scholarly journals Past Trauma Is Associated With a Higher Risk of Experiencing an Epileptic Seizure as Traumatic in Patients With Pharmacoresistant Focal Epilepsy

2021 ◽  
Vol 12 ◽  
Author(s):  
Sara Mariotti ◽  
Damien Valentin ◽  
Deniz Ertan ◽  
Louis Maillard ◽  
Alexis Tarrada ◽  
...  
Keyword(s):  
Focal Epilepsy ◽  
Traumatic Events ◽  
Epileptic Seizures ◽  
Traumatic Experience ◽  
Pharmacoresistant Epilepsy ◽  
Psychiatric Comorbidities ◽  
Traumatic Life Events ◽  
Determining Factors ◽  
Previous Trauma ◽  
History Of

Objective: The present study aimed to evaluate the prevalence of traumatic experienced seizures (TES) and of postepileptic seizure PTSD (PS-PTSD) in patients with pharmacoresistant focal epilepsy and to explore the determining factors of TES.Methods: We conducted an observational study enrolling 107 adult refractory epilepsy patients. We used the DSM-5 criteria of traumatic events and PTSD to define TES and PS-PTSD. We assessed all traumatic life events unrelated to epilepsy, general and specific psychiatric comorbidities, and quality of life.Results: Nearly half (n = 48) of the 107 participants reported at least one TES (44.85%). Among these, one-third (n = 16) developed PS-PTSD. The TES group was more likely to experience traumatic events unrelated to epilepsy (p < 0.001), to have generalized anxiety disorder (p = 0.019), and to have specific psychiatric comorbidities [e.g., interictal dysphoric disorder (p = 0.024) or anticipatory anxiety of seizures (p = 0.005)]. They reported a severe impact of epilepsy on their life (p = 0.01). The determining factors of TES according to the multifactorial model were the experience of trauma (p = 0.008), a history of at least one psychiatric disorder (p = 0.03), and a strong tendency toward dissociation (p = 0.03).Significance: Epileptic seizures may be a traumatic experience in some patients who suffer from pharmacoresistant epilepsy and may be the source of the development of PS-PTSD. Previous trauma unrelated to epilepsy and psychiatric history are determining factors of TES. These clinical entities should be explored systematically.

scholarly journals The Impact of the FKBP5 Gene Polymorphisms on the Relationship between Traumatic Life Events and Psychotic-Like Experiences in Non-Clinical Adults

2021 ◽  
Vol 11 (5) ◽  
pp. 561
Author(s):  
Filip Stramecki ◽  
Dorota Frydecka ◽  
Łukasz Gawęda ◽  
Katarzyna Prochwicz ◽  
Joanna Kłosowska ◽  
...  
Keyword(s):  
Physical Abuse ◽  
Life Events ◽  
Psychotic Disorders ◽  
Traumatic Events ◽  
Psychosis Proneness ◽  
Traumatic Life Events ◽  
History Of ◽  
The Impact ◽  
The Relationship ◽  
Pituitary Adrenal Axis

Common variations of the FKBP5 gene are implicated in psychotic disorders, by modulating the hypothalamic–pituitary–adrenal axis reactivity to stress. It has been demonstrated that some of them might moderate the effects of childhood trauma on psychosis proneness. However, these associations have not been investigated with respect to traumatic life events (TLEs). Therefore, we aimed to explore whether the FKBP5 polymorphisms moderate the effects of TLEs on the level of psychotic-like experiences (PLEs). A total of 535 non-clinical adults were approached for participation, and genotyping of six FKBP5 polymorphisms (rs3800373, rs9470080, rs4713902, rs737054, rs1360780 and rs9296158) was performed. The Prodromal Questionnaire-16 (PQ-16) and the Traumatic Events Checklist (TEC) were administered to assess PLEs and TLEs, respectively. Among the rs1360780 CC homozygotes, a history of physical abuse was associated with significantly higher PQ-16 scores. This difference was not significant in the rs1360780 T allele carriers. Similarly, a history of physical abuse was associated with significantly higher PQ-16 scores in the rs9296158 GG homozygotes but not in the rs9296158 A allele carriers. Finally, emotional neglect was related to significantly higher PQ-16 scores in the rs737054 T allele carriers but not in the rs737054 CC homozygotes. The present study indicates that variation in the FKBP5 gene might moderate the effects of lifetime traumatic events on psychosis proneness.

scholarly journals The effect of epilepsy control on psychogenic non epileptic seizures

