scholarly journals Rational Approach to Children with Drug-Resistant Epilepsy

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Elaine Wirrell
Keyword(s):  
Quality Of Life ◽  
Psychiatric Disorders ◽  
Neurological Disorders ◽  
Poor Quality ◽  
Rational Approach ◽  
Drug Resistant ◽  
Unexpected Death ◽  
Increased Risk ◽  
Drug Resistant Epilepsy

Epilepsy is one of the most common neurological disorders to affect children, and has its highest incidence in infancy. Approximately one-quarter of children have seizures which are drug-resistant, and place the child at increased risk of cognitive delays, attention, behavior and psychiatric disorders, injury, sudden unexpected death and poor quality of life. This article presents a rational approach to the investigation and management of children with drug-resistant epilepsy.    

scholarly journals Determinants of quality of life in Latin American people with drug-resistant epilepsy: A cross-sectional, correlational study

2020 ◽  
Author(s):  
Marco Antonio Díaz-Torres ◽  
Edith Giselle Buzo-Jarquín ◽  
Aime Carolina Rodríguez-Martínez ◽  
Diana Laura De León-Altamira ◽  
Gerardo Padilla-Rivas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Latin American ◽  
Poor Quality ◽  
American People ◽  
Drug Resistant ◽  
Cross Sectional ◽  
Antiepileptic Drug Treatment ◽  
Parametric Statistics ◽  
Drug Resistant Epilepsy

AbstractOne third of people with epilepsy (PWE) continue to have seizures despite adequate antiepileptic drug treatment. This condition, known as drug-resistant epilepsy (DRE) significantly impairs their social, family and work environment. The aims of this study were to assess the quality of life (QoL) in PWE with DRE and to investigate which factors are associated with a better QoL. This was a cross-sectional observational study of 133 Latin American PWE. QoL was assessed with the Spanish version of the Quality of Life with Epilepsy questionnaire (QOLIE-10). Independent clinical variables were analyzed with non-parametric statistics and their association with QoL was investigated with multiple linear regression. Poor quality of life was found in 25.8% of PWE. A low number of antiepileptic drugs (AEDs) was the major factor associated with better quality of life, closely followed by seizure frequency. We conclude that careful selection of AED treatment may contribute to improving both seizure control and QoL.

Psychiatric disorders, depression and quality of life in patients with psychogenic non-epileptic seizures and drug resistant epilepsy living in Argentina

Seizure ◽  
2021 ◽  
Vol 92 ◽  
pp. 174-181
Author(s):  
Laura Scévola ◽  
Camila Wolfzun ◽  
Mercedes Sarudiansky ◽  
María Marta Areco Pico ◽  
Micaela Ponieman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychiatric Disorders ◽  
Epileptic Seizures ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

Fifteen-minute consultation: When medicines don’t work—the child with poorly controlled seizures

2018 ◽  
Vol 104 (3) ◽  
pp. 135-140
Author(s):  
Pooja Harijan ◽  
Arnab Kumar Seal ◽  
Manish Prasad ◽  
William P Whitehouse
Keyword(s):  
Quality Of Life ◽  
Epilepsy Surgery ◽  
Drug Resistant ◽  
Algorithmic Approach ◽  
Life Management ◽  
Drug Resistant Epilepsy

Drug-resistant epilepsy (DRE) occurs in 20%–30% of children with epilepsy with significant impact on their quality of life. Management of this group of children has greatly improved in the recent years with streamlining of epilepsy surgery services and associated quaternary multimodal evaluation. This article provides a review of DRE in children and management based on recent evidence and published opinion. We have also presented an algorithmic approach to the child with possible DRE.

