Objectives
The novel coronavirus disease (COVID‐19) pandemic has led to social distancing measures and impaired medical care of chronic neurological diseases, including epilepsy, which may have adversely affected well‐being and quality of life of patients with epilepsy (PWE). The objective of this study is to evaluate the impact of the COVID‐19 pandemic in the levels of anxiety, depression, somnolence, and quality of life using validated scales in PWE in real‐life clinical practice.
Materials & Methods
Self‐administered scales of anxiety disorders (GAD‐7), depression (NDDI‐E), somnolence (Epworth Sleepiness Scale; ESS), and quality of life (QOLIE‐31‐P) in PWE treated in a Refractory Epilepsy Unit were longitudinally analyzed. Data were collected before the beginning (December 2019 – March 2020) and during the COVID‐19 pandemic (September 2020–January 2021).
Results
158 patients (85 from the first round and 73 from the second round) 45.0 ± 17.3 years of age, 43.2% women, epilepsy duration 23.0 ± 14.9 years, number of antiepileptic drugs 2.1 ± 1.4, completed the survey. Significant longitudinal reduction of QOLIE‐31‐P (from 58.9 ± 19.7 to 56.2 ± 16.2, p = .035) and GAD‐7 scores (from 8.8 ± 6.2 to 8.3 ± 5.9, corrected p = .024) was identified. No statistically significant longitudinal changes in the number of seizures (from 0.9 ± 1.9 to 2.5 ± 6.2, p = .125) or NDDI‐E scores (from 12.3 ± 4.3 to 13.4 ± 4.4, p = .065) were found. Significant longitudinal increase of ESS (from 4.9 ± 3.7 to 7.4 ± 4.9, p = .001) was found.
Conclusions
During the COVID‐19 pandemic, quality of life and anxiety levels were lower in PWE, and sleepiness levels were raised, without seizure change.
Motor epilepsia partialis continua (EPC) is a frequent and widely described variant of simple focal motor status epilepticus. However, lingual EPC is an unusual epileptic condition. We present a case of lingual EPC secondary to low‐grade glioma in which the EEG and neuroimaging features were particularly remarkable. The video‐EEG showed lateralized periodic discharges with superimposed rhythmic activity and frequent recurrent focal epileptic seizures. Moreover, brain magnetic resonance imaging showed a right temporo‐insular cortico‐subcortical lesion which was hyperintense on FLAIR, suggestive of low‐grade glioma. In addition, diffusion‐weighted imaging and arterial spin labelling series showed restricted diffusion in the right temporo‐insular and parietal cortex and increased cerebral flow, respectively. All these findings are in keeping with changes related to persistent focal status epilepticus. Finally, we review the literature and discuss the differential diagnosis of this rare epileptic entity. [Published with video sequence].
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