2021 ◽  
Author(s):  
Muaz.A.Ibrahim ◽  
Tasneem.M.F ◽  
Khabab Abbasher Hussien Mohamed Ahmed ◽  
Abdallah M. Abdallah ◽  
Mohammed Eltahier Abdalla Omer ◽  
...  
Keyword(s):  
Epileptic Seizure ◽  
Focal Epilepsy ◽  
Neurological Diseases ◽  
Epileptic Seizures ◽  
Abnormal Behavior ◽  
Detailed History ◽  
Follow Up Care ◽  
History Of ◽  
Patients With Epilepsy

Abstract Background: Epilepsy is one of the most common neurological diseases. The coexistence of epilepsy and PNES poses a major challenge to neurologists and psychiatrists in the treatment and follow-up care of patients. Methods: 33 Sudanese patients with epilepsy and concomitant psychogenic non epileptic seizure where included in this study and full detailed history of both epilepsy and PNES was obtained. The study was conducted in Daoud charity clinic during the period from May to July 2018Results : Out of 33 patients 19 were males and 14 were females. Seven patients had focal epilepsy, 23 had generalized tonic clonic epilepsy (GTC), 2 had GTC with atypical absent seizure, and one had GTC with myoclonus.Six patients experienced an attack of PNES after more than 1 year of being free of epilepsy, while 9 patients had PNES attack between 3 months to 1 year of the last attack of epilepsy, and 18 patients developed both PNES and epilepsy within less than 3 months.The pattern of presentation of PNES was bizarre movements in 13 patients, abnormal behavior in 9 patients, while 11 patients experienced both bizarre movement and abnormal behavior note that all those 11 patients had GTC epilepsy. Conclusion: Experiencing psychogenic non epileptic seizure (PNES) in patients with coexisting PNES and epilepsy is not affected by the epilepsy free period

scholarly journals Transient lesion in the splenium of the corpus callosum and a sudden antiepileptic drugs withdrawal: A case with focal epilepsy in presurgical evaluation

2010 ◽  
Vol 67 (5) ◽  
pp. 427-430
Author(s):  
Aleksandar Ristic ◽  
Slobodan Lavrnic ◽  
Ljubica Zovic ◽  
Nikola Vojvodic ◽  
Slavko Jankovic ◽  
...  
Keyword(s):  
Corpus Callosum ◽  
Antiepileptic Drugs ◽  
Focal Epilepsy ◽  
Rare Complication ◽  
Brain Mri ◽  
Epileptic Seizures ◽  
Focal Lesion ◽  
Pharmacoresistant Epilepsy ◽  
Transient Nature ◽  
Flair Sequence

Introduction. A sudden withdrawal of antiepileptic drugs gives higher rate of epileptic seizures in the settings of video electroencephalography (vEEG), monitoring that is a subject to further registration and analysis. A very rare complication of this method is transient lesion of the splenium of corpus callosum (SCC) detected with brain MRI. Case report. We presented a patient with a 5-year history of pharmacoresistant epilepsy admitted to the Institute of Neurology (August, 2008) for vEEG monitoring. Interictal epileptic discharges but none seizure were recorded after the sudden withdrawal of antiepileptic medications, during 5 days of vEEG monitoring Initial brain MRI three days after vEEG monitoring revealed focal lesion in SCC, hyperintense on T2 and FLAIR sequence. A longitudinal radiological follow-up (7 and 49 days after initial acquisition) confirmed transient nature of the lesion without diffusion coefficient changes. Conclusion. SCC lesion, reversible and harmless, may occur after a sudden antiepileptic withdrawal. Its early detection makes further extensive neuroradiological and clinical examinations unnecessary.

The Value of Hypnosis in the Resolution of Dissociation: Clinical Lessons from World War I on the Integration of Traumatic Memories

2019 ◽  
pp. 11-49 ◽  
Author(s):  
Onno van der Hart
Keyword(s):  
World War I ◽  
Traumatic Experience ◽  
Traumatic Memory ◽  
World War ◽  
Traumatic Memories ◽  
Previous Trauma ◽  
History Of ◽  
War Experiences ◽  
Simple Phase

