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1.
Iran J Med Sci ; 47(6): 588-593, 2022 11.
Article in English | MEDLINE | ID: covidwho-2100905

ABSTRACT

Background: Previous studies have shown that patients with epilepsy (PWE) perceived significant disruption in the quality and provision of care due to the coronavirus disease 2019 (COVID-19) pandemic. The present study aimed to investigate the effect of this pandemic on seizure control status and changes in seizure frequency in PWE. Methods: A consecutive sample of adult PWE registered in the database of Shiraz Epilepsy Center (Shiraz, Iran) was included in the study. In July 2021, phone interviews were conducted with all selected patients. Information such as age, sex, last seizure, seizure type, and frequency during the 12 months before the study, and history of COVID-19 contraction was extracted. The seizure control status of the patients in 2019 (pre-pandemic) was compared with that during the COVID-19 pandemic. Data were analyzed using SPSS software with the Fisher's exact test and Pearson's Chi squared test. P<0.05 was considered statistically significant. Results: A total of 158 patients were included in the study, out of which 62 (39.2%) patients had a stable seizure control status, 47 (29.7%) had fewer seizures, and 50 (31.6%) had more seizures. Breakthrough seizures were reported by 32 (34.4%) patients. Seizure frequency increased in 18 (27.7%) and decreased in 46 (70.7%) patients. Conclusion: Overall, the COVID-19 pandemic has not been a major precipitating factor nor has it affected the seizure control status of PWE. In treated epilepsy, a fluctuating course with periods of seizure freedom followed by relapses is part of its natural history.


Subject(s)
COVID-19 , Epilepsy , Adult , Humans , Infant , Pandemics , COVID-19/epidemiology , Seizures/epidemiology , Epilepsy/complications , Epilepsy/epidemiology , Recurrence
2.
Intern Med ; 61(15): 2287-2293, 2022 Aug 01.
Article in English | MEDLINE | ID: covidwho-1968929

ABSTRACT

Objective To investigate seizure control in patients with epilepsy during the coronavirus disease 2019 (COVID-19) pandemic. Method A systematic review and meta-analysis was conducted, and the MEDLINE, EMBASE, CENTRAL, and ClinicalTrials.gov databases were comprehensively searched for relevant studies. Studies that reported seizure control in patients with epilepsy during the COVID-19 pandemic were included. Pooled proportions with 95% confidence intervals (CIs) of patients with epilepsy who experienced seizure worsening during the COVID-19 pandemic were assessed using a random-effects model. The quality of the assessment for each study, heterogeneity between the studies, and publication bias were also evaluated. Subgroup analyses were performed, excluding studies with reports of seizures worsening from caregivers. Results A total of 24 studies with 6,492 patients/caregivers were included in the meta-analysis. The pooled proportion of seizure worsening was 18.5% (95% CI: 13.9-23.6; I2=96%; p<0.01). The pooled proportion of seizure worsening in the subgroup analysis was 18.9% (95% CI: 13.5-25.0; I2=96%; p<0.01). Conclusion Although the heterogeneity was high, our results showed a relatively high incidence of seizure worsening during the COVID-19 pandemic. During the COVID-19 pandemic, physicians should be aware of the likelihood of worsening seizures in patients with epilepsy.


Subject(s)
COVID-19 , Epilepsies, Partial , Epilepsy, Generalized , Epilepsy , Anticonvulsants/therapeutic use , COVID-19/epidemiology , Epilepsies, Partial/drug therapy , Epilepsy/complications , Epilepsy/drug therapy , Epilepsy/epidemiology , Epilepsy, Generalized/drug therapy , Humans , Pandemics , Seizures/drug therapy , Seizures/epidemiology
3.
J Neurol ; 269(7): 3761-3769, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1913921

