Crize epileptice și managementul lor.
127 de articoleA study of 403 epileptic children who discontinued anti-seizure medication after ≥2 years seizure-free identified that 12.7% experienced seizure relapse, with highest rates in genetic (25%) and structural (14.9%) etiologies. Key predictors of relapse included diagnosis age >2 years, defined etiology, focal seizures, and rapid medication withdrawal (<3 months).
This review examines how p75 neurotrophin receptor (p75NTR) contributes to epilepsy development through altered neurotransmitter balance and increased pro-BDNF/p75NTR expression in brain cells. The authors synthesize current evidence on the mechanistic pathways linking p75NTR overexpression to epileptogenesis and seizure pathogenesis.
This case analysis examines a driver with longstanding epilepsy who caused a traffic accident during a seizure-induced state of profound consciousness disturbance, addressing how courts determine criminal responsibility in such situations. The authors argue for expanded legal frameworks requiring multidisciplinary medical evaluation and therapeutic rather than purely penal measures to prevent future incidents and minimize psychiatric complications.
This retrospective study evaluated lacosamide (LCM) monotherapy in 55 adult epilepsy patients, comparing those with (n=19) and without (n=36) psychiatric comorbidities over 6 months. Both groups achieved >80% seizure freedom with minimal psychiatric adverse effects (one case of irritability), and two patients with anxiety experienced symptom improvement, suggesting LCM is well-tolerated in epilepsy patients with pre-existing psychiatric conditions.
This meta-analysis of 25 observational studies (24,596 pregnancies) found that pregnant women with epilepsy who experience seizures have increased risks of caesarean delivery, peripartum depression, preterm birth, and small-for-gestational-age infants compared to those without seizures. The review also examined how socioeconomic factors may influence seizure control during pregnancy.
Hemispherotomy is a neurosurgical technique that disconnects one cerebral hemisphere to control severe, drug-resistant seizures in children following traumatic brain injury. This specialized intervention is considered when epilepsy originating from one hemisphere cannot be managed with medications, offering potential seizure control through anatomical brain disconnection rather than tissue removal.
This mechanistic review examines shared ion channel dysfunctions (particularly KCNQ1, KCNH2, SCN5A variants) that may simultaneously cause seizure susceptibility and cardiac repolarization abnormalities, proposing an integrated 'cardio-cerebral ion channelopathy' framework for understanding SUDEP risk. The authors discuss critical implications for anti-seizure medication safety assessment and precision medicine strategies in patients with overlapping neurological and cardiac vulnerability.
This study examines patterns of brain electrical synchronization during seizures using EEG network analysis with methods that generalize across different patients. The research contributes to understanding the neurophysiological mechanisms underlying seizure propagation and may inform clinical assessment or treatment approaches.
This cross-sectional study validated a self-report questionnaire (EST-Q) to assess perceived seizure triggers in 100 adults with epilepsy from Brazil. The seven-item core module showed adequate internal consistency for group-level research but insufficient reliability for individual clinical decisions, with exploratory factor analysis supporting a predominantly unidimensional structure.
Focal impaired awareness seizures (formerly complex partial seizures) originating in the temporal lobe frequently present with psychiatric symptoms including behavioral and affective disturbances, with peak incidence in elderly populations. This case report describes an older adult whose transient psychosis was ultimately attributed to seizure activity rather than primary psychiatric illness, highlighting the diagnostic challenge of recognizing seizure-related psychosis in geriatric patients.
This study demonstrates that huntingtin protein levels affect the occurrence of a spontaneous seizure disorder in FVB/N mice, with reduced huntingtin increasing seizure frequency while overexpression prevents seizures entirely. The findings raise important considerations for huntingtin-lowering therapies being tested for Huntington disease, suggesting potential adverse effects on seizure susceptibility as a consequence of reduced wild-type huntingtin levels.
This study compared personality traits and attachment patterns in 25 patients with psychogenic non-epileptic seizures (PNES), 23 epilepsy patients, and 20 healthy controls using standardized psychological inventories. Patients with PNES showed lower IQ scores and modest differences in personality traits (agreeableness and openness) compared to controls, but no significant differences in attachment styles or life satisfaction.
This retrospective study analyzed German national health insurance records to assess epilepsy treatment pathways and guideline adherence, identifying a 0.67% national prevalence with 36% of patients classified as drug-refractory. The research validated hospital-based epilepsy center data against national databases to evaluate timely specialist escalation and optimal treatment recommendations.
This systematic literature review examined how seizure freedom is defined and operationalized across clinical trials, regulatory evaluations, and health technology assessments for epilepsy treatments. The review found significant variability in seizure freedom definitions based on patient population, seizure type, clinical setting, and analytical methods, highlighting the need for standardized definitions to improve treatment outcome comparability.
This retrospective case series examines 15 children with both neurofibromatosis type 1 and epilepsy, documenting seizure types (most commonly generalized tonic-clonic), neuroimaging findings (abnormalities in brain structures like corpus callosum and basal ganglia in 6 cases), and developmental complications. Among the 13 patients with complete follow-up data, 8 achieved seizure freedom with appropriate antiepileptic treatment.
This mechanistic review examines how metformin, an FDA-approved antidiabetic agent, may reduce seizures in treatment-resistant epilepsy through multiple pathways including AMPK activation, mTOR inhibition, and BDNF enhancement with neuroprotective effects. The authors propose metformin as a potential adjunctive agent to conventional anti-epileptic drugs, supported by preclinical evidence of reduced neuroinflammation and seizure severity.
This prospective cohort study enrolls 350 patients (200 with first seizure, 150 newly diagnosed) to identify biomarkers predicting anti-seizure medication response and comorbid psychiatric/cognitive outcomes using EEG, MRI, PET imaging, and neuropsychological testing. Patients receive standardized treatment with lamotrigine or levetiracetam with 5-year follow-up monitoring clinical response, seizure recurrence, psychiatric symptoms, and quality of life.
A follow-up study of 47 patients with initially negative ambulatory EEG results found that 45% received an epilepsy diagnosis within 12 years, suggesting that negative EEG does not exclude epilepsy. Quality of life outcomes were associated with age, employment, and seizure history, highlighting the importance of comprehensive clinical evaluation beyond EEG testing alone.