Age, cancer site and gender associations with symptoms and problems in specialised palliative care: a large, nationwide, register-based study

2019 ◽  
pp. bmjspcare-2019-001880 ◽  
Author(s):  
Maiken Bang Hansen ◽  
Lone Ross ◽  
Morten Aagaard Petersen ◽  
Mogens Groenvold
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Physical Function ◽  
Cancer Diagnosis ◽  
Poor Quality ◽  
Cancer Site ◽  
Patients With Cancer ◽  
Increased Risk ◽  
And Gender

BackgroundPatients referred to specialised palliative care are troubled by symptoms/problems, but more knowledge is needed on the level and frequency of symptoms/problems. It is also uncertain how gender, age and cancer diagnosis, respectively, are associated with symptoms/problems.AimsTo describe symptoms/problems in patients with cancer at the start of specialised palliative care, and to study how age, gender and cancer diagnosis were associated with symptoms/problems.DesignA register-based study including data from the Danish Palliative Care Database.Setting/ParticipantsPatients with cancer who reported their symptoms/problems using the European Organisation for Research and Treatment of Cancer Quality of Life Questionaire-Core-15-Palliative Care (EORTC QLQ-C15-PAL) at the start of specialised palliative care were included. Ordinal logistic regression was performed to test if gender, age and cancer diagnosis were associated with each symptom/problem.Results31 771 patients with cancer were included in the study. The most prevalent and severe symptoms/problems were pain, appetite loss, fatigue, poor physical function and poor quality of life. Gender, age and cancer diagnosis were significantly associated with most symptoms/problems. The strongest associations between symptoms/problems and gender and age, respectively, were increased risk of nausea in women, as well as increased risk of poor physical function and reduced risk of sleeplessness and pain with increasing age. Patients with brain/central nervous system cancer had the lowest risk of symptoms but the highest risk of poor physical function.ConclusionAt the start of specialised palliative care, patients with cancer experience severe levels of symptoms, poor physical function and poor quality of life. Age, gender and diagnosis were significantly associated with most symptoms/problems, but the strength and direction of the associations differed across symptoms/problems.

Care-related quality of life in caregivers of children with drug-resistant epilepsy

2018 ◽  
Vol 265 (10) ◽  
pp. 2221-2230 ◽  
Author(s):  
Puneet Jain ◽  
◽  
Jhananiee Subendran ◽  
Mary Lou Smith ◽  
Elysa Widjaja
Keyword(s):  
Quality Of Life ◽  
Drug Resistant ◽  
Related Quality ◽  
Drug Resistant Epilepsy

scholarly journals 62 Predictors of Tardive Dyskinesia in Psychiatric Patients Taking Concomitant Antipsychotics

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 207-208 ◽  
Author(s):  
Oscar Patterson-Lomba ◽  
Rajeev Ayyagari ◽  
Benjamin Carroll
Keyword(s):  
Quality Of Life ◽  
New York ◽  
Bipolar Disorder ◽  
Depressive Disorder ◽  
Prediction Model ◽  
Psychiatric Disorders ◽  
Index Date ◽  
Atypical Antipsychotics ◽  
Increased Risk

