scholarly journals Recurrent seizures in patients with focal epilepsy

2021 ◽  
Vol 5 (10) ◽  
pp. 654-658
Author(s):  
E.A. Sandu ◽  
◽  
K.V. Firsov ◽  
V.M. Frolova ◽  
A.S. Kotov ◽  
...  
Keyword(s):  
Treatment Efficacy ◽  
Disease Duration ◽  
Focal Epilepsy ◽  
Communicable Disease ◽  
Low Frequency ◽  
Spontaneous Remission ◽  
Main Task ◽  
Keywords Epilepsy ◽  
Focal Seizures ◽  
Short Disease Duration

Epilepsy is a chronic non-communicable disease of the brain that affects people of all ages. It is diagnosed in 2.4 million people annually. Epilepsy includes focal seizures that are more common than generalized ones. The incidence of focal epilepsy in the population reaches 0.5– 0.8%. Resistant types account for approximately 30% of all epilepsy forms, especially in patients with focal seizures. Thereby, the main task of epilepsy treatment is to control seizures. Patients with a newly diagnosed focal epilepsy in 55–68% of cases achieve long-term remission of seizures. Adding that, there is a spontaneous remission of untreated epilepsy considered a common event. The article gives the following negative prognostic factors: onset with seizure clusters, high disease duration, multiple treatment attempts, high frequency of seizures and incompetence, cognitive impairment. The article also presents the following treatment efficacy predictors of focal epilepsy: low frequency of seizures, short disease duration, pathological activity absence on the EEG, isolated generalized seizures. Predictors of recurrent seizures include pathological changes on the EEG, family history of seizures, established etiology of seizures and nocturnal seizures. KEYWORDS: epilepsy, relapses, predictors, factors, prognosis, remission, treatment, efficacy. FOR CITATION: Sandu E.A., Firsov K.V., Frolova V.M., Kotov A.S. Recurrent seizures in patients with focal epilepsy. Russian Medical Inquiry. 2021;5(10):654–658 (in Russ.). DOI: 10.32364/2587-6821-2021-5-10-654-658.

Dramatic Onset of Focal Seizures: Differentiating Structural Focal Epilepsy from Ring Chromosome 20

2017 ◽  
Vol 48 (S 01) ◽  
pp. S1-S45
Author(s):  
A. Herting ◽  
T. Cloppenborg ◽  
A. Hofmann-Peters ◽  
T. Polster
Keyword(s):  
Focal Epilepsy ◽  
Ring Chromosome ◽  
Focal Seizures ◽  
Chromosome 20

scholarly journals 125 Short Duration Monoballismus

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 79-80
Author(s):  
Davinder Dhillon ◽  
Priya Batta ◽  
Alan R. Hirsch
Keyword(s):  
Short Duration ◽  
Parietal Lobe ◽  
Focal Epilepsy ◽  
Memory Loss ◽  
Low Frequency ◽  
Normal Animal ◽  
Conversion Disorder ◽  
Huntington's Chorea ◽  
Study Objective ◽  
Alien Hand Syndrome

AbstractStudy ObjectiveWhile monoballismus has been reported to be associated with hemorrhagic lesions in the subthalamic nucleus (Ohnishi, 2009) and multiple sclerosis (MS) (Rosa, 2011), the duration has been reported to be at least six days (Soysal, 2012). A patient with epochs of monoballismus lasting for 45 minutes is presented.MethodsCase Study: A 57 year old right handed female with attention deficit hereditary disorder predominantly inattentive on amphetamine sulphate, presented with two years of memory loss. For instance, after ordering food in restaurants, by the time the food arrives, she could not recall what she ordered. At the onset of this symptom, she noted three epochs of her left arm jerking for 45 minutes. The jerking would begin with low amplitude and low frequency and rapidly progress to the forearm and arm of greater magnitude and low frequency. With her right hand she would try to hold down her left arm without success. There was no associated paresis, sensory phenomena, headaches, dizziness, presyncope, loss of consciousness, or strong emotions. She admitted to frequent jamais vu.ResultsAbnormalities: Neurological Examination: Mental Status Examination: Memory: Immediate Recall: 5 digits forward and 2 digits backwards. Cranial Nerve (CN) Examination: CN I: Alcohol Sniff Test 8 (hyposmia). CN XII: tongue tremor on protrusion. Motor Examination: Drift Test: positive right pronator drift. Gait Examination: Tandem Gait: unstable. Reflexes: 0-1 throughout. Neuropsychiatric Examination: Go-No-Go Test: 6/6 (normal). Animal Fluency Test: 15 (normal). Clock Drawing Test: 3 (abnormal). Center for Neurologic Study Lability Scale: 16 (pseudobulbar affect). Other: MRI with and without infusion: normal.ConclusionTransient tonic-clonic movements of one limb have been described with focal epilepsy associated with diabetic non-ketotic hyperglycemia (Grant, 1985). A metabolic abnormality such as transient hypoglycemia or hyperkalemia can cause a focal dystonia (Soysal, 2012), which theoretically could manifest with monoballismus. This could be a somatic manifestation of underlying conflict, conversion disorder, or as a result of a physical manifestation of panic attack with hyperventilation and tetany (Mihai, 2008). This may be the first manifestation of a generalized cerebral disorder associated with chorea or ballismus such as Wilson’s disease, or Huntington’s Chorea (Mihai, 2008). It is possible that this is a variant of Alien Hand Syndrome with parietal lobe involvement (Shrestha, 2015). But this is unlikely given the absence of hemineglect or hemiagnosia. It is possible that amphetamines may have induced a monochorea. Chronic amphetamine use has been demonstrated to cause chorea (Klawans, 1974) and it theoretically could have caused ballismus movements in this case. In patients who present with short duration monoballismus, evaluation for subthalamic nuclei function, seizure disorders and other origins of ballismus are warranted.Funding AcknowledgementsSmell & Taste Treatment and Research Foundation

