A brief update on psychogenic non-epileptic seizures: a challenge to overcome

n/

Accidents at work among people with epilepsy Results of a European prospective cohort study

Summary Studies on accidents at work in people with epilepsy are scarce and the evidence that epilepsy carries an increased risk of accidents at work is mostly anecdotal. The present survey is a multicentre prospective cohort study of everyday life risks recently conducted in eight European countries (Estonia, Germany, Italy, the Netherlands, Portugal, Russia, Slovenia and United Kingdom) comparing referral children and adults with epilepsy to age-and sex-matched non-epileptic controls. In this context, every accident occurring during work over a 1-3 year follow-up was prospectively reported by patients and controls. Six hundred and thirty-one adult patients with epilepsy and 592 controls from this cohort have been studied here. Each patient and his/her control received a diary to record any accident or illness, with severity, circumstances, causes, consequences (including days off-work) and (for the cases) the possible relation to a seizure. A slightly higher number of unskilled workers were present among patients with epilepsy than in controls. Twenty-two patients with epilepsy and nine controls reported accidents during work ( p < 0.05). Only two cases reported seizure-related accidents. In both groups the injuries were mild (only one requiring hospitalization) and caused abstention from work to the same extent. In patients with epilepsy, the risk of accidents was unaffected by seizure type and frequency. This study confirms that patients with epilepsy are at higher risk of accidents compared to the general population. However, injuries provoked by work accidents are generally mild and unrelated to seizures

Ultrasonography of the shoulder: asymptomatic findings from working-age women in the general population

[Purpose] The aim of this study was to estimate the prevalence of abnormal shoulder ultrasonographic findings in a sample of asymptomatic women. [Subjects and Methods] A secondary analysis of a cross-sectional study was performed. We recruited 305 women (aged 18–56 years). All the subjects had a structured interview screening for self-reported symptoms and underwent a shoulder ultrasonographic examination, in which both shoulders were examined. The radiologist was blinded to the clinical history of the participants. All detectable shoulder abnormalities were collected. [Results] Of the subjects, 228 (74.75%) were asymptomatic at both shoulders, and 456 asymptomatic shoulders were analyzed. Lack of uniformity (supraspinatus, infraspinatus, subscapularis, and biceps brachii long head) was found in 28 shoulders (6.14%), 19 (4.17%) on the dominant side and 9 (1.97%) on the non-dominant side. Tendinosis (supraspinatus, infraspinatus, subscapularis, and biceps brachii long head) was found in 19 shoulders (5.32%), 12 (2.63%) on the dominant side and 7 (1.53%) on the non-dominant side. Calcification and other abnormal findings were reported. [Conclusion] The most common abnormalities were calcifications within the rotator-cuff tendons and humeral head geodes; other degenerative findings were less commo

Accidents at work among people with epilepsy Results of a European prospective cohort study

SummaryStudies on accidents at work in people with epilepsy are scarce and the evidence that epilepsy carries an increased risk of accidents at work is mostly anecdotal. The present survey is a multicentre prospective cohort study of everyday life risks recently conducted in eight European countries (Estonia, Germany, Italy, the Netherlands, Portugal, Russia, Slovenia and United Kingdom) comparing referral children and adults with epilepsy to age- and sex-matched non-epileptic controls. In this context, every accident occurring during work over a 1–3 year follow-up was prospectively reported by patients and controls.Six hundred and thirty-one adult patients with epilepsy and 592 controls from this cohort have been studied here. Each patient and his/her control received a diary to record any accident or illness, with severity, circumstances, causes, consequences (including days off-work) and (for the cases) the possible relation to a seizure. A slightly higher number of unskilled workers were present among patients with epilepsy than in controls.Twenty-two patients with epilepsy and nine controls reported accidents during work (p<0.05). Only two cases reported seizure-related accidents. In both groups the injuries were mild (only one requiring hospitalization) and caused abstention from work to the same extent. In patients with epilepsy, the risk of accidents was unaffected by seizure type and frequency. This study confirms that patients with epilepsy are at higher risk of accidents compared to the general population. However, injuries provoked by work accidents are generally mild and unrelated to seizures

Conversation Analysis in the differential diagnosis of Italian patients with epileptic or psychogenic non-epileptic seizures: a blind prospective study

The differential diagnosis of epileptic seizures (ES) and psychogenic non-epileptic seizures (PNES) is often difficult. The diagnostic gold standard is video-EEG, but this procedure is limited because of its high cost and is not always available. Research groups from Germany and Britain have used conversation analysis (CA) of patients' descriptions of their seizures as a means of differentiating the type of seizure. The aim of this study was to verify the value of their considerations in relation to the Italian language. Ten subjects (five with ES and five with PNES) diagnosed by means of the video-EEG recording of one seizure were studied under blind conditions by a linguist. The patients with ES described their seizures in as much detail as possi- ble and tried to reconstruct the experience as fully as they can, making an effort to describe their subjective symptoms, quantify the duration of the phases preceding and following the seizure, and use the image of an external entity overcoming them. On the contrary, the patients with PNES repeated their extraneousness to the events that occur, refused to reply, expressed amnesia, reconstructed the happening by referring to de- scriptions provided by witnesses, and often describe their seizures using the image of an internal entity of which they were victims. The linguist correctly identified nine cases out of ten using CA

Spin of information and inconsistency between abstract and full text in RCTs investigating upper limb rehabilitation after stroke: An overview study

Researchers may be tempted to favorably distort the interpretation of their findings when reporting the abstract (i.e., spin). Spin bias overemphasizes the beneficial effects of the intervention compared with the results shown in the full text

Metaphoric language in the differential diagnosis of epilepsy and psychogenic non-epileptic seizures: Time to move forward

Conversation analysis (CA) to identify metaphoric language (ML) has been proposed as a tool for the differential diagnosis of epileptic (ES) and psychogenic nonepileptic seizures (PNES). However, the clinical relevance of metaphoric conceptualizations is not clearly defined. The current study aims to investigate the ML utilized by individuals with ES and PNES in a pulled multi-country sample. Two blinded researchers examined the transcripts and videos of 54 interviews of individuals (n = 29, Italy; n = 11, USA; n = 14, Russia) with ES and PNES, identifying the patient-seizure relationship representative of the patient's internal experience. The diagnoses were based on video-EEG. Metaphors were classified as “Space/place”, “External force”, “Voluntary action”, and “Other”. A total of 175 metaphors were identified. No differences between individuals with ES and PNES were found in metaphoric occurrence (χ2 (1, N = 54) = 0.07; p = 0.74). No differences were identified when comparing the types of metaphors utilized by participants with ES and those with PNES. Patients with PNES and ES did not demonstrate differences in terms of occurrence and categories in ML. Therefore, researchers and clinicians should carefully consider the use of metaphor conceptualizations for diagnostic purposes