ABSTRACT

BACKGROUND: Diagnosis of epileptic seizures, particularly regarding status epilepticus (SE), may be challenging in an emergency room setting. The aim of the study was to study the diagnostic yield of perfusion computed tomography (pCT) in patients with single epileptic seizures and SE. METHODS: We retrospectively reviewed the records of patients who followed an acute ischemic stroke pathway during a 9-month period and who were finally diagnosed with a single epileptic seizure or SE. Perfusion maps were visually analyzed for the presence of hyperperfusion and hypoperfusion. Clinical data, EEG patterns, and neuroimaging findings were compared. RESULTS: We included 47 patients: 20 (42.5%) with SE and 27 (57.5%) with single epileptic seizure. Of 18 patients who showed hyperperfusion on pCT, 12 were ultimately diagnosed with SE and eight had EEG findings compatible with an SE pattern. Focal hyperperfusion on pCT had a sensitivity of 60% (95% CI 36.4-80.2) and a specificity of 77.8% (95% CI 57.2-90.6) for predicting a final diagnosis of SE. The presence of cerebral cortical and thalamic hyperperfusion had a high specificity for predicting SE presence. Of note, 96% of patients without hyperperfusion on pCT did not show an SE pattern on early EEG. CONCLUSIONS: In acute settings, detection by visual analysis of focal cerebral cortical hyperperfusion on pCT in patients with epileptic seizures, especially if accompanied by the highly specific feature of thalamic hyperperfusion, is suggestive of a diagnosis of SE and requires clinical and EEG confirmation. The absence of focal hyperperfusion makes a diagnosis of SE unlikely.


Subject(s)
Epilepsy , Ischemic Stroke , Status Epilepticus , Cerebral Cortex , Electroencephalography , Emergency Service, Hospital , Epilepsy/complications , Humans , Perfusion , Retrospective Studies , Seizures/diagnostic imaging , Status Epilepticus/complications , Status Epilepticus/diagnostic imaging , Tomography, X-Ray Computed/methods
4.
Zh Nevrol Psikhiatr Im S S Korsakova ; 122(2): 101-106, 2022.
Article in Russian | MEDLINE | ID: covidwho-1737453

ABSTRACT

To compare an impact of coronavirus disease and Sputnik V COVID-19 vaccine on the dynamics of epilepsy. The study is part of the ongoing «Epilepsy and COVID-19¼ independent research which recruited patients with epilepsy into two groups: group 1 - COVID-19 survivors and group 2 - patients vaccinated with a COVID-19 vaccine. The study compares two clinical cases: seizure recurrence with COVID-19 disease in a young patient and good tolerability of vaccination in a female elderly patient following surgical management of pharmacoresistant epilepsy with concomitant pathology. In group 1, a 32-year-old patient with idiopathic generalized epilepsy and 3-year seizure remission had generalized seizure recurrence with electroencephalographic deterioration against the backdrop of mild COVID-19. In group 2, a 59-year-old patient, with focal pharmacoresistant epilepsy, and 3-year seizure remission after surgical management, and comorbid endocrine dysfunction showed no side-effects with Sputnik V COVID-19 vaccination and maintained clinical and electroencephalographic remission. The study revealed that the Sputnik V vaccine was well tolerated, and that seizure remission was maintained after epilepsy surgery in an elderly patient with comorbidity, as well as there was the possibility of seizure recurrence in younger patients with mild COVID-19. The findings will aid practitioners in making decisions on how to manage epilepsy patients. More study into the impact of the disease and COVID-19 vaccination on epilepsy dynamics in a larger sample is required.


Subject(s)
COVID-19 , Epilepsy , Adult , Aged , Anticonvulsants/therapeutic use , COVID-19 Vaccines , Epilepsy/complications , Epilepsy/drug therapy , Epilepsy/surgery , Female , Humans , Middle Aged , SARS-CoV-2 , Vaccines, Synthetic
5.
Curr Neurol Neurosci Rep ; 22(1): 11-17, 2022 01.
Article in English | MEDLINE | ID: covidwho-1653759

ABSTRACT

PURPOSE OF REVIEW: Seizures, including status epilepticus, have been reported in association with acute COVID-19 infection. People with epilepsy (PWE) have suffered from seizure exacerbations during the pandemic. This article reviews the data for clinical and electrographic seizures associated with COVID-19, technical EEG considerations for reducing risk of transmission, and factors contributing to seizure exacerbations in PWE as well as strategies to address this issue. RECENT FINDINGS: An increasing number of studies of larger cohorts, accounting for a variety of variables and often utilizing EEG with standardized terminology, are assessing the prevalence of seizures in hospitalized patients with acute COVID-19 infections, and gaining insight into the prevalence of seizures and their effect on outcomes. Additionally, recent studies are evaluating the effect of the pandemic on PWE, barriers faced, and the usefulness of telehealth. Although there is still much to learn regarding COVID-19, current studies help in assessing the risk of seizures, guiding EEG utilization, and optimizing the use of telehealth during the pandemic.


