| 1. |
- Ahorsu, Daniel Kwasi, et al.
(author)
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Testing an app-based intervention to improve insomnia in patients with epilepsy : A randomized controlled trial
- 2020
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In: Epilepsy & Behavior. - : Elsevier BV. - 1525-5050 .- 1525-5069. ; 112
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Journal article (peer-reviewed)abstract
- Purpose: Insomnia has adverse effects on people with epilepsy. We aimed to test a novel cognitive behavioral therapy for insomnia (CBT-I) app-based intervention on insomnia symptoms and social psychological factors in people with epilepsy and to examine the possible mechanisms among the factors.Methods: Participants were recruited from neurology clinics in Iran and comprised individuals diagnosed with epilepsy and having moderate to severe insomnia. A two-arm randomized controlled trial design was used, consisting of a treatment group (CBT-I; n = 160) and control group (patient education; n = 160). Primary outcomes were self-reported sleep quality, insomnia severity, and sleep hygiene behavior and objective sleep characteristics measured by actigraphy. Secondary outcomes were attitude, perceived behavioral control, intention, action planning, coping planning, behavioral automaticity, self-monitoring, anxiety, depression, and quality of life (QoL). All outcomes were measured at baseline, and at one, three, and six months postintervention, except objective sleep, which was assessed at baseline, and one and six months postintervention. Data were analyzed using linear mixed models.Results: Current findings showed that sleep quality, insomnia severity, sleep hygiene behavior, and sleep onset latency were significantly improved in the CBT-I group compared with the patient education group at all measurement points. Also, the CBT-I group had significantly improved anxiety, depression, and QoL compared with the patient education group. Mediation analyses showed that attitude, intention, coping planning, self-monitoring, and behavioral automaticity significantly mediated the effect of the intervention on sleep outcomes.Conclusion: Results support the use of the CBT-I app to improve sleep outcomes among people with epilepsy.
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| 2. |
- Arzy, Shahar, et al.
(author)
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Neural generators of psychogenic seizures: Evidence from intracranial and extracranial brain recordings
- 2014
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In: Epilepsy & Behavior. - : Elsevier BV. - 1525-5069 .- 1525-5050. ; 31, s. 381-385
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Journal article (peer-reviewed)abstract
- Psychogenic seizures (PSs) convincingly mimic seizure phenomena but with no underlying epileptic activity. However, not much is known about their neurophysiological basis. We had the rare opportunity to analyze intracranial brain recordings of PSs occurring besides epileptic seizures (ESs), which identified distinct frequency changes over the parietal cortex. For further validation, we applied topographic frequency analysis to two other patients who presented PSs and ESs during long-term monitoring. The analysis revealed a power decrease in the theta band at the posterior parietal cortex in all three patients during PSs but not during ESs. These changes may reflect disturbed self-referential processing associated with some PSs. (C) 2013 Elsevier Inc. All rights reserved.
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| 3. |
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| 4. |
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| 5. |
- Bjurulf, Björn, 1962, et al.
(author)
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Caregiver reported behavior, sleep and quality of life in children with Dravet syndrome: A population-based study
- 2024
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In: Epilepsy and Behavior. - 1525-5050 .- 1525-5069. ; 150
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Journal article (peer-reviewed)abstract
- Objective: The aim of this population-based study was to assess behavior, sleep, and quality of life, and explore factors associated with these in children with Dravet syndrome. Methods: The Developmental Behavior Checklist, the Insomnia Severity Index, and a global question regarding quality of life from the Epilepsy and Learning Disabilities Quality of Life scale were completed by primary caregivers of 42/48 Swedish children with Dravet syndrome, born 2000–2018. Factors associated with problems with insomnia, behavior and quality of life were analyzed using multivariable linear regression. Results: Scores indicating significant behavioral problems were seen in 29/40 (72 %) children, scores indicating moderate or severe clinical insomnia in 18/42 (43 %) and scores indicating poor or very poor quality of life in 7/41 (17 %). On multivariable analysis, autistic symptoms were significantly associated with behavioral problems (p = 0.013), side-effects of anti-seizure medications (ASMs) were associated with insomnia (p = 0.038), whilst insomnia was significantly associated with poor quality of life (p = 0.016). Significance: Dravet syndrome in children is associated with significant problems with behavior, sleep and quality of life. There is a need to optimize treatment via ASMs and develop and evaluate interventions to treat behavioral and sleep difficulties to optimize outcomes.
