ObjectiveTo investigate the clinical characteristics of epileptics with pregnancy and then provide reference for standardized management of epileptics with pregnancy. MethodsFrom June 2012 to June 2021, epileptics with pregnancy who delivered in Jinan Central Hospital were selected as the research subjects. The clinical data such as the application of Antiseizure medications (ASMs) during pregnancy, seizure frequency, pregnancy outcomes, delivery ways, offspring feeding ways and the incidence of complications were investigated and analyzed. ResultsAmong 36 epileptics with pregnancy, 20 cases (55.56%) were treated with ASMs alone, 5 cases (13.88%) were treated with combined medication, and 11 cases (30.56%) were treated without ASMs during pregnancy. 15 cases (41.67%) adhered to systematic application of ASMs, 17 cases (47.22%) did not adhere to systematic application of ASMs, and 4 cases (11.11%) had unknown medication history. The frequency of seizures increased in 5 cases, decreased in 7 cases and unchanged in 24 cases during pregnancy. Pregnancy outcomes: full-term delivery in 33 cases (91.67%), preterm delivery in 1 case (2.78%) and abortion in 2 cases (5.56%). Delivery mode: cesarean section in 31 cases (91.18%), vaginal delivery in 3 cases (8.82%). After delivery, 4 cases (11.76%) were fed with milk powder and 30 cases (88.24%) were breast-fed. Complications: There were 6 cases complicated with anemia (16.67%), 5 cases complicated with gestational hypertension (13.89%), 3 cases complicated with gestational diabetes (8.33%), 4 cases complicated with premature rupture of membranes (11.11%), 2 cases complicated with fetal growth restriction (5.56%), 2 cases complicated with oligohydramnios (5.56%), 3 cases complicated with fetal distress (8.33%) and 3 cases complicated with neonatal asphyxia (8.33%). ConclusionsThe proportion of epileptics with pregnancy who were systematically treated with ASMs was low and the seizures were poorly controlled. There is a lack of standardized management for such patients in clinical practice.
ObjectiveTo systematically review the efficacy and safety of new anti-epileptic drugs in the treatment of epilepsy. MethodsPubMed, EMbase, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of new anti-epileptic drugs rufinamide, zonisamide, and perampanel in the treatment of epilepsy from January 2006 to May 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.3 and Stata 16.0 software. ResultsA total of 16 RCTs involving 4 382 patients were included. The results of meta-analysis showed that the effective rate (RR=1.66, 95%CI 1.45 to 1.89, P<0.000 01) and seizure-free rate (RR=2.82, 95%CI 2.01 to 3.96, P<0.000 01) in new anti-epileptic drugs group were higher than those in the control group, while it did not increase the serious adverse events (RR=0.95, 95%CI 0.72 to 1.27, P=0.75). ConclusionCurrent evidence shows that new anti-epileptic drugs have trends of better effectiveness, and their safety is satisfactory. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.
ObjectiveThis study aimed to explore the timing of the long-term antiepileptic drugs (AEDs) therapy in patients with stroke related seizures. MethodsWe enrolled 90 Patients with post-stroke seizures who diagnosed in neurology and epilepsy specialist clinic of Tianjin Medical University General Hospital and followed up for at least 12 months from September 2014 to August 2016. The patients were divided into early-onset seizure group (occurring within 2 weeks of stroke) and late-onset seizure group (occurring after 2 weeks of stroke).The two groups were subdivided into treated and untreated group after the first seizure. ResultsThe patients were followed up for 12~96m (median 20m). 31 patients in ES group, 19 of which in treated group and 12 of which in untreated group. 59 patients in LS group, 36 of which in treated group and 23 of cases in untreated group. The recurrence rate of second seizures occurred in each group and the comparison between the subgroups in the 3rd, 6th, 9th and 12th mouth of follow-up as follows. 1 LS group compared with the group of ES, the recurrence rate of second seizures was high (25.81%~38.71% vs. 49.15%~69.49%), and there was statistical difference (P < 0.05). 2 The recurrence rate of ES in untreated group was lower than that in untreated LS group (16.77% 33.33% vs. 56.52% 73.91%), but only in 3m and 12m the difference was statistically significant (P < 0.05). 3 There was on statistically significant different in ES treated group compared to untreated group, LS treated group compared to untreated group, ES treated group compared to LS treated group (P > 0.05). Both in group of ES and LS, The ratio of seizure recurred patients at different time points during follow-up period was highest at the time of 3m, 3 6m followed, within six months respectively as high as 91.67% and 76.59%. ConclusionOnly one early-onset seizure after stroke can be suspended long-term AEDs treatment, once it recurred that indicates the need for treatment. However, the recurrence rate of late-onset seizure was higher than that of early-onset seizure and it should be given long term AEDs treatment after the first seizure.
ObjectiveTo investigate the anxious level of people with epilepsy (PWE) during the outbreak of 2019 Novel Coronavirus Diseases (COVID-19) and explore the reasons of anxiety.MethodsAn internet questionnaire survey were conducted on the anxiety state of PWE and health controls (HC) aged 18 to 45 years old between Feb 9, 2020 and Feb 17, 2020. The questionnaire included demographic information, general status and the State-Trait Anxiety Inventory (STAI).ResultsIn all, 148 PWE and 300 HC were included in this study. The total SAI score (46.72±9.98 vs. 41.77±10.20, P<0.001) and the total TAI score (44.18±8.88 vs. 31.27±17.44, P<0.001) were significantly higher in PWE than in HC. PWE concerned most (69.9%) about the difficulty of obtaining antiepileptic drugs (AEDs) while HC concerned most about the lack of face masks (73.3%).ConclusionHigh anxious level in PWE during the outbreak of COVID is probably due to the difficulty of obtaining AEDs. Thus, the society should strengthen the solution of the problem of purchasing AEDs and conduct timely psychological counseling.