Subject(s)
COVID-19 , Epilepsy , Status Epilepticus , COVID-19/epidemiology , Epilepsy/complications , Epilepsy/epidemiology , Epilepsy/therapy , Humans , Pandemics , Seizures/complications , Seizures/epidemiology , Seizures/therapy , Status Epilepticus/epidemiology , Status Epilepticus/etiology , Status Epilepticus/therapy
6.
Epilepsy Behav ; 129: 108581, 2022 04.
Article in English | MEDLINE | ID: covidwho-1648820

ABSTRACT

INTRODUCTION: In 2020, Coronavirus Disease 2019 (COVID-19) was declared as a global pandemic. Self-reported stress, anxiety, and insomnia, which are believed to be common triggers for epilepsy, are more likely to occur. We aimed to establish the influence of COVID-19 pandemic itself on changes in the daily life routine related to pandemic on epilepsy course in pediatric patients. The unique form of clinical care which is telemedicine was also taken into consideration. We wanted to evaluate patients' satisfaction with telemedicine and if changing stationary visits into telemedicine influenced epilepsy course in our patients. METHODS: Patients, who attended developmental neurology outpatient clinic in the period March-December 2020 were collected. As patients were minors, legal guardians were asked to fill out the questionnaire. Patients were divided according to the outcome into three groups: those with a worsened, stable, or improved course of epilepsy during the pandemic. Appropriate statistical tests for two-group and multi-group comparisons have been implemented. Post hoc p values were also calculated. RESULTS: Four hundred and two questionnaires were collected. Most of the patients had a stable course of epilepsy during the pandemic; in 13% of participants an improvement has been observed, worsening of the disease was seen in 16% of patients. Age, sex, type of epilepsy, number of seizure incidents before pandemic, and duration of the disease had no statistically significant connection with changes in the course of the disease. Behavioral changes and altered sleep patterns were found to be more common in the worsened group. Fifty-eight percent of patients were satisfied with telemedicine. Poorer satisfaction was connected with less frequent visits, cancellation of scheduled appointments, and lack of help in case of need in an emergency situation. CONCLUSION: Epilepsy course in pediatric patients seems to be stable during COVID-19 pandemic. Sleep disturbances and changes in a child's behavior may be related to increase in seizure frequency. Telemedicine is an effective tool for supervising children with epilepsy. Patients should be informed about possible ways of getting help in urgent cases.


Subject(s)
COVID-19 , Epilepsy , Telemedicine , COVID-19/epidemiology , Child , Epilepsy/complications , Epilepsy/epidemiology , Humans , Pandemics , Seizures
7.
Epilepsy Behav ; 128: 108536, 2022 03.
Article in English | MEDLINE | ID: covidwho-1586245

ABSTRACT

OBJECTIVE: To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the disease course, lives, and psychosocial wellbeing of persons with epilepsy (PWE) in Uganda. METHODS: From April 2021 till May 2021, we carried out a descriptive cross-sectional study at four hospitals located in four regions of Uganda. PWE presenting at the study sites were offered a structured questionnaire in the local language. We used the PHQ-9 questionnaire to screen for depression and the GAD-7 to screen for anxiety. Univariate and multivariable logistic regression was used to investigate factors associated with anxiety and depression. RESULTS: A total of 370 responses were collected. The median age of the respondents was 20.5 years (IQR 15-29), and 51.9% were males. During the lockdown period, the seizure frequency increased in 87 (23.5%) PWE. Various forms of physical and psychological violence were inflicted upon 106 (28.6%) PWE. Fifty-eight (15.7%) screened positive for anxiety and 65 (17.6%) positive for depression. Both increased seizure frequency and experienced violence were associated with experiencing depression and anxiety. CONCLUSION: The COVID-19 pandemic and lockdown impacted seizure frequency and the psychosocial wellbeing of PWE in Uganda. Increased seizure frequency was associated with higher rates of anxiety and depression. This underlines the importance of continued follow-up of PWE and a low threshold to screen for depression, anxiety, and domestic violence.


Subject(s)
COVID-19 , Epilepsy , Adolescent , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Communicable Disease Control , Cross-Sectional Studies , Depression/epidemiology , Epilepsy/complications , Epilepsy/epidemiology , Humans , Male , Pandemics , SARS-CoV-2 , Uganda/epidemiology , Young Adult
8.
J Neurol Sci ; 434: 120100, 2022 03 15.
Article in English | MEDLINE | ID: covidwho-1587195

