ESTUDO SOBRE O CANABIDIOL: UMA ALTERNATIVA AO TRATAMENTO DE DOENÇA EPILÉTICA

Objetivo: descrever os efeitos terapêuticos e sobre a utilização do cannabidiol no tratamento da epilepsia. Métodos: O presente estudo se caracteriza como sendo uma revisão de literatura do tipo integrativa, com abordagem qualitativa.Resultados: Foram localizadas 118 produções cientificas. Sendo excluídos produções realizadas em um período maior que dez anos e aquelas que não estavam disponíveis ao acesso gratuito. Os estudos demonstraram melhora na frequência das crises. Não foi encontrada associação entre o percentual de redução das frequências das crises e tempo de tratamento. Os efeitos adversos mais encontrados foram sonolência, hiporexia, diarreia, vômitos alterações comportamentais e tonturas. Considerações finais: It is concluded that the therapeutic use of cannabidiol was associated with a decrease in the frequency of epileptic seizures, as well as an improvement in the quality of life in individuals with refractory epilepsy.

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Mood Disturbances, Anxiety, and Impact on Quality of Life in Patients Admitted to Epilepsy Monitoring Units

Frontiers in Neurology ◽

10.3389/fneur.2021.761239 ◽

2021 ◽

Vol 12 ◽

Author(s):

Rodrigo Rocamora ◽

Beatriz Chavarría ◽

Eva Pérez ◽

Carmen Pérez-Enríquez ◽

Ainara Barguilla ◽

...

Keyword(s):

Quality Of Life ◽

Refractory Epilepsy ◽

Depression Scale ◽

Epileptic Seizures ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Patients With Epilepsy ◽

Anxiety Depression ◽

Epilepsy Monitoring

Introduction: The overall combined prevalence of anxiety and depression in patients with epilepsy has been estimated at 20.2 and 22.9%, respectively, and is considered more severe in drug-refractory epilepsy. Patients admitted to epilepsy monitoring units constitute a particular group. Also, patients with psychogenic non-epileptic seizures can reach more than 20% of all admissions. This study aims to characterize these symptoms in a large cohort of patients admitted for evaluation in a tertiary epilepsy center.Materials and Methods: The study was conducted among 493 consecutive patients (age: 38.78 ± 12.7, 57% females) admitted for long-term video EEG from January 2013 to February 2021. Demographic, clinical, and mood disorder patients' data were collected. Anxiety and depression symptoms were assessed through the Hospital Anxiety Depression Scale (HADS-A and HADS-D), the State Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI-II). Quality of life was determined using the QOLIE-10. Patients were divided into three groups: patients with epilepsy (n = 395), psychogenic non-epileptic seizures (PNES) (n = 56), and combined (n = 33). A univariate and multivariate regression analysis was performed for variables associated with quality of life.Results: Of 493 patients, 45.0% had structural etiology, and considering epilepsy classification, 43.6% were of temporal lobe origin. In addition, 32.45% of patients had a previous psychiatric history, 49.9% of patients had depressive symptoms in BDI, and 30.9% according to HADS-D; 56.42 and 52.63% of patients presented pathological anxiety scores in STAI-T and STAI-S, respectively; and 44.78% according to HADS-A. PNES and combined groups revealed a higher incidence of pathologic BDI scores (64.29 and 78.79%, p < 0.001) as well as pathologic HADS-A scores (p = 0.001). Anxiety and depression pathologic results are more prevalent in females, HADS-A (females = 50.7%, males = 36.8%; p = 0.0027) and BDI > 13 (females = 56.6%, males = 41.0%; p = 0.0006). QOLIE-10 showed that 71% of the patients had their quality of life affected with significantly higher scores in the combined group than in the epilepsy and PNES groups (p = 0.0015).Conclusions: Subjective anxiety, depression, and reduced quality of life are highly prevalent in patients with refractory epilepsy. These symptoms are more evident when PNES are associated with epilepsy and more severe among female patients. Most of the cases were not previously diagnosed. These factors should be considered in everyday clinical practice, and specific approaches might be adapted depending on the patient's profile.

