Perceived trigger factors of seizures in persons with epilepsy

Balamurugan, Elumalai; Aggarwal, Mehak; Lamba, Anurag; Dang, Nitika; Tripathi, Manjari

doi:10.1016/j.seizure.2013.05.018

Cited by 82 publications

(79 citation statements)

References 25 publications

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“…The factors precipitating recurrence of seizures were emotional stress, sleep deprivation, and poor compliance with calcium and vitamin D therapy. The recurrence rate for seizures and precipitating factors were similar to that reported for non-hypoparathyroid epilepsy (20,21). Berg & Shinnar (20) observed 25% recurrence rate during the first year of AED withdrawal in epilepsy.…”

Section: Discussionsupporting

confidence: 80%

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Seizures in patients with idiopathic hypoparathyroidism: effect of antiepileptic drug withdrawal on recurrence of seizures and serum calcium control

Modi¹,

Tripathi²,

Saha³

et al. 2014

European Journal of Endocrinology

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Objective: There is limited information on seizures in patients with idiopathic hypoparathyroidism (IH). We assessed seizure characteristics at presentation, subclinical seizures during follow-up, and the effect of antiepileptic drug (AED) withdrawal in IH patients. Designs and methods: Seizure characteristics were assessed in 70 patients with IH attending endocrine clinic. Provoked electroencephalography (EEG) was performed for subclinical seizures in 44 of them. AEDs were withdrawn using strict criteria, i.e. i) no seizure during past 2 years, ii) normal EEG, iii) serum total calcium R1.8 mmol/l, and iv) feasibility to follow-up regularly after AED withdrawal for at least 9 months (nZ14). The effects of AED withdrawal on seizures and serum total calcium were assessed. Results: Seizures were present in 64.3% of patients, generalized tonic-clonic in 86.7%, and treated with phenytoin (46.7%), valproate (40%), and carbamazepine (26.7%). Most (69/70) patients were seizure-free during the follow-up of 6.6G4.5 years. Ten of 14 (71.4%) patients were successfully withdrawn from AED and remained seizure free during the follow-up period of 13.5G2.4 months (range 9-18). AEDs were restarted because of the recurrence of seizures (nZ3) and poor compliance with calcium/vitamin D (nZ1). The mean serum total calcium increased from 1.9G0.19 to 2.1G0.14 mmol/l after AED withdrawal (PZ0.004). Conclusion: Seizures were present in 64.3% of patients with IH and they responded to AED and calcium/1-a-(OH)D during the follow-up. With strict eligibility criteria, it was possible to withdraw AED in 71% of patients with IH. Serum total calcium improved significantly after AED withdrawal.

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Section: Discussionsupporting

confidence: 80%

“…Berg & Shinnar (20) observed 25% recurrence rate during the first year of AED withdrawal in epilepsy. A recent study in patients with epilepsy has reported noncompliance with medications (40.9%), emotional stress (31.3%), sleep deprivation (19.7%), and fatigue (15.3%) as the common factors triggering seizures (21).…”

Section: Discussionmentioning

confidence: 99%

Seizures in patients with idiopathic hypoparathyroidism: effect of antiepileptic drug withdrawal on recurrence of seizures and serum calcium control

Modi¹,

Tripathi²,

Saha³

et al. 2014

European Journal of Endocrinology

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“…The seizure episode may be triggered by several factors such as sleep deprivation, missed medication, stress, alcohol, menstruation, and flickering light [16]. In this study, stress (24%) is the major triggering factor.…”

Section: Ayswarya and Kumarmentioning

confidence: 67%

“…On the other hand, Sweileh et al found that 64% of the patients were nonadherent [18]. While 38.3% were nonadherent reported by Gabr and Shams in 2014 [16]. WHO in 2007 reported that satisfactory adherence among the patients ranges from 30% to 45%.…”

Section: Ayswarya and Kumarmentioning

confidence: 96%

A Prospective Study on Impact of Patient Counselling on Quality of Life and Medication Adherence in Epileptic Patients

