Social and family characteristics of Hispanics with epilepsy

AbstractThe purpose of this study is to determine how acculturation, social support, family emotional involvement, perceived family criticism and stigma are associated with epilepsy self-efficacy and depression. A principal components analysis (PCA) was used to describe the salience of these characteristics within a sample of Hispanics with epilepsy.A total of 50 Hispanic adults of Mexican descent identified in our Epilepsy Clinic participated in this study. The PCA identified four distinct types, two were relatively culture-free, and two were distinctly culturally oriented. The first non-culture affiliated type described a well-adjusted group of individuals that tended to be males with moderate self-efficacy, who received social support, and who were unlikely to have depression or feel stigmatized. The second non-culture affiliated type described a dimension in which family emotional involvement tended to co-occur with perceived criticism. The Anglo-oriented group had a family environment that did not appear to criticize the individual with epilepsy and had good self-efficacy. The Mexican-oriented group had high self-efficacy and was unlikely to have depression. Results suggest that acculturation variables must be taken into consideration among ethnic groups because social, psychological and acculturation variables interact in complex ways. Additionally, it is clear that a diagnosis of epilepsy does not automatically lead to poor quality of life, stigma, or depression

Epilepsy surgery in the United States: Analysis of data from the National Association of Epilepsy Centers

To examine trends in epilepsy-related surgical procedures performed at major epilepsy centers in the US between 2003 and 2012, and in the service provision infrastructure of epilepsy centers over the same time period. We analyzed data from the National Association of Epilepsy Centers' (NAEC) annual surveys. The total annual figures, annual average figures per center and annual rates of each surgical procedure based on US population numbers for that year were calculated. Additional information on center infrastructure and manpower was also examined. The number of the NAEC's level 3 and level 4 epilepsy centers submitting annual survey reports increased from 37 centers in 2003 to 189 centers in 2012. The average reported number of Epilepsy Monitoring Unit (EMU) beds per center increased from 7 beds in 2008 to 8 beds in 2012. Overall annual EMU admission rates doubled between 2008 and 2012 but the average number of EMU admissions and epilepsy surgeries performed per center declined over the same period. The annual rate of anterior temporal lobectomies (ATL) for mesial temporal sclerosis (MTS) declined by >65% between 2006 and 2010. The annual rate of extratemporal surgery exceeded that of ATL for MTS from 2008 onwards, doubled between 2007 and 2012 and comprised 38% of all resective surgeries in 2012. Vagus nerve stimulator implant rates consistently increased year on year and exceeded resective surgeries in 2011 and 2012. The last decade has seen a major change in the US epilepsy surgery landscape. Temporal lobectomies, particularly for MTS, have declined despite an increase in EMU admissions. On the other hands, case complexity correspondingly increased as evidenced by more extratemporal surgery, intracranial recordings and palliative procedures

Essential services, personnel, and facilities in specialized epilepsy centers-Revised 2010 guidelines

Summary This document was developed by the members of the Committee to Revise the Guidelines for Services, Personnel, and Facilities at Specialized Epilepsy Centers. After discussions with the general membership they were adopted by the Board of the National Association of Epilepsy Centers. The Guidelines will be reviewed and updated when considered necessary by the Board. © 2010 International League Against Epilepsy

Indications and methodology for video-electroencephalographic studies in the epilepsy monitoring unit

Wiley Periodicals, Inc. © 2017 International League Against Epilepsy Although the epilepsy and neurology communities have position papers on a number of topics pertaining to epilepsy diagnosis and management, no current paper exists for the rationale and appropriate indications for epilepsy monitoring unit (EMU) evaluation. General neurologists, hospital administrators, and insurers also have yet to fully understand the role this type of testing has in the diagnosis and management of individuals with paroxysmal neurologic symptoms. This review outlines the indications for long-term video-electroencephalography (VEEG) for typical elective admissions to a specialized inpatient setting. The common techniques used in EMUs to obtain diagnostic information are reviewed. The added benefit of safety measures and clinical testing above that available for routine or long-term ambulatory electroencephalography is also discussed. The indications for admission to the EMU include differential diagnosis of paroxysmal spells, characterization of seizure types, presurgical epilepsy evaluations, seizure quantification, monitoring medication adjustment in a safe setting, and differentiation between seizures and side effects. We conclude that the appropriate use of this specialized testing can lead to an early and correct diagnosis in a variety of clinical circumstances. The EMU evaluation is considered the gold standard test for the definitive diagnosis of epilepsy and seizure-like spells

Leukocyte expression profiles reveal gene sets with prognostic value for seizure-free outcome following stereotactic laser amygdalohippocampotomy

Among patients with intractable epilepsy, the most commonly performed surgical procedure is craniotomy for amygdalohippocampectomy (AH). Stereotactic laser amygdalohippocampotomy (SLAH) has also been recently employed as a minimally invasive treatment for intractable temporal lobe epilepsy (TLE). Among patients treated with AH and SLAH approximately 65% and 54% of patients become seizure-free, respectively. Therefore, selection criteria for surgical candidates with improved prognostic value for post-operative seizure-free outcome are greatly needed. In this study, we perform RNA sequencing (RNA-Seq) on whole blood leukocyte samples taken from 16 patients with intractable TLE prior to SLAH to test the hypothesis that pre-operative leukocyte RNA expression profiles are prognostic for post-operative seizure outcome. Multidimensional scaling analysis of the RNA expression data indicated separate clustering of patients with seizure free (SF) and non-seizurefree (NSF) outcomes. Differential expression (DE) analysis performed on SF versus NSF groups revealed 24 significantly differentially expressed genes (>= 2.0-fold change, p-value < 0.05, FDR < 0.05). Network and pathway analyses identified differential activation of pathways involved in lipid metabolism, morphology of oligodendrocytes, inflammatory response, and development of astrocytes. These results suggest that pre-operative leukocyte expression profiles have prognostic value for seizure outcome following SLAH.NIH from Temple University [RO1MH065151, HCS 04-42]; Department of Surgery 2016 Faculty Seed Grant, University of Arizona College of Medicine; 2016 University of Arizona Health Sciences Clinical Research Pilot Program Award (UAHS-CRPA)Open access journal.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]