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Psychiatric and psychosocial morbidity 1 year after epilepsy surgery

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2020.114 ◽

2020 ◽

pp. 1-8

Author(s):

S. Patel ◽

M. Clancy ◽

H. Barry ◽

N. Quigley ◽

M. Clarke ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Epilepsy Surgery ◽

Refractory Epilepsy ◽

Post Surgery ◽

Axis I ◽

Patients With Epilepsy ◽

The Impact

Abstract Objectives: There is a high rate of psychiatric comorbidity in patients with epilepsy. However, the impact of surgical treatment of refractory epilepsy on psychopathology remains under investigation. We aimed to examine the impact of epilepsy surgery on psychopathology and quality of life at 1-year post-surgery in a population of patients with epilepsy refractory to medication. Methods: This study initially assessed 48 patients with refractory epilepsy using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life in Epilepsy Inventory 89 (QOLIE-89) on admission to an Epilepsy Monitoring Unit (EMU) as part of their pre-surgical assessment. These patients were again assessed using the SCID-I, QOLIE-89 and HADS at 1-year follow-up post-surgery. Results: There was a significant reduction in psychopathology, particularly psychosis, following surgery at 1-year follow-up (p < 0.021). There were no new cases of de novo psychosis and surgery was also associated with a significant improvement in the quality of life scores (p < 0.001). Conclusions: This study demonstrates the impact of epilepsy surgery on psychopathology and quality of life in a patient population with refractory surgery. The presence of a psychiatric illness should not be a barrier to access surgical treatment.

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Medical technology: A systematic review on medical devices utilized for epilepsy prediction and management

Current Neuropharmacology ◽

10.2174/1570159x19666211108153001 ◽

2021 ◽

Vol 19 ◽

Author(s):

Jen Sze Ong ◽

Shuet Nee Wong ◽

Alina Arulsamy ◽

Jessica L. Watterson ◽

Mohd. Farooq Shaikh

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Medical Devices ◽

Epileptic Seizures ◽

Well Being ◽

Sudden Unexpected Death ◽

Unexpected Death ◽

Long Time ◽

Wearable Medical

: Epilepsy is a devastating neurological disorder that affects nearly 70 million people worldwide. Epilepsy causes uncontrollable, unprovoked and unpredictable seizures that reduces the quality of life of those afflicted, with 1-9 epileptic patient deaths per 1000 patient occurring annually due to sudden unexpected death in epilepsy (SUDEP). Predicting the onset of seizures and managing them may help patients from harming themselves and may improve their well-being. For a long time, electroencephalography (EEG) devices have been the mainstay for seizure detection and monitoring. This systematic review aimed to elucidate and critically evaluate the latest advancements of medical devices, besides EEG, that have been proposed for the management and prediction of epileptic seizures. A literature search was performed on three databases; PubMed, Scopus and EMBASE. Following title/abstract screening by two independent reviewers, 27 articles were selected for critical analysis in this review. These articles revealed ambulatory, non-invasive and wearable medical devices such as the in-ear EEG devices, the accelerometer-based devices and the subcutaneous implanted EEG devices might be more acceptable than traditional EEG systems. In addition, extracerebral signal-based devices may be more efficient than EEG-based systems, especially when combined with an intervention trigger. Although further studies may still be required to improve and validate these proposed systems before commercialization, these findings may give hope to epileptic patients, particularly those with refractory epilepsy, to predict and manage their seizures. The use of medical devices for epilepsy may improve patients' independence and quality of life and possibly prevent sudden unexpected death in epilepsy (SUDEP).

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The effects of epileptic seizures upon quality of life

Journal of Epilepsy and Clinical Neurophysiology ◽

10.1590/s1676-26492009000300003 ◽

2009 ◽

Vol 15 (3) ◽

pp. 110-113 ◽

Cited By ~ 5

Author(s):

Priscila Camile Barioni Salgado ◽

Fernando Cendes

Keyword(s):

Quality Of Life ◽

Seizure Frequency ◽

Seizure Control ◽

Epileptic Seizures ◽

Anxiety And Depression ◽

Co Morbidity ◽

Item Quality ◽

Patients With Epilepsy ◽

And Control

OBJECTIVE: understand the psychological considerations of the relationship between the effect of seizures upon the patients' perception of seizure control, depression, anxiety and quality of life (QoL). METHODS: 151 adult patients with epilepsy diagnosed for over two years were interviewed and responded the 31-Item Quality of Life in Epilepsy (QOLIE-31), the Trait Form of the State/Trait Anxiety Inventory (STAI II) and the Beck Depression Inventory (BDI). RESULTS: 45 patients were depressed (29.8%) and 29 (19.2%) had anxiety. Depression scores ranged from 0 to 49 (M=7.4; SD=8.9) and anxiety scores ranged from 19 to 69 (M=41.5, SD=11.9). Total QoL score was correlated to seizure control (p<0.001), perception of epilepsy control (p<0.001), anxiety (p<0.001), and depression (p=0.003). The perception of epilepsy control was correlated to seizure control (p<0.001), seizure frequency (p=0.001), anxiety (p<0.001) and depression (p<0.001). Seizure control was associated to anxiety (p=0.033) and depression (p<0.001). There was co-morbidity between anxiety and depression (p<0.001). CONCLUSION: This study highlights the importance of the seizure frequency and control to the evaluation of perception of epilepsy control and shows that anxiety and depression in epilepsy are predicted by seizure-related (seizure frequency and control) and psychosocial aspects (perception of control and QoL) together.

