Predictive risk factors of seizure-related injury in persons with epilepsy

Tiamkao, Somsak; Sawanyawisuth, Kittisak; Asawavichienjinda, Thanin; Yaudnopakao, Prapun; Arunpongpaisal, Suwanna; Phuttharak, Warinthorn; Auevitchayapat, Narong; Vannaprasaht, Suda; Tiamkao, Siriporn; Phunikhom, Kutcharin; Chaiyakum, Aporanee; Saengsuwan, Jiamjit; Jitpimolmard, Suthipun

doi:10.1016/j.jns.2009.05.021

Cited by 10 publications

(10 citation statements)

References 9 publications

(10 reference statements)

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“…In a questionnaire-based study of 300 patients from Thailand, the potential risk factors identified were occurrence of GTCS, seizures at least 12 times per year, and daytime seizures. 10 In contrast to this, we found no significant correlation with the time of seizure and risk of SRI.…”

Section: Discussioncontrasting

confidence: 91%

Predictors of Seizure-Related Injuries in an Epilepsy Cohort from North India

et al. 2018

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Background and PurposeTo identify predictors of seizure-related injury (SRI) and death in people with epilepsy (PWE) in a North Indian cohort.MethodsThis ambispective cohort study included PWE registered in an epilepsy clinic in Delhi between May 2010 and December 2011. Five hundred twenty-six patients were enrolled and followed for 25 months. Patients were categorized into two groups based on SRI/no SRI during the study period. We analyzed various factors to identify predictors of SRI and death.ResultsOf 526 patients, 355 (67.5%) reported having no SRIs and 171 (32.5%) had sustained an SRI. Among patients with SRI, 72.5% were male; 62% of those with no SRI were male. The injury type included soft tissue (60%), head trauma (20%), dental trauma (10%), orthopedic (10%), and burns (5%). On univariate analysis, factors predicting SRI occurrence were male gender, abnormal birth history (p < 0.01), abnormal mental status (p < 0.01), seizure duration (p < 0.04), daytime seizures (p < 0.05), dependence on a caregiver (p < 0.008), and uncontrolled seizures (p < 0.001), history of cluster seizures or status epilepticus (p < 0.001), occurrence of generalized tonic-clonic seizures (GTCS), and use of >3 antiepileptic drugs (p < 0.008). On multiple logistic regression analysis, male gender, uncontrolled seizures, history of cluster seizures or status epilepticus, and GTCS were significant risk factors. Sixteen deaths occurred in our cohort, and 13 fit the definition of probable sudden unexpected death in epilepsy (SUDEP). Most patients with SUDEP had an unwitnessed event (69.2%). The only significant factor in predicting death was uncontrolled seizures.ConclusionsMale gender, occurrence of GTCS, uncontrolled seizures, and history of cluster seizures or status epilepticus predicted SRI occurrence in PWE. Precautions should be taken by caregivers of patients with these risk factors, to prevent injury.

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Section: Discussioncontrasting

confidence: 91%

Predictors of Seizure-Related Injuries in an Epilepsy Cohort from North India

et al. 2018

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“…A further potential confounding factor is facial injury. Individuals with epilepsy have a 1.6 times greater risk of accident than the general population (van den Broek and Beghi, 2004), and this is related to the type and frequency of seizures (Tiamkao et al , 2009). Such injuries include fractures, contusions and burns, which often affect the face.…”

Section: Discussionmentioning

confidence: 99%

Atypical face shape and genomic structural variants in epilepsy

Chinthapalli¹,

Bartolini²,

Nový³

et al. 2012

Brain

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Many pathogenic structural variants of the human genome are known to cause facial dysmorphism. During the past decade, pathogenic structural variants have also been found to be an important class of genetic risk factor for epilepsy. In other fields, face shape has been assessed objectively using 3D stereophotogrammetry and dense surface models. We hypothesized that computer-based analysis of 3D face images would detect subtle facial abnormality in people with epilepsy who carry pathogenic structural variants as determined by chromosome microarray. In 118 children and adults attending three European epilepsy clinics, we used an objective measure called Face Shape Difference to show that those with pathogenic structural variants have a significantly more atypical face shape than those without such variants. This is true when analysing the whole face, or the periorbital region or the perinasal region alone. We then tested the predictive accuracy of our measure in a second group of 63 patients. Using a minimum threshold to detect face shape abnormalities with pathogenic structural variants, we found high sensitivity (4/5, 80% for whole face; 3/5, 60% for periorbital and perinasal regions) and specificity (45/58, 78% for whole face and perinasal regions; 40/58, 69% for periorbital region). We show that the results do not seem to be affected by facial injury, facial expression, intellectual disability, drug history or demographic differences. Finally, we use bioinformatics tools to explore relationships between facial shape and gene expression within the developing forebrain. Stereophotogrammetry and dense surface models are powerful, objective, non-contact methods of detecting relevant face shape abnormalities. We demonstrate that they are useful in identifying atypical face shape in adults or children with structural variants, and they may give insights into the molecular genetics of facial development.

