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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Depressive disorders are commonly found among selected groups of patients with epilepsy, but hypomania is seldom seen. Three cases of hypomania seen at a unit specialising in epilepsy are presented. The cases are of interest because of their association with recent seizures, and location in the non-dominant temporal lobe.
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PMID:Hypomania following complex partial seizures. A report of three cases. 316 24

Data about psychiatric disorders associated with epilepsy as well as their risk factors are heterogeneous. The overall prevalence of psychiatric disturbances in epileptic patients can be estimated between 20 and 30 per cent. It is the highest in pharmocoresistant cases seen in specialized centers. Psychotic disorders, depression, and suicide are the three most common among interictal disturbances. Psychoses affect 2 to 9 per cent of patients and are more frequent in cases with aura or altered consciousness, such as in complex partial seizures and absences. They correlate positively with the multiplicity of seizures but often inversely with their frequency. Temporal lobe epilepsy is associated with schizo phrenic-like and paranoid types of psychosis, but frontal lobe epilepsy is also common. A putative association with predominant left or bilateral EEG abnormalities in cases with partial epilepsy remains to be confirmed, as well as the frequency of underlying structural lesions. Depressive disorders affect 20 to 60 per cent of patients. While their occurrence with partial complex seizures and left hemisphere foci is common, the role of temporal lobe involvement still appears controversial. Depression prevails in cases with seizures that occasionally, albeit rarely, secondarily generalize and correlates with the duration of the disease, intractable seizures, and polypharmacy. A genetic factor is likely to play a role. Suicides rates are increased, encountered in 0.2-0.5 per cent of patients and causing deaths in 3-7 per cent of them. The overall risk might be the highest during the first years after diagnosis of epilepsy, as well as in patients with temporal lobe foci, depression, or psychosis. Great variability and discordance in results show the major difficulties encountered in epidemiologic studies. Most of these problems relate to the classification of epileptic disorders as well as that of psychiatric disorders, the variability in the methods and measures which are used, and frequent bias in the selection of patients. We review here data about the frequency of major psychiatric disorders in epileptic patients or the frequency of epileptic disorders in psychiatric patients, and also possible risk factors related to the epileptic disease and its evolution.
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PMID:[Epilepsy and psychiatric disorders: epidemiological data]. 977 58

Article abstract Depressive disorders (DDs) are the most common type of psychiatric co-morbidity in patients with epilepsy. They are more likely to occur in patients with partial seizure disorders of temporal and frontal lobe origin and are more frequent among patients with poorly controlled seizures. Despite their relatively high prevalence, DDs remain unrecognized and untreated in a large proportion of patients. This article highlights the evidence of a close association between DDs and epilepsy, beginning with the bi-directional relationship between the two disorders. Not only are patients with epilepsy more likely to experience a DD, but a history of DD preceding the onset of the seizure disorder is more likely to be identified in patients with epilepsy than in a control group. In support of these observations, we review data from animal models of epilepsy showing that decreased activity of serotonin, norepinephrine, dopamine, and GABA facilitate the kindling process of seizure foci, worsen seizure frequency and severity, and are reversed or blocked by antidepressant drugs. Decreased activity of these neurotransmitters is a pivotal pathogenic mechanism of DDs and forms the basis of their pharmacotherapy. Thus, DDs and epilepsy may share common pathogenic mechanisms that facilitate the occurrence of one in the presence of the other. Contrary to long-held beliefs by patients and clinicians alike, in the sense that DDs are a "normal reaction" to the obstacles posed by epilepsy, we review evidence that points to their biologic or endogenous nature. We find a genetic predisposition to DDs, as evidenced by the frequent family history of mood disorders in these patients. Neuroimaging and neuropsychological data support a frontal lobe dysfunction in DDs, and a recent study documents concomitant dysfunction of mesial temporal structures. Depressive disorders have various clinical presentations, some typical of the different types of mood disorders in non-epileptic patients, others constituting rather frequent atypical presentations that can easily go unrecognized. A review of the pharmacologic treatment of DDs in epilepsy highlights the lack of scientific data and points to the empirical form in which these patients have been treated up to the present time. Contrary to clinicians' fears, most antidepressant drugs are safe in patients with epilepsy.
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PMID:Depression and epilepsy: how closely related are they? 1197 Nov 30

