Abstract:
OBJECTIVE:We examine improvement and worsening in quality of life (QOL) in terms of proportions achieving minimum clinically important change (MCID), and factors related to MCID, in patients with temporal lobe epilepsy randomized to medical or surgical treatment. METHODS:Eighty patients with temporal lobe epilepsy randomized to surgical (n(1) = 40) or medical (n(2) = 40) therapy were followed for 12 months, reporting QOL at baseline, and at 6 and 12 months. Previously established thresholds for MCID across various general and epilepsy-specific QOL instruments were used to determine meaningful improvement (positive MCID) or worsening (negative MCID). Generalized linear mixed-effects models were used to compare MCID in both groups. RESULTS:At 6 months, 56.0% of patients in the surgical group achieved positive MCID on the Quality of Life in Epilepsy (QOLIE)-89, as compared to 11.0% of those in the medical group (p < 0.001). On the QOLIE-31, 62.0% of the surgical group and 17.0% of the medical group achieved positive MCID (p < 0.001). Substantially more medically treated patients exhibited clinically significant worsening in QOL, as compared with those surgically treated. The respective medical versus surgical proportions with worsening were 36.67% versus 13.8% in QOLIE31, 20% versus 15% in Health Utility Index-III (HUI-III), and 30% versus 19% in Short Form-36 (SF-36) Mental Composite Score (MCS). The number of patients who need to undergo surgery for one additional person to have a meaningful improvement in the QOLIE-31 is two (number needed to treat = 2). The results also favored surgery using the generic HUI-III instrument, but not with the mental of physical function subscales of the SF-36. SIGNIFICANCE:Significantly more patients in the surgical group achieved meaningful improvement in epilepsy-specific measures of QOL at 6 and 12 months compared to those in the medical group. Substantially more patients in the medical therapy group exhibited clinically significant worsening in their QOL assessed with epilepsy-specific and generic instruments. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.
journal_name
Epilepsiajournal_title
Epilepsiaauthors
Fiest KM,Sajobi TT,Wiebe Sdoi
10.1111/epi.12625subject
Has Abstractpub_date
2014-06-01 00:00:00pages
886-92issue
6eissn
0013-9580issn
1528-1167journal_volume
55pub_type
杂志文章,随机对照试验相关文献
EPILEPSIA文献大全abstract:OBJECTIVES:Health-related quality of life (HRQOL) is an important indicator of well-being in patients with epilepsy. When assessing changes in HRQOL over time, some of the changes observed may be due to the patients' change in the internal standards, value, or meaning that they attribute to the HRQOL domain being measu...
journal_title:Epilepsia
pub_type: 杂志文章,随机对照试验
doi:10.1111/epi.12697
更新日期:2014-09-01 00:00:00
abstract:PURPOSE:To clarify the electroclinical manifestation of epileptic seizures and the evolution of epilepsy in patients with peroxisomal diseases. METHODS:Retrospective review of the medical records and EEGs of 14 patients with peroxisomal diseases: seven with Zellweger syndrome (ZS), two with neonatal adrenoleukodystrop...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1997.tb01095.x
更新日期:1997-02-01 00:00:00
abstract:PURPOSE:We evaluated the dose-related impacts of tiagabine (TGB) on cognition and mood in a monotherapy study. METHODS:Patients were 123 adults with uncontrolled partial seizures, each treated with a single currently available antiepileptic drug (AED) for management of clinical epilepsy. They completed a battery of ne...