Kumar

Ayswarya²

2016

Asian J Pharm Clin Res

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Objective: To study the impact of patient counseling on medication adherence and quality of life (QOL) in epileptic patients and to assess the factors affecting medication adherence.Methods: This study is a prospective observational study involving 100 patients with an age limit of 8-60 years and those taking Antiepileptic drugs for at least 3 months. The study population received patient counseling during their first visit. The impact of patient counseling on QOL and medication adherence was assessed using self-reported questionnaire QOLIE-31 and MMAS-8 between the first visit and the second visit. Statistical analysis (Paired t-test and Paired Chi-square test) was performed to analyze the impact of patient counseling on QOL and medication adherence in epileptic patients. Results:A total of 100 patients were included in the study. After providing patient counseling, it was observed that there was a statistically significant (p<0.05) improvement in all domains of QOLIE-31 and MMAS-8 scores. Before counseling, mean overall T-score of QOLIE-31 was 44.08±2.07which was changed to 49.14±1.27 after patient counseling with a mean change of 5.06 in overall T-score. In the case of medication adherence, before counseling 77% subjects were nonadherent to therapy, after counseling it was reduced to 41%. The common reasons for medication adherence were forgetfulness, unawareness, therapy related, and economics related. Out of which forgetfulness along with unawareness was the major one. Conclusion:The study described that patient counseling plays a major role in improving QOL and medication adherence.

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“…Diese verteilen sich nicht zufällig über den Tag hinweg, sondern entstehen nach identifizierbaren Auslösereizen. Einer neueren Erhebung zufolge [Balamurugan et al, 2013] sind dies vor allem Unregelmäßigkeiten in der Medikamenteneinnahme (40,9%), emotionale Belastungen (31,3%), Schlafmangel (19,7%), Müdigkeit (15,3%), ausgelassene Mahlzeiten (9,1%), Fieber (6,4%) und Rauchen (6,4%); gelegentlich wird auch noch die Menstruation genannt. Das Erkennen derartiger Auslöser lässt sich schulen, und über den kontingenten Einsatz der bereits genannten Verhaltensalternativen kann ein beginnender Anfall blockiert werden [Andrews et al, 2000; Danach weisen schwer beeinträchtigte ALS-Patienten dann eine gute Lebensqualität auf, wenn das soziale Netzwerk intakt ist und als fürsorglich erlebt wird.…”

Section: Das Brain-computer-interface Als Methode Der Kompensationunclassified

Verhaltensmedizin in der Neurologie: State of the Art

Leplow

2014

Verhaltenstherapie

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Verhaltensmedizinische Interventionen setzen bei neurologischen Erkrankungen mit dem Ziel an, die gesellschaftliche Teilhabe so weit wie möglich zu erhalten oder wiederherzustellen. Dies kann über restitutive und kompensatorische Zugangswege mit oder ohne direkte Intervention am somatischen Substrat erfolgen. So lassen sich schlaganfallbedingte Paresen zumindest teilweise auch als Verlust des motorischen Gedächtnisses erklären. Durch lernpsychologisch begründete Interventionen ist neben der funktionellen Verbesserung auch eine Wiederherstellung der somatosensorischen Repräsentation möglich. Über EEG-Feedback-gestützte Brain-Computer-Interfaces kann dagegen die bei nahezu kompletten Lähmungen der Willkürmotorik ausgefallene Kommunikation mit der Umwelt kompensiert werden. Therapeutische Maßnahmen, die nicht direkt am somatischen Substrat ansetzen, zielen entweder auf die Wechselwirkung zwischen kurzfristigen, symptomatischen Verschlechterungen und situativen Auslösern oder auf den emotionalen und behavioralen Umgang mit einer somatischen Erkrankung. So ist eine situationsspezifische Symptomkontrolle unter anderem bei Anfallserkrankungen mit oder ohne Neurofeedback-Unterstützung möglich. Darüber hinaus kann die Behandlung psychischer Beschwerden und Störungen heute bei fast allen neurologischen Erkrankungen indiziert sein. Deshalb sollen mit diesem Beitrag die vielfältigen Möglichkeiten herausgestellt werden, die bereits jetzt zur verhaltensmedizinischen Unterstützung der Selbstregulation bei ganz unterschiedlichen neurologischen Krankheitsbildern zur Verfügung stehen.

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Perceived trigger factors of seizures in persons with epilepsy

Abstract: TFs should be evaluated during the management of PWE. However, self perceived TF should be interpreted with caution and differentiated from actual TF. Future studies may consider empowering patients with avoidance strategies and self-control techniques done.

Cited by 82 publications

References 25 publications

Seizures in patients with idiopathic hypoparathyroidism: effect of antiepileptic drug withdrawal on recurrence of seizures and serum calcium control

Seizures in patients with idiopathic hypoparathyroidism: effect of antiepileptic drug withdrawal on recurrence of seizures and serum calcium control

A Prospective Study on Impact of Patient Counselling on Quality of Life and Medication Adherence in Epileptic Patients

Verhaltensmedizin in der Neurologie: State of the Art

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