SAT0060 Best Chance of Achieving Remission in RA Patients with Very Short Disease Duration:

2014 ◽  
Vol 73 (Suppl 2) ◽  
pp. 611.1-611
Author(s):  
T. Uhlig ◽  
V. Norvang ◽  
E. Lie ◽  
E. Rødevand ◽  
K. Mikkelsen ◽  
...  
Keyword(s):  
Disease Duration ◽  
Short Disease Duration

scholarly journals Results of the infrasonic array on the Valaam Island primary data processing

2020 ◽  
Vol 2 (1) ◽  
pp. 85-91
Author(s):  
Vladimir Karpinsky ◽  
Vladimir Asming
Keyword(s):  
Data Processing ◽  
Seismic Station ◽  
Sampling Rate ◽  
Low Frequency ◽  
Primary Data ◽  
Joint Analysis ◽  
Main Task ◽  
Significant Difference ◽  
Infrasound Signal ◽  
Short Time

The infrasound array VALS developed in Kola Branch GS RAS has been installed in June 2016 on the Valaam Island in addition to the continuously operating seismic station VALR. The array consists of 3 spaced low-frequency microphones. The data with a sampling rate of 100 Hz is stored continuously at the acquisition computer; the timing is carried out using GPS. In addition to the acquisition system, an infrasound signal detector is installed on the computer. It works in near real-time mode and enables us to find signals and compute their back azimuths. At the end of 2018, a new version of the detector was developed at the Kola Branch GS RAS. The detector began to work much faster, which enabled us to carry out data processing for 2.5 years in two frequency ranges in a short time. The main task of the array is acoustic monitoring, the detection of infrasound events, the determination of their parameters, and the selection of events of natural origin. The data are also used (in combination with the VALR seismic station data) to locate near seismic events, especially weak ones. The analysis of the obtained data revealed the prevailing directions to the signal sources. The change of directions to sources in time was investigated, seasonal features were revealed. Acoustic events were detected in the frequency bands 1–5 Hz and 10–20 Hz, and a significant difference was found in the azimuthal distribution of events for these ranges. A joint analysis of acoustic and seismic data showed that the part of events with both acoustic and seismic components is low – it is almost completely exhausted by career explosions. It was also noted that in addition to explosions in nearby quarries (Kuznechnoye, Pitkäranta) located at a distance of 50–60 km, according to acoustic data, events corresponding to explosions at quarries located at a distance of 100 km or more were repeatedly identified.

scholarly journals Activity of kallikrein-kinin system at patients with asiderotic anemia

2004 ◽  
Vol 3 (2) ◽  
pp. 56-61
Author(s):  
N. N. Zhilkova
Keyword(s):  
Disease Duration ◽  
Proteinase Inhibitors ◽  
Stable State ◽  
Continuous Treatment ◽  
Kinin System ◽  
Α2 Macroglobulin ◽  
Short Disease Duration ◽  
Severity Of The Disease ◽  
Kallikrein Kinin System ◽  
Severity Degree

The aim of investigation is to study the state of kallikrein-kinin system (KKS) and proteinase inhibitors at patients with asiderotic anemia prior to and after the treatment. 58 patients with asiderotic anemia prior to the treatment and in dynamics after 3 weeks have been examined. KKS state has been estimated by kallikrein, prekallikrein, proteinase α1-inhibitor (Pα1I) and α2-macroglobulin (α2-MG) levels in blood plasma having been investigated by Paskhina’s et al.chromatographic method and by Nartikova’s and Paskhina’s unified enzymatic method.Patients with asiderotic anemia had the rise of KKS activity. Its change differences depending on the disease duration have been revealed. At short disease duration a regulated KKS activation and its stable state have been marked. After the treatment at patients with medium severity degree it happens a normalization of all KKS parameters, at patients with serious anemia the high activity of Pα1I persists. The continuous treatment of anemia has led to the development of pathological type activation that had persisted at patients after the treatment.It has been revealed that the degree of KKS activation intensity and its renewal after the implemented treatment depended on the duration and severity of the disease.

European trends in epilepsy surgery

Neurology ◽  
2018 ◽  
Vol 91 (2) ◽  
pp. e96-e106 ◽  
Author(s):  
Maxime O. Baud ◽  
Thomas Perneger ◽  
Attila Rácz ◽  
Max C. Pensel ◽  
Christian Elger ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Disease Duration ◽  
Focal Epilepsy ◽  
Seizure Freedom ◽  
Early Referral ◽  
Temporal Epilepsy ◽  
Included Patient ◽  
Class 1 ◽  
Postsurgical Outcomes ◽  
Over Time

ObjectiveResective surgery is effective in treating drug-resistant focal epilepsy, but it remains unclear whether improved diagnostics influence postsurgical outcomes. Here, we compared practice and outcomes over 2 periods 15 years apart.MethodsSixteen European centers retrospectively identified 2 cohorts of children and adults who underwent epilepsy surgery in the period of 1997 to 1998 (n = 562) or 2012 to 2013 (n = 736). Data collected included patient (sex, age) and disease (duration, localization and diagnosis) characteristics, type of surgery, histopathology, Engel postsurgical outcome, and complications, as well as imaging and electrophysiologic tests performed for each case. Postsurgical outcome predictors were included in a multivariate logistic regression to assess the strength of date of surgery as an independent predictor.ResultsOver time, the number of operated cases per center increased from a median of 31 to 50 per 2-year period (p = 0.02). Mean disease duration at surgery decreased by 5.2 years (p < 0.001). Overall seizure freedom (Engel class 1) increased from 66.7% to 70.9% (adjusted p = 0.04), despite an increase in complex surgeries (extratemporal and/or MRI negative). Surgeries performed during the later period were 1.34 times (adjusted odds ratio; 95% confidence interval 1.02–1.77) more likely to yield a favorable outcome (Engel class I) than earlier surgeries, and improvement was more marked in extratemporal and MRI-negative temporal epilepsy. The rate of persistent neurologic complications remained stable (4.6%–5.3%, p = 0.7).ConclusionImprovements in European epilepsy surgery over time are modest but significant, including higher surgical volume, shorter disease duration, and improved postsurgical seizure outcomes. Early referral for evaluation is required to continue on this encouraging trend.

How to better help cancer patients face their coming death?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21505-e21505 ◽  
Author(s):  
Francois-Xavier Goudot ◽  
Milena Maglio ◽  
Sandrine Bretonniere
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Disease Duration ◽  
Hospice Care ◽  
Good Practice ◽  
Terminal Phase ◽  
Palliative Care Teams ◽  
Short Disease Duration ◽  
Impending Death ◽  
The Mean

e21505 Background: According to literature and medical experience, the doctor-patient relationship becomes strained when oncologists tell their patients that they have no more curative treatments to offer them. Patients often resist when they are told that it is in their best interest to meet with the palliative teams. Little is known about how to meet patients’ expectations at this advanced stage. Methods: We conducted a multicenter qualitative research in an oncology department, a hospital at home service and in an inpatient hospice care center. We met 47 patients (M = 21, F = 27, mean age = 65 yrs, mean disease duration = 5 yrs) for in-depth face to face interviews performed by a multi-disciplinary ethics team. Interviews were carried out between 1 and 3 months before death. Results: Qualitative analysis revealed 4 main results. 1/ For respondents, palliative care introduction meant impending death. 2/ Palliative care introduction meant loss of hope. Without hope, the cancer trajectory is impossible to sustain, they said. 3/ Hope was intricately interwoven with the request for more chemotherapy, even if doctors had clearly refused to provide it. 4/ The oncologist remained the referent physician, even for patients in hospice care. Patients for which the mean duration between cancer diagnosis and interview was 5 years or more, were more willing to talk about death and better accepted palliative care than patients for which the mean duration of cancer was inferior to 3 yrs. For patients with fast progressing cancer (n = 11), 10 were not willing to talk about death and 7 strongly resisted palliative care introduction. There was no difference between patients according to age, sex, type of cancer or center of inclusion. Conclusions: In the terminal phase of cancer, patients are unwilling to talk about death and are reluctant to meet with palliative care teams. Short disease duration strongly reinforces this attitude. If patients resist discussions about their impending death, should physicians continue to consider it good practice to introduce such discussions? Is it beneficent for patients?

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