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| 6. |
- Blomberg, Karin, 1970-, et al.
(author)
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Fifty-year follow-up of childhood epilepsy : Social, psychometric, and occupational outcome
- 2019
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In: Epilepsy & Behavior. - : Elsevier. - 1525-5050 .- 1525-5069. ; 96, s. 224-228
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The objective of this study was to explore and describe the experience of a childhood diagnosis of epilepsy and its consequences for the experiences of daily life over a span of 50 years.METHODS: A descriptive mixed method design was chosen. Data were collected through a survey returned by 86 persons (59% response rate) who had received diagnoses of epilepsy as children. The survey contained questions about education, vocation, family status, and included the 14-item Hospital Anxiety and Depression Scale (HAD). Additionally, interviews (n = 11) were conducted and analyzed by interpretative description.RESULTS: Few persons reported that the childhood diagnosis of epilepsy had affected their choice of education, work, or leisure activities. However, 20% reported that the diagnosis had caused problems in school or at work and had restricted their activities of daily living. Sixty-six percent of the participants were married, and 68% had children; of those, 12 (20%) reported that one or more of the children had also had seizures. Almost all reported no anxiety (82%) and no depression (90%). The results of the interviews revealed a balancing act between 'Controlling and managing the situation' and 'Not being restricted by the condition'.SIGNIFICANCE: This long-term follow-up over a 50-year life-span of persons who received childhood diagnoses of epilepsy suggests that the consequences for education, work, and leisure activities were few. Most of the participants had developed strategies to manage their situation.
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| 7. |
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| 8. |
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| 9. |
- Cardeña, Etzel, et al.
(author)
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Differentiating psychogenic nonepileptic from epileptic seizures: A mixed-methods, content analysis study
- 2020
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In: Epilepsy & Behavior. - : Elsevier BV. - 1525-5069 .- 1525-5050. ; 109
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Journal article (peer-reviewed)abstract
- Background: Identification of clinical features that might distinguish psychogenic nonepileptic seizures (PNES)from epileptic seizures (ES) is of value for diagnosis, management, and understanding of both conditions. Previousstudies have shown that patients' descriptions of their seizures reflect differences in content and delivery.Weaimed to compare verbal descriptions of PNES and ES using a mixed-methods approach.Methods: We analyzed data from semi-structured interviews in which patients with video-electroencephalography(EEG)-confirmed ES (n=30) or PNES (n=10) described their seizures. Two masked raters independentlycoded the transcripts for relevant psychological categories and discrepancies that were noted and resolved. Additionalanalyses were conducted using the Linguistic Inquiry and Word Count system. The identified phenomenawere descriptively compared, and inferential analyses assessed group differences in frequencies. A logisticregression analysis examined the predictive power of the most distinctive phenomena for diagnosis.Results: As compared with ES, PNES reported longer seizures, more preseizure negative emotions (e.g., fear), anxietysymptoms (e.g., arousal, hyperventilation), altered vision/olfaction, and automatic behaviors. During seizures,PNES reported more fear, altered breathing, and dissociative phenomena (depersonalization, impairedtime perception). Epileptic seizures reported more self-injurious behavior. Postseizure, PNES reported morefear and weeping and ES more amnesia and aches. The predictive power when including these variables was97.5%. None of the single predictor variables was significant. The few but consistent linguistic differences relatedto the use of some pronouns and references to family.Conclusions: Although no single clinical feature definitively distinguishes PNES from ES, several features may besuggestive of a PNES diagnosis, including longer duration, negative emotion (i.e., fear) throughout the events,preseizure anxiety, ictal dissociation, and postseizure weeping. Fewer reports of ictal self-injury and postseizureamnesia and aches may also indicate the possibility of PNES.
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| 10. |
- Compagno Strandberg, Maria, et al.
