Late onset epileptic seizures A retrospective study of 250 patients

Individuals with Down syndrome (DS) have an increased risk for epilepsy during the whole lifespan, but especially after age 40 years. The increase in the number of individuals with DS living into late middle age due to improved health care is resulting in an increase in epilepsy prevalence in this population. However, these epileptic seizures are probably underdiagnosed and inadequately treated. This late onset epilepsy is linked to the development of symptomatic Alzheimer’s disease (AD), which is the main comorbidity in adults with DS with a cumulative incidence of more than 90% of adults by the seventh decade. More than 50% of patients with DS and AD dementia will most likely develop epilepsy, which in this context has a specific clinical presentation in the form of generalized myoclonic epilepsy. This epilepsy, named late onset myoclonic epilepsy (LOMEDS) affects the quality of life, might be associated with worse cognitive and functional outcomes in patients with AD dementia and has an impact on mortality. This review aims to summarize the current knowledge about the clinical and electrophysiological characteristics, diagnosis and treatment of epileptic seizures in the DS population, with a special emphasis on LOMEDS. Raised awareness and a better understanding of epilepsy in DS from families, caregivers and clinicians could enable earlier diagnoses and better treatments for individuals with DS.

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Breastfeeding initiation among women with preeclampsia with and without severe features

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-200508 ◽

2020 ◽

pp. 1-8

Author(s):

L. Cordero ◽

M.R. Stenger ◽

M.B. Landon ◽

C.A. Nankervis

Keyword(s):

Retrospective Study ◽

Breast Milk ◽

Hospital Stay ◽

Late Onset ◽

Preterm Births ◽

Severity Of Illness ◽

Premature Delivery ◽

Breastfeeding Initiation ◽

Expressed Breast Milk ◽

Timely Delivery

BACKGROUND: Timely delivery and magnesium sulfate (MgSO4) are mainstay in the treatment of preeclampsia with severe features (PWSF). Premature delivery, severity of illness and mother-infant separation may increase the risk for breastfeeding (BF) initiation failure. OBJECTIVE: To compare BF initiation among women with late-onset PWSF for women with late-onset preeclampsia without severe features (WOSF). METHODS: Retrospective study of 158 women with PWSF and 104 with WOSF who delivered at ≥34 weeks. Intention to BF, formula feed (FF) or partially BF was declared prenatally. At discharge, exclusive BF included direct BF or direct BF with expressed breast milk (EBM). RESULTS: PWSF and WOSF groups were similar in age, race, and obstetric history. PWSF and WSOF differed in primiparity (65 & 51%), late preterm births (73 vs 15%), admission to NICU (44 &17%) and mother (5 & 4d) and infant (6 & 3d) hospital stay. Both groups were similar in intention to BF (80 & 84%), to FF (16 & 13%) and to partially BF (5 & 5%). At discharge, exclusive BF (37 & 39%), partial BF (33 & 31%) and FF (30 & 30%) were similar. Exclusive BF in the PWSF group was 43% direct BF, 28% direct BF and EBM and 29% EBM alone whereas in the WOSF group exclusive BF was 93% direct BF and 7% direct BF and EBM. CONCLUSION: BF initiation rates for women with PWSF and WOSF were similar. EBM alone or with direct BF enabled infants in the PWSF group to exclusively BF at discharge.

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Screening of epileptic seizures in children and adolescents with hydrocephalus and ventriculoperitoneal shunt

Journal of Epilepsy and Clinical Neurophysiology ◽

10.1590/s1676-26492009000300002 ◽

2009 ◽

Vol 15 (3) ◽

pp. 106-109 ◽

Cited By ~ 1

Author(s):

Raimundo Francisco de Amorim Júnior ◽

Suerda Emiliana Cavalcanti Dantas ◽

Rodrigo de Holanda Mendonça ◽

Abdiel de Lira Rolim ◽

Maria Luiza de Carvalho Jales ◽

...

Keyword(s):

Retrospective Study ◽

Data Analysis ◽

Prospective Study ◽

Children And Adolescents ◽

Ventriculoperitoneal Shunt ◽

Epileptic Seizures ◽

Significant Difference ◽

A Prospective Study ◽

Larger Sample ◽

Diagnosis Age

OBJECTIVES: To assess the occurrence of epileptic seizures (ES) in children and adolescents with hydrocephalus and their relationship with ventriculoperitoneal shunt (VPS) treatment. METHODS: Retrospective study of 45 patients from both genders, aged 0 to 18 years, with hydrocephalus and presenting with ES or not. The following variables were analyzed: gender, hydrocephalus etiology, age at diagnosis, age at initial VPS treatment, age at first ES and types of ES. RESULTS: Data analysis showed the following: 20 (44.4%) presented with ES, 13 (65%) of the girls and seven (35%) of the boys. There was a predominance of ES in the girls, but with no statistically significant difference. In total, 13 (65%) patients used VPS. Of the 13 patients with VPS and ES, it was observed that the onset of ES was after VPS in 10 (76.9%) individuals, whereas it occurred before VPS in two (15.4%). CONCLUSIONS: The results showed no association between VPS treatment and ES (ρ=0.832); however, most of the patients presented with their first ES episode after VPS, suggesting a possible relationship between this treatment and the occurrence of ES. A larger sample and a prospective study might answer this question.

