Kannabidioli epilepsian hoidossa

VertaisarvioituKannabidioli on yksi kannabiskasvin yhdisteistä. Se on osoittautunut lumelääkettä tehokkaammaksi kolmessa kontrolloidussa tutkimuksessa vaikean epilepsian hoidossa. Puhtaalle kannabidiolille haetaan parhaillaan myyntilupaa Euroopassa. Muihin indikaatioihin tarkoitetut Suomessa saatavilla olevat lääkekannabisvalmisteet sisältävät enemmän delta-9-tetrahydrokannabinoli THC:tä kuin kannabidiolia, eivätkä ne siten sovellu epilepsian hoitoon.Peer reviewe

Interictal magnetoencephalography in parietal lobe epilepsy – comparison of equivalent current dipole and beamformer (SAMepi) analysis

Objective To evaluate a novel analysis method (SAMepi) in the localization of interictal epileptiform magnetoencephalographic (MEG) activity in parietal lobe epilepsy (PLE) patients in comparison with equivalent current dipole (ECD) analysis. Methods We analyzed the preoperative interictal MEG of 17 operated PLE patients utilizing visual analysis and: (1) ECD with a spherical conductor model; (2) ECD with a boundary element method (BEM) conductor model; and (3) SAMepi - a kurtosis beamformer method. Localization results were compared between the three methods, to the location of the resection and to the clinical outcome. Results Fourteen patients had an epileptiform finding in the visual analysis; SAMepi detected spikes in 11 of them. A unifocal finding in both the ECD and in the SAMepi analysis was associated with a better chance of seizure-freedom (p=0.02). There was no significant difference in the distances from the unifocal MEG localizations to the nearest border of the resection between the different analysis methods. Conclusions Localizations of unifocal interictal spikes detected by SAMepi did not significantly differ from the conventional ECD localizations. Significance SAMepi - a novel semiautomatic analysis method - is useful in localizing interictal epileptiform MEG activity in the presurgical evaluation of parietal lobe epilepsy patients.Peer reviewe

Aikuispotilaiden epilepsian leikkaushoidon kehitysnäkymiä

English summaryPeer reviewe

Response to letter to editor regarding Seizure-precipitating factors in dogs with idiopathic epilepsy

Non peer reviewe

Seizure-precipitating factors in dogs with idiopathic epilepsy

Background: Stress, sleep deprivation, and infectious diseases are important seizure-precipitating factors in human epilepsy patients. However, these factors have not been thoroughly studied in epileptic dogs. Objective: Seizure-precipitating factors are common in dogs with idiopathic epilepsy and the occurrence of these factors associate with the dogs' signalment, personality, and epilepsy-related factors. Animals: Fifty dogs with diagnosed idiopathic epilepsy from the hospital populations of University Veterinary Teaching Hospital of University of Helsinki and Referral Animal Hospital Aisti. Methods: In a retrospective cross-sectional observational study, owners were interviewed about their dogs' possible seizure-precipitating factors according to a predefined questionnaire. The dogs were identified and selected by searching the medical records of the participating animal hospitals. Results: The prevalence of seizure-precipitating factors in the study population was 74% (37/50). The most frequently reported factors included stress-related situations, sleep deprivation, weather, and hormonal factors. In dogs with focal onset seizures, the number of precipitating factors was 1.9 (95% CI 1.1-3.4) times higher compared to dogs with generalized seizures. Conclusions and Clinical Importance: Seizure-precipitating factors are common in dogs with idiopathic epilepsy, and the nature of these factors is consistent with those of human patients. Aside from antiepileptic medication, acknowledging and avoiding seizure-precipitating factors could help veterinarians achieve better treatment outcomes.Peer reviewe

High-resolution SNP array analysis of patients with developmental disorder and normal array CGH result (vol 13, 84, 2012)

Peer reviewe

Epilepsiat ja kuumekouristukset (lapset) : KÄYPÄHOITO-SUOSITUS (Tiivistelmä)

LIISA METSÄHONKALA (puheenjohtaja), EIJA GAILY, OLGA GILBERT, JARKKO KIRJAVAINEN, JORMA KOMULAINEN, TUIRE LÄHDESMÄKI, PÄIVI VIEIRA, Suomalaisen Lääkäriseuran Duodecimin ja Suomen Lastenneurologinen Yhdistys ry:n asettama työryhm

High-resolution SNP array analysis of patients with developmental disorder and normal array CGH results

Erratum to: high-resolution SNP array analysis of patients with developmental disorder and normal array CGH result BMC Medical Genetics 2014, 15:124 10.1186/s12881-014-0124-3Peer reviewe

Tuberoosiskleroosi - suomalainen diagnoosi- ja seurantasuositus

•Tuberoosiskleroosia sairastavat potilaat tarvitsevat systemaattista, monen erikoisalan seurantaa läpi elämän. •Tavoitteena on haitallisten tai jopa hengenvaarallisten elinmuutosten varhainen toteaminen ja hoito. •Epilepsian tehokkaalla hoidolla ja kehityksen oikea-aikaisella tuella pyritään vaikuttamaan potilaiden kehitys¬ennusteeseen ja neuropsykiatristen häiriöiden esiintymiseen. •Tässä suosituksessa esitetään diagnosointi- ja seurantavaiheessa tarvittavat tutkimukset ja niiden toteutus, jossa hyödynnetään sekä erikoissairaanhoidon että perusterveydenhuollon palveluja.Peer reviewe

Common Variant Burden Contributes to the Familial Aggregation of Migraine in 1,589 Families

Complex traits, including migraine, often aggregate in families, but the underlying genetic architecture behind this is not well understood. The aggregation could be explained by rare, penetrant variants that segregate according to Mendelian inheritance or by the sufficient polygenic accumulation of common variants, each with an individually small effect, or a combination of the two hypotheses. In 8,319 individuals across 1,589 migraine families, we calculated migraine polygenic risk scores (PRS) and found a significantly higher common variant burden in familial cases (n = 5,317, OR = 1.76, 95% CI = 1.71-1.81, p = 1.7 × 10-109) compared to population cases from the FINRISK cohort (n = 1,101, OR = 1.32, 95% CI = 1.25-1.38, p = 7.2 × 10-17). The PRS explained 1.6% of the phenotypic variance in the population cases and 3.5% in the familial cases (including 2.9% for migraine without aura, 5.5% for migraine with typical aura, and 8.2% for hemiplegic migraine). The results demonstrate a significant contribution of common polygenic variation to the familial aggregation of migraine