• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 484
  • 404
  • 100
  • 49
  • 44
  • 30
  • 23
  • 12
  • 10
  • 8
  • 8
  • 8
  • 8
  • 8
  • 8
  • Tagged with
  • 1383
  • 426
  • 229
  • 219
  • 118
  • 106
  • 103
  • 96
  • 95
  • 87
  • 86
  • 80
  • 77
  • 77
  • 76
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
181

Die invloed van 'n groepterapeutiese begeleidingsprogram op epileptiese adolessente dogters

Roberts, Antoinette Johanna 06 1900 (has links)
In die studie is besin oor die wyse waarop die opvoedkundige sielkundige die probleme wat deur die epileptiese adolessente dogter ondervind word, kan aanspreek. 'n Groepterapeutiese begeleidingsprogram is ten doel gestel sodat die intra- en inter-psigiese effek daarvan op die epileptiese adolessente dogter bepaal kon word. Agt epileptiese adolessente dogters is vir die doel van hierdie studie geselekteer, waama hulle aan 'n reeks psigometriese toetse onderwerp is. Voorts het die onderskeie vakonderwysers 'n evalueringsvraelys voltooi. Daar is bevind dat die dogters in die algemeen 'n negatiewe selfkonsep het. Die meeste proefpersone was angstig en depressief. Verhoudingsprobleme en 'n gebrek aan doelstellings het ook onder hulle voorgekom. Volgens die literatuurstudie blyk dit 66k dat die epileptiese kind oor die algemeen 'n hoe voorkoms van psigo-sosiale probleme toon en <lat <lit dikwels lei tot 'n negatiewe selfkonsep. Faktore wat die psigo-sosiale wording van die epileptiese kind kan bei'nvloed, is neuroIV biologiese faktore (byvoorbeeld die tipe toeval), psigo-sosiale faktore (byvoorbeeld stigmatisering) en farmakologiese faktore (byvoorbeeld newe-effekte van medikasie ). Die proefpersone is onderwerp aan 'n groepterapeutiese begeleidingsprogram van tien sessies. Die program het gefokus op intra-psigiese aspekte soos die regstelling van negatiewe selfspraak, asook op die bewusmaking en oefening van interpersoonlike vaardighede. Uit die resultate van die na-toetsing kan afgelei word dat persoonlike groei plaasgevind het - in die algemeen was daar 'n verhoging ten opsigte van die selfkonsep. Interpersoonlike verhoudinge het skynbaar ook verbeter, terwyl angs afgeneem en depressie verminder het. Voorts het die proefpersone se skolastiese prestasie met 5,1 persent verbeter. Die groepterapeutiese begeleidingsprogram het dus 'n positiewe intra- en inter-psigiese effek op die epileptiese adolessente dogter gehad. / This study addressed the ways in which the educational psychologist can address the problems experienced by epileptic adolescent girls. Eight epileptic adolescent girls were subjected to a series of psychometric tests. The results indicated that in general, the majority of the girls were suffering from a negative self-concept, depression and anxiety. They experienced problems with relationships and reflected a lack of goals. The epileptic adolescent girls were subjected to a group therapeutic guidance programme. The programme focussed on intra- and interpsychological aspects such as the modification of negative self-talk and the exercising of interpersonal skills. The results of follow-up tests revealed that in general there had been an improvement of the self-concept. Apparently inter-personal relations had improved, whereas anxiety and depression had declined. At the same time, school performance had increased. Hence, the group therapeutic guidance programme had a positive intra- and interpsychological effect on the epileptic adolescent girls. / Psychology of Education / M.Ed.
182

Estudo crítico dos modelos experimentais em epilepsia espontânea do tipo ausência / Critical study of experimental models of absence-like epilepsy