ABSTRACT

OBJECTIVE: To study the longitudinal seizure outcomes of people with epilepsy (PWE) following the acute and chronic phases of the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Consecutive PWE who were treated at the epilepsy center of Hiroshima University Hospital between 2018 and 2021 were enrolled. We evaluated the incidence of seizure frequency increase or decrease following the pandemic during observational periods in 2020 and 2021. Data between 2018 and 2019 were used as a control set. The sustainability of the altered seizure frequency condition was evaluated throughout the study period. We analyzed the clinical, psychological, and social factors associated with PWE with seizure exacerbation or amelioration. RESULTS: Among the 223 PWE who were evaluated (mean age 37.8 ± 16.3 years), seizure frequency increased for 40 (16.8%) and decreased for 34 (15.2%) after the pandemic began. While seizure exacerbation tended to be a transient episode during 2020, seizure amelioration was likely to maintain excellent status over the observation periods; the sustainability of the altered seizure frequency condition was more prominent for amelioration than exacerbation (p < 0.001). Seizure exacerbation was significantly associated with "no housemate" (odds ratio [OR] 3.37; p = 0.045) and "comorbidity of insomnia" (OR 5.80; p = 0.004). Conversely, "structural abnormality of MRI" (OR 2.57; p = 0.039) and "two-generation householding" (OR 3.70; p = 0.004) were independently associated with seizure amelioration. CONCLUSION: This longitudinal observation confirmed that seizure exacerbation and amelioration emerged during the COVID-19 pandemic. The COVID-19 pandemic has shed light on the stark difference that social support systems can make on outcomes for PWE.


Subject(s)
COVID-19 , Epilepsy , Adult , COVID-19/epidemiology , Epilepsy/complications , Epilepsy/epidemiology , Epilepsy/therapy , Humans , Middle Aged , Pandemics , Seizures/complications , Seizures/epidemiology , Young Adult
9.
Epilepsy Behav ; 125: 108437, 2021 12.
Article in English | MEDLINE | ID: covidwho-1545488

ABSTRACT

BACKGROUND: Patients with epilepsy experience seizures, which have been reported to increase and worsen during the coronavirus disease (COVID-19) pandemic. However, the association between epilepsy and COVID-19 outcomes remains unclear. The aim of this study was to analyze whether patients with epilepsy have an increased risk of having poor COVID-19 outcomes. METHODS: We comprehensively evaluated potential articles extracted from the medRxiv, Europe PMC, and PubMed databases until June 30, 2021, using selected keywords. All published studies on epilepsy and COVID-19 were selected. We used the Review Manager 5.4 and Comprehensive Meta-Analysis 3 software for statistical analysis. RESULTS: Thirteen studies with 67,131 patients with COVID-19 were included in the analysis. Evaluation of the collated data revealed an association between epilepsy and increased severity of COVID-19 (OR, 1.69; 95%CI: 1.11-2.59; p = 0.010; I2 = 29%; random-effect modeling) and mortality from COVID-19 (OR, 1.71; 95%CI: 1.14-2.56; p = 0.010; I2 = 53%; random-effect modeling). The results also showed that the association between epilepsy and increased risk of developing severe COVID-19 is influenced by sex and neurodegenerative disease. CONCLUSIONS: The findings of this study suggest that patients with epilepsy are at risk of having poor COVID-19 outcomes. Patients with epilepsy need special attention and should be prioritized for administration of the COVID-19 vaccine. Registration details: PROSPERO (CRD42021264979).


Subject(s)
COVID-19 , Epilepsy , Neurodegenerative Diseases , COVID-19 Vaccines , Epilepsy/complications , Epilepsy/epidemiology , Humans , SARS-CoV-2
11.
Epilepsy Behav ; 125: 108376, 2021 12.
Article in English | MEDLINE | ID: covidwho-1514332

ABSTRACT

BACKGROUND: Social factors are believed to affect mental health in patients with epilepsy (PWE). However, there is still a lack of sufficient manifest proof, given the difficulty of exposing PWE to relatively consistent natural social environments with a low or high level of social interaction to study their significant role. METHODS: This single-center, longitudinal study was conducted via online questionnaires during the coronavirus disease 2019. PWE were recruited from downtown Wuhan and surrounding areas. The Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 were used to assess psychological status. RESULTS: We analyzed 588 questionnaires completed by 294 PWE who participated in the dual survey. Under lockdown and reopening, the prevalence of anxiety was 13.6%/22.5%, and the prevalence of depression was 19.4%/34.0%. Raising children and seizure-related characteristics, including uncontrolled seizures, seizure exacerbation, seizure frequency ≥ 2/m, and changes in drug regimen, were risk factors in the first and second surveys. A high education level (OR = 1.946, 95% CI = 1.191-3.182), low life satisfaction (OR = 1.940, 95% CI = 1.007-3.737), worry about unanticipated seizures (OR = 2.147, 95% CI = 1.049-4.309), and worry about purchasing medication outside (OR = 2.063, 95% CI = 1.060-4.016) were risk factors for higher scores after reopening. Worry about unanticipated seizures (OR = 3.012, 95% CI = 1.302-6.965) and in-person medical consultation (OR = 2.319, 95% CI = 1.262-4.261) were related to newly diagnosed patients with psychological disorder after reopening. CONCLUSIONS: We identified an association between social variables and epileptic psychiatric comorbidities.