(author)
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Validation of the Swedish version of the Beliefs about Medicines Questionnaire, based on people with epilepsy
- 2021
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In: Epilepsy and Behavior. - : Elsevier BV. - 1525-5050 .- 1525-5069. ; 115
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Journal article (peer-reviewed)abstract
- Title: Validation of the Swedish version of the Beliefs about Medicines Questionnaire, based on people with epilepsy. Purpose: The aims of the study were to explore the latent structure of the Swedish Beliefs about Medicines Questionnaire (BMQ), to investigate its reliability and to identify the extent to which individual factors among people with epilepsy (PWE), as well as their general beliefs about medication, predict their beliefs about their specific anti-seizure drugs (ASDs). Methods: One-hundred and fifty six included study participants diagnosed with epilepsy and with a well-established neurological follow-up completed an array of rating scales. Included were the Swedish BMQ, which captures beliefs about medicines, scales for symptoms of anxiety and depression and sense of self-efficacy, as well as a general questionnaire regarding their social situation in general. Statistical analysis included Principal Component Analyses (PCA) and hierarchical multiple regression analysis. Results: The PCA revealed a two-factor structure for each of the BMQ-subscales with acceptable (BMQ-G) to high (BMQ-S) internal consistency. The only individual factor that predicted variance in beliefs about medication was patient gender, where levels of both anxiety and depression were elevated in women. Conclusion: The Swedish BMQ exhibits psychometric features indicating its reliable use in adult PWE. Our results suggest that the BMQ provides information about the patients’ view of their medication regardless of their general mood and that women hold stronger beliefs of concern beyond influence from their levels of depression and anxiety.
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| 11. |
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| 12. |
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| 13. |
- Ehrstedt, Christoffer, et al.
(author)
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Cognition, health-related quality of life, and mood in children and young adults diagnosed with a glioneuronal tumor in childhood
- 2018
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In: Epilepsy & Behavior. - : Elsevier BV. - 1525-5050 .- 1525-5069. ; 83, s. 59-66
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Journal article (peer-reviewed)abstract
- Aims: The aim of this study was to investigate long-term cognitive outcome, health-related quality of life (HRQoL), and psychiatric symptoms in children and young adults diagnosed with a glioneuronal tumor in childhood.Methods: Twenty-eight children and adolescents (0-17.99 years) with a minimum postoperative follow-up time of five years were eligible for the study; four persons declined participation. A cross-sectional long-term follow-up evaluation was performed using the following study measures: Wechsler Intelligence Scale for Children (WISC-IV) or Wechsler Adult Intelligence Scale (WAIS-IV), Reys Complex Figure Test (RCFT), Short Form 36 version 2 (SF-36v2), Short Form 10 (SF-10), Quality of Life in Epilepsy 31 (QOLIE-31), Hospital Anxiety Depression Scale (HADS) or Beck Youth Inventory Scales (BYI), and Rosenberg Self-Esteem Scale. Historical WISC-III and RCFT data were used to compare cognitive longitudinal data.Results: Mean follow-up time after surgery was 12.1 years. Sixty-three percent (15/24) were seizure-free. Despite a successive postoperative gain in cognitive function, a significant reduction relative to norms was seen in the seizure-free group with respect to perceptual reasoning index (PRI), working memory index (WMI), and full-scale intelligence quotient (FSIQ). Seizure freedom resulted in acceptable HRQoL. Thirty-two percent and 16% exceeded the threshold level of possible anxiety and depression, respectively, despite seizure freedom.Conclusion: Although lower than in corresponding reference groups, cognitive outcome and HRQoL are good provided that seizure freedom or at least a low seizure severity can be achieved. There is a risk of elevated levels of psychiatric symptoms. Long-term clinical follow-up is advisable.
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| 14. |
- Ehrstedt, Christoffer, et al.
