scholarly journals Risk factors influencing the outcomes in infants with epilepsy

2007 ◽  
Vol 47 (5) ◽  
pp. 202 ◽  
Author(s):  
Setyo Handryastuti ◽  
Irawan Mangunatmadja

Background Epilepsy in young children should always beconsidered as a symptom of an underlying brain disease. Parentsand caregivers often asked whether the seizures can be controlledand whether the epilepsy will affect the child development.Objective To find out risk factors influencing the outcomes ininfants with epilepsy.Methods This was a retrospective study on infants aged 1 monthuntil 12 months with recurrent epileptic seizures. We looked forthe risk factors as sex, types of medication, age at onset of seizure,epilepsy syndrome, etiology of epilepsy, history of neonatal seizure,first EEG features, and type of seizure for the last 6 month-period.The outcomes evaluated were controlled seizure and developmentalstatus.Results Hundred forty infants with epilepsy were reviewed,consisted of 84 (60%) infants with symptomatic epilepsy, and 56(40%) infants categorized as idiopathic. Forty-six (33%) infantshad controlled seizure, while 94 (67%) infants had uncontrolledseizure. Abnormal developmental status was found in 75 infants(54%). Abnormal developmental status was more found in infantswith polytherapy, age at onset of 1-4 months, symptomaticepilepsy, positive remote symptomatic, history of neonatal seizure,abnormality of first EEG, and uncontrolled seizure. Uncontrolledseizure of epilepsy was more found in infants with polytherapy,early age at onset (1-4 month old), symptomatic epilepsy, positiveremote symptomatic, history of neonatal seizure, and abnormalityof first EEG.Conclusion Our data indicate that classifying syndrome of epilepsythrough diagnostic screening and age of onset are important todetermine the outcomes.

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 895-901
Author(s):  
Anne L. Wright ◽  
Catharine J. Holberg ◽  
Marilyn Halonen ◽  
Fernando D. Martinez ◽  
Wayne Morgan ◽  
...  

Objective. To investigate the natural history of and risk factors for allergic rhinitis in the first 6 years of life. Methods. Parents of 747 healthy children followed from birth completed a questionnaire when the child was 6 years old. Data were obtained regarding physician-diagnosed allergic rhinitis (PDAR), associated symptoms, and age at onset. Risk-factor data were taken from earlier questionnaires, and data regarding immunoglobulin E (IgE) and skin-test reactivity were obtained at age 6. Results. By the age of 6, 42% of children had PDAR. Children whose rhinitis began in the first year of life had more respiratory symptoms at age 6 and were more likely to have a diagnosis of asthma. Early introduction of foods or formula, heavy maternal cigarette smoking in the first year of life, and higher IgE, as well as parental allergic disorders, were associated with early development of rhinitis. Risk factors for PDAR that remained significant in a multivanate model included maternal history of physician-diagnosed allergy (odds ratio: 2.2, 95% confidence interval: 1.35-3.54), asthma in the child (4.06, 2.06-7.99), and IgE greater than 100 IU/mL at age 6 (1.93, 1.18-3.17). The odds for atopic as opposed to nonatopic PDAR were significantly higher only among those with high IgE and those who had dogs. Conclusion. Allergic rhinitis developing in the first years of life is an early manifestation of an atopic predisposition, which may be triggered by early environmental exposures.


PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. 216-225 ◽  
Author(s):  
Shlomo Shinnar ◽  
Anne T. Berg ◽  
Solomon L. Moshe ◽  
Christine O'Dell ◽  
Marta Alemany ◽  
...  