Depressive disorders (DDs) represent the most frequent psychiatric comorbidity in epilepsy (1-5). Despite their relatively high prevalence, DDs remain unrecognized and untreated in many patients with epilepsy. The purpose of this review is to examine the reasons behind the failure to recognize and treat DDs in epilepsy. We highlight the essential epidemiologic, etiopathogenic, and clinical aspects that need to be considered in the evaluation of every epileptic patient and dedicate the last section of this paper to the review of the most relevant treatment issues. If we are successful in our goals, the reader will be impressed by the significant impact of DDs on the quality of life of these patients, and by the need to investigate treatment modalities with the same scientific rigor used in the assessment of efficacy of antiepileptic drugs in the control of seizures.
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PMID:Depression in epilepsy: a common but often unrecognized comorbid malady. 1260 26

The overall prevalence of psychiatric disorders in epileptic patients is estimated between 19 and 62%. Depressive disorders may be the most common psychiatric disorders and the main reason for psychiatric hospitalisation and taking psychotropic drugs. The underdiagnosis and undertreatment of depressive disorders among epileptic patients represent a problem of considerable magnitude. The aim of the present study was to evaluate the prevalence of depressive disorders among patients with primary epilepsy and to determine the risk factors of the occurrence of the depressive illness. The survey was conducted in a outpatient epilepsy clinic in the Ibn Rochd University Hospital Centre in Casablanca. All patients with idiopathic or cryptogenic epilepsy aged 15 Years and above, were eligible, except for patients with severe physical and mental disabilities. Neurologists diagnosed the epilepsy based on clinical criteria with electroencephalograms data. The depressive disorders met a psychiatrist's evaluation of an ICD-10 criterion. Ninety-two subjects participated in the survey, 57.6% were men and the mean age was 30.3 +/- 10.8 Years. The epilepsy age of onset was 16.3 +/- 11.4 Years with an average duration of 14.1 +/- 9.2 Years. The prevalence of depressive disorders among epileptic patients in our survey was 18.5%. According to sex, the prevalence was 23.1% in women and 15.1% in men. The depressed patients were compared with the remaining patients without depression with regard to seizure variables and sociodemographic characteristics. The epilepsy-depression and epilepsy-control groups did not differ significantly in the duration of epilepsy or in the type of anticonvulsant therapy (mono versus polytherapy). Three variables were significantly different between the two groups. The mean age in the epilepsy-depression group was significantly higher (34.4 +/- 9.6 Years versus 29.4 +/- 10.9, p<0.03), the mean age of epilepsy age of onset was also higher in the epilepsy-depression group than in the epilepsy-control group (21.8 +/- 11.9 Years versus 15.04 +/- 11.0, p<0.03) and the seizure frequency per week was more important among depressed epileptic patients (2.4 + 5.2 seizures versus 0.4 + 1.5, p<0.007). The present survey confirms the findings of previous studies that the prevalence of the comorbidity between epilepsy and depression is common in specialised outpatient units. The detection and the treatment of depressive disorders among the epileptic patients remains a very great challenge in the management of the epileptic illness. It will improve the quality of life of these patients. A closer involvement of psychiatric and psychological treatment in patient management is necessary.
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PMID:[Depressive disorders among epileptic patients attending a specialised outpatient clinic]. 1502 75

The neurologic dysfunction underlying epilepsy can predispose patients to psychiatric disorders, and the incidence of both depression and psychosis is increased in people with epilepsy. Depressive disorders are the most frequently recognized psychiatric comorbidities in people with epilepsy, but depression in children can be particularly difficult to recognize. Clinicians need to inquire about not only classic symptoms of depression such as anhedonia but also less obvious symptoms such as unprovoked irritability, unsubstantiated complaints of lack of love from family members, somatic complaints, and problems with concentration and poor school performance. The diagnosis of depressive disorders in children with epilepsy and mental retardation is even more difficult. Physicians need to be alert for the presence of iatrogenic depression, which may result from antiepileptic drugs or epilepsy surgery. People with epilepsy are also at increased risk for psychosis, which can be interictal, postictal, or (rarely) an expression of ictal activity. This psychosis can be related to seizure remission (ie, alternative psychosis) or iatrogenic (eg, related to antiepileptic drugs or following temporal lobectomy). Although both antidepressants and antipsychotic drugs have the potential to lower the seizure threshold and increase seizures, careful drug selection, dosing, and slow titration can minimize this risk, allowing treatment to proceed.
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PMID:Diagnosis and management of depression and psychosis in children and adolescents with epilepsy. 1552 62

