Ettore Beghi

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..Seizure control by drugs, ketogenic diet or surgery is associated with a significant reduction in the costs of epilepsy...

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..In addition, 20-30% of patients are refractory to these drugs...

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..Future studies should be implemented using a standardized approach to define the costs and outcomes of representative cohorts of patients with newly diagnosed epilepsy recruited from different countries and followed prospectively...

..Information is now available on non-pharmacological treatments and palliative care, and the economic aspects and quality of life of ALS patients are being investigated...

..When epileptogenic conditions and seizure-related events are excluded, patients with epilepsy are only at a slightly greater risk of accidents and injuries than the general population...

..Suggestions for future research are also made as concluding remarks, by indicating the areas of investigation and the design of future studies...

..3, 1.1 and 9.4% (p=0.009). Based on these results, psychopathology of primary headache can be a reflection of the burden of the disease rather than a hallmark of a specific headache category...

..In contrast, state-dependent LD are potentially reversible and treatable; they are caused by epilepsy-related factors. If allowed to persist for a long period, a state-dependent LD may become permanent...

..prospective). We review the four studies of this topic...

..Some patients become obstinate and are impressionable. The cognitive and behavioral aspects of these patients suggest an involvement of frontal lobes...

..To assess the incidence and trends of ALS in a large population at risk...

..Long-term treatment may be considered in patients with abnormal EEG and imaging data and after consideration of the social, emotional, and personal implications of seizure relapse...

..To develop an Italian adaptation of the shortened version of the Quality-of-Life in Epilepsy Inventory (QOLIE-31)...

..To provide a critical review of studies published between December 2005 and November 2006, and detect the advances of basic and clinical research in epilepsy...

..However, there are no cost-effectiveness studies in the elderly and further evidence is needed to confirm these assumptions...

..To investigate the costs of epilepsy from a nationwide survey comparing adult patients included in different prognostic categories...

..A proper knowledge of the problems in the conduction and interpretation of the epidemiological studies helps the investigators to optimise the study protocols and the practicing physicians to critically view the published results...

..68-10.88) and duration of sport-related physical exercise (OR 1.03; 95% CI 1.00-1.05) were independent variables in multivariate analysis. We concluded that ALS is associated with physical exercise but not with traumatic events...

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..To assess the risk of illnesses and accidents in patients with epilepsy and to evaluate the proportion of those risks attributable to epilepsy...

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..Phenytoin, carbamazepine, phenobarbital, lamotrigine, oxcarbazepine, felbamate, and zonisamide have been implicated. The pathogenic mechanisms of AHS are incompletely understood...

..The accuracy of the El Escorial criteria was tested in clinical practice, but the reliability is unknown when the diagnosis of ALS must be assessed on the basis of medical records...

..This also applied to obsessive-compulsive disorder (OR 4.8; 95% CI 1.1-20.9) in migraine plus tension-type headache. Psychopathology of primary headache can reflect shared risk factors, pathophysiologic mechanisms, and disease burden...

..To count patients with newly diagnosed epilepsy entering early and late remission and to identify prognostic predictors of late remission...

..Alternative trial designs can include the use of natural history controls, the so-called minimization method for treatment allocation, and the futility approach...

..Further understanding of these factors will lead to improvements in patient stratification, and in the design of future clinical trials...

..No correlation was found between psychiatric events, demographic and disease characteristics. Our results suggest that people with epilepsy if unselected are not at higher risk for psychiatric disorders than the general population...

..An increasing use of AEDs has been recently observed over a 6-year period in Italian general practice, mostly explained by newer compounds used for conditions other than epilepsy...

..67 (95% CI [1.35-2.07]) chance of birth in October-December. Independent predictors were younger age at inclusion and being firstborn. Different neurobiological hypotheses can be drawn to explain these findings...

..More specifically, conditions in which behavioral disorders may be associated with epilepsy include depression, psychosis, particular personality traits, aggression, anxiety, and attention deficit and hyperactivity disorder...

..The probability of entering 5-year remission was 47 to 40, 58 to 58, and 64 to 64% (p = NS). Early treatment does not affect the long-term prognosis of epilepsy...

..The risk of seizures increases after stroke, but not all risk factors are known. We aimed to identify factors that increase the risk of a first seizure after a stroke...

..Compared with the general population, depressed women have greater impairment of HRQOL with epilepsy, which reflects the physical, social, and emotional implications of the disease...

..We aimed to identify factors that increase the risk of a first seizure in patients with BT or BVM...

..CONCLUSIONS: The direct costs of epilepsy vary significantly depending on the severity of the disease and the response to treatment. Hospital admissions and drugs are the commonest items of expenditure...

..To assess incidence, indicators and outcome of satisfaction with antiepileptic drugs in children...

..CONCLUSIONS: Patients with epilepsy are at higher risk of NS and ENT illnesses and complications than the general population. However, the risk of illness is significantly reduced when seizure-related events are excluded...

..We believe that a new specific questionnaire for the evaluation of HRQOL in Italy can contribute much to the understanding of the influence of epilepsy on patients' lives...

..The potential effect of age-related factors on health-related quality of life (HRQOL) of patients with epilepsy has rarely been analyzed in the literature...

..In conclusion, patients with ALS differ in terms of measures and predictors of disability. These factors are sources of bias and confounding in randomized clinical trials...

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..Further work is required to determine whether outcome could be improved through identification of specific AED combinations with synergistic activity...

..We compared the efficacy and tolerability of 6-month therapy with IVIg versus that with intravenous methylprednisolone...