Subject(s)
COVID-19 , Epilepsy , Anxiety/epidemiology , Anxiety/etiology , Anxiety Disorders , Child , Communicable Disease Control , Depression/epidemiology , Depression/etiology , Epilepsy/complications , Epilepsy/epidemiology , Humans , Longitudinal Studies , SARS-CoV-2 , Social Factors , Surveys and Questionnaires
12.
Epilepsy Behav ; 125: 108410, 2021 12.
Article in English | MEDLINE | ID: covidwho-1488009

ABSTRACT

OBJECTIVE: COVID-19 pandemic disease has profound consequences for physical and mental health. In this regard, health care for chronic diseases, especially epilepsy is neglected The purpose of this systematic review study was to investigate the epidemic effect of COVID-19 on increasing the prevalence of mental disorders such as depression, anxiety, and sleep disorders in people with epilepsy (PWE). METHODS: We systematically searched MEDLINE, Cochrane, Embase, Web of science, Scopus, and Psych info databases for studies that estimate the prevalence of mental disorders in PWE during the COVID-19 until December 2020. Inclusion criteria included samples of population, with a confirmed diagnosis of epilepsy. RESULTS: Irrespective of PWE or people without epilepsy (PWOE), all experienced stress and anxiety during COVID-19 pandemic. Most of the studies showed that PWE and even PWOE during the pandemic, suffer from depression. The highest rate of depression was attributed to female PWE with financial problems (66.7%) and the lowest rate of depression in PWE was reported in 8.6%. 7.1-71.2% and 28.2% of patients reported sleep disorders and insomnia, respectively. Less than 2% experienced a sleep improvement. LIMITATIONS: Due to a large amount of heterogeneities across the results, we could not evaluate the exact rate of prevalence in spite of using effective measures. CONCLUSIONS: People with epilepsy were considered as a susceptible group to the impact of the pandemic. Therefore, great attention should be paid to PWE and adequate psychological supports provided in this period to relieve or inhibit risks to mental health in PWE.


Subject(s)
COVID-19 , Epilepsy , Psychological Distress , Anxiety/epidemiology , Anxiety/etiology , Depression/epidemiology , Depression/etiology , Epilepsy/complications , Epilepsy/epidemiology , Female , Humans , Pandemics , Prevalence , SARS-CoV-2
13.
Curr Mol Pharmacol ; 15(6): 832-845, 2022.
Article in English | MEDLINE | ID: covidwho-1468285

ABSTRACT

The currently circulating novel SARS-CoV-2 coronavirus disease (COVID-19) has brought the whole world to a standstill. Recent studies have deciphered the viral genome structure, epidemiology and are in the process of unveiling multiple mechanisms of pathogenesis. Apart from atypical pneumonia and lung disease manifestations, this disease has also been found to be associated with neurological symptoms, which include dizziness, headache, stroke, or seizures, among others. However, a possible direct or indirect association between SARS-CoV-2 and seizures is still not clear. In any manner, it may be of interest to analyze the drugs being used for viral infection in the background of epilepsy or vice versa. To identify the most credible drug candidate for COVID-19 in persons with epilepsy or COVID-19 patients experiencing seizures. A literature search for original and review articles was performed, and further, the Comparative Toxicogenomics Database was used to unearth the most credible drug candidate. Our search based on common mechanistic targets affecting SARS-CoV-2 and seizures revealed ivermectin, dexamethasone, anakinra, and tocilizumab for protection against both COVID-19 and seizures. Amongst the antiseizure medications, we found valproic acid as the most probable pharmacotherapy for COVID-19 patients experiencing seizures. These findings would hopefully provide the basis for initiating further studies on the pathogenesis and drug targeting strategies for this emerging infection accompanied with seizures or in people with epilepsy.