journal_title:Epilepsia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1528-1157.1998.tb01271.x
更新日期:1998-01-01 00:00:00
abstract::Over the past decade, much progress has been made in understanding the mechanisms of ketogenic diet (KD) action. From the complex systemic and metabolic changes induced by the KD have emerged innovative hypotheses attempting to link biochemical adaptations to its clinical effects. Despite such developments, the fundam...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.1528-1167.2008.01857.x
更新日期:2008-11-01 00:00:00
abstract::Drug-resistant epilepsy poses a challenge in neonatal patients, especially those in the neonatal intensive care unit (NICU), who have various secondary comorbidities. We present results of four children with a history of drug-resistant epilepsy for whom a ketogenic diet was initiated and used in the NICU. A nonfasting...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.13650
更新日期:2017-02-01 00:00:00
abstract:PURPOSE:To investigate in vitro, the cellular network activity of the hippocampus in Q54 mice that display spontaneous seizures because of a gain-of-function mutation of the Scn2a sodium channel gene. METHODS:Extacellular recordings were obtained from CA1 and CA3 pyramidal neurons in hippocampal slices prepared from Q...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2007.01413.x
更新日期:2008-03-01 00:00:00
abstract:PURPOSE:We sought to investigate the anticonvulsant activity of the new antiepileptic drug (AED), valrocemide or TV1901 (VGD) in various animal (rodent) models of human epilepsy to determine its anticonvulsant profile and safety margin. METHODS:VGD was administered intraperitoneally to CF no. 1 mice and orally or intr...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1046/j.1528-1157.2001.042007831.x
更新日期:2001-07-01 00:00:00
abstract::The anticonvulsant and motor effects of gabapentin (GBP) were evaluated in rat pups aged 16-17 days. Fourteen-day-old rat pups received an implanted stimulating electrode in the amygdala unilaterally. Kindled seizures were produced on day 16 of life by repeatedly applying an electrical current stimulus to the amygdala...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1046/j.1528-1157.2001.30900.x
更新日期:2001-04-01 00:00:00
abstract::Felbamate (2-phenyl-1,3-propanediol dicarbamate), phenytoin, phenobarbital, ethosuximide, and valproate were evaluated in mice and rats with a battery of well-standardized anticonvulsant test procedures. The results obtained indicate that felbamate exhibits a wider range of experimental anticonvulsant activity than ei...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1986.tb03497.x
更新日期:1986-01-01 00:00:00
abstract::The progressive myoclonus epilepsies (PMEs) are a group of rare genetic disorders previously shrouded in nosological confusion. Recent advances have clarified the features of these disorders and provided a rational approach to diagnosis. The major causes of PME are now known to be Unverricht-Lundborg disease, myoclonu...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.1528-1167.1993.tb06256.x
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVES:We aimed to determine whether implementation of a structured multidisciplinary electroencephalography (EEG) monitoring pathway improved the timeliness of administration of antiseizure medication in response to electrographic seizures in encephalopathic critically ill children. METHODS:A multidisciplinary te...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.13354
更新日期:2016-05-01 00:00:00
abstract:PURPOSE:We studied temporal changes of brain sodium and apparent diffusion coefficient (ADC) in a temporal lobe epilepsy (TLE) rat model using kainic acid (KA). METHODS:In situ three-dimensional 23Na magnetic resonance imaging (MRI) and proton diffusion-weighted imaging (DWI) were used. KA at a dose of 10 mg/kg body w...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1996.tb00539.x
更新日期:1996-10-01 00:00:00
abstract:PURPOSE:Interest in the association of epilepsy and pseudobulbar palsy was rekindled since the identification through magnetic resonance imaging (MRI) of bilateral perisylvian polymicrogyria (PMG). Seizures are often intractable, but resective epilepsy surgery has not been recommended. However, a similar clinical pictu...
journal_title:Epilepsia
pub_type: 杂志文章,多中心研究
doi:10.1111/epi.12160
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:Low-frequency fiber-tract stimulation has been shown to be effective in treating mesial temporal lobe epilepsies through activation of the hippocampal commissure in rodents and human patients. The corpus callosum is a major pathway connecting the two hemispheres of the brain; however, few experiments have doc...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.14595
更新日期:2018-12-01 00:00:00
abstract::Development of tolerance (i.e., the reduction in response to a drug after repeated administration) is an adaptive response of the body to prolonged exposure to the drug, and tolerance to antiepileptic drugs (AEDs) is no exception. Tolerance develops to some drug effects much more rapidly than to others. The extent of ...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.1528-1167.2006.00607.x
更新日期:2006-08-01 00:00:00
abstract:PURPOSE:To validate a brief screening instrument for identifying people with epilepsy in epidemiologic or genetic studies. METHODS:We designed a nine-question screening instrument for epilepsy and administered it by telephone to individuals with medical record-documented epilepsy (lifetime history of >or=2 unprovoked ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2009.02274.x
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:Treatments for convulsive status epilepticus (SE) have a wide range of effectiveness. The estimated effectiveness of non-intravenous benzodiazepines (non-IV BZDs) ranges from approximately 70% to 90% and the estimated effectiveness of non-benzodiazepine antiseizure medications (non-BZD ASMs) ranges from appro...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.16646
更新日期:2020-10-01 00:00:00
abstract:PURPOSE:The aim of this study was to examine the impact of clinical variables, particularly age at onset of epilepsy, on intellectual function in a group of children with temporal lobe epilepsy (TLE). METHODS:We reviewed the preoperative neuropsychological test results of 79 children with unilateral TLE who subsequent...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2006.00904.x
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:Common data elements (CDEs) are standardized questions and answer choices that allow aggregation, analysis, and comparison of observations from multiple sources. Clinical CDEs are foundational for learning health care systems, a data-driven approach to health care focused on continuous improvement of outcomes...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.16733
更新日期:2021-01-01 00:00:00
abstract:PURPOSE:Benign epilepsy with centrotemporal spikes (BECTS) is associated with mild cognitive deficits, especially language impairment. This study aimed to clarify whether children with BECTS with left- or right-hemispheric, or bilateral focus have specific neuropsychological language deficits when compared to healthy c...