..7 (95% CI: 0.5, 1.0), 0.5 (95% CI: 0.3, 0.7), and 0.4 (95% CI: 0.2, 0.8), respectively. These findings provide epidemiologic evidence of an inverse correlation between coffee intake and ALS risk...

..CONCLUSIONS: The incidence of typical GBS is comparable with that in other reports using the NINCDS diagnostic criteria. Atypical GBS accounts for a limited number of cases...

..To assess inter-rater agreement among child neurologists and psychiatrists on evaluation of response to physical and cognitive rehabilitation of children and adolescents with epilepsy...

..All the other instruments should at present be considered only for second choice...

..Prevalence of cluster headache (CH) is estimated at 56 to 69 per 100,000...

..Patients will ultimately have to decide themselves whether they wish to discontinue drug treatment...

..To consider the definition of acute symptomatic seizures for epidemiological studies, and to refine the criteria used to distinguish these seizures from unprovoked seizures for specific etiologies...

..Chronic headache is common among individuals seen in general practice. The patterns of health care use tend to be correlated to its severity. A better knowledge of the IHS criteria may be directly related to lower management costs...

..In the absence of biological markers, the diagnosis of primary headache in epidemiological studies rests on clinical findings, as reported through ad-hoc interviews...

..006 and p=0.0002). Pattern mixture model thus seem superior and we recommend its use to obtain more accurate estimates even when the information is missing...

..The aim of this study was to assess knowledge and attitudes toward epilepsy surgery among practicing neurologists and identify the barriers that delay the treatment...

..Drugs with low epileptogenic potential include fluorquinolones, carbapenems, bupropion and iodinated contrast media. Drugs with minimal or inconclusive epileptogenic potential include interferon alpha...

..The accuracy of HDDs was tested, to assess whether they could be used to trace patients with amyotrophic lateral sclerosis (ALS)...

..4%), fever (6.7%) and pulmonary disease (5.2%). Heart disease was the earliest and shortest complication. Most complications occurred during the first week. Except for hypertension, all complications resolved within 2 weeks...

..These distinctive immune alterations may represent a biological tool in differential diagnosis and future therapeutic approaches...

..0 (95% CI, 1.1-3.2) when the analysis was limited to the primary diagnostic level. HDDs from neurology departments are a fairly valid surrogate of GBS incidence in Lombardy, Italy...

..The purpose of this study was to analyze such possible association in a cohort of Italian PD patients...

..To assess the recurrence rate of epilepsy attributable to discontinuation of treatment in seizure free patients and to identify the risk factors for recurrence...

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..Forty-eight of them shifted to a second therapeutic agent. A different trend, to lower or higher doses of interferon or immunosuppression, according to reasons of discontinuation, was observed...

..Accidents and related events occurred in similar proportions in the 2 groups. Based on the results of the pilot study, idiopathic, cryptogenic and remote symptomatic epilepsy may be compatible with an at least fairly normal social life...

..4-0.8 mEq/L, therapeutic group [TG], vs 0.2-0.4 mEq/L, subtherapeutic group [STG])...

..A 43% reduction of high-affinity glutamate uptake rate (p < 0.0001) was observed in patients with ALS compared with normal controls and chronic neurologic disorder patients, suggesting a systemic impairment of glutamate uptake in ALS...

..Based on our results, patients seen at the ER for a headache episode can be fairly successfully managed by the ER physician, except those who present a first attack, for whom neurological consultation is needed...

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..CAS implies instrumentation of the carotid bulb, so baroceptor dysfunction may provoke hemodynamic instability. The aim of this work was to calculate the incidence of this complication and to detect factors to predict it...

..CONCLUSIONS: Our findings confirm that this questionnaire is a useful method for CH screening in epidemiological studies...

..Moreover, the preventive measures in legislation may be ignored by many people with epilepsy...

..This study confirms that patients with epilepsy are at higher risk of accidents compared to the general population. However, injuries provoked by work accidents are generally mild and unrelated to seizures...

..General patterns across patients with different types of conditions are reported. Gaps in the literature are identified and future research needs are assessed...

..The goal is to provide planners and policymakers with tools to analyze the impact of healthcare services and systems and evaluate efforts to improve performance...

..Partial seizures were the most common type, and localization-related symptomatic epilepsies were the largest syndromic category...

..About 80% of incident cases were trial eligible with AHC criteria. However, a significant number of subjects with ALS, characterized by a limited spread of signs, were not trial eligible while alive...

..Based on available epidemiologic, health economic, and international population statistics literature, the cost of epilepsy in Europe was estimated...

..The SMR in patients with a newly diagnosed unprovoked seizure ranges from 2.5 to 4.1 according to the study population and design. The SMR is highest in the youngest patients and in those with symptomatic seizures...

..The decision plan should also take into account social factors (driving license, job and leisure activities) as well as emotional and personal factors, and must be tailored to and discussed with the individual patient and his/her family...

..CONCLUSIONS: Mortality statistics based on official death records do not accurately reflect interregional mortality for ALS in Italy...

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..This figure is however likely to be underestimated as it is based on retrospective methodology and samples of brain disorders, and does not include intangible costs...

..The burden of neurological activities is unrelated to the geographical area and hospital's complexity (size, structural and functional context, ER organisation, presence of stroke units, neurosurgery units or 24/7 neurological service)...

..CONCLUSIONS: Patients with epilepsy are at higher risk of accidents and their complications. However, the risk was substantially lower after exclusion of seizure-related events...

..Because of the multifactorial nature of impairment and disablity in ALS, multidisciplinary clinics (MDC) have been recently introduced in the management of ALS patients; their effects on survival remain, however, largely debated...

..Although amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disorder, some ALS cases can survive beyond 10 years. However, the predictors of long survival in ALS patients remain uncertain...