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1.
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
2.
Eur Neurol ; 84(3): 192-199, 2021.
Article in English | MEDLINE | ID: covidwho-1183420

ABSTRACT

BACKGROUND AND AIM: Although anyone can be affected by the COVID-19 pandemic, it may cause additional concern for people with chronic conditions. Epilepsy is the most common neurological disease in childhood and adolescence. The aim of this study was to determine anxiety levels among the mothers of children under follow-up for epilepsy in our clinic during the COVID-19 pandemic. METHODS: The study group consisted of the mothers of epilepsy patients who were under follow-up in the pediatric neurology outpatient clinic of the tertiary care center and were scheduled for a routine examination during the COVID-19 pandemic. The mothers' anxiety levels according to the Beck Anxiety Inventory and their opinions about COVID-19 in relation to their child were assessed and compared based on whether the mother/patient attended their appointments in person and whether the child had frequent or infrequent seizures. RESULTS: There was no statistically significant difference in anxiety level between the mothers of 64 children with epilepsy who attended their appointment during the pandemic and those of the mothers of 52 who did not attend their appointment. However, the mothers of children with frequent seizures had significantly higher anxiety levels. CONCLUSION: Anxiety level of mothers whose children have frequent seizures was significantly higher compared to mothers whose children have infrequent seizures. It is important to be aware about this point and using telemedicine approach in suitable population and postpone routine outpatient follow-up appointments as much as possible.


Subject(s)
Anxiety , COVID-19/psychology , Epilepsy , Mothers/psychology , Adolescent , Adult , Anxiety/etiology , Child , Child, Preschool , Female , Humans , Middle Aged , SARS-CoV-2 , Surveys and Questionnaires , Young Adult
3.
Seizure ; 88: 102-108, 2021 May.
Article in English | MEDLINE | ID: covidwho-1164463

ABSTRACT

OBJECTIVES: To investigate the impact of the COVID-19 outbreak on the behaviours, mental health and seizure control of adult patients with epilepsy (PWE) and to identify the correlation of seizure increase and the COVID-19 outbreak to guide the medical care of individuals with epilepsy during a public health crisis. METHODS: This study was conducted at 28 centres from February 2020 to April 2020. Participants filled out a 62-item online survey including sociodemographic, COVID-19-related, epilepsy-related and psychological variables and were divided into two groups based on whether their seizure frequency increased during the COVID-19 pandemic. Chi-square tests and t-tests were used to test differences in significant characteristics. Multiple logistic regression analyses were used to identify risk factors for seizure worsening. RESULTS: A total of 1,237 adult PWE were enrolled for analysis. Of this sample, 31 (8.33%) patients experienced an increase in seizures during the pandemic. Multivariate logistic regression suggested that feeling nervous about the pandemic (P < 0.05), poor quality of life (P = 0.001), drug reduction/withdrawal (P = 0.032), moderate anxiety during the COVID-19 outbreak (P = 0.046) and non-seizure free before the COVID-19 outbreak (P < 0.05) were independently related to seizure increase during the pandemic. CONCLUSIONS: During the COVID-19 pandemic, PWE with poor quality of life and mental status, as well as AED reduction/withdrawal, were more likely to experience seizure increase. This observation highlights the importance of early identification of the population at high risk of seizure worsening and implementation of preventive strategies during the pandemic.


Subject(s)
COVID-19/psychology , Epilepsy/epidemiology , Quality of Life/psychology , Seizures/epidemiology , Adult , COVID-19/epidemiology , China/epidemiology , Disease Outbreaks , Female , Humans , Male , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
4.
Ann Indian Acad Neurol ; 24(1): 51-55, 2021.
Article in English | MEDLINE | ID: covidwho-1150827

ABSTRACT

BACKGROUND: Epilepsy is one of the most common problems in neurology clinical practice and currently we are in the midst of the coronavirus outbreak. The coronavirus pandemic is an epidemiological and psychological crisis, which is likely to affect persons with epilepsy. OBJECTIVES: This study was designed to evaluate the impact of COVID-19 pandemic on patients with epilepsy and effects on their mental health. MATERIALS AND METHODS: This was a cross-sectional web-based survey carried out at the department of Neurology at a tertiary care hospital. A questionnaire was designed in the local language using Google Forms to assess basic knowledge regarding epilepsy, coronavirus, effects of COVID-19 and lockdown on epileptic patients and also effects on their mental health. The link to the online survey was distributed via WhatsApp messenger to epilepsy patients. RESULTS: One hundred fifty-six cases were enrolled with 69.1% were below 34 years of age and male: female ratio was 1.2:1. Only 34.3% of the participants were employed and 50% of patients had an income of less than Rs. 3000 per month. Of the patients enrolled, 20.5% reported the "devil" and superstitions as a cause of epilepsy and only 10% of patients thought that tantric (holy priest) could treat the disease better than doctors. 53.8% of patients worried about getting COVID-19 and could not stop thoughts about being infected by coronavirus bothering them. 30.3% patients had increased seizure frequency during COVID-19 pandemic, of which the most common reason was that they forgot to take regular antiepileptic drugs (22.7%) or they had faced difficulty in obtaining medicine due to lockdown (12.1%). During the pandemic, 17% of patients reported depression symptoms and another 21% reported anxiety symptoms. CONCLUSION: The current COVID-19 pandemic negatively affected patients with epilepsy and increased seizure frequency, depression, anxiety, unemployment, and financial difficulty in obtaining medication.

