scholarly journals Bilateral anterior capsulotomy enhances medication compliance in patients with epilepsy and psychiatric comorbidities

Author(s):  
Peng Huang ◽  
Deng Zheng‐Dao ◽  
Bo‐Min Sun ◽  
Yi‐Xin Pan ◽  
Jing Zhang ◽  
...  
2020 ◽  
pp. 10.1212/CPJ.0000000000000874 ◽  
Author(s):  
Marco Mula ◽  
Andres M Kanner ◽  
Nathalie Jette ◽  
Josemir W. Sander

ABSTRACTPurposeof review: To review the latest evidence concerning the epidemiology, clinical implications and management of psychiatric disorders in epilepsy.Recent findings:People with epilepsy have a 2 to 5 times increased risk of developing any psychiatric disorder and 1 in 3 patients with epilepsy have a lifetime psychiatric diagnosis. Psychiatric comorbidities represent a poor prognostic marker as they have been associated with a poor response to treatment (drugs and surgery), increased morbidity and mortality. Validated screening instruments are available for mood and anxiety disorders in adults as well as attention deficit hyperactivity disorder in children with epilepsy.Summary:All patients with epilepsy should be routinely screened for psychiatric disorder at the onset and at least once a year. Patients with epilepsy and their relatives should be informed of the risk of mental health problems and the implications.


Author(s):  
Saurabh Jaiswal ◽  
Santosh Kumar

ABSTRACT Introduction People with epilepsy are more likely than the general population to have comorbid psychiatric disorders that include anxiety, depression, and interictal and chronic psychoses. Even though psychiatric comorbidity is common in epilepsy, it is underrecognized and undertreated, both in specialty epilepsy centers and also in community-based services. A thorough assessment of this was sought in this study among the patients of Rohilkhand region of Uttar Pradesh (India). Materials and methods A total of 100 patients with epilepsy who visited the psychiatry outpatient clinic were recruited for this study. They were assessed in detail for the presence of comorbid psychiatric disorders on Axis 1 with the help of Structured Clinical Interview for Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders. Results Overall, it was found that a comorbidity of psychiatric disorders was present in 45% of patients with epilepsy. The frequency of cooccurrence of different types of psychiatric disorders was as follows: Mood disorders 21%, anxiety disorders 14%, and psychotic disorders 28%. Conclusion Psychiatric comorbidities were found to be a common problem in patients with epilepsy. The results of this study are in line with many different research works both in India and abroad. A proper address of this issue is important for management, better outcome, and policy making in patients with epilepsy. How to cite this article Jaiswal S, Kumar S, Sharma CS, Kuchhal A, Jaiswal A. Psychiatric Comorbidities in Patients with Epilepsy: A Cross-sectional Study. Int J Adv Integ Med Sci 2017;2(1):24-28.


2021 ◽  
Vol 15 ◽  
Author(s):  
Irena Balzekas ◽  
Vladimir Sladky ◽  
Petr Nejedly ◽  
Benjamin H. Brinkmann ◽  
Daniel Crepeau ◽  
...  

Intracranial electroencephalographic (iEEG) recordings from patients with epilepsy provide distinct opportunities and novel data for the study of co-occurring psychiatric disorders. Comorbid psychiatric disorders are very common in drug-resistant epilepsy and their added complexity warrants careful consideration. In this review, we first discuss psychiatric comorbidities and symptoms in patients with epilepsy. We describe how epilepsy can potentially impact patient presentation and how these factors can be addressed in the experimental designs of studies focused on the electrophysiologic correlates of mood. Second, we review emerging technologies to integrate long-term iEEG recording with dense behavioral tracking in naturalistic environments. Third, we explore questions on how best to address the intersection between epilepsy and psychiatric comorbidities. Advances in ambulatory iEEG and long-term behavioral monitoring technologies will be instrumental in studying the intersection of seizures, epilepsy, psychiatric comorbidities, and their underlying circuitry.


2019 ◽  
Vol 98 ◽  
pp. 302-305 ◽  
Author(s):  
Maria R. Lopez ◽  
Steven C. Schachter ◽  
Andres M. Kanner

2020 ◽  
Vol 102 ◽  
pp. 106649 ◽  
Author(s):  
Caroline Abe ◽  
David Denney ◽  
Alexander Doyle ◽  
Munro Cullum ◽  
Jessica Adams ◽  
...  

2020 ◽  
pp. 1-10
Author(s):  
Wenying Xu ◽  
Xiaoxiao Zhang ◽  
Yuhan Wang ◽  
Hengfen Gong ◽  
Yiwen Wu ◽  
...  

<b><i>Introduction:</i></b> Globus pallidus internus (GPi) deep brain stimulation (DBS) combined with anterior capsulotomy offers a promising treatment option for severe medication-refractory cases of Tourette’s syndrome (TS) with psychiatric comorbidities. Several patients treated with this combined surgery experienced sustained relief after discontinuation of stimulation over the course of treatment. <b><i>Methods:</i></b> Retrospectively, the medical records and clinical outcomes were reviewed of 8 patients (6 men; 2 women with mean age of 20.3 years) who had undergone bilateral GPi-DBS combined with anterior capsulotomy for medically intractable TS and psychiatric comorbidities. All patients had experienced an accidental interruption or intentional withdrawal of pallidal stimulation during treatment. <b><i>Results:</i></b> The widespread clinical benefits achieved during the combined treatment were fully maintained after intentional or accidental DBS discontinuation. The improvement in overall tic symptoms achieved was on average 78% at the follow-up or close to the DBS discontinuation, while it was 83% at last follow-up (LFU). At LFU, most patients had functionally recovered; exhibited only mild tics; displayed minor or no obsessive-compulsive disorder symptoms, anxiety, or depression; and experienced a much better quality of life. <b><i>Conclusion:</i></b> Bilateral GPi-DBS combined with anterior capsulotomy appears to result in marked and sustained improvements in TS symptoms and psychiatric comorbidities, which are fully maintained over time, even without pallidal stimulation.


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