(author)
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Glioneuronal tumors in childhood - Before and after surgery. A long-term follow-up study
- 2017
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In: Epilepsy & Behavior. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 1525-5050 .- 1525-5069. ; 72, s. 82-88
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Journal article (peer-reviewed)abstract
- Aim: To give a detailed description of the long-term outcome of a cohort of children with glioneuronal tumors regarding pre-and postsurgical factors, including "dual" and "double" pathology, seizure freedom, and psychosocial outcome.Methods: During a fifteen-year period (1995-2009), all patients (age 0-17.99 years) with a glioneuronal brain tumor diagnosed and treated at Uppsala University Children's Hospital were identified from the National Brain Tumor Registry and the National Epilepsy Surgery Registry. Hospital medical records were reviewed and neuroradiological and neuropathological findings were re-evaluated. A cross-sectional long-term follow-up prospective evaluation, including an interview, neurologic examination, and electroencephalogram, was accomplished in patients accepting participants in the study.Results: A total of 25 out of 28 (89%) eligible patientswere included. The M: F ratiowas 1.5: 1. Mean follow-up time after surgery was 12.1 years (range 5.0-19.3). Twenty patients were adults (N18 years) at follow-up. Seizure freedomwas achieved in 64%. Gross total resection (GTR) was the only preoperative factor significantly correlating to seizure freedom (p= 0.027). Thirty-eight percent were at some time postoperatively admitted for a psychiatric evaluation. There was a trend towards both higher educational level and employment status in adults who became seizure free.Conclusion: Long-termoutcome is good regarding seizure freedom if GTR can be achieved, but late seizure recurrence can occur. "Dual" and "double" pathology is uncommon and does not influence seizure outcome. Obtaining seizure freedomseems to be important for psychosocial outcome, but there is a risk for psychiatric comorbidities and long-term follow-up by a multi-professional team is advisable.
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| 15. |
- Eriksson, Hanna, et al.
(author)
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Acute symptomatic seizures and epilepsy after mechanical thrombectomy
- 2020
-
In: Epilepsy and Behavior. - : Elsevier BV. - 1525-5050 .- 1525-5069. ; 104
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Journal article (peer-reviewed)abstract
- Purpose: The purpose of this study was to assess the incidence of acute symptomatic seizures and poststroke epilepsy (PSE) in a well-characterized cohort of patients treated with mechanical thrombectomy. In addition, we aimed to describe the dynamics of blood markers of brain injury in patients that developed PSE. Methods: Participants of the prospective AnStroke Trial of anesthesia method during mechanical thrombectomy were included and acute symptomatic seizures and PSE ascertained by medical records review. Blood markers neurofilament light (NFL), tau, glial fibrillary acidic protein (GFAP), S100 calcium-binding protein B (S100B), and neuron-specific enolase (NSE) were assessed. Results: A total of 90 patients with acute anterior ischemic stroke were included. Median National Institutes of Health Stroke Scale (NIHSS) at admission to hospital was 18 (IQR 15–22). Recanalization was achieved in 90%. No patients had epilepsy prior to the ischemic stroke. Four patients (4.4%) had acute symptomatic seizures and four patients (4.4%) developed PSE during the follow-up time (to death or last medical records review) of 0–4.5 years (median follow-up 1070 days IQR 777–1306), resulting in a two-year estimated PSE risk of 5.3% (95%CI: 0.2–10.4%). Blood markers of brain injury (NFL, tau, GFAP, S100B, and NSE) were generally above the cohort median in patients that developed PSE. Conclusions: The incidence of PSE after mechanical thrombectomy was low in our cohort. All blood biomarkers displayed interesting sensitivity and specificity. However, the number of PSE cases was small and more studies are needed on risk factors for PSE after mechanical thrombectomy. The potential of blood markers of brain injury markers to contribute to assessment of PSE risk should be explored further. This article is part of the Special Issue "Seizures & Stroke".
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| 16. |
- Feldwisch-Drentrup, Hinnerk, et al.