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“…Although atonic seizures are more common during childhood (due to the Lennox-Gastaut syndrome), adults can also suffer generalized atonic seizures 11 or even negative frontal motor seizures 12 . These types of seizures can cause severe injuries due to falls, especially of the face and mouth, since the head is unprotected 13 . According to Aragon et al, the most common types of injuries that follow seizures are head trauma, fractures, burns and dental trauma 8 .…”

Section: Discussionmentioning

confidence: 99%

Oral and maxillofacial trauma in patients with epilepsy: prospective study based on an outpatient population

Nonato¹,

Borges²

2011

Arq. Neuro-Psiquiatr.

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Objective: This study aimed to evaluate oral and maxillofacial trauma caused by falls during epileptic seizures. Method: A prospective case-control study was carried out among patients recruited from both the Epileptic Outpatient Clinic and the Emergency Room of Hospital de Base during 2006. The study group was composed of patients with epilepsy that had been diagnosed by a specialist. Oral and maxillofacial trauma was diagnosed using a questionnaire together with physical and radiographic examinations. A control group was formed from non-epileptic relatives or neighbors of the patients. The two groups were compared with regard to the number and type of oral and maxillofacial trauma events suffered. Odds ratios with a 95% confidence interval, dependency analysis and the Pearson c 2 test were used for statistical analysis, and the significance level was set at p≤0.05. Results: A total of 159 patients with epilepsy (91 males; 57.3%) and 68 control individuals (28 males; 41.1%) were enrolled in the study. The frequencies of oromaxillary trauma in the study and control groups were 23.9% and 4.4%, respectively. Generalized tonic-clonic, generalized and non-classified seizures were strongly associated with trauma. The commonest lesions were fractures of dental tooth crowns (32.9%), followed by tooth avulsion (7.6%), tooth luxation (5%) and fracturing of prostheses in edentulous patients (3.8%). Conclusion: This work shows that injuries to the face and teeth are statistically more common in patients with epilepsy than in the general population, and that individuals who suffer seizures without aura are the most affected. Key words: epilepsy, oral trauma, maxillofacial trauma.Trauma oral e maxilofacial em pessoas com epilepsia: estudo prospectivo com base ambulatorial RESUMO Objetivo: O objetivo desse estudo foi avaliar a relação da epilepsia sobre as ocorrências de trauma dento-alveolar e maxilofacial causados por quedas. Método: Estudo casocontrole prospectivo foi conduzido no ambulatório de epilepsia e do Pronto Atendimento do Hospital de Base de São José do Rio Preto-SP no ano de 2006. Pacientes do grupo caso foram diagnosticados pelo neurologista chefe (sênior) especialista em epilepsia e avaliados quanto ao trauma oral e maxilo-facial pelo pesquisador, por meio de questionário, exame clínico e radiográfico, por ordem de chegada. O grupo controle (GC) foi constituído incluindo indivíduos sem crises, que fossem familiares ou vizinhos próximos dos pacientes com diagnóstico de epilepsia. Intervalo de confiança 95%, ODD, análise de dependência (ANADEP) e c 2 de Pearson foram utilizados para análise estatística e se adotou nível de significância de p≤0,05. Resultados: Analisaram-se 159 pacientes com epilepsia, dos quais 91(57,3%) masculinos e 68 do GC, dos quais 28 (41,1%) masculinos. A frequência do trauma oro-maxilar em paciente com epilepsia foi 23,9% e no GC foi de 4,4. As crises tônico-clônicas generalizadas, crises generalizadas e as não classificadas estão fortemente co-relacionadas ao trauma. Fraturas das...

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Predictive risk factors of seizure-related injury in persons with epilepsy

Cited by 10 publications

References 9 publications

Predictors of Seizure-Related Injuries in an Epilepsy Cohort from North India

Predictors of Seizure-Related Injuries in an Epilepsy Cohort from North India

Atypical face shape and genomic structural variants in epilepsy

Oral and maxillofacial trauma in patients with epilepsy: prospective study based on an outpatient population

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