5.
Epilepsy Behav ; 116: 107791, 2021 03.
Article in English | MEDLINE | ID: covidwho-1071999

ABSTRACT

Climate change is with us. As professionals who place value on evidence-based practice, climate change is something we cannot ignore. The current pandemic of the novel coronavirus, SARS-CoV-2, has demonstrated how global crises can arise suddenly and have a significant impact on public health. Global warming, a chronic process punctuated by acute episodes of extreme weather events, is an insidious global health crisis needing at least as much attention. Many neurological diseases are complex chronic conditions influenced at many levels by changes in the environment. This review aimed to collate and evaluate reports from clinical and basic science about the relationship between climate change and epilepsy. The keywords climate change, seasonal variation, temperature, humidity, thermoregulation, biorhythm, gene, circadian rhythm, heat, and weather were used to search the published evidence. A number of climatic variables are associated with increased seizure frequency in people with epilepsy. Climate change-induced increase in seizure precipitants such as fevers, stress, and sleep deprivation (e.g. as a result of more frequent extreme weather events) or vector-borne infections may trigger or exacerbate seizures, lead to deterioration of seizure control, and affect neurological, cerebrovascular, or cardiovascular comorbidities and risk of sudden unexpected death in epilepsy. Risks are likely to be modified by many factors, ranging from individual genetic variation and temperature-dependent channel function, to housing quality and global supply chains. According to the results of the limited number of experimental studies with animal models of seizures or epilepsy, different seizure types appear to have distinct susceptibility to seasonal influences. Increased body temperature, whether in the context of fever or not, has a critical role in seizure threshold and seizure-related brain damage. Links between climate change and epilepsy are likely to be multifactorial, complex, and often indirect, which makes predictions difficult. We need more data on possible climate-driven altered risks for seizures, epilepsy, and epileptogenesis, to identify underlying mechanisms at systems, cellular, and molecular levels for better understanding of the impact of climate change on epilepsy. Further focussed data would help us to develop evidence for mitigation methods to do more to protect people with epilepsy from the effects of climate change.


Subject(s)
COVID-19/epidemiology , Climate Change , Epilepsy/epidemiology , Global Health/trends , Public Health/trends , Animals , COVID-19/prevention & control , Death, Sudden , Epilepsy/therapy , Hot Temperature/adverse effects , Humans , Humidity/adverse effects , Sleep Deprivation/epidemiology , Sleep Deprivation/therapy , Weather
6.
Epilepsy Behav ; 112: 107323, 2020 11.
Article in English | MEDLINE | ID: covidwho-642555

ABSTRACT

OBJECTIVES: The objective of the study was to assess if patients with epilepsy (PWE) experienced an increase in seizure frequency and self-reported stress during the COVID-19 pandemic. METHODS: This is a cross-sectional study conducted in Saudi Arabia in April 2020. An electronic self-administered questionnaire was distributed to PWE via their treating neurologist. The variables included were demographic and baseline clinical characteristics (age, gender, living situation, occupational status, type of epilepsy, duration of epilepsy, number of antiepileptic medications (AEDs), presence of known psychiatric illness, and use of psychiatric medications), their seizure control in the month prior to the pandemic, perceived stress during this period of time, sleep changes, compliance changes, and change in seizure control during the pandemic. RESULTS: A total of 156 patients completed the questionnaire, with 29.5% reporting an increase in seizure frequency. Additionally, 59.4% reported an increase in self-reported stress and 71.2% experienced a significant change in their sleep during this period. Higher baseline seizure frequency, more AEDs, noncompliance, increase in self-reported stress, and sleep changes are the significant factors associated with increase in seizure frequency during the pandemic. CONCLUSION: Identifying high-risk patients for seizure recurrence is important in order to provide them with adequate support to reduce such risk.


Subject(s)
Anticonvulsants/therapeutic use , Coronavirus Infections , Epilepsy/drug therapy , Pandemics , Pneumonia, Viral , Sleep Wake Disorders/epidemiology , Stress, Psychological/epidemiology , Adult , Betacoronavirus , COVID-19 , Cross-Sectional Studies , Employment , Epilepsy/physiopathology , Epilepsy/psychology , Female , Humans , Male , Mental Disorders/drug therapy , Mental Disorders/epidemiology , Middle Aged , Psychotropic Drugs/therapeutic use , Recurrence , SARS-CoV-2 , Saudi Arabia/epidemiology , Seizures/drug therapy , Self Report , Sleep , Sleep Wake Disorders/psychology , Stress, Psychological/psychology , Students , Surveys and Questionnaires , Treatment Outcome , Young Adult
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