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Long-term health-related quality of life in 262 patients with brain arteriovenous malformation

Neurology ◽

10.1212/wnl.0000000000008196 ◽

2019 ◽

Vol 93 (14) ◽

pp. e1374-e1384

Author(s):

Anni Pohjola ◽

Elias Oulasvirta ◽

Risto P. Roine ◽

Harri P. Sintonen ◽

Ahmad Hafez ◽

...

Keyword(s):

Quality Of Life ◽

Arteriovenous Malformation ◽

Refractory Epilepsy ◽

Analysis Of Covariance ◽

Postoperative Treatment ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Bleeding Episodes

ObjectiveTo discover the health-related quality of life (HRQOL) of patients with treated arteriovenous malformation (AVM), we used the self-applicable HRQOL instrument, the 15D, and analyzed the scores in both in the whole study population and specified cohorts.MethodsThe 15D questionnaires were mailed to adult patients with AVM alive in 2016 (n = 432) in our database. Patients with completely eradicated AVM (n = 262) were included in a subsequent analysis. The results were compared with those of the general population standardized for age and sex. Subgroup analyses were conducted for epilepsy, number of bleeding episodes, location of the lesion, modified Rankin Scale score, and Spetzler-Ponce classification (SPC) using independent-samples t test or analysis of covariance. Tobit regression was used to explain the variance in the 15D score.ResultsPatients had impaired HRQOL compared to the reference population (p < 0.0001). Deep location, multiple bleeding episodes, and refractory epilepsy were associated with impaired HRQOL. Patients in SPC A and B had similar posttreatment 15D scores, whereas those in class C had an impaired HRQOL. Significant explanatory variables in the regression model were age, sex, number of bleeding episodes, refractory epilepsy, and SPC.ConclusionsWith careful patient selection, patients in SPC B can reach as favorable HRQOL as those in SPC A provided the operation is successful. Multiple bleeding episodes should be prevented with effective treatment aiming at complete AVM obliteration. The postoperative treatment of patients with AVM should focus on preventing depressive symptoms, anxiety, and epileptic seizures. We encourage other research groups to use HRQOL instruments to fully understand the consequences of neurologic and neurosurgical diseases on patients' HRQOL.

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Correlates of health-related quality of life in youth with psychogenic non-epileptic seizures

Seizure ◽

10.1016/j.seizure.2020.09.030 ◽

2020 ◽

Vol 83 ◽

pp. 203-207

Author(s):

Kassie D. Flewelling ◽

Angelina Koehler ◽

Jonathan Shaffer ◽

Edward J. Dill

Keyword(s):

Quality Of Life ◽

Epileptic Seizures ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Quality of Life in Children with Epilepsy

Journal of Pediatric Epilepsy ◽

10.1055/s-0040-1710054 ◽

2020 ◽

Vol 09 (02) ◽

pp. 036-041

Author(s):

Mukesh Kumar Prajapati ◽

Deepak Dwivedi ◽

Naresh Bajaj

Keyword(s):

Quality Of Life ◽

Refractory Epilepsy ◽

Linear Regression Analysis ◽

Tertiary Care ◽

Age Groups ◽

Categorical Variables ◽

Care Hospital ◽

Duration Of Treatment ◽

Factors Associated

Abstract Objective The main aim of this study was to assess quality of life in children with epilepsy. Materials and Methods A prospective observational study was conducted in Regional Early Intervention Centre of the Department of Pediatrics Tertiary Care Hospital in central India. This study included 120 children with epilepsy aged between 2 and 18 years. In this study, we assessed the quality of life in children with epilepsy with the help of Pediatric Quality of Life Inventory (PedsQL). We further analyzed the quality of life in various dimensions. For the statistical analyses for SPSS version, 20 was used, chi-squared and Fisher's exact test was used for categorical variables, and Student's t-test was used for quantitative variables. Linear regression analysis was done for multivariate analysis. Result Mean total PedsQL score for total cohort was 70.96. The cognitive dimension of epileptic children was more affected than physical, social, and emotional dimensions. Factors associated with lower PedsQL scores in epilepsy patients were associated with long duration of epilepsy, polytherapy, male gender, low head circumference, presence of intellectual disability, and refractory epilepsy. Conclusion Epilepsy affects the quality of life in children across all age groups. Among epilepsy indicators, polytherapy, refractory epilepsy, and duration of epilepsy were the most important factors associated with poor quality of life. We can conclude that every effort should be made to decrease the duration of treatment and minimize the number of drugs for improving the quality of life in this patient cohort.

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