AbstractBackgroundTardive dyskinesia (TD) is typically caused by exposure to antipsychotics, is often irreversible, and can be debilitating. TD symptoms can increase the social stigma of patients with comorbid psychiatric disorders, negatively impact quality of life, and potentially increase medical morbidity and mortality. An increased risk of developing TD has been associated with factors such as older age, female sex, underlying mental illness, and long-term use and higher doses of antipsychotics. The association of TD with the use of typical versus atypical antipsychotics has also been evaluated, with mixed results. To date, predictive models assessing the joint effect of clinical characteristics on TD risk have not been developed and validated in the US population.Study ObjectiveTo develop a prediction model to identify patient and treatment characteristics associated with the occurrence of TD among patients with psychiatric disorders taking antipsychotic medications, using a retrospective database analysis.MethodsAdult patients with schizophrenia, major depressive disorder, or bipolar disorder who were taking oral antipsychotics, and who had 6months of data prior to the index date were identified from Medicaid claims from six US states. The index date was defined as the date of the first claim for an antipsychotic drug after a claim for the underlying disorder but before TD diagnosis. A multivariate Cox prediction model was developed using a cross-validated version of the least absolute shrinkage and selection operator (LASSO) regression method to improve prediction accuracy and interpretability of the model. The predictive performance was assessed in a separate validation set via model discrimination (concordance) and calibration.ResultsA total of 189,415 patients were identified: 66,723 with bipolar disorder, 68,573 with depressive disorder, and 54,119 with schizophrenia. The selected prediction model had a clinically meaningful concordance of 70% and was well calibrated (P=0.46 for Hosmer–Leme show goodness-of-fit test). Patient’s age at index date (hazard ratio [HR]: 1.03), diagnosis of schizophrenia (HR: 1.73), dosage of antipsychotic at index date (up to 100mg/day chlorpromazine equivalent; HR: 1.40), and presence of bipolar and related disorders (HR: 1.16) were significantly associated with an increased risk of TD diagnosis. Use of atypical antipsychotics at index date was associated with a modest reduction in the risk of TD (HR=0.94).ConclusionsThis study identified a group of factors associated with the development of TD among patients with psychiatric disorders treated with antipsychotics. This may allow physicians to better monitor their patients receiving antipsychotics, allowing for the prompt identification and treatment of TD to help maintain quality of life.Presented at: American Psychiatric Association Annual Meeting; May 5–9, 2018, New York, New York, USAFunding Acknowledgements: This study was supported by Teva Pharmaceuticals, Petach Tikva, Israel.

scholarly journals Characteristics associated with quality of life among people with drug-resistant epilepsy

2017 ◽  
Vol 264 (6) ◽  
pp. 1174-1184 ◽  
Author(s):  
Leone Ridsdale ◽  
◽  
Gabriella Wojewodka ◽  
Emily Robinson ◽  
Sabine Landau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

Treating Drug-resistant Epilepsy – Why are we Waiting?

2015 ◽  
Vol 10 (2) ◽  
pp. 171
Author(s):  
Paul Boon ◽  
Philippe Ryvlin ◽  
James W Wheless ◽  
Kensuke Kawai ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychiatric Disease ◽  
Drug Resistant ◽  
Treatment Gap ◽  
Health Service Provision ◽  
Adequate Treatment ◽  
Seizure Reduction ◽  
Number Of Patients ◽  
Drug Resistant Epilepsy

Drug-resistant epilepsy (DRE) has been defined by the ad hoc Task Force of the International League Against Epilepsy (ILAE) Commission on Therapeutic Strategies as the failure of two appropriately chosen and tolerated anti-epileptic drugs (AEDs) (whether as monotherapy or in combination) to control seizures when used for an adequate period of time. The difference between the number of patients with DRE and the number of these patients who do not get access to adequate treatment is defined as the ‘treatment gap’, which is considered to be substantial. There are multiple possible causes that underlie the treatment gap in DRE: economic costs, natural history of epilepsy, deficiencies in health service provision, social stigma and other as yet unidentified causes. Factors affecting quality of life in DRE include depression and anxiety, raised risk of mortality and morbidity, increased healthcare utilisation and increased risk of adverse events with long- term use of AEDs, cognitive and memory impairment, seizure-related injuries, impaired ability to achieve educational and vocational goals, to drive, establish families and benefit from social relationships. Among the reasons for the greater risk of premature death are the raised risk of suicide in those patients with comorbid psychiatric disease and the increased incidence of sudden unexpected death among those with epilepsy. Managing epilepsy well involves more than just seizure reduction and when freedom from seizures cannot be achieved, addressing quality of life is likely to be more beneficial than interventions aimed at seizure reduction alone. Options exist for patients with DRE who are not candidates for epilepsy surgery, including dietary treatments, further attempts with AEDs and non-pharmacological interventions with devices. Further, non-invasive modalities are emerging, creating a more hopeful picture that the treatment gap for patients with DRE may be narrowed or even closed.

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