scholarly journals Pathogenesis of seizures and epilepsy after stroke

2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Jiayu Chen ◽  
Haijiao Ye ◽  
Jie Zhang ◽  
Aihong Li ◽  
Yaohui Ni
Keyword(s):  
Late Onset ◽  
Medical Profession ◽  
Basic Research ◽  
Epileptic Seizures ◽  
The Elderly ◽  
Cerebral Stroke ◽  
Post Stroke ◽  
Epilepsy In The Elderly ◽  
Secondary Epilepsy

AbstractStroke is the most frequent cause of secondary epilepsy in the elderly. The incidence of cerebral stroke is increasing with the extension of life expectancy, and the prevalence of post-stroke epilepsy (PSE) is rising. There are various seizure types after stroke, and the occurrence of epilepsy is closely related to the type and location of stroke. Moreover, the clinical treatment of post-stroke epilepsy is difficult, which increases the risk of disability and death, and affects the prognosis and quality of life of patients. Now seizure and epilepsy after stroke is more and more get the attention of the medical profession, has been more and more researchers have devoted to seizures after stroke and PSE clinical and basic research, and hope to get a scientific and unified guideline, to give timely and effective treatment, but the exact pathophysiologic mechanism has not yet formed a unified conclusion. It has been found that ion channels, neurotransmitters, proliferation of glial cells, genetics and other factors are involved in the occurrence and development of PSE. In this review, we discuss the pathogenesis of early-onset epileptic seizures and late-onset epilepsy after stroke, in order to provide a basis for clinicians to understand the disease, and expect to provide ideas for future exploration.

scholarly journals Research progress on the prediction of post-stroke epilepsy

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Shangnan Zou ◽  
Yangmei Chen
Keyword(s):  
Risk Factors ◽  
Prediction Model ◽  
Prediction Models ◽  
Epileptic Seizures ◽  
The Elderly ◽  
Research Progress ◽  
Future Research ◽  
Stroke Severity ◽  
Post Stroke ◽  
Epilepsy In The Elderly

AbstractEpilepsy is a common neurological disease that not only causes difficulties in the work and life activities of patients, but also brings complex social problems. Cerebrovascular disease is currently the main cause of epilepsy in the elderly. With the increased survival rate of patients after stroke, the incidence of epilepsy after stroke has also increased. Effective prediction of epilepsy after stroke is extremely crucial for the prognosis of patients, the initiation of antiepileptic therapy and the reduction of epileptic seizures. In this review, we summarize and compare the current models for the prediction of epilepsy after stroke, including the SeLECT prediction model, Post-Stroke Epilepsy Risk Scale (PoSERS), CAVE score, electroencephalogram (EEG) prediction model, and Scandinavian Stroke Scale (SSS) score, in order to provide reference for clinical practice and future research. Prediction models can be selected based on the clinical classification of cerebrovascular events. The SeLECT score prognostic model is a better choice for ischemic stroke, especially for the exclusive prediction of mild post stroke epilepsy. The CAVE score model is suitable for intra-cerebral hemorrhage patients. It is simple and offers high correlation between the risk factors and epilepsy. The PoSERS score simultaneously predicts ischemic and hemorrhagic stroke, and is superior to other methods in specificity as well as positive and negative prediction rate. The SSS score, which only measures stroke severity, is not strictly considered as a mature predictor, but it can be used as a first step screening tool. A growing number of large studies are under the way to identify risk factors of poststroke epilepsy (PSE) and to improve the inclusion of predictive indicators. New and advanced findings by EEG recordings may further improve the prediction of PSE.

scholarly journals Epilepsy in Down Syndrome: A Highly Prevalent Comorbidity

2021 ◽  
Vol 10 (13) ◽  
pp. 2776
Author(s):  
Miren Altuna ◽  
Sandra Giménez ◽  
Juan Fortea
Keyword(s):  
Down Syndrome ◽  
Functional Outcomes ◽  
Clinical Presentation ◽  
Late Onset ◽  
Current Knowledge ◽  
Epileptic Seizures ◽  
Myoclonic Epilepsy ◽  
Increased Risk ◽  
Number Of Individuals

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.

scholarly journals Etiological prevalence of epilepsy and epileptic seizures in hospitalized elderly in a Brazilian tertiary center – Salvador - Brazil

2015 ◽  
Vol 73 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Telma Rocha de Assis ◽  
Aroldo Bacellar ◽  
Gersonita Costa ◽  
Osvaldo J. M. Nascimento
Keyword(s):  
Ischemic Stroke ◽  
Statistical Significance ◽  
Epileptic Seizures ◽  
The Elderly ◽  
Metabolic Disturbances ◽  
Hospitalized Elderly ◽  
Epilepsy In The Elderly ◽  
Tertiary Center ◽  
Elderly Inpatients ◽  
Common Etiology

