Conocimiento de la población general y de familiares de pacientes con epilepsia sobre primeros auxilios ante una crisis epiléptica

Objetivo: Evaluar el nivel de conocimiento sobre las actuaciones de primeros auxilios ante una CE entre la población general y los familiares de PcE.Material Y Métodos: Se llevó a cabo un estudio observacional descriptivo en el que se realizaron encuestas a familiares de PcE y población general, excluyendo a personas con formación profesional sanitaria. Se analizaron datos demográficos y los resultados de respuestas a una pregunta abierta inicial seguida de otras preguntas cerradas de opción múltiple sobre diferentes actuaciones de primeros auxilios ante una CE.Resultados: Se obtuvieron 216 encuestas: 124 de participantes de la población general y 92 de familiares de PcE. La mayoría fueron mujeres y la media de edad fue de 42 años. En el análisis de la pregunta abierta inicial sobre el manejo de una CE, la acción adecuada más indicada es colocar al paciente en posición lateral de seguridad (42,6% del total de encuestados). En el resto de las preguntas, los familiares de PcE muestran un mayor número de aciertos que la población general y son más proactivos a la hora de auxiliar las CE. Sin embargo, actuaciones peligrosas como sujetar al individuo e introducir algún objeto en la boca del paciente siguen siendo puestas en práctica por un gran número de individuos de ambos grupos (46,3% del total en ambas actuaciones).Conclusión: El nivel de conocimiento sobre primeros auxilios ante una CE no es adecuado de forma global, observándose mejores resultados en el grupo de familiares de PcE. Estos análisis permitirán adecuar e intensificar la formación sobre los primeros auxilios en aquellos grupos que más lo necesitan y optimizar la educación de la sociedad sobre la actuación básica ante una CE.<br /

Migraña crónica y memoria

Las quejas de menor rendimiento cognitivo son muy frecuentes en la práctica clínica habitual por parte de los pacientes con migraña crónica. El objetivo de este estudio es valorar mediante tests cognitivos dicho rendimiento y comparar esta población con un grupo control de sujetos que no padecen esta patología. Los resultados confirman que efectivamente existen diferencias significativas, objetivándose puntuaciones más bajas de forma global en estos tests en el grupo caso

Individualised prediction of drug resistance and seizure recurrence after medication withdrawal in people with juvenile myoclonic epilepsy: A systematic review and individual participant data meta-analysis

Summary Background A third of people with juvenile myoclonic epilepsy (JME) are drug-resistant. Three-quarters have a seizure relapse when attempting to withdraw anti-seizure medication (ASM) after achieving seizure-freedom. It is currently impossible to predict who is likely to become drug-resistant and safely withdraw treatment. We aimed to identify predictors of drug resistance and seizure recurrence to allow for individualised prediction of treatment outcomes in people with JME. Methods We performed an individual participant data (IPD) meta-analysis based on a systematic search in EMBASE and PubMed – last updated on March 11, 2021 – including prospective and retrospective observational studies reporting on treatment outcomes of people diagnosed with JME and available seizure outcome data after a minimum one-year follow-up. We invited authors to share standardised IPD to identify predictors of drug resistance using multivariable logistic regression. We excluded pseudo-resistant individuals. A subset who attempted to withdraw ASM was included in a multivariable proportional hazards analysis on seizure recurrence after ASM withdrawal. The study was registered at the Open Science Framework (OSF; https://osf.io/b9zjc/). Findings  368) was predicted by an earlier age at the start of withdrawal, shorter seizure-free interval and more currently used ASMs, resulting in an average internal-external cross-validation concordance-statistic of 0·70 (95%CI 0·68–0·73). Interpretation We were able to predict and validate clinically relevant personalised treatment outcomes for people with JME. Individualised predictions are accessible as nomograms and web-based tools. Funding MING fonds

Individualised prediction of drug resistance and seizure recurrence after medication withdrawal in people with juvenile myoclonic epilepsy: A systematic review and individual participant data meta-analysis

Background A third of people with juvenile myoclonic epilepsy (JME) are drug-resistant. Three-quarters have a seizure relapse when attempting to withdraw anti-seizure medication (ASM) after achieving seizure-freedom. It is currently impossible to predict who is likely to become drug-resistant and safely withdraw treatment. We aimed to identify predictors of drug resistance and seizure recurrence to allow for individualised prediction of treatment outcomes in people with JME. Methods We performed an individual participant data (IPD) meta-analysis based on a systematic search in EMBASE and PubMed – last updated on March 11, 2021 – including prospective and retrospective observational studies reporting on treatment outcomes of people diagnosed with JME and available seizure outcome data after a minimum one-year follow-up. We invited authors to share standardised IPD to identify predictors of drug resistance using multivariable logistic regression. We excluded pseudo-resistant individuals. A subset who attempted to withdraw ASM was included in a multivariable proportional hazards analysis on seizure recurrence after ASM withdrawal. The study was registered at the Open Science Framework (OSF; https://osf.io/b9zjc/). Findings Our search yielded 1641 articles; 53 were eligible, of which the authors of 24 studies agreed to collaborate by sharing IPD. Using data from 2518 people with JME, we found nine independent predictors of drug resistance: three seizure types, psychiatric comorbidities, catamenial epilepsy, epileptiform focality, ethnicity, history of CAE, family history of epilepsy, status epilepticus, and febrile seizures. Internal-external cross-validation of our multivariable model showed an area under the receiver operating characteristic curve of 0·70 (95%CI 0·68–0·72). Recurrence of seizures after ASM withdrawal (n = 368) was predicted by an earlier age at the start of withdrawal, shorter seizure-free interval and more currently used ASMs, resulting in an average internal-external cross-validation concordance-statistic of 0·70 (95%CI 0·68–0·73). Interpretation We were able to predict and validate clinically relevant personalised treatment outcomes for people with JME. Individualised predictions are accessible as nomograms and web-based tools