Subject(s)
COVID-19 , Epilepsy , COVID-19/drug therapy , Drug Repositioning , Epilepsy/complications , Humans , SARS-CoV-2 , Seizures/drug therapy
14.
Acta Neurol Scand ; 143(2): 206-209, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1388169

ABSTRACT

BACKGROUND: Lockdown due to the SARS-CoV-2 pandemic became a challenge to maintain care for patients with epilepsy; we aimed to find out how the pandemic affected them. METHODS: We sent an online 22-item questionnaire to patients from our outpatient clinic, a reference centre in Spain for drug-resistant epilepsy, inquiring about the effects of lockdown, from March to May 2020. RESULTS: We sent the survey to 627 patients; 312 (58% women) sent a complete response and were included. Of all respondents, 57% took >2 antiseizure medications. One-third of respondents (29%) declared an associated cognitive or motor disability. A minority had confirmed infection with SARS-CoV-2 (1.92%). Seizure frequency remained like usual in 56% of patients, while 31.2% reported an increase. Less than 10% needed emergent assistance. Almost half reported anxiety or depression, and 25% increased behavioural disorders. Mood (F: 5.40; p: 0.002) and sleep disorders (F = 2.67; p: 0.05) were associated with increase in seizure frequency. Patients were able to contact their physicians when needed and were open to a future telematic approach to follow-up visits. CONCLUSIONS: Seizure frequency and severity remained unchanged in most patients during the lockdown. Mood and sleep disorders were common and associated with seizure worsening. Patients were open to telematic care in the future.


Subject(s)
COVID-19 , Epilepsy/therapy , Pandemics , Quarantine/statistics & numerical data , Adult , Anticonvulsants/therapeutic use , Anxiety/complications , COVID-19/complications , COVID-19/epidemiology , Cognition Disorders/complications , Communicable Disease Control , Depression/complications , Disabled Persons , Epilepsy/complications , Female , Humans , Male , Mental Disorders/complications , Mental Disorders/epidemiology , Middle Aged , Motor Disorders/complications , Outpatients , Seizures/epidemiology , Sleep Wake Disorders/classification , Sleep Wake Disorders/epidemiology , Spain/epidemiology , Surveys and Questionnaires , Telemedicine
15.
Pediatr Int ; 64(1): e14972, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1378056

ABSTRACT

BACKGROUND: Telemedicine has spread rapidly during the coronavirus disease 2019 (COVID-19) pandemic and shown its usefulness, particularly for patients with epilepsy, compared to face-to-face visits. We sought to evaluate the clinical features of patients with childhood onset epilepsy associated with consultations by telephone call during the COVID-19 pandemic. METHODS: We retrospectively investigated the medical records of patients with childhood onset epilepsy who visited an outpatient clinic in Saitama Children's Medical Center, Saitama, Japan, from 1 March 2020 to 30 September 2020. To find the clinical features of patients who utilized telemedicine consultation (by telephone call), we divided the patients into the telemedicine group and the face-to-face group. We then reviewed the clinical features. Telemedicine consultation was not implemented for new patients. RESULTS: We enrolled 776 outpatients in total, and 294 patients (37.9%) utilized telemedicine consultations. The total number of visits was 2,299 and the total number of telemedicine consultations was 373 (16.2%). No clinical feature was associated with telemedicine consultations except for age at onset of epilepsy. The number of oral antiepileptic drugs prescriptions decreased in 23 of 776 (3.0%) of the patients who did not experience seizure deterioration, including status epilepticus, or who visited the emergency room. CONCLUSION: Telemedicine consultations were successfully utilized for epilepsy treatment at our outpatient clinic, regardless of epilepsy type, etiology, seizure frequency, comorbidities, and patients' residential areas. Thus, telemedicine by telephone call may be a useful resource in the management of patients with childhood onset epilepsy during the pandemic.


Subject(s)
COVID-19 , Epilepsy , Telemedicine , COVID-19/epidemiology , Child , Epilepsy/complications , Epilepsy/epidemiology , Epilepsy/therapy , Humans , Pandemics , Retrospective Studies , SARS-CoV-2 , Seizures/complications
16.
Curr Neurovasc Res ; 18(1): 162-168, 2021.
Article in English | MEDLINE | ID: covidwho-1374189

ABSTRACT

BACKGROUND: Robust evidence has described that Parkinson´s disease (PD) is associated with an increased risk for developing epileptic seizures. In fact, an interplay between PD and epilepsy has been of interest for many years. An emerging hypothesis is that inflammation could link both diseases. OBJECTIVE: Bearing in mind the experience of our group in the field of Ca2+/cAMP signalling pathways, this article discussed, beyond inflammation, the role of these signalling pathways in this link between PD and epilepsy. METHODS: Publications involving Ca2+/cAMP signalling pathways, PD, and epilepsy (alone or combined) were collected by searching PubMed and EMBASE. RESULTS: The comprehension of the interplay between PD and epilepsy could improve the drug therapy. In addition, a Ca2+ signalling dyshomeostasis due to Coronavirus disease 2019 (COVID-19), an emerging and rapidly evolving situation, has been reported. CONCLUSION: Thus, this article also debated recent findings about therapeutics involving Ca2+ channel blockers for preventing Ca2+ signalling dyshomeostasis due to COVID-19, including the correlation among COVID-19, epilepsy, and PD.


