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At least 883 records · Page 49Linked to original sources
PubMed1979

The impact of psychiatric intervention on patients with uncontrolled seizures.

There is much evidence that emotional stess can trigger both neurogenic and hysterical seizures in susceptible patients. We reviewed out experience with 37 patients whose seizures appeared to be precipitated at times by emotional stress and had not been controlled by anticonvulsant medication alone. Approximately 70 per cent of patients demonstrated substantial improvement in seizure control after psychiatric treatment and maintained this improvement during follow-up. The findings of this study suggest that patient characteristics associated with better prognosis include normal intelligence, partial (as opposed to generalized) neurogenic seizures, a diagnosis of hysterical seizures, a less severely abnormal EEG, and being hypnotizable. After psychiatric treatment, 32 per cent of patients had their anticonvulsant medication reduced and another 16 per cent had it discontinued.

Adolescent↗
PubMed1984

Lack of significant correlation between circadian profiles of valproic acid serum levels and epileptiform electroencephalographic activity.

Using mobile long-term electroencephalographic (EEG) monitoring in 7 absence epilepsy patients, the course of spike-wave discharge rate before and during valproate monotherapy was measured and compared to the profile of valproic acid serum level. Correlation analysis was done, taking into account an eventual time delay between drug concentration and effect on EEG. No significant correlation was found when comparing serum levels with the actual discharge profile or with the profile of changes in discharge rate.

Adolescent↗
PubMed2026

Genetically predicted childhood traits and parental health and risk of pediatric psychiatric disorders: A 2-sample Mendelian randomization study.

The etiology of pediatric psychiatric disorders is complex, involving intergenerational influences and a child's own developmental health. We aimed to investigate the potential effects of genetically predicted childhood traits (childhood obesity, absence epilepsy, intelligence) and parental health traits (longevity, Alzheimer disease, severe depression) on the risk of several childhood and adolescent psychiatric disorders. We employed a 2-sample Mendelian randomization (MR) design using summary statistics from large-scale genome-wide association studies. Data for parental health exposures were primarily from the UK Biobank. Data for childhood trait exposures were from various consortia. Data for outcomes - conduct disorder, mixed conduct and emotional disorders, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and broader behavioral/emotional and social disorders - were sourced from FinnGen and the Psychiatric Genomics Consortium, among others. We used the inverse-variance weighted method for the primary analysis, with MR-Egger, weighted median, and weighted mode as additional analyses. To test the robustness of the results, we conducted sensitivity analyses using MR-Egger regression, Cochran Q test for heterogeneity, the MR-pleiotropy residual sum and outlier test, and a leave-one-out analysis. Genetic liability for childhood obesity was associated with an increased risk of ASD (odds ratio = 1.06, P = .016) and ADHD (odds ratio = 1.09, P = .026), even though these associations did not withstand multiple testing correction. No other robust, statistically significant causal associations were identified. Sensitivity analyses showed limited evidence of bias from horizontal pleiotropy for the main findings. Our findings provide MR evidence supporting potential links from genetic liability for childhood obesity to increased risks of ASD and ADHD. These results highlight the importance of considering a child's early-life health trajectory in the etiology of pediatric psychiatric disorders.

Humans↗
PubMed2002

Dynamics of large-scale brain activity in normal arousal states and epileptic seizures.

Links between electroencephalograms (EEGs) and underlying aspects of neurophysiology and anatomy are poorly understood. Here a nonlinear continuum model of large-scale brain electrical activity is used to analyze arousal states and their stability and nonlinear dynamics for physiologically realistic parameters. A simple ordered arousal sequence in a reduced parameter space is inferred and found to be consistent with experimentally determined parameters of waking states. Instabilities arise at spectral peaks of the major clinically observed EEG rhythms-mainly slow wave, delta, theta, alpha, and sleep spindle-with each instability zone lying near its most common experimental precursor arousal states in the reduced space. Theta, alpha, and spindle instabilities evolve toward low-dimensional nonlinear limit cycles that correspond closely to EEGs of petit mal seizures for theta instability, and grand mal seizures for the other types. Nonlinear stimulus-induced entrainment and seizures are also seen, EEG spectra and potentials evoked by stimuli are reproduced, and numerous other points of experimental agreement are found. Inverse modeling enables physiological parameters underlying observed EEGs to be determined by a new, noninvasive route. This model thus provides a single, powerful framework for quantitative understanding of a wide variety of brain phenomena.