Elton Pallone de Oliveira 25 February 2011 (has links)
A epilepsia é uma das afecções neurológica mais comum na população mundial. Trata-se de uma condição crônica altamente incapacitante que acomete indivíduos de ambos os sexos e de todas as faixas etárias, com um discreto predomínio em homens e, maior freqüência em crianças abaixo de dois anos e idosos acima de 65 anos. As conseqüências de morbidade e mortalidade desta patologia repercutem negativamente na sociedade e, conseqüentemente na economia global. Estima-se que de 60 a 100 milhões de pessoas ao redor do mundo apresentaram alguma condição epiléptica durante suas vidas. Segundo alguns autores a incidência da epilepsia varia de 11 a 131/100 mil habitantes por ano e a prevalência de 1,5 a 30/1000 habitantes por ano, sendo que os maiores valores encontram-se nos países em desenvolvimento, particularmente na America Latina e na África. As epilepsias generalizadas idiopáticas (EGI) constituem-se cerca de um terço de todas as formas de epilepsias e são 15 a 20% mais freqüentes em relação aos demais tipos de epilepsia. As EGI do tipo ausência, as quais são estritamente relacionadas à faixa etária infantil e adolescente podem muitas vezes (2,8 5,7% dos casos) afetar pacientes com idade superior a 15 anos. A fisiopatologia, assim como, as causas reais da ocorrência e/ou recorrência das crises de ausência na idade adulta não estão completamente esclarecidos e se representam um importante desafio para os epileptologistas. As epilepsias generalizadas idiopáticas (EGIs), (etiologia genética) são classificadas em: a) crises de ausência típicas, b) crises de ausência atípicas, c) crises de ausência com fatores especiais, d) crises mioclônicas, e) crises mioclônicas atônicas, f) crises mioclônicas tônicas, g) crises clônicas, h) crises tônicas e, i) crises atônicas. O tratamento e comumente farmacológico e as crises são controladas na maioria dos casos, no entanto, cerca de um terço dos pacientes são refratários às drogas anticonvulsivantes. Tendo como principal finalidade a elucidação de mecanismos básicos e, auxílio no desenvolvimento de abordagens terapêuticas eficazes para esses pacientes, pesquisadores do mundo inteiro dedicam muitos esforços para o desenvolvimento de modelos experimentais capazes de mimetizar o fenômeno que se pretende reproduzir. Dentre os principais modelos experimentais em EGIs, pode-se citar: (1) o modelo de epilepsia generalizada induzida por penicilina em gatos; (2) modelos de investigação da bicuculina; (3) indução por estimulação elétrica; (4) ratos geneticamente epilépticos de Strasbourg (GAERS); (5) cepa WAG/Rij; (6) modelo do gama-hidroxibutirato (GHB) e (7) os camundongos mutantes. Tais modelos experimentais têm provido meios para que os pesquisadores possam avaliar e quantificar adequadamente as alterações neuronais que ocorrem durante os processos epileptógenos tanto in vitro ou in vivo, possibilitando importantes avanços no desenvolvimento de novas abordagens terapêuticas e, melhora na qualidade de vida de portadores de epilepsia / Epilepsy is a very commom neurological disorders in world population. It is a chronicle condition highly disabling that affects both genera male and female independent of your age with a soft predominance in men and is more frequent in child under 2 years old and adult above 65 years old. The morbidity and mortality consequences of this disorder have many negative repercussions at society and global economy consequently. It is estimated about 60 to 100 millions of people around the world present any epileptic condition during their lives. According some researchers the epilepsy incidence varies about 11 to 131/100 thousand habitants for year and the prevalence between 1.5 to 30/1000 habitants for year, about this statics the higher values are found in developing countries, Latin America and Africa particularly. The Idiopathic Generalized Epilepsy (IGE) are about a third of all others kinds of epilepsies and are 15 to 20% more frequent tha n others types of epilepsies. The absences IGEs are strictly related with childhood and adolescence age group and sometimes can affect patients (2.8 5.7 of cases) with age higher than 15 years old. The physiopathology as the real causes of to occur and to reoccur of absences crises in adult age are not completely enlightened and represent a important challenge to epileptlogists. The IGEs (genetic etiology) are classified in: a) typical absence seizures, b) atypical absence seizures, c) absence seizures with special factors, d) mioclonics seizures, f) tonic mioclonic seizures, g) clone seizures, h) tonic seizures and i) atonic seizures. The treatment commonly is pharmacologic and seizures are controlled in major parts of cases although about a third of patients are refratory to anticonvulsants drugs. Having as principal finality the elucidation of basic mechanisms and help of development of effectiv e therapeutical approaches to these patients, researchers around the world spend many efforts to develop experimental models able to reproduce the phenomena that want to reproduce. Among the principal experimental models of IGEs, it is possible to cite: (1) the general epilepsy model induced by penicillin in cats; (2) the models of investigation of bicuculin; (3) induction by electrical stimulation; (4) Genetic Absence Epilepsy Rats of Strasbourg (GAERS); (5) cepa WAG/Rij; (6) the model of gamma-hydroxybutyric (GHB) and (7) mutant rats. These experimental models have promoted ways to researchers can to evaluate and quantify adequately the neuronal alterations that occur during epileptigenes process both in vitro or in vivo, making possible important advances in development of new therapeutical approaches and improvement in quality of life of epilepsy carriers
183

Estudo crítico dos modelos experimentais em epilepsia espontânea do tipo ausência / Critical study of experimental models of absence-like epilepsy