Subject(s)
Calcium Signaling , Cyclic AMP , Epilepsy/complications , Inflammation/complications , Parkinson Disease/complications , Signal Transduction , COVID-19/complications , Calcium Channel Blockers/therapeutic use , Epilepsy/physiopathology , Humans , Inflammation/physiopathology , Parkinson Disease/physiopathology
17.
Epilepsy Res ; 176: 106741, 2021 10.
Article in English | MEDLINE | ID: covidwho-1356224

ABSTRACT

OBJECTIVES: During the ongoing pandemic of COVID-19, wearing face masks was recommended, including patients with epilepsy doing the hyperventilation (HV) test during electroencephalogram (EEG) examination somewhere. However, evidence was still limited about the effect of HV with face mask on cortical excitability of patients with epilepsy. The motivation of this work is to make use of the graph theory of EEG to characterize the cortical excitability of patients with epilepsy when they did HV under the condition wearing a surgical face mask. METHODS: We recruited 19 patients with epilepsy and 17 normal controls. All of participants completed two HV experiments, including HV with face mask (HV+) and HV without a mask (HV). The interval was 30 min and the sequence was random. Each experiment consisted of three segments: resting EEG, EEG of HV, and EEG of post-HV. EEG were recorded successively during each experiment. Participants were asked to evaluate the discomfort degree using a questionnaire when every HV is completed. RESULTS: All of the participants felt more uncomfortable after HV + . Moreover, not only HV decreased small-worldness index in patients with epilepsy, but also HV + significantly increased the clustering coefficient in patients with epilepsy. Importantly, the three-way of Mask*HV*Epilepsy showed interaction in the clustering coefficient in the delta band, as well as in the path length and the small-worldness index in the theta band. CONCLUSIONS: The results of this study indicated that patients with epilepsy showed the increased excitability of brain network during HV + . We should pay more attention to the adverse effect on brain network excitability caused by HV + in patients with epilepsy. In the clinical practice under the COVID-19 pandemic, it is important that the wearing face mask remain cautious for the individuals with epilepsy when they carried out HV behavior such as exercise (e.g., running, etc.).


Subject(s)
Epilepsy/complications , Hyperventilation/etiology , Masks/adverse effects , Nerve Net/physiopathology , Adult , Brain/physiopathology , COVID-19/prevention & control , Case-Control Studies , Electroencephalography , Epilepsy/physiopathology , Female , Humans , Hyperventilation/physiopathology , Male
18.
Epilepsy Behav ; 122: 108184, 2021 09.
Article in English | MEDLINE | ID: covidwho-1305328

ABSTRACT

OBJECTIVE: To investigate whether published studies that identified a causal relationship between psychological stress and seizure worsening in patients with epilepsy during the coronavirus disease 2019 (COVID-19) pandemic considered the temporality of Hill's criteria. METHOD: A systematic review approach was used to comprehensively search MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov databases for relevant studies. Studies that reported an association between psychological stress and seizure worsening in patients with epilepsy during the COVID-19 pandemic were included accordingly. The quality of assessments in each study was evaluated and an assessment for considering temporality in the causal relationship between the two events in each study was carried out. RESULTS: Seventeen studies were included in the analysis. Most (14/17) were cross-sectional studies and only four out of these 17 studies (23.5%) considered temporality in the causality. Further, these four studies did not consider temporality in the study design, they only described it as a limitation. CONCLUSION: We found that many articles reported a causal relationship between psychological stress and seizure worsening without considering temporality. As both researchers and readers, we need to consider temporality when interpreting the causal relationship between increased psychological stress and seizure worsening in patients with epilepsy during the COVID-19 pandemic.


