Crize epileptice și managementul lor.
127 de articoleThis 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 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.
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 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 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.
A double-blinded, placebo-controlled crossover study evaluated MCT-enriched therapeutic diet combined with zonisamide in 7 dogs with idiopathic epilepsy over 6 months. While no significant difference in seizure frequency was found between diet groups overall, individual responses varied with 3 of 7 dogs achieving ≥50% seizure reduction during the MCT diet period, including one achieving seizure freedom.
This veterinary study examines seizure triggers in six Border Collies with idiopathic epilepsy, identifying breed-specific environmental and behavioral factors such as stress, lack of mental stimulation, social stressors, and external stimuli. Management strategies targeting identified triggers resulted in reduced seizure frequency or seizure freedom in these cases, demonstrating the clinical value of recognizing individualized precipitating factors in canine epilepsy.
This study examined glymphatic system function in 100 focal epilepsy patients versus 79 healthy controls using diffusion tensor imaging analysis along the perivascular space (DTI-ALPS). Poor responders to anti-seizure medication showed significantly lower DTI-ALPS indices compared to good responders, suggesting impaired glymphatic clearance may relate to medication resistance in focal epilepsy.
Fyodor Dostoevsky, a 19th-century Russian novelist with epilepsy, incorporated his personal experience with seizure disorder into his novels, particularly in The Brothers Karamazov where he explores family dynamics and uses psychogenic non-epileptic seizures as a narrative element in the character Smerdyakov's criminal alibi.
Calcified neurocysticercosis (NCC) is a major cause of acquired adult-onset epilepsy in low and middle-income countries, responsible for approximately 30% of seizure cases. Focal-onset seizures typically respond well to anti-seizure monotherapy, and these seizure disorders are largely preventable through appropriate management of NCC stages.
This study proposes a deep learning approach for predicting epileptic seizures using EEG signal analysis, employing convolutional neural networks for feature extraction and Bi-LSTM for classification. The method achieved 99.61% accuracy and aims to improve patient quality of life through early seizure detection and timely intervention.