Some World War I clinicians related the symptoms of traumatized servicemen to an underlying dissociation of their personality, consisting of two prototypical conditions: one involving functioning in daily life (inspired by Myers, whose work is also discussed in this article, and which will be labeled apparently normal part of the personality [ANP]) and one involving fixation in the traumatic experience and related attempts at defense (emotional part of the personality [EP]). These authors described two dissociative patterns. As illustrated in this article, one pattern consisted in the presentation of a dominant ANP suffering from constant or frequent intrusions from EP. The other pattern consisted in repeated complete alternations between ANP and EP. Instead of the use of purely symptom-oriented approaches, for the dissociative symptoms to be really resolved, an integration of traumatic memory in the personality, that is, between EP and ANP had to take place. These clinicians used hypnosis to access the traumatic memory and EP and to foster such integration; they agreed on the importance of the quality of the therapeutic relationship in this regard. However, they differed in opinion and practice as to the need to assists patients in their expression of traumatic emotions during this process. When the trauma was related merely to war experiences, such therapeutic processes took place within a simple phase-oriented treatment model, while in the presence of a history of previous trauma and related dissociation of the personality, this model had more complex applications. This is similar to modern treatment approaches of the sequelae - such as a complex dissociative disorder - of chronic (childhood) traumatization.

scholarly journals Problems of diagnosing focal cortical dysplasia

2021 ◽  
Vol 13 (1) ◽  
pp. 33-43
Author(s):  
K. D. Yakovleva ◽  
E. A. Kantemirova ◽  
D. V. Dmitrenko
Keyword(s):  
Clinical Case ◽  
Focal Epilepsy ◽  
Focal Cortical Dysplasia ◽  
Epileptiform Activity ◽  
Epileptic Seizures ◽  
Cortical Dysplasia ◽  
Differential Diagnostics ◽  
Pharmacoresistant Epilepsy ◽  
Structural Epilepsy ◽  
Generalized Epilepsy

Focal cortical dysplasia (FCD) is one of the most common causes in developing pharmacoresistant epilepsy. We present the clinical case of the patient with generalized seizures. Routine electroencephalography (EEG) data registered diffuse epileptiform activity that allowed to diagnose genetic  eneralized epilepsy and pharmacoresistant course of seizures.After performing magnetic resonance imaging using the epileptological program and video-EEG-monitoring, the diagnosis was revised: structural focal epilepsy with seizures with  focal onset with oroalimentary, gesture automatisms in the right hand, bilateral tonic-clonic, uncompensated by levetiracetam monotherapy (1500 mg/day). Background disease: congenital  malformation of the brain: FCD in the basal parts of the left temporal lobe. Lacosamide was added to the therapy in the drug dose 300 mg/day, and the frequency of epileptic seizures decreased. Differential diagnosis between genetic generalized  epilepsy and structural epilepsy with FCD usually poses no  obstacles. However, in some cases, structural epilepsy occurs  under the “mask” of generalized epilepsy. Hence, this clinical  case demonstrates the importance of diagnostic measures in the  differential diagnostics of various forms of epilepsy to determine  further tactics of patient management. 

scholarly journals Patients with resistant focal epilepsy: what affects the quality of life?

2019 ◽  
Vol 11 (3) ◽  
pp. 233-243
Author(s):  
K. V. Firsov ◽  
M. G. Amirhanyan ◽  
A. S. Kotov
Keyword(s):  
Quality Of Life ◽  
Focal Epilepsy ◽  
Brain Mri ◽  
Epileptic Seizures ◽  
Social Situation ◽  
Psychological State ◽  
Treatment Resistant ◽  
History Of ◽  
The Impact

The aim is to assess the impact of resistant focal epilepsy on the quality of patients' life.Materials and methods. Prospective, comparative, observational study conducted under conditions of real clinical practice. Inclusion criteria: age over 18 years; the presence of two or more epileptic seizures in history; a long history of treatment-resistant focal epileptic seizures; current AED therapy. Exclusion criteria: history of non-epileptic seizures of any etiology; inability to perform an MRI and/or EEG. The design included two patient visits, the second 3-12 months after the first ("primary" and "repeated" examinations). The examination included the medical history, analysis of seizure diary, clinical and neurological examination, routine EEG and/or EEG video monitoring, brain MRI, and laboratory tests. During the initial and repeated visits, the patients were asked to answer the QOLIE-31, NHS3, HADS questionnaires. The patients were also asked to give their own subjective assessment of their physical and psychological state, treatment results, side effects, social situation, and the quality of life. All patients had a follow-up history of at least one year.Results. In total, 120 patients with current or past treatment-resistant epileptic seizures were examined (53 men and 67 women aged 18 to 77 years). At the time of the re-examination (under continuing AED therapy), seizures stopped in 50.8% of them. The number of seizure types decreased in 65.9% of people. The effect of resistant focal epilepsy on the patient's quality of life was determined.Conclusion. The use of commonly accepted tests (QOLIE-31, HADS, etc.) in the "expertise" mode is incorrect, probably because these tests had been originally created for the "client" situation. A discrepancy was found between an objective improvement in the clinical picture as a result of successful treatment and a subjective "insignificant" improvement in the quality of life as per patients' assessments.