Subject(s)
COVID-19 , Epilepsy , Cross-Sectional Studies , Epilepsy/complications , Epilepsy/epidemiology , Humans , Pandemics , SARS-CoV-2 , Seizures/epidemiology , Seizures/etiology , Stress, Psychological/epidemiology , Stress, Psychological/etiology
19.
Epilepsy Behav ; 118: 107919, 2021 05.
Article in English | MEDLINE | ID: covidwho-1253750

ABSTRACT

Insular epilepsy is increasingly recognized in epilepsy surgery centers. Recent studies suggest that resection of an epileptogenic zone that involves the insula as a treatment for drug-resistant seizures is associated with good outcomes in terms of seizure control. However, despite the existing evidence of a role of the insula in emotions and affective information processing, the long-term psychological outcome of patients undergoing these surgeries remain poorly documented. A group of 27 adults (18 women) who underwent an insulo-opercular resection (in combination with a part of the temporal lobe in 10, and of the frontal lobe in 5) as part of epilepsy surgery at our center between 2004 and 2019 completed psychometric questionnaires to assess depression (Beck Depression Inventory - 2nd edition; BDI-II), anxiety (State-Trait Anxiety Inventory, Trait Version; STAI-T), and quality of life (Patient Weighted Quality of Life In Epilepsy; QOLIE-10-P). Scores were compared to those of patients who had standard temporal lobe epilepsy (TLE) surgery with similar socio-demographic and disease characteristics. Seizure control after insular epilepsy surgery was comparable to that observed after TLE surgery, with a majority of patients reporting being seizure free (insular: 63.0%; temporal: 63.2%) or having rare disabling seizures (insular: 7.4%; temporal: 18.4%) at the time of questionnaire completion. Statistical comparisons revealed no significant group difference on scores of depression, anxiety, or quality of life. Hemisphere or extent of insular resection had no significant effect on the studied variables. In the total sample, employment status and seizure control, but not location of surgery, significantly predicted quality of life. Self-reported long-term psychological status after insulo-opercular resection as part of epilepsy surgery thus appears to be similar to that observed after TLE surgery, which is commonly performed in epilepsy surgery centers.


Subject(s)
Epilepsy, Temporal Lobe , Epilepsy , Adult , Anxiety/etiology , Cerebral Cortex , Depression/etiology , Epilepsy/complications , Epilepsy/surgery , Epilepsy, Temporal Lobe/complications , Epilepsy, Temporal Lobe/surgery , Female , Humans , Male , Quality of Life
20.
Epilepsy Res ; 174: 106675, 2021 08.
Article in English | MEDLINE | ID: covidwho-1233420

ABSTRACT

In regard to the global pandemic of COVID-19, it seems that persons with epilepsy (PWE) are not more vulnerable to get infected by SARS-CoV-2, nor are they more susceptible to a critical course of the disease. However, management of acute seizures in patients with COVID-19 as well as management of PWE and COVID-19 needs to consider potential drug-drug interactions between antiseizure drugs and candidate drugs currently assessed as therapeutic options for COVID-19. Repurposing of several licensed and investigational drugs is discussed for therapeutic management of COVID-19. While for none of these approaches, efficacy and tolerability has been confirmed yet in sufficiently powered and controlled clinical studies, testing is ongoing with multiple clinical trials worldwide. Here, we have summarized the possible mechanisms of action of drugs currently considered as potential therapeutic options for COVID-19 management along with possible and confirmed drug-drug interactions that should be considered for a combination of antiseizure drugs and COVID-19 candidate drugs. Our review suggests that potential drug-drug interactions should be taken into account with drugs such as chloroquine/hydroxychloroquine and lopinavir/ritonavir while remdesivir and tocilizumab may be less prone to clinically relevant interactions with ASMs.


Subject(s)
Anti-Inflammatory Agents/adverse effects , Anticonvulsants/adverse effects , Antiviral Agents/adverse effects , COVID-19/drug therapy , Enzyme Inhibitors/adverse effects , Epilepsy/drug therapy , Adenosine Monophosphate/adverse effects , Adenosine Monophosphate/analogs & derivatives , Alanine/adverse effects , Alanine/analogs & derivatives , Amides/adverse effects , Antibodies, Monoclonal, Humanized/adverse effects , COVID-19/complications , Chloroquine/adverse effects , Cytochrome P-450 CYP3A Inducers/adverse effects , Dexamethasone/adverse effects , Drug Combinations , Drug Interactions , Epilepsy/complications , Glucocorticoids/adverse effects , Humans , Hydroxychloroquine/adverse effects , Interleukin 1 Receptor Antagonist Protein/adverse effects , Ivermectin/adverse effects , Lopinavir , Pyrazines/adverse effects , Ritonavir , SARS-CoV-2
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