast optical recording technique using voltage-sensitive dyes and an array of 100 photodiodes was employed. The use of a low-magnification objective lens allowed the visualization of almost the entire transverse hippocampal slice. Three in vitro models of epilepsy were employed, utilizing different manipulations of the bath perfusion medium to induce epileptiform activity: 1) raising the external potassium (K+) concentration, 2) adding the potassium channel blocker 4-aminopyridine (4-AP), and 3) adding antagonists of gamma-aminobutyric acid-A (GABAA) receptors (bicuculline and picrotoxin, BIC-PTX). 2. Spontaneous epileptiform discharges were detected in each subfield of cornu ammonis (CA) but not in the dentate gyrus (DG) of each studied species. Preliminary experiments confirmed that interictal-like epileptiform activity originated in the CA2-CA3 region. Ictal-like activity was never observed in our experiments. 3. In the guinea pig, when GABAA antagonists were employed, the site of origin of spontaneous epileptiform discharges was consistently located in the CA2-CA3a region. When high K+ or 4-AP was used, this region was the most frequent site of origin. Subsequent epileptiform discharges with similar sites of origin occasionally invaded different areas of the CA2-CA3 region, revealing a variable area of occupance of epileptiform discharges. 4. In the mouse and rat, the site of origin of spontaneous discharges was invariably located in the CA3b-CA3c region independent of the epilepsy model. 5. In both the guinea pig and rat, when the CA2-CA3a region was surgically separated from the CA3b-CA3c region, independent discharges were observed in both regions. Areas that could generate discharges only under certain epileptogenic conditions were found in these species (potential sites of origin). Two independent sites of origin with different propagation patterns and area of occupance were occasionally observed within the CA2-CA3a region. 6. In the guinea pig, such lesions demonstrated that both regions can independently generate epileptiform discharges at different frequencies. When high K+ or 4-AP was employed, epileptiform activity was observed in both regions. Although BIC-PTX only generated discharges in the CA2-CA3a region, a subsequent increase in K+ induced additional discharges in the CA3b-CA3c region, revealing a potential site of origin. 7. In rat hippocampal slices with such lesions, spontaneous epileptiform discharges were observed in both CA2-CA3a and CA3b-CA3c region when 4-AP was employed.(ABSTRACT TRUNCATED AT 400 WORDS)

Sign in / Sign up

Export Citation Format

Share Document