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Impaired consciousness in epilepsy investigated by a prospective responsiveness in epilepsy scale (RES)

Title
Impaired consciousness in epilepsy investigated by a prospective responsiveness in epilepsy scale (RES)
Authors
Yang L.Shklyar I.Lee H.W.Ezeani C.C.Anaya J.Balakirsky S.Han X.Enamandram S.Men C.Cheng J.Y.Nunn A.Mayer T.Francois C.Albrecht M.Hutchison A.L.Yap E.-L.Ing K.Didebulidze G.Xiao B.Hamid H.Farooque P.Detyniecki K.Giacino J.T.Blumenfeld H.
Ewha Authors
이향운
SCOPUS Author ID
이향운scopus
Issue Date
2012
Journal Title
Epilepsia
ISSN
0013-9580JCR Link
Citation
vol. 53, no. 3, pp. 437 - 447
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Purpose: Impaired consciousness in epileptic seizures has a major negative impact on patient quality of life. Prior work on epileptic unconsciousness has mainly used retrospective and nonstandardized methods. Our goal was to validate and to obtain initial data using a standardized prospective testing battery. Methods: The responsiveness in epilepsy scale (RES) was used on 52 patients during continuous video-electroencephalography (EEG) monitoring. RES begins with higher-level questions and commands, and switches adaptively to more basic sensorimotor responses depending on patient performance. RES continues after seizures and includes postictal memory testing. Scoring was conducted based on video review. Key Findings: Testing on standardized seizure simulations yielded good intrarater and interrater reliability. We captured 59 seizures from 18 patients (35% of participants) during 1,420 h of RES monitoring. RES impairment was greatest during and after tonic-clonic seizures, less in partial seizures, and minimal in auras and subclinical seizures. In partial seizures, ictal RES impairment was significantly greater if EEG changes were present. Maximum RES impairment (lowest ictal score) was also significantly correlated with long postictal recovery time, and poor postictal memory. Significance: We found that prospective testing of responsiveness during seizures is feasible and reliable. RES impairment was related to EEG changes during seizures, as well as to postictal memory deficits and recovery time. With a larger patient sample it is hoped that this approach can identify brain networks underlying specific components of impaired consciousness in seizures. This may allow the development of improved treatments targeted at preventing dysfunction in these networks. © 2012 International League Against Epilepsy.
DOI
10.1111/j.1528-1167.2011.03341.x
Appears in Collections:
의과대학 > 의학과 > Journal papers
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