Rorschach Assessment of Complex Trauma in Youth

2020 ◽  
Vol 41 (1) ◽  
pp. 19-41
Author(s):  
David Ephraim
Keyword(s):  
Psychological Assessment ◽  
Complex Trauma ◽  
Personality Development ◽  
Traumatic Events ◽  
History Of ◽  
The Way

Abstract. A history of complex trauma or exposure to multiple traumatic events of an interpersonal nature, such as abuse, neglect, and/or major attachment disruptions, is unfortunately common in youth referred for psychological assessment. The way these adolescents approach the Rorschach task and thematic contents they provide often reflect how such experiences have deeply affected their personality development. This article proposes a shift in perspective in the interpretation of protocols of adolescents who suffered complex trauma with reference to two aspects: (a) the diagnostic relevance of avoidant or emotionally constricted Rorschach protocols that may otherwise appear of little use, and (b) the importance of danger-related thematic contents reflecting the youth’s sense of threat, harm, and vulnerability. Regarding this last aspect, the article reintroduces the Preoccupation with Danger Index ( DI). Two cases are presented to illustrate the approach.

Anterior Cruciate Ligament Rupture Associated with Cardiomyopathy in Three Cats

1991 ◽  
Vol 4 (01) ◽  
pp. 35-37 ◽  
Author(s):  
G. O. Janssens ◽  
D. L. Janssens ◽  
L. A. A. Janssens
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Anterior Cruciate Ligament Rupture ◽  
Acl Rupture ◽  
Thoracic Radiography ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Previous Trauma ◽  
History Of ◽  
Anterior Cruciate

SummaryOver a period of 14 years, three cats with anterior cruciate ligament (ACL) rupture were seen in our practice. In all, the rupture had occurred without a history of previous trauma. All were treated surgically. All died within a period of 14 days. The reason of death was in all cases cardiomyopathy. We now suggest that cats with rupture of the anterior cruciate ligament undergo an electrocardiographic recording and eventually an thoracic radiography before surgery is considered. We also suggest that cats with ACL rupture should preferably be treated conservatively.

Мотив хвороби в історії літератури і культури посттоталітарних країн Центрально-Східної Європи

2021 ◽  
pp. 219-222
Author(s):  
Mariya Yankova
Keyword(s):  
Eastern Europe ◽  
World Literature ◽  
Central And Eastern Europe ◽  
Traumatic Experience ◽  
International Conference ◽  
Women's Art ◽  
History Of ◽  
History Of Literature

The article is dedicated to the issues considered during the international conference “The motive of the disease in the history of literature and culture of post-totalitarian states of Central and Eastern Europe”, which took place on November 6, 2020. The main topics of the speakers were focused on the disease as a weakness in the literature, the trauma of loss, the theme of illness and healing in world literature from its beginning to the present, including the periods of Kyiv Rus, Renaissance, Baroque and Modernism and the traumatic experience in the narratives of the Holodomor, Ukrainian women’s prose and the ability of Ukrainian sacred and decorative, as well as modern women’s art to visualize the disease and help artists overcome their injuries.

scholarly journals Osteoporosis-Related Simultaneous Four Joints Fractures and Dislocation after a Seizure: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-4
Author(s):  
Abdullah S. AlOmran
Keyword(s):  
Vitamin D ◽  
Case Report ◽  
Clinical Examination ◽  
Epileptic Seizures ◽  
Antiresorptive Therapy ◽  
Multiple Fractures ◽  
Steroid Use ◽  
Skeletal Injury ◽  
History Of ◽  
Rule Out

A case of steroid-induced osteoporosis-related multiple fractures and dislocations are described after a seizure is reported. Patient had two years history of steroid use with no supplement or antiresorptive therapy. There was a delay in the diagnosis which affected an otherwise good outcome in such situations. It is recommended that patients on steroid should be given calcium, vitamin D, and an antiresorptive. Furthermore, a meticulous clinical examination is required in patients who are on steroids and suffer epileptic seizures to rule out skeletal injury.

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