Objective. To assess the long-term recurrence risks after a first unprovoked seizure in childhood. Methods. In a prospective study, 407 children who presented with a first unprovoked seizure were then followed for a mean of 6.3 years from the time of first seizure. Results. One hundred seventy-one children (42%) experienced subsequent seizures. The cumulative risk of seizure recurrence was 29%,37%,42%, and 44% at 1,2,5, and 8 years, respectively. The median time to recurrence was 5.7 months, with 53% of recurrences occurring within 6 months, 69% within 1 year, and 88% within 2 years. Only 5 recurrences (3%) occurred after 5 years. On multivariable analysis, risk factors for seizure recurrence included a remote symptomatic etiology, an abnormal electroencephalogram (EEG), a seizure occurring while asleep, a history of prior febrile seizures, and Todd's paresis. In cryptogenic cases, the risk factors were an abnormal EEG and an initial seizure during sleep. In remote symptomatic cases, risk factors were a history of prior febrile seizures and age of onset younger than 3 years. Risk factors for late recurrences (after 2 years) were etiology, an abnormal EEG, and prior febrile seizures in the overall group and an abnormal EEG in the cryptogenic group. These are similar to the risk factors for early recurrence. Conclusions. The majority of children with a first unprovoked seizure will not have recurrences. Children with cryptogenic first seizures and a normal EEG whose initial seizure occurs while awake have a particularly favorable prognosis, with a 5-year recurrence risk of only 21%. Late recurrences do occur but are uncommon.


1990 ◽  
Vol 20 (1) ◽  
pp. 99-123 ◽  
Author(s):  
William J. McCarthy ◽  
M. Douglas Anglin

The family background characteristics of 756 male heroin users were examined to determine the effects of selected family risk factors on the timing of onset of emancipation and drug use, on pre-addiction incarcerations and on educational attainment. These risk factors included family size, birth order, socioeconomic status, family drug use, parental history of alcoholism, parental absence, and family history of incarceration. The two measures of age of emancipation were age on leaving school and age on leaving home. Age of onset of regular use was measured for the following drugs: tobacco, alcohol, marijuana and heroin. Incarceration measures included the occurrence of juvenile detention and the time spent in prison prior to first addiction. Educational attainment was a score on a California State achievement test. Larger family size, higher birth order, parental alcoholism and parental absence were found to have a cumulatively negative effect on how young the respondents were when they first left home and when they first used particular drugs regularly, on their level of tested academic achievement, and on their probability of juvenile detention. Implications for social policies designed to prevent drug abuse are discussed.


Neurology ◽  
2017 ◽  
Vol 88 (17) ◽  
pp. 1642-1649 ◽  
Author(s):  
Frank J. Wolters ◽  
Sven J. van der Lee ◽  
Peter J. Koudstaal ◽  
Cornelia M. van Duijn ◽  
Albert Hofman ◽  
...  

Objective:To determine the association of parental family history with risk of dementia by age at onset and sex of affected parent in a population-based cohort.Methods:From 2000 to 2002, we assessed parental history of dementia in participants without dementia of the Rotterdam Study. We investigated associations of parental history with risk of dementia until 2015, adjusting for demographics, cardiovascular risk factors, and known genetic risk variants. Furthermore, we determined the association between parental history and markers of neurodegeneration and vascular disease on MRI.Results:Of 2,087 participants (mean age 64 years, 55% female), 407 (19.6%) reported a history of dementia in either parent (mean age at diagnosis 79 years). During a mean follow-up of 12.2 years, 142 participants developed dementia. Parental history was associated with risk of dementia independently of known genetic risk factors (hazard ratio [HR] 1.67, 95% confidence interval [CI] 1.12–2.48), in particular when parents were diagnosed at younger age (<80 years: HR 2.58, 95% CI 1.61–4.15; ≥80 years: HR 1.01, 95% CI 0.58–1.77). Accordingly, age at diagnosis in probands was highly correlated with age at diagnosis in their parents <80 years (r = 0.57, p = 0.001) but not thereafter (r = 0.17, p = 0.55). Among 1,161 participants without dementia with brain MRI, parental history was related to lower cerebral perfusion and higher burden of white matter lesions and microbleeds. Dementia risk and MRI markers were similar for paternal and maternal history.Conclusions:Parental history of dementia increases risk of dementia, primarily when age at parental diagnosis is <80 years. Unexplained heredity may be attributed in part to cerebral hypoperfusion and small vessel disease. We found no evidence of preferential maternal compared to paternal transmission.


CNS Spectrums ◽  
2009 ◽  
Vol 14 (7) ◽  
pp. 362-370 ◽  
Author(s):  
Maria Alice de Mathis ◽  
Juliana B. Diniz ◽  
Roseli G. Shavitt ◽  
Albina R. Torres ◽  
Ygor A. Ferrão ◽  
...  

ABSTRACTIntroduction: Research suggests that obsessive-compulsive disorder (OCD) is not a unitary entity, but rather a highly heterogeneous condition, with complex and variable clinical manifestations.Objective: The aims of this study were to compare clinical and demographic characteristics of OCD patients with early and late age of onset of obsessive-compulsive symptoms (OCS); and to compare the same features in early onset OCD with and without tics. The independent impact of age at onset and presence of tics on comorbidity patterns was investigated.Methods: Three hundred and thirty consecutive outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD were evaluated: 160 patients belonged to the “early onset” group (EOG): before 11 years of age, 75 patients hadResults: The EOG had a predominance of males, higher frequency of family history of OCS, higher mean scores on the “aggression/violence” and “miscellaneous” dimensions, and higher mean global DY-BOCS scores. Patients with EOG without tic disorders presented higher mean global DY-BOCS scores and higher mean scores in the “contamination/cleaning” dimension.Conclusion: The current results disentangle some of the clinical overlap between early onset OCD with and without tics.


Author(s):  
Dattatraya D. Bant ◽  
Shiv Kumar

Background: Anaemia in pregnancy is one of the major causes of maternal morbidity and mortality in India and world. Anaemia in pregnancy continues to be a problem in spite of national programs for its prevention and control. It accounts for 1/5th of maternal deaths worldwide and 16% in India and is the major factor responsible for low birth weight, abortions, premature birth, and post-partum haemorrhage. Hence determining the status and factors influencing anaemia among pregnant women is essential to treat and prevent the same. Objective of this study was to assess the prevalence and risk factors associated with anaemia among pregnant women.Methods: A cross sectional study was conducted among 200 pregnant women attending for antenatal care at KIMS OPD from 3rd June to 4th July. A pretested, semi-structured questionnaire was applied to collect data. Haemoglobin estimation was done by Sahli’s method.Results: Prevalence of anaemia among pregnant women was found to be 81%; majority had moderate anaemia 57%. The mean age of pregnant women in the study is 24.55 years and 46.5% belong to lower socioeconomic status, 43% lived in joint families. Factors influencing anaemia were multi-parity, short inter-pregnancy interval, no history of recent deworming and iron and folic acid tablets intake.Conclusions: In the present study, the prevalence of anaemia among pregnant women was found to be very high i.e., 81% especially among illiterates, low income groups, multiparous women, short inter-pregnancy interval, no history of recent deworming and iron and folic acid tablets intake. 


Author(s):  
Syeda Ujala Sohail ◽  
Nasima Iqbal ◽  
Ashok Kumar ◽  
Sarwath Fatimee ◽  
Ayesha Khan ◽  
...  

Aim: To find out the prevalence of psoriasis vulgaris and its associated risk factors. Study Design: Descriptive cross-sectional. Place and Duration of Study: Study was conducted at Rawalpindi Leprosy Hospital during January 2019 to December 2019. Methodology: The diagnosed cases of Psoriasis Vulgaris (PsV) were included in the study. All the patients were investigated on the basis of an in depth Performa. The Performa include all the relevant clinical and family history of the patient along with the personal details. Data was analyzed by using Statistical Package for the Social Sciences (SPSS) version 20. All the numerical variables were presented as mean with standard deviation while categorical data as frequency and percentages. The association of risk factors with the Psoriasis was calculated by using the Chi-square test. p-value less than 0.05 was considered as significant. Results: Mean age with standard deviation of patients was 34.7±14. Most of the diagnosed patients were male and below 40 years of age, only 4.2% cases were having positive family history of Psoriasis and found significant correlation. The frequency of onset of symptoms in adolescent was more as compared to childhood i.e. 95.3% and 4.7% respectively. Majority of psoriasis cases (65.3%) were from non-smoker group and having strong association with smoking. The frequency of arthritis among psoriasis patients was 23.7% and majority of the patients, who developed arthritis were those having age <40 year and were suffering from psoriasis since 5-10 years. Conclusion: Current study concluded that Psoriasis vulgar is having higher prevalence rate among male and below 40 years of age group. The results also suggested a strong association of severity of psoriasis with certain risk factors including family history, age of onset of symptoms, smoking and arthritis.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0259405
Author(s):  
Valentina Guarnotta ◽  
Stefano Radellini ◽  
Enrica Vigneri ◽  
Achille Cernigliaro ◽  
Felicia Pantò ◽  
...  

Aim The aim of this study was to analyze changes in the incidence, management and mortality of DFU in Sicilian Type 2 diabetic patients hospitalized between two eras, i.e. 2008–2013 and 2014–2019. Methods We compared the two eras, era1: 2008–13, era2: 2014–19. In era 1, n = 149, and in era 2, n = 181 patients were retrospectively enrolled. Results In the population hospitalized for DFU in 2008–2013, 59.1% of males and 40.9% of females died, whilst in 2014–2019 65.9% of males and 34.1% of females died. Moderate chronic kidney disease (CKD) was significantly higher in patients that had died than in ones that were alive (33% vs. 43%, p < 0.001), just as CKD was severe (14.5% vs. 4%, p < 0.001). Considering all together the risk factors associated with mortality, at Cox regression multivariate analysis only moderate-severe CKD (OR 1.61, 95% CI 1.07–2.42, p 0.021), age of onset greater than 69 years (OR 2.01, 95% CI 1.37–2.95, p <0.001) and eGFR less than 92 ml/min (OR 2.84, 95% CI 1.51–5.34, p 0.001) were independently associated with risk of death. Conclusions Patients with DFU have high mortality and reduced life expectancy. Age at onset of diabetic foot ulcer, eGFR values and CKD are the principal risk factors for mortality.


2017 ◽  
Vol 41 (S1) ◽  
pp. s499-s499
Author(s):  
J. Nogueira ◽  
R. Taylor

IntroductionNon-epileptic seizures (NES) are a diverse group of disorders, whose paroxysmal events can be mistaken for epilepsy, although they are caused by a mental or psychogenic process rather than a neurological cause.Objectives/methodsWe present a case of a 45-year-old female patient with history of generalized seizures prior to Meningioma resection in August 2015, referred to the Liaison Psychiatry outpatient follow up clinic at the Royal London Hospital after has gone several times to emergency department complaining about flush and hot sensation that proceeded to corners of mouth turning down, teeth chattering, shaking of left arm and torso at first and then legs. During the episodes, she was awake with no consciousness loss. Her mood was low, with clinical evidence of depression and she had very high levels of health anxiety.DiscussionA diagnosis of non-epileptic attacks was made in the sequence of those episodes. A holistic and multidisciplinary approach was made, including pharmacotherapy, cognitive-behavioral therapy and domiciliary support. The clinical response was good regarding both mood, anxiety levels and NES.ConclusionsApproximately 25% of patients who have a previous diagnosis of epilepsy and are not responding to drug therapy are found to be misdiagnosed and it is common that epileptic patients have both epileptic and non-epileptic seizures. Although distinguishing epileptic and non-epileptic seizures is not easy, there are some clinical clues that the physicians should look for, like age of onset, time of the day that episodes occur and presence or absence of postictal confusion.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
Vol 7 (5) ◽  
pp. 1130
Author(s):  
Gobinaath . ◽  
Arun Daniel J.

Background: Febrile seizures occur commonly in the under 5 age group and is associated with few risk factors causing its recurrence like very high fever, family history of seizures, low sodium levels and younger age of onset which are subject to seasonal and wide geographical variations. This study aimed at detecting the major risk factors associated with recurrent febrile seizures in an Indian population.Methods: A retrospective hospital-based study was conducted among a total of 300 cases aged 6 months to 5 years attending to the paediatric OPD with history of fever followed by febrile seizures. Information regarding socio-demographic and clinical variables associated with febrile seizure was collected and analyzed.Results: The mean age of the study participants was 25.6±2.2 months and majority (60%) were males. Family history of seizures was present in 25.3% (n=76) of the children with febrile seizures. Respiratory infections (73.3%) and gastroenteritis (17%) were the major infective reasons associated with the occurrence of febrile seizures followed by pneumonia (6.3%) and urinary tract infections (5%). Recurrence of FS was significantly higher among the children with family history of FS (p=0.009), age at onset lesser (p<0.001) and simple FS seizures.Conclusions: Younger age at onset and positive family history of seizures were important socio-demographic risk factors associated with recurrent febrile seizures.


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