Epilepsy in the elderly has high incidence and prevalence and is often underecognized. Objective To describe etiological prevalence of epilepsy and epileptic seizures in elderly inpatients. Methods Retrospective analysis was performed on elderly patients who had epilepsy or epileptic seizures during hospitalization, from January 2009 to December 2010. One hundred and twenty patients were enrolled. They were divided into two age subgroups (median 75 years) with the purpose to compare etiologies. Results The most common etiology was ischemic stroke (36.7%), followed by neoplasias (13.3%), hemorrhagic stroke (11.7%), dementias (11.4%) and metabolic disturbances (5.5%). The analysis of etiological association showed that ischemic stroke was predominant in the younger subgroup (45% vs 30%), and dementias in the older one (18.9% vs 3.8%), but with no statistical significance (p = 0.23). Conclusion This study suggests that epilepsy and epileptic seizures in the elderly inpatients have etiological association with stroke, neoplasias and dementias.

scholarly journals Quality of Life in People with Young-Onset Alzheimer’s Dementia and Frontotemporal Dementia

2018 ◽  
Vol 45 (1-2) ◽  
pp. 91-104 ◽  
Author(s):  
Lara Hvidsten ◽  
Knut Engedal ◽  
Geir Selbæk ◽  
Torgeir Bruun Wyller ◽  
Frøydis Bruvik ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Late Onset ◽  
Neuropsychiatric Symptoms ◽  
The Elderly ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Young Onset ◽  
Proxy Version ◽  
Late Onset Dementia

Aims: The aims of this study were to compare quality of life (QOL) in people with young-onset Alzheimer’s (AD) and frontotemporal (FTD) dementia, explore variables associated with QOL, and compare QOL in young-onset dementia (YOD) and late-onset dementia (LOD). Methods: Cross-sectional data from a Nordic multicenter study of 50 community-dwelling participants with AD and 38 with FTD were included. A comparison group consisted of 100 people with LOD. QOL was measured using self-reported Euro-QOL 5-Dimension and the proxy version of Quality of Life in Alzheimer’s Disease (QOL-AD) questionnaire. Neuropsychiatric symptoms and needs were assessed using the Cornell Scale for Depression in Dementia (CSDD), Neuropsychiatric Inventory (NPI), and Camberwell Assessment of Needs in the Elderly. Multiple linear regression and multilevel modeling was used to determine variables associated with QOL. Results: We found no differences between the two YOD groups in QOL. The variables associated with QOL were scores on the CSDD, NPI, and unmet needs. The proxy QOL-AD score in YOD was significantly higher compared to LOD (median 36.0 [IQR 10.0] vs. 33.0 [IQR 9.0]). Conclusion: The QOL in Nordic people with YOD was better compared to people with LOD. Our results show depressive symptoms to be associated with QOL irrespective of age and diagnosis.

scholarly journals Surgery for temporal lobe epilepsy in the elderly: Improving quality of life despite cognitive impairment

Seizure ◽  
2020 ◽  
Vol 79 ◽  
pp. 112-119 ◽  
Author(s):  
Daniel Delev ◽  
Julia Taube ◽  
Christoph Helmstaedter ◽  
Karlijn Hakvoort ◽  
Alexander Grote ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
The Elderly ◽  
Epilepsy In The Elderly

Epileptic seizures and epilepsy in the elderly

2001 ◽  
Vol 58 (11) ◽  
pp. 684-690 ◽  
Author(s):  
Günter Krämer
Keyword(s):  
Epileptic Seizures ◽  
The Elderly ◽  
Epileptische Anfälle ◽  
Epilepsy In The Elderly ◽  
Fokale Anfälle ◽  
Kindheit Und Jugend

Entgegen früherer Auffassungen sind die Inzidenzraten inzwischen nach dem 65. Lebensjahr höher als in der Kindheit und Jugend, und epileptische Anfälle und Epilepsien stellen eines der häufigsten neurologischen Probleme im höheren Lebensalter dar. Die häufigsten Anfallsformen bei im höheren Lebensalter beginnenden Epilepsien sind bei rund zwei Drittel primär fokale Anfälle, die sekundär generalisieren können, die häufigsten Ursachen bestehen nach vaskulären Störungen in Hirntumoren, Traumen und degenerativen Erkrankungen. Relativ häufig sind Toddsche Paresen oder andere länger dauernde postiktale Störungen. Die vorliegende Arbeit beschäftigt sich mit diagnostischen und therapeutischen Aspekten und dabei in erster Linie mit der Bedeutung von Begleitkankheiten (speziell der Leber- und Niere).

scholarly journals Clinical and Etiological Characteristics of Epilepsy in the Elderly: A Hospital-Based Study from a Tertiary Care Referral Center of Niamey, Niger

2019 ◽  
Vol 10 (04) ◽  
pp. 571-575
Author(s):  
Hamid Assadeck ◽  
Moussa Toudou-Daouda ◽  
Zakaria Mamadou ◽  
Mahadi Moussa-Konate ◽  
Fatimata Hassane-Djibo ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Tertiary Care ◽  
The Elderly ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
Epilepsy In The Elderly ◽  
Clonic Seizures ◽  
The Mean

Abstract Objectives The aim of this study is to evaluate the management of epilepsy in the elderly at a tertiary referral center in Niger to obtain a comprehensive understanding to determine the intrahospital deficiencies to improve and to make recommendations in terms to improve the management of epilepsy in the elderly in Niger. Materials and Methods We conducted a retrospective study at the Neurology Outpatient Clinic of the National Hospital of Niamey (Niger) over a period of 5 years from May 2013 to May 2018, collecting all cases of patients aged 60 years or over diagnosed with epilepsy by neurologists. From the registers of consultation, we collected and analyzed for each patient the demographic, clinical, etiological, and therapeutic data, as well as the outcomes during follow-up visits. Results Of the 4,576 patients of all ages seen during the period of our study, we included 62 patients aged 60 years or over diagnosed with epilepsy with a hospital frequency of 1.35%. The mean age of patients was 65.82 ± 5.72 years (range: 60 and 83 years) with a predominance of the male sex (sex ratio at 1.6). Patients aged 60 to 64 years were the most represented (43.5%). Generalized tonic–clonic seizures were the most frequent (41.9%), followed by focal to bilateral tonic-clonic seizures (25.8%). All patients underwent electroencephalogram. Only 30 patients (48.4%) underwent brain imaging, and mainly brain computed tomography scan. The etiologies included poststroke epilepsy (25.8%), brain tumors (3.2%), cerebral toxoplasmosis (3.2%), and cerebral meningioma (1.6%). We found 41 cases (66.1%) of epilepsy without definite etiology and with an incomplete workup. Carbamazepine and phenobarbital were the only two antiepileptic drugs (AEDs) used. Conclusion The present study shows limited access to newer generation AEDs and diagnostic tests of epilepsy in Niger. Considerable efforts should be made to facilitate for people living with epilepsy the accessibility to diagnostic tests and the newer generation AEDs to improve the quality of epilepsy management in Niger.

Ageing, Meaning and the Allocation of Resources

1995 ◽  
Vol 15 (2) ◽  
pp. 163-184 ◽  
Author(s):  
Harry R. Moody
Keyword(s):  
Quality Of Life ◽  
Old Age ◽  
Age Groups ◽  
Health Resources ◽  
Basic Research ◽  
The Elderly ◽  
Ageing Society ◽  
Scarce Resources ◽  
Productive Ageing

ABSTRACTDifferent scenarios for an ageing society presume different approaches to the meaning of old age. One scenario anticipates a Prolongation of Morbidity, where quality of life concerns might permit active euthanasia or suicide as a means of saving money. Those who believe in a Compression of Morbidity opt for health promotion to delay morbidity in favour of productive ageing. Optimists look to a scenario of Lifespan Extension, where scarce health resources are not expended for incremental gains in life expectancy but rather for basic research to postpone or eliminate ageing. Finally, those who emphasize Voluntary Acceptance of Limits identify the meaning of old age with voluntary acceptance of finitude, where claims of future generations might limit longevity for any one generation. Thus, contrasting meanings such as quality of life, productive ageing, indefinite survival and voluntary limits entail very different consequences for the allocation of scarce resources across age-groups and among sub-groups of the elderly population.

Epilepsy in the elderly: restrictions, fears, and quality of life

2014 ◽  
Vol 131 (3) ◽  
pp. 176-186 ◽  
Author(s):  
T. W. May ◽  
M. Pfäfflin ◽  
C. Brandt ◽  
N. Füratsch ◽  
B. Schmitz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
The Elderly ◽  
Epilepsy In The Elderly

scholarly journals Assessment of Quality of Life and Incidence of Depression in Post Stroke Patients

2020 ◽  
Vol 11 (4) ◽  
pp. 7146-7150
Author(s):  
Aditya Dharman ◽  
Chandrina Loungchot ◽  
Ven Davis ◽  
Mahshid Delavari ◽  
Binai K Sankar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Depression Scale ◽  
Severe Depression ◽  
The Elderly ◽  
Hamilton Depression Scale ◽  
Early Assessment ◽  
Stroke Patients ◽  
Post Stroke

Depression is a common illness worldwide. Social, psychological and biological factors can lead to depression. Chronic illness among the elderly is a significant reason affecting mental health. Often it is not diagnosed correctly. An observational study was conducted to assess the quality of life and the incidence of depression in post-stroke patients. Subjects were recruited to the study by investigations during ward/OP visits. The subjects were briefed about the study, and informed consent was obtained. Data were collected using various study tools and analyzed statistically by computing proportion for all qualitative data and mean, standard deviation, median, the interquartile range for quantitative data. A total of 50 subjects were enrolled in the study based on inclusion and exclusion criteria. Severe cognitive impairment was revealed in 14% of the patients. The burden of depression and severity was evaluated using Patient health questionnaire-9 and Hamilton depression scale, respectively. It was found that 22 subjects (44%) had moderate depression, while 2 (4%) had severe depression. The functionality of the subjects was measured and found that 18% of subjects were 'dependent' on their caregiver. SSQOL assessment showed the lowest score in the domains 'work & productivity' and 'energy". As much as treating the etiological factors of stroke, dealing with the mental aspect of stroke is necessary. Assessing and treating post-stroke depression is essential to reduce the morbidity and mortality of patients. Hence, early assessment and management of mental health after stroke is necessary to prevent a chance of developing another stroke.

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