Oliveira, Elton Pallone de 25 February 2011 (has links)
A epilepsia é uma das afecções neurológica mais comum na população mundial. Trata-se de uma condição crônica altamente incapacitante que acomete indivíduos de ambos os sexos e de todas as faixas etárias, com um discreto predomínio em homens e, maior freqüência em crianças abaixo de dois anos e idosos acima de 65 anos. As conseqüências de morbidade e mortalidade desta patologia repercutem negativamente na sociedade e, conseqüentemente na economia global. Estima-se que de 60 a 100 milhões de pessoas ao redor do mundo apresentaram alguma condição epiléptica durante suas vidas. Segundo alguns autores a incidência da epilepsia varia de 11 a 131/100 mil habitantes por ano e a prevalência de 1,5 a 30/1000 habitantes por ano, sendo que os maiores valores encontram-se nos países em desenvolvimento, particularmente na America Latina e na África. As epilepsias generalizadas idiopáticas (EGI) constituem-se cerca de um terço de todas as formas de epilepsias e são 15 a 20% mais freqüentes em relação aos demais tipos de epilepsia. As EGI do tipo ausência, as quais são estritamente relacionadas à faixa etária infantil e adolescente podem muitas vezes (2,8 5,7% dos casos) afetar pacientes com idade superior a 15 anos. A fisiopatologia, assim como, as causas reais da ocorrência e/ou recorrência das crises de ausência na idade adulta não estão completamente esclarecidos e se representam um importante desafio para os epileptologistas. As epilepsias generalizadas idiopáticas (EGIs), (etiologia genética) são classificadas em: a) crises de ausência típicas, b) crises de ausência atípicas, c) crises de ausência com fatores especiais, d) crises mioclônicas, e) crises mioclônicas atônicas, f) crises mioclônicas tônicas, g) crises clônicas, h) crises tônicas e, i) crises atônicas. O tratamento e comumente farmacológico e as crises são controladas na maioria dos casos, no entanto, cerca de um terço dos pacientes são refratários às drogas anticonvulsivantes. Tendo como principal finalidade a elucidação de mecanismos básicos e, auxílio no desenvolvimento de abordagens terapêuticas eficazes para esses pacientes, pesquisadores do mundo inteiro dedicam muitos esforços para o desenvolvimento de modelos experimentais capazes de mimetizar o fenômeno que se pretende reproduzir. Dentre os principais modelos experimentais em EGIs, pode-se citar: (1) o modelo de epilepsia generalizada induzida por penicilina em gatos; (2) modelos de investigação da bicuculina; (3) indução por estimulação elétrica; (4) ratos geneticamente epilépticos de Strasbourg (GAERS); (5) cepa WAG/Rij; (6) modelo do gama-hidroxibutirato (GHB) e (7) os camundongos mutantes. Tais modelos experimentais têm provido meios para que os pesquisadores possam avaliar e quantificar adequadamente as alterações neuronais que ocorrem durante os processos epileptógenos tanto in vitro ou in vivo, possibilitando importantes avanços no desenvolvimento de novas abordagens terapêuticas e, melhora na qualidade de vida de portadores de epilepsia / Epilepsy is a very commom neurological disorders in world population. It is a chronicle condition highly disabling that affects both genera male and female independent of your age with a soft predominance in men and is more frequent in child under 2 years old and adult above 65 years old. The morbidity and mortality consequences of this disorder have many negative repercussions at society and global economy consequently. It is estimated about 60 to 100 millions of people around the world present any epileptic condition during their lives. According some researchers the epilepsy incidence varies about 11 to 131/100 thousand habitants for year and the prevalence between 1.5 to 30/1000 habitants for year, about this statics the higher values are found in developing countries, Latin America and Africa particularly. The Idiopathic Generalized Epilepsy (IGE) are about a third of all others kinds of epilepsies and are 15 to 20% more frequent tha n others types of epilepsies. The absences IGEs are strictly related with childhood and adolescence age group and sometimes can affect patients (2.8 5.7 of cases) with age higher than 15 years old. The physiopathology as the real causes of to occur and to reoccur of absences crises in adult age are not completely enlightened and represent a important challenge to epileptlogists. The IGEs (genetic etiology) are classified in: a) typical absence seizures, b) atypical absence seizures, c) absence seizures with special factors, d) mioclonics seizures, f) tonic mioclonic seizures, g) clone seizures, h) tonic seizures and i) atonic seizures. The treatment commonly is pharmacologic and seizures are controlled in major parts of cases although about a third of patients are refratory to anticonvulsants drugs. Having as principal finality the elucidation of basic mechanisms and help of development of effectiv e therapeutical approaches to these patients, researchers around the world spend many efforts to develop experimental models able to reproduce the phenomena that want to reproduce. Among the principal experimental models of IGEs, it is possible to cite: (1) the general epilepsy model induced by penicillin in cats; (2) the models of investigation of bicuculin; (3) induction by electrical stimulation; (4) Genetic Absence Epilepsy Rats of Strasbourg (GAERS); (5) cepa WAG/Rij; (6) the model of gamma-hydroxybutyric (GHB) and (7) mutant rats. These experimental models have promoted ways to researchers can to evaluate and quantify adequately the neuronal alterations that occur during epileptigenes process both in vitro or in vivo, making possible important advances in development of new therapeutical approaches and improvement in quality of life of epilepsy carriers
184