Patients with epilepsy are more likely to suffer from psychiatric illnesses, and more specifically depressive disorders (9% to 22%), than the general population. Depression in epilepsy is often described by the temporal correlation to a seizure, with interictal depression being the most commonly described. Furthermore, epileptic patients with depression often report a poorer quality of life on global assessments and are at an increased risk of suicide as compared to the general population, 11.5 percent versus 1.2 percent, respectively. Despite the clinical significance of depression, it often goes unrecognized and hence untreated in this population. Recently, more efforts at screening epilepsy patients for coexisting depression have been undertaken, yielding fair results. However, some epilepsy patients express a certain constellation of symptoms, including an explosive or irritable mood, somatic pains, anxiety and fear, and periods of brief euphoria, which are not captured by common depression screening tools. Fears of antidepressants lowering seizure thresholds coupled with potential pharmacokinetic interactions between antiepileptic and antidepressant medications have strongly contributed to the undertreatment of this population. Finally, the treatment of depressive disorders in epilepsy is understudied and the few existing research studies have yet to display an effective treatment. Depressive disorders in patients with epilepsy pose significant and specific problems with regard to recognition, diagnosis, and treatment that require careful and thorough management.
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PMID:Managing depressive disorders in patients with epilepsy. 2080 26

Depressive disorders represent a significant health concern as they are associated with high social and physical dysfunction and increased risk for suicide. Electroconvulsive therapy (ECT) is the most effective treatment for patients with drug-resistant severe depressive disorders. However, the underlying biological mechanisms of ECT are not well characterized. In particular, the regulation of transcription factors upon ECT has only just started to be unveiled. The schizophrenia and bipolar disorder associated bromodomain containing 1 (BRD1) gene is important for the acetylation of histone H3K14 and holds a key role in normal embryonic development and survival. In this study, we have measured Brd1 mRNA in the hippocampus and the frontal cortex of male Sprague-Dawley rats upon acute and repeated electroconvulsive seizures (ECS) over a period of 10 days. We found an increase in the general expression of Brd1 mRNA in the hippocampus after repeated ECS compared to sham (F = 8.108, P = 0.003). Furthermore, we provide evidence suggesting a decrease in the expression of the Brd1 mRNA variant comprising an extended version of exon 7 (Brd1-L) in the frontal cortex after repeated ECS compared to sham (F = 6.225, P = 0.023). These findings indicate that regulation of the Brd1 gene is part of the biological response to ECS and that splice variants are induced differentially in different brain regions.
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PMID:Electroconvulsive seizures regulates the Brd1 gene in the frontal cortex and hippocampus of the adult rat. 2267 30

Objectives To assess depressive disorders in patients with mesial temporal lobe epilepsy (MTLE) refractory to medical treatment. Methods Adult patients with refractory MTLE completed two questionnaires (Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory (BDI) had a semi-structured psychiatric interview and a high resolution MRI scan. For complete neuropsychiatric diagnosis, as per International Classification of Diseases (ICD-10), the results were combined with clinical history and additional information from the patients' family. Results Of the 40 patients identified for this case series study which took place from 2008-2012, 31 (77.5%) had a depressive disorder: 14 had dysthymia, 11 had recurrent depressive disorder and 6 had bipolar disorder. Of the nine patients without a firm diagnosis of mood disorder, seven had isolated symptoms of depression or anxiety and two presented with mixed depression/anxiety symptoms. Only 8/31 (25.8%) patients were receiving antidepressant treatment. There was no association between BDI scores and seizure frequency. No significant difference was found between patients with and without depression and the presence or laterality of HA. Conclusions Depressive disorders are common, underdiagnosed and undertreated in patients with refractory MTLE.
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PMID:Depressive disorders in patients with pharmaco-resistant mesial temporal lobe epilepsy. 2923 39