(author)
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Anticipating the unobserved: Prediction of subclinical seizures
- 2011
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In: Epilepsy & Behavior. - : Elsevier. - 1525-5050 .- 1525-5069. ; 22, s. S119-S126
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Journal article (peer-reviewed)abstract
- Subclinical seizures (SCS) have rarely been considered in the diagnosis and therapy of epilepsy and have not been systematically analyzed in studies on seizure prediction. Here, we investigate whether predictions of subclinical seizures are feasible and how their occurrence may affect the performance of prediction algorithms. Using the European database of long-term recordings of surface and invasive electroencephalography data, we analyzed the data from 21 patients with SCS, including in total 413 clinically manifest seizures (CS) and 3341 SCS. Based on the mean phase coherence we investigated the predictive performance of CS and SCS. The two types of seizures had similar prediction sensitivities. Significant performance was found considerably more often for SCS than for CS, especially for patients with invasive recordings. When analyzing false alarms triggered by predicting CS, a significant number of these false predictions were followed by SCS for 9 of 21 patients. Although currently observed prediction performance may not be deemed sufficient for clinical applications for the majority of the patients, it can be concluded that the prediction of SCS is feasible on a similar level as for CS and allows a prediction of more of the seizures impairing patients, possibly also reducing the number of false alarms that were in fact correct predictions of CS. less thanbrgreater than less thanbrgreater thanThis article is part of a Supplemental Special Issue entitled The Future of Automated Seizure Detection and Prediction.
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| 17. |
- Gauffin, Helena, et al.
(author)
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Impaired language function in generalized epilepsy : Inadequate suppression of the default mode network
- 2013
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In: Epilepsy & Behavior. - : Elsevier. - 1525-5050 .- 1525-5069. ; 28:1, s. 26-35
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Journal article (peer-reviewed)abstract
- We aimed to study the effect of a potential default mode network (DMN) dysfunction on language performance in epilepsy. Language dysfunction in focal epilepsy has previously been connected to brain damage in language-associated cortical areas. In this work, we studied generalized epilepsy (GE) without focal brain damage to see if the language function was impaired. We used functional magnetic resonance imaging (fMRI) to investigate if the DMN was involved. Eleven persons with GE and 28 healthy controls were examined with fMRI during a sentence-reading task. We demonstrated impaired language function, reduced suppression of DMN, and, specifically, an inadequate suppression of activation in the left anterior temporal lobe and the posterior cingulate cortex, as well as an aberrant activation in the right hippocampal formation. Our results highlight the presence of language decline in people with epilepsy of not only focal but also generalized origin.
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| 18. |
- Gauffin, Helena, et al.
(author)
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Living with epilepsy accompanied by cognitive difficulties: Young adults experiences
- 2011
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In: Epilepsy & Behavior. - : Elsevier. - 1525-5050 .- 1525-5069. ; 22:4, s. 750-758
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Journal article (peer-reviewed)abstract
- Objective: Epilepsy can sometimes be followed by memory impairment. This can result from the underlying cause of epilepsy or from recurrent seizures, or can be a side effect of antiepileptic drugs or a symptom of another disease such as depression. The aim of the study described here was to explore the experience of living with epilepsy and subjective cognitive decline. less thanbrgreater than less thanbrgreater thanMethod: To better understand the deeper meaning of the phenomenon, a qualitative design was chosen. Fourteen adults aged 18-35 took part in focus group interviews. The participants were divided into four groups, two groups of women and two groups of men, and the interviews were conducted according to a semistructured protocol. Transcripts were analyzed in accordance with the content analysis guidelines. less thanbrgreater than less thanbrgreater thanResults: Four themes emerged: "affecting the whole person," "influencing daily life," "affecting relationships," and "meeting ignorance in society." less thanbrgreater than less thanbrgreater thanConclusions: Cognitive decline has a heavy impact on young adults with intractable epilepsy. In contrast to seizures, the cognitive decline is persistent. The themes reflected different hardships faced by the participants. The consequences of living with epilepsy and cognitive impairment concerned education, employment, social life, self-esteem, and hope for the future. The participants were already using strategies to cope with their cognitive decline, but may benefit from help in developing new strategies to better adjust to their memory problems. Development of more educational programs for both people with epilepsy and their relatives could improve their difficult situations. With help, people can learn to adjust their goals in life and live a fulfilling life despite the disease.
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| 19. |
- Ghanean, Helia, et al.
(author)
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Self-perception of stigma in persons with epilepsy in Tehran, Iran
- 2013
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In: Epilepsy & Behavior. - : Elsevier BV. - 1525-5050 .- 1525-5069. ; 28:2, s. 163-167
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Journal article (peer-reviewed)abstract
- Epilepsy is one of the most stigmatizing medical conditions worldwide. It could be argued that the problem of stigma and discrimination might be different in an Islamic culture. A cross-sectional study of 130 patients with epilepsy was performed using the Internalized Stigma of Mental Illness (ISMI) questionnaire that was adapted for epilepsy. The questionnaire contained 29 items on a 4-point scale in addition to an open-ended question about experience of discrimination. An average score above the midpoint (2.5) is suggested to indicate a high level of stigma. Approximately 23.7% of the patients reported a score above the midpoint. Unemployment and low education were significantly associated with a high level of internalized stigma. Although epilepsy can be effectively treated, patients in Tehran still experience much stigma. For this reason, strategies for reducing self-perception of stigma should be included in a treatment plan.(C) 2013 The Authors. Published by Elsevier Inc. All rights reserved.
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| 20. |
- Ioannidis, P., et al.
(author)
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Transient epileptic amnesia in a memory clinic setting. A report of three cases
- 2011
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In: Epilepsy & Behavior. - : Elsevier. - 1525-5050 .- 1525-5069. ; 20:2, s. 414-417
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Journal article (peer-reviewed)abstract
- Transient epileptic amnesia (TEA) is a recently described, typically misdiagnosed at presentation, distinctive syndrome, characterized by recurrent, brief attacks of memory loss in middle-aged or elderly people, accompanied by significant interictal memory difficulties. We describe the clinical, neuroimaging, electrophysiological, and neuropsychological characteristics of three patients fulfilling the proposed criteria for TEA, initially referred to our memory clinic for evaluation and treatment of probable dementia. Neuropsychological performance on admission and 6 months after treatment demonstrated a broad range of performance on measures of executive function, lower than expected visuospatial perception, and poor autobiographical memory. TEA should be included in the differential diagnosis of dementia to avoid misdiagnosis and needless medication. It is a benign and treatable condition, yet the associated decline in autobiographical and remote memory despite antiepileptic therapy poses challenges for further research.
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| 21. |
- Johanson, Mirja, et al.
(författare)
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Alterations in the contents of consciousness in partial epileptic seizures
- 2008
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Ingår i: Epilepsy & Behavior. - : Elsevier. - 1525-5050 .- 1525-5069. ; 13:2, s. 366-371
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Tidskriftsartikel (refereegranskat)abstract
- Epilepsy research suffers from a deficiency of systematic studies concerning the phenomenology of the contents of consciousness during seizures, partially because of the lack of suitable research methods. The Phenomenology of Consciousness Inventory (PCI), a standardized, valid, and reliable questionnaire, was used here to study which dimensions of the contents of consciousness are distorted during partial epileptic seizures compared with baseline. Further, the similarity of the altered pattern of subjective experiences across recurring seizures was also explored. Our results indicate that patients with epilepsy report alterations on most dimensions of the contents of consciousness in conjunction with seizures, but individual seizure experiences remain similar from one seizure to another. The PCI was found suitable for the assessment of subjective experiences during epileptic seizures and could be a valuable tool in providing new information about phenomenal consciousness in epilepsy in both the research and clinical settings.
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| 22. |
- Johanson, Mirja, et al.
(författare)
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Content analysis of subjective experiences in partial epileptic seizures
- 2008
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Ingår i: Epilepsy & Behavior. - : Elsevier. - 1525-5050 .- 1525-5069. ; 12:1, s. 170-182
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Tidskriftsartikel (refereegranskat)abstract
- A new content analysis method for systematically describing the phenomenology of subjective experiences in connection with partial epileptic seizures is described. Forty patients provided 262 descriptions of subjective experience relative to their partial epileptic seizures. The results revealed that subjective experiences during seizures consist mostly of sensory and bodily sensations, hallucinatory experiences, and thinking. The majority of subjective experiences during seizures are bizarre and distorted; nevertheless, the patients are able to engage in adequate behavior. To the best of our knowledge, this is the first study for which detailed subjective seizure descriptions were collected immediately after each seizure and the first study in which the content of verbal reports of subjective experiences during seizures, including both the ictal and postictal experiences, has been analyzed in detail.
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