journal_title:Epilepsia
pub_type: 杂志文章,多中心研究
doi:10.1111/epi.12067
更新日期:2013-03-01 00:00:00
abstract::The purpose of the study was to examine the impact of idiopathic epilepsy on mothers and fathers in terms of strain, burden of care, worries and perception of vulnerability. Data were collected and analyzed shortly after the diagnosis (T0) and 12 months later (T1). The results indicated that at T0 parents of children ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2007.01145.x
更新日期:2007-09-01 00:00:00
abstract::Before a health education program can be established, one must first know what the target population believes and does with respect to the disease in question. Therefore, we performed a study among Tanzanian rural inhabitants to identify their knowledge, attitude, and practice (KAP) toward epilepsy: 3,256 heads of hou...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1993.tb02127.x
更新日期:1993-11-01 00:00:00
abstract::A 28-year-old man with regularly occurring clusters of complex partial seizures was studied over a total of 224 days. His seizure periods lasted 2-4 days and occurred at intervals of 5-6 weeks. Several parameters were studied. The most striking finding was an increase in the serum concentration of thyroxine prior to a...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1986.tb03561.x
更新日期:1986-07-01 00:00:00
abstract::The mechanism by which animals develop tolerance to the antiepileptic effects of the carbonic anhydrase (CA) inhibitor, acetazolamide, was explored using a quantitative immunocytochemical method. Cerebral cortex sections of DBA/2J mice susceptible to audiogenic seizures and of C57BL/6J nonsusceptible mice were stained...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1986.tb03576.x
更新日期:1986-09-01 00:00:00
abstract::Recent clinical trials indicate that cannabidiol (CBD) may reduce seizure frequency in pediatric patients with certain forms of treatment-resistant epilepsy. Many of these patients experience significant impairments in quality of life (QOL) in physical, mental, and social dimensions of health. In this study, we measur...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.13815
更新日期:2017-08-01 00:00:00
abstract::Approximately three-quarters of epileptic patients seen in consultation by specialists can easily be assigned to one of the diagnostic categories of the International League against Epilepsy. When patient age is taken into account, such a distribution shows that partial epilepsy is more common than generalized epileps...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1975.tb06073.x
更新日期:1975-09-01 00:00:00
abstract::The combination of phenobarbital (PB) and phenytoin (PHT) was recommended for many years for treatment of epilepsy in humans. We tested the effectiveness of the combination in a model of hippocampal seizures termed maximal dentate activation (MDA). Two parameters of MDA were measured: duration and time to onset. Neith...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1994.tb02936.x
更新日期:1994-01-01 00:00:00
abstract:PURPOSE:The study was conducted to determine the familiarity with, knowledge of, misunderstandings, and attitudes toward epilepsy among the Kuwaiti population. METHODS:A pretested questionnaire was used to collect data from a sample of 784 Kuwaiti individuals, selected from five governorates in Kuwait using a multista...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2007.01433.x
更新日期:2008-04-01 00:00:00
abstract:PURPOSE:Although anterior temporal lobectomy (ATL) is an effective treatment for many patients with medically refractory temporal lobe epilepsy (TLE), one risk associated with this procedure is postsurgical decline in memory. A substantial number of past studies examined factors that predict memory decline after surger...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2006.00807.x
更新日期:2006-11-01 00:00:00
abstract:PURPOSE:Management of seizures in learning disabled people is challenging. This prospective study explored the efficacy and tolerability of adjunctive topiramate (TPM) in patients with learning disability and refractory epilepsy attending a single centre. METHODS:Sixty-four patients (36 men, 28 women, aged 16-65 years...
journal_title:Epilepsia
pub_type: 临床试验,杂志文章
doi:10.1046/j.1528-1157.2002.47401.x
更新日期:2002-04-01 00:00:00