Crize epileptice și managementul lor.
127 de articoleThis clinical study of 189 adult patients found that inadequate dosing of anti-seizure medications was independently associated with treatment failure and higher mortality in non-convulsive status epilepticus, regardless of treatment sequence. The research suggests that ensuring appropriate medication dosing is more critical than the specific order of drug administration in managing this condition.
This study proposes SALT, a deep learning model combining LSTM-Transformer architecture with self-supervised pretraining to detect epileptic seizures from EEG signals without requiring large labeled datasets. The method achieved >98% sensitivity and accuracy on two public benchmark datasets using both segment-based and event-based evaluation protocols.
This study identifies DIRAS2, a Ras-related GTPase, as a regulator of seizure susceptibility through its effects on neuronal excitation/inhibition balance and ferroptosis pathways in epilepsy models and temporal lobe epilepsy patients. DIRAS2 overexpression reduces seizure activity and protects against ferroptosis via inhibition of ERK/p38 MAPK signaling, identifying a potential therapeutic target for epilepsy treatment.
A retrospective study of 56 children (ages 0-21) presenting to a pediatric ED with active seizures found that 46% required intubation, most commonly for airway protection or respiratory failure. Intubated patients typically had complex febrile seizures, longer seizure duration, and required multiple antiseizure medications for control.
A 59-year-old woman with behavioral changes, memory impairment, and hyponatremia was diagnosed with LGI1 antibody-positive autoimmune encephalitis after brain MRI revealed temporal lobe involvement and EEG showed electrographic seizure patterns. Treatment with steroid pulse therapy, plasma exchange, and lacosamide resulted in lesion resolution within 90 days, highlighting the importance of EEG monitoring for early detection of autoimmune encephalitis.
This study compared EEG recordings with and without hyperventilation to assess their role in detecting epileptiform abnormalities across 659 patients. Hyperventilation, longer recording duration, and sleep deprivation all increased the likelihood of detecting epileptiform discharges, with hyperventilation showing particular benefit in children but not adults.
This study proposes a causal attention network (CANet) that combines dilated causal convolution and attention mechanisms to predict seizures during extended preictal periods (up to 2 hours before onset). Testing on standard epilepsy datasets showed high sensitivity (92-100%) and low false alarm rates, with average prediction times exceeding 90 minutes, potentially allowing sufficient time for therapeutic intervention.
A case report documents successful breastfeeding by a mother with drug-resistant epilepsy treated with eslicarbazepine acetate, with measured infant serum drug levels at 9.1% and 7.5% of maternal concentration and no adverse effects at 13 months follow-up. The authors conclude that breastfeeding may be considered under clinical supervision for healthy term infants of mothers on eslicarbazepine monotherapy, while noting that safety data remain limited.
This case-control study of 132 epilepsy patients and 131 controls found significantly lower serum subfatin levels in epilepsy patients compared to controls, with ROC analysis showing good diagnostic discriminatory power (AUC 0.84). The authors propose subfatin as a promising biomarker that may reflect neuroinflammatory processes in epileptogenesis, with potential diagnostic and prognostic utility.
This study examined how diazepam nasal spray, an FDA-approved rescue medication for seizure clusters in children aged 2-5 years, affected the time interval between cluster episodes. Results showed the mean interval between seizure clusters approximately doubled over the treatment period, suggesting improved seizure control with continued use of the medication.
This systematic review synthesized 47 observational studies on seizure emergencies in Spain, revealing that status epilepticus patients experience high mortality (24.3%), prolonged seizure duration (8-51 hours), and significant ICU admissions. Patients presenting with epileptic seizures at emergency departments showed variable hospitalization rates (6-32%) and medical complications (19.4-52.1%), highlighting the substantial clinical and healthcare resource burden of seizure emergencies.
A quasi-experimental study of 344 adolescents in Quito found that an educational comic book significantly improved median global knowledge-attitudes-practices (KAP) scores from 11.5 to 15.1. Students showed greater improvements regardless of baseline knowledge, though those with prior seizure exposure improved less, suggesting comic-based education effectively reduces epilepsy stigma in diverse adolescent populations.
This paper presents a SnNb₂O₆-based capacitive memristor device that mimics biosynaptic neurons with leaky-integrate-and-fire dynamics for monitoring epileptic seizures. The device achieves 95.8% classification accuracy for epilepsy-related states when integrated with convolutional neural networks for EEG signal analysis.
This narrative review examines the complex bidirectional interactions between antiseizure medications and hormonal contraceptives, which can affect seizure control, contraceptive efficacy, and medication serum levels in people with epilepsy of childbearing age. The authors emphasize that planned pregnancies lead to better outcomes and provide comprehensive guidance on selecting appropriate contraception methods while addressing special populations including adolescents and those with intellectual disabilities.
This study optimizes EEG signal acquisition by jointly selecting the most relevant channels and frequency bands for seizure classification while reducing computational costs, using a genetic algorithm approach tested on the CHB-MIT database. Results identified specific channels (P3-O1, P4-O2, CZ-PZ) and frequency bands (gamma and alpha) as most relevant for accurate seizure detection in resource-constrained clinical settings.
This multi-center Chinese cohort study of 1,013 women with epilepsy examined how folic acid supplementation affects pregnancy outcomes, finding that FA use in ASM-exposed pregnancies reduced risks of adverse composite outcomes and fetal death. Supplementation at ≥0.4 mg/day provided protection, with dose-response relationships analyzed using appropriate statistical models.
A prospective study of 40 children on levetiracetam monotherapy found no significant changes in thyroid hormone levels or autoimmune markers over 6 months of treatment. Although thyroid volume standard deviation scores decreased slightly, absolute thyroid volume and thyroid function remained stable, suggesting levetiracetam does not adversely affect thyroid health in the short term.
This study proposes a machine learning framework combining Hjorth parameters extracted from time and time-frequency domains with deep neural networks (CNN, BiLSTM, and attention mechanisms) to classify epileptic seizure stages. The approach achieved 98.4% accuracy for binary classification and 85.4% for five-class discrimination on the Bonn EEG dataset using rigorous cross-validation.