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Prophylactic phenytoin in severe head injuries

Journal of Neurosurgery ◽

10.3171/jns.1979.51.4.0507 ◽

1979 ◽

Vol 51 (4) ◽

pp. 507-509 ◽

Cited By ~ 56

Author(s):

Richard N. W. Wohns ◽

Allen R. Wyler

Keyword(s):

Retrospective Study ◽

Head Injury ◽

High Probability ◽

Late Onset ◽

Head Injuries ◽

Content Type ◽

Posttraumatic Epilepsy ◽

Fine Print

✓ We are reporting a retrospective study of 62 patients whose head injury was sufficiently severe to cause a high probability of posttraumatic epilepsy. Of 50 patients treated with phenytoin, 10% developed epilepsy of late onset. Twelve patients not treated with phenytoin but who had head injuries of equal magnitude had a 50% incidence of epilepsy. These data from a highly selected group of patients with severe head injuries confirm the bias that treatment with phenytoin decreases the incidence of posttraumatic epilepsy.

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Branch atheromatous disease has a stronger association with late-onset epileptic seizures than lacunar infarction in Japanese patients

Journal of International Medical Research ◽

10.1177/0300060519831572 ◽

2019 ◽

Vol 48 (1) ◽

pp. 030006051983157

Author(s):

Kaoru Obata ◽

Masako Kinoshita ◽

Kazuaki Sato ◽

Masaki Chin ◽

Sen Yamagata ◽

...

Keyword(s):

Late Onset ◽

Epileptic Seizures ◽

Japanese Patients ◽

Lacunar Infarction ◽

Branch Atheromatous Disease

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Positive bronchoalveolar lavage and quantitative cultures results in suspected late-onset ventilator associated pneumonia evaluation – retrospective study

Revista Portuguesa de Pneumologia (English Edition) ◽

10.1016/s2173-5115(11)70027-6 ◽

2011 ◽

Vol 17 (3) ◽

pp. 117-123

Author(s):

A.P. Vaz ◽

A. Amorim ◽

M.J. Espinar ◽

T. Oliveira ◽

J.M. Pereira ◽

...

Keyword(s):

Retrospective Study ◽

Bronchoalveolar Lavage ◽

Late Onset ◽

Ventilator Associated Pneumonia

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Comparison of lupus patients with early and late onset nephritis: a study in 71 patients from a single referral center

Advances in Rheumatology ◽

10.1186/s42358-019-0105-5 ◽

2020 ◽

Vol 60 (1) ◽

Cited By ~ 1

Author(s):

Juliana Delfino ◽

Thiago Alberto F. G. dos Santos ◽

Thelma L. Skare

Keyword(s):

Systemic Lupus Erythematosus ◽

Treatment Outcome ◽

Retrospective Study ◽

Lupus Erythematosus ◽

Early Onset ◽

Response Rate ◽

Late Onset ◽

Systemic Lupus ◽

Serological Profile ◽

Treatment Data

Abstract Background Nephritis occurs frequently in systemic lupus erythematosus (SLE) and may worsen disease morbidity and mortality. Knowing all characteristics of this manifestation helps to a prompt recognition and treatment. Aim To compare the differences in clinical data, serological profile and treatment response of nephritis of early and late onset. Methods Retrospective study of 71 SLE patients with biopsy proven nephritis divided in early nephritis group (diagnosis of nephritis in the first 5 years of the disease) and late nephritis (diagnosis of nephritis after 5 years). Epidemiological, serological, clinical and treatment data were collected from charts and compared. Results In this sample, 70. 4% had early onset nephritis and 29.6% had late onset. No differences were noted in epidemiological, clinical, serological profile, SLICC and SLEDAI, except that late onset nephritis patients were older at nephritis diagnosis (p = 0.01). Regarding renal biopsy classification, C3 and C4 levels, serum creatinine, 24 h proteinuria and response rate to treatment the two groups were similar (p = NS). Patients with early onset had lower levels of hemoglobin at nephritis onset than those of late onset (p = 0.02). Conclusions Most of SLE patients had nephritis in the first 5 years of disease. No major differences were noted when disease profile or treatment outcome of early and late onset nephritis were compared.

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