Problematika pracovního uplatnění osob s epilepsií / The problematics of people with epilepsy in employment

Stuchlíková, Jana January 2018 (has links)
This diploma thesis was devoted to the topic: the issue of the employment of persons with epilepsy. The theoretical part was focused on the description of epilepsy as a disease. However, most of the work was devoted to social work. These were areas such as employment and financial support for individuals with epilepsy. The research part focused mainly on the factors influencing the employed persons with epilepsy between the ages of 18 and 65 years. This information was obtained through a questionnaire survey.
185

Die invloed van 'n groepterapeutiese begeleidingsprogram op epileptiese adolessente dogters

Roberts, Antoinette Johanna 06 1900 (has links)
In die studie is besin oor die wyse waarop die opvoedkundige sielkundige die probleme wat deur die epileptiese adolessente dogter ondervind word, kan aanspreek. 'n Groepterapeutiese begeleidingsprogram is ten doel gestel sodat die intra- en inter-psigiese effek daarvan op die epileptiese adolessente dogter bepaal kon word. Agt epileptiese adolessente dogters is vir die doel van hierdie studie geselekteer, waama hulle aan 'n reeks psigometriese toetse onderwerp is. Voorts het die onderskeie vakonderwysers 'n evalueringsvraelys voltooi. Daar is bevind dat die dogters in die algemeen 'n negatiewe selfkonsep het. Die meeste proefpersone was angstig en depressief. Verhoudingsprobleme en 'n gebrek aan doelstellings het ook onder hulle voorgekom. Volgens die literatuurstudie blyk dit 66k dat die epileptiese kind oor die algemeen 'n hoe voorkoms van psigo-sosiale probleme toon en <lat <lit dikwels lei tot 'n negatiewe selfkonsep. Faktore wat die psigo-sosiale wording van die epileptiese kind kan bei'nvloed, is neuroIV biologiese faktore (byvoorbeeld die tipe toeval), psigo-sosiale faktore (byvoorbeeld stigmatisering) en farmakologiese faktore (byvoorbeeld newe-effekte van medikasie ). Die proefpersone is onderwerp aan 'n groepterapeutiese begeleidingsprogram van tien sessies. Die program het gefokus op intra-psigiese aspekte soos die regstelling van negatiewe selfspraak, asook op die bewusmaking en oefening van interpersoonlike vaardighede. Uit die resultate van die na-toetsing kan afgelei word dat persoonlike groei plaasgevind het - in die algemeen was daar 'n verhoging ten opsigte van die selfkonsep. Interpersoonlike verhoudinge het skynbaar ook verbeter, terwyl angs afgeneem en depressie verminder het. Voorts het die proefpersone se skolastiese prestasie met 5,1 persent verbeter. Die groepterapeutiese begeleidingsprogram het dus 'n positiewe intra- en inter-psigiese effek op die epileptiese adolessente dogter gehad. / This study addressed the ways in which the educational psychologist can address the problems experienced by epileptic adolescent girls. Eight epileptic adolescent girls were subjected to a series of psychometric tests. The results indicated that in general, the majority of the girls were suffering from a negative self-concept, depression and anxiety. They experienced problems with relationships and reflected a lack of goals. The epileptic adolescent girls were subjected to a group therapeutic guidance programme. The programme focussed on intra- and interpsychological aspects such as the modification of negative self-talk and the exercising of interpersonal skills. The results of follow-up tests revealed that in general there had been an improvement of the self-concept. Apparently inter-personal relations had improved, whereas anxiety and depression had declined. At the same time, school performance had increased. Hence, the group therapeutic guidance programme had a positive intra- and interpsychological effect on the epileptic adolescent girls. / Psychology of Education / M.Ed.
186

Postoje vybraných pomáhajících profesí k epilepsii / Attitudes of selected helping professions to Epilepsy

Filipová, Hana January 2019 (has links)
The Diploma thesis is focused on attitudes of helping profession to epilepsy. The aim of theoretical part is to introduce life with epilepsy and to increase public awareness of the illness. As a part of the thesis there is refuting myths and prejudices that are often cause of negative attitudes. Helping professions are a main part of life both of epileptics and their families as well their surroundings and their attitudes affect most of it so it is main sample of the research. Theoretical part is divided into few chapters. In the initial chapter there are defined basic concepts important for good orientation in the topic - stereotypes, prejudices and attitudes. Its theories, functