Association Between Migraine Comorbidity and Psychiatric Symptoms Among People With Newly Diagnosed Focal Epilepsy

2021 ◽  
Author(s):  
Olivia Begasse De Dhaem ◽  
Sandra India Aldana ◽  
Andres Miguel Kanner ◽  
Michael Sperling ◽  
Jacqueline French ◽  
...  
Keyword(s):  
Psychiatric Symptoms ◽  
Focal Epilepsy ◽  
Newly Diagnosed

scholarly journals Autoimmune encephalitis: the clinical evolution as a key to the diagnosis

2019 ◽  
Vol 12 (9) ◽  
pp. e231094 ◽  
Author(s):  
Sara Teixeira ◽  
Joana Caldeira Santos ◽  
Marta Vila Real ◽  
Fátima Santos
Keyword(s):  
Neurological Examination ◽  
Psychiatric Symptoms ◽  
Focal Epilepsy ◽  
Disease Onset ◽  
Autoimmune Encephalitis ◽  
Lower Limbs ◽  
Response To Treatment ◽  
Late Response ◽  
Nmdar Encephalitis ◽  
Age Appropriate

Anti-N-methyl D-aspartate receptor (NMDAR) encephalitis is a devastating disease, that despite being increasingly diagnosed, there are no consensus guidelines for the optimal management. A previously healthy 3-year-old-boy brought to the emergency department due to seizures. Neurological examination was normal, and electroencephalogram (EEG) suggested focal epilepsy. Anticonvulsive medication was initiated. He progressively lost age-appropriate language skills, presented behavioural changes and psychiatric symptoms. Neurological examination at that time revealed symmetric gross motor weakness of the lower limbs. Brain and spinal cord MRI and cerebrospinal fluid were normal. Repeated EEG showed global lentification. Steroid therapy was initiated for the suspicion of autoimmune encephalitis, later confirmed as NMDAR encephalitis. He became clinically improved after 10 days of treatment but only returned to his baseline after 3 months of disease onset. The authors emphasised the variable course of the disease and possible late response to treatment.

scholarly journals Can we predict drug response by volumes of the corpus callosum in newly diagnosed focal epilepsy?

2017 ◽  
Vol 7 (8) ◽  
pp. e00751 ◽  
Author(s):  
Hyung Chan Kim ◽  
Sung Eun Kim ◽  
Byung In Lee ◽  
Kang Min Park
Keyword(s):  
Corpus Callosum ◽  
Drug Response ◽  
Focal Epilepsy ◽  
Newly Diagnosed

scholarly journals Anxiety and Depression in Newly Diagnosed Epilepsy: A Matter of Psychological History?

2021 ◽  
Vol 12 ◽  
Author(s):  
Natacha Forthoffer ◽  
Alexis Tarrada ◽  
Hélène Brissart ◽  
Louis Maillard ◽  
Coraline Hingray
Keyword(s):  
Depressive Symptoms ◽  
Focal Epilepsy ◽  
Psychological Trauma ◽  
Structured Interview ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Psychiatric History ◽  
Newly Diagnosed ◽  
History Of ◽  
And Gender

Purpose: Anxiety and depression are highly prevalent in patients with epilepsy (PWE), and these symptoms can even precede the onset of the pathology. We aimed to define the prevalence of anxiety and depressive symptoms at the time of the epilepsy diagnosis and the factors related to their presence in newly diagnosed adult patients.Methods: One hundred and twelve newly diagnosed patients were assessed, usually in the week after diagnosis. Patients were untreated at this time. We used the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E, cut-off ≥15) and the Generalized Anxiety Disorder 7-Item scale (GAD-7, cut-off >7). A semi-structured interview was conducted to collect sociodemographic and epilepsy data and patients' psychiatric history. We first compared patients with and without anxiety symptoms, then patients with and without depressive symptoms.Results: According to the GAD-7 scale, the prevalence of anxiety symptoms at the time of diagnosis was 35%. Patients with anxiety symptoms had significantly more psychiatric history (26%, p = 0.001) and more history of psychological trauma (51%, p = 0.003) than patients with no anxiety symptoms. According to the NDDI-E scores, the prevalence of depressive symptoms at the time of the diagnosis was 11%. Patients with depressive symptoms had significantly more psychiatric history (43%, p < 0.001) and more history of psychological trauma (65%, p = 0.007) than patients with no depressive symptoms. No difference between groups was found for other sociodemographic variables (age and gender), epilepsy characteristics (number of seizures prior to diagnosis, time from first seizure to diagnosis, type of epilepsy, and localization in focal epilepsy), or neurological comorbidities.Conclusions: Anxiety symptoms are common whereas depressive symptoms are less prevalent at the time of diagnosis. It appears essential to be aware of anxiety and depression in newly diagnosed epileptic patients. They should be screened and routinely monitored, especially those patients with a history of psychological trauma and/or psychiatric disorders. Longitudinal follow-up is required to identify whether these factors and anxiety and depression themselves have an impact on the future course of care.

