Neuropsychological Deficits in Children with Epilepsy in Ghana: A Study at Korle-Bu Teaching Hospital

Bioh, Rona; Badoe, Ebenezer; Klutse, Kokui; Durowaa, Regina

doi:10.9734/indj/2017/39142

Cited by 1 publication

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“…Breakthrough seizures due to provocative factors may not be classified as "treatment-resistant" since seizures resulted from lifestyle factors, not ASM failure. Although executive dysfunction is associated with ASM nonadherence, 43 our patients with GGE who experienced SUDEP had slightly higher rates of historical ASM adherence than patients with FE, and nearly identical rates of terminal ASM adherence. However, this difference was not significant, and data relied primarily on NOK recall, as records infrequently document ASM adherence, even at tertiary care epilepsy centers.…”

Section: Discussionmentioning

confidence: 55%

Genetic generalized and focal epilepsy prevalence in the North American SUDEP Registry

et al. 2020

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ObjectiveTo assess relative rates and clinical features of patients with genetic generalized epilepsy (GGE), focal epilepsy (FE), and developmental encephalopathic epilepsy (DEE) in the North American SUDEP Registry (NASR).MethodsWe identified all adjudicated definite, definite plus, and probable sudden unexpected death in epilepsy (SUDEP) cases (n = 262) and determined epilepsy type (GGE, FE, or DEE) from medical record review including history, imaging and EEG results, genetics, and next-of-kin interviews.ResultsOf the 262 SUDEP cases, 41 occurred in GGE, 95 in FE, 24 in DEE, and 102 were unclassifiable. GGE cases comprised 26% of NASR cases with an epilepsy syndrome diagnosis. The relative frequency of FE:GGE was slightly lower (2.3:1) than in population cohorts (2.1–6:1). Compared to patients with FE, patients with GGE had similar (1) ages at death and epilepsy onset and rates of (2) terminal and historical antiseizure medication adherence; (3) abnormal cardiac pathology; (4) illicit drug/alcohol use histories; and (5) sleep state when SUDEP occurred.ConclusionsGGE cases were relatively overrepresented in NASR. Because GGEs are less often treatment-resistant than FE or DEE, seizure type rather than frequency may be critical. Many people with GGE predominantly have generalized tonic-clonic seizures (GTCS) when they have uncontrolled or breakthrough seizures, whereas patients with FE more commonly experience milder seizures. Future mechanistic SUDEP studies should assess primary and focal-to-bilateral GTCS to identify potential differences in postictal autonomic and arousal disorders and to determine the differential role that lifestyle factors have on breakthrough seizures and seizure types in GGE vs FE to effectively target SUDEP mechanisms and prevention.

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Section: Discussionmentioning

confidence: 55%