Adult↗
PubMed2004

Factor XIII deficiency associated with valproate treatment.

PURPOSE: We present two children who developed a deficiency of factor XIII with valproate (VPA) treatment. This coagulation disorder has not been described in association with VPA treatment in children, and only very recently in one adult patient. RESULTS: Both patients showed recurrent epistaxis as major clinical sign of a combination of decreased coagulation parameters (factor XIII deficiency with thrombocytopenia and decreased von Willebrand factor, respectively). A few days after reduction or withdrawal of VPA treatment, clinical symptoms disappeared, and laboratory findings were within normal range. CONCLUSIONS: VPA is known to influence the synthetic function of the liver and the number and function of megakaryocytes. Therefore an alteration of the factor XIII level by VPA is conceivable. Our case reports suggest that bleeding symptoms during VPA treatment may be caused or aggravated by a decreased factor XIII activity. A determination of factor XIII activity should be considered before surgical procedures during VPA treatment to minimize the risk of (severe) postsurgical bleeding complications.

Anticonvulsants↗
PubMed1990

A familial form of convulsive disorder with or without mental retardation limited to females: extension of a pedigree limits possible genetic mechanisms.

An unusual pedigree of female-limited seizures with or without mental retardation is updated. The disorder was first detected in a large cohort of women whose fathers were brothers, and affected women had previously transmitted the disorder. Four brothers of affected females have now had five unaffected daughters while four affected women have had four affected and one unaffected daughters and two unaffected sons. This unusual transmission pattern is discussed in terms of germ-line imprinting, neuronal sexual differentiation, and the generally higher risk of seizures seen when the mother, rather than the father, is affected.

Child, Preschool↗
PubMed1983

Antiepileptic drugs and psychiatric disorders: mechanism involved in manifestation of psychic symptoms of high blood level of antiepileptics.

The adverse psychic effects of antiepileptics embrace all categories of psychiatric symptomatology, including disturbances of consciousness (delirium, confusion), psychotic state (schizophrenia-like psychosis, affective disorder), neurotic state, behavior and character disorder. Antiepileptic intoxication can take the form of a psychotic episode. The lowered level of consciousness due to a high blood level of antiepileptics is expressed as inhibitory symptoms such as a lack of initiative, psychomotor slowing, lowering mood, stuporous state and the like. Another group of manifestation of a high blood level of antiepileptics, by contrast, consists of salient positive symptoms such as irritability, hyperkinetic syndrome, hysterical symptoms, aggravation of character change, delirium and confusion. An elevated blood level of antiepileptics by itself is not sufficient to give rise to a psychiatric symptom, which is rather prone to occur in the presence of some trouble or problems (defect in intelligence or personality, fragility of brain function, organic brain damage, psychogenic factors) in the patient.

Adult↗
PubMed1986

Serum prolactin, cortisol and growth hormone concentrations after various epileptic seizures.

The serial serum concentrations of prolactin (PRL), cortisol and growth hormone (GH) were measured after clinical fits of seizures in 49 epileptic patients, aged 13-77. In generalized tonic-clonic seizures, both the serum PRL and cortisol levels transiently rose and reached their maximum 30 min after the onset of clinical fits. Serum GHs were elevated in some of the patients. After complex partial seizures, significant rises were found only in serum cortisol, but no demonstrable change was observed in PRL and GH. In the other minor seizure group, no remarkable change was observed in any of the hormones. These results suggest that the postictal hormonal change is different in each type of seizure, respectively.

Adolescent↗