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Status epilepticus (SE) and super-refractory status epilepticus (SRSE) are life-threatening medical emergencies. The first-line treatment for SE or SRSE includes i. v. anesthetic agents with respiratory support, AEDs, and steroids. Surgical interventions are indicated if medical treatments fail to abrupt the seizures. Apart from resective epilepsy surgery employed for the treatment of SE and SRSE, deep brain stimulation (DBS) of thalamic nuclei is aimed at directly influencing the brain function.
The main objective of this review is to present the efficacy and safety of DBS in SE and SRSE in humans.
We performed the literature search regarding DBS therapy in the treatment of SE and SRSE. All manuscripts written in English have been analyzed and included in this review.
We were able to find 7 case reports describing DBS outcomes for the treatment of SE or SRSE in 8 patients. Six patients operated for SE or SRSE gained a significant seizure reduction or total abolition of seizures. One patient due to an infection and the other one due to a stimulation-related adverse event required the total DBS hardware removal.
Case reports suggest that DBS can be considered as one of the treatment choices in SE and SRSE cases. A small number of treated cases and various thalamic nuclei targeted by DBS electrodes preclude drawing definitive conclusions. It can be speculated that a shorter duration of refractory SE or SRSE before a DBS procedure may efficiently reduce seizure frequency.
Case reports suggest that DBS can be considered as one of the treatment choices in SE and SRSE cases. A small number of treated cases and various thalamic nuclei targeted by DBS electrodes preclude drawing definitive conclusions. It can be speculated that a shorter duration of refractory SE or SRSE before a DBS procedure may efficiently reduce seizure frequency.
Depression is the most commonly seen psychiatric co-morbidity of epilepsy. Depression in patients with epilepsy (PWE) is underrecognized. The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is a useful tool to screen for major depressive episodes (MDEs) in PWE. This study validated the Taiwanese version of the NDDI-E using data from adult PWE in our hospital.
PWE were recruited from the Taipei Veterans General Hospital from April 2017 to December 2019. The Chinese version of the NDDI-E for the Taiwanese population and the Beck Depression Inventory-II (BDI-II) were completed as part of the self-rated psychiatric assessments. The mood disorder module of the Mini International Neuropsychiatric Interview (MINI) was completed as part of the psychiatric assessment before the self-rated assessment. Internal consistency, external validation, and receiver operator characteristic (ROC) curve analysis were used to assess the utility of the Taiwanese version of the NDDI-E.
We recruited 109 patients during the 33-month study period. The mean age was 33.1 ± 8.94 years old. The mean NDDI-E score was 12.32 ± 4.96. The mean BDI-II score was 13.26 ± 12.77. All NDDI-E items were significantly positively associated with the corrected overall NDDI-E score (Cronbach's alpha = 0.902, r = 0.825, p < 0.0001). The cut-off point for the NDDI-E determined with receiver operating characteristic (ROC) curve analysis is 15 (sensitivity = 85.0%, specificity = 87.64%).
The Chinese version of the NDDI-E adapted for the Taiwanese population is a reliable and valid self-reported questionnaire for detecting MDE in Taiwanese PWE.
The Chinese version of the NDDI-E adapted for the Taiwanese population is a reliable and valid self-reported questionnaire for detecting MDE in Taiwanese PWE.
Febrile seizures (FS) are the most common seizures found in pediatric patients. Recently, microRNA (miRNA) have been used as a novel biomarker for the diagnosis of various diseases. This study aims to explore the exosomal miRNA expression profile of the cerebrospinal fluid (CSF) in atypical FS patients.
This is a case-control study including CSF specimens of 41 pediatric patients. The CSF specimens were categorized into FS and a control group. Microarray assays were performed to evaluate the CSF exosomal miRNA expression profile. Quantitative PCR (qPCR) assays were conducted to validate the microarray assay result. Bioinformatic analysis was performed to analyze the result.
Thirteen (62%) patients in the FS group experienced complex FS. A total of 96 miRNAs were significantly expressed in the CSF study samples and 95 amongst them, exhibited higher expression in FS than in the control group. Further validation qPCR test indicated that the top 5 highly expressed miRNA (miR-4486, miR-6850-5p, miR-642b-3p, miR-7107-5p, miR-4281) showed same results as in the microarray assay. Bioinformatic analysis identified 455 target genes in the FS group.
FS patients displayed higher CSF exosomal miRNA profiles than the control. These altered miRNA profiles appeared to be related to complex FS.
FS patients displayed higher CSF exosomal miRNA profiles than the control. These altered miRNA profiles appeared to be related to complex FS.Evidence suggests that drinking cope (DTC) motivation becomes a greater risk factor for drinking-related problems as individuals progress through young adulthood. https://www.selleckchem.com/products/ABT-263.html To test this, we examined how the effect of DTC motivation on a variety of drinking-related problems, controlling for drinking level, changed as individuals made the transition from college life to post-college life. We also included social, enhancement and conformity motives in our models to examine how their unique effects on drinking-related problems change across this developmental period. College students (N = 939) reported their drinking motives, drinking level, and drinking-related problems during college and again approximately five years later (post-college). Results showed that DTC motivation became a stronger positive predictor for drinking-related interpersonal problems, but none of the other problem types. Conformity motivation became a stronger positive predictor for five out of the six problem types examined and some evidence indicated that social motives become more protective post-college, showing unique negative associations with certain problems.
Website: https://www.selleckchem.com/products/ABT-263.html
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