scholarly journals Treatment Patterns for Adult Patients with Newly Diagnosed Focal Epilepsy in Germany

2017 ◽  
Vol 20 (9) ◽  
pp. A728-A729
Author(s):  
A Groth ◽  
S Borghs ◽  
P Gille ◽  
L Joeres ◽  
T Wilke
Keyword(s):  
Focal Epilepsy ◽  
Treatment Patterns ◽  
Adult Patients ◽  
Newly Diagnosed

Prescription patterns of antiepileptic drugs for adult patients with newly diagnosed focal epilepsy from 2006 to 2017 in Japan

2021 ◽  
Vol 169 ◽  
pp. 106503
Author(s):  
Siming Chen ◽  
Satomi Yoshida ◽  
Riki Matsumoto ◽  
Akio Ikeda ◽  
Koji Kawakami
Keyword(s):  
Antiepileptic Drugs ◽  
Focal Epilepsy ◽  
Adult Patients ◽  
Newly Diagnosed ◽  
Prescription Patterns

scholarly journals Impact of diagnostic delay on seizure outcome in newly diagnosed focal epilepsy

2020 ◽  
Vol 5 (4) ◽  
pp. 605-610
Author(s):  
Laura Parviainen ◽  
Reetta Kälviäinen ◽  
Leena Jutila
Keyword(s):  
Focal Epilepsy ◽  
Diagnostic Delay ◽  
Seizure Outcome ◽  
Newly Diagnosed

076 The expanding clinical phenotype of NMDAR encephalitis

2018 ◽  
Vol 89 (6) ◽  
pp. A31.1-A31
Author(s):  
Jessica Qiu ◽  
Jacob Helou ◽  
Nicholas Urriola ◽  
Miriam Welgampola ◽  
John Parratt ◽  
...  
Keyword(s):  
Psychiatric Symptoms ◽  
Focal Epilepsy ◽  
Insular Cortex ◽  
Ovarian Teratoma ◽  
Downbeat Nystagmus ◽  
Progressive Dementia ◽  
Epilepsia Partialis Continua ◽  
Truncal Ataxia ◽  
The Right ◽  
The Brain

IntroductionThe classic phenotype of anti-N-methyl-d-aspartate receptor (NMDA-R) encephalitis is a constellation of prodromal psychiatric symptoms, seizures, movement disorder and progressive autonomic dysfunction, frequently associated with ovarian teratoma. We describe four cases illustrating the expanding phenotype of NMDA-R encephalitis. We present two cases from two tertiary hospitalsCase 1 A 31 year old woman presented with focal onset seizures. She developed epilepsia partialis continua. CSF and serum NMDA-R antibodies were detected and PET of the brain showed bi-frontal hyper-metabolism. The seizures resolved with immunotherapy.Case 2 A 26 year old woman presented with vomiting and dysequilibrium. She was found to have torsional downbeat nystagmus with otherwise normal eye movements and vestibulo-ocular reflexes. She developed bilateral appendicular and truncal ataxia, head bobbing and ocular flutter. PET demonstrated diffuse cerebellar hyper-metabolism. CSF NMDA-R antibodies were detected and an ovarian teratoma was identified.Case 3 A 67 year old right-handed woman was treated for HSV encephalitis. MRI of the brain demonstrated typical changes in the right anteromedial temporal lobe, inferior frontal lobe and insular cortex. Five months later, she deteriorated with progressive cognitive dysfunction and prominent orofacial dyskinesia. Initially both CSF and serum were negative for NMDAR antibodies, but repeat CSF and serum were positive.Case 4 A 61 year old woman presented with progressive cognitive impairment over eight months initially characterised by difficulty with calculations and making mistakes at work but subsequent severe impairment of language, executive function and memory and the development of facile and disinhibited behaviour. PET demonstrated mesial bi-temporal hyopo-metabolism and NMDA-R antibodies were detected in serum. She recovered with immunotherapy.ConclusionNMDA-R encephalitis should be considered in various neurological presentations including explosive onset focal epilepsy, rapidly progressive dementia, post HSV encephalitis and rhombencephalitis. Early detection is important given the frequent response to immunotherapy.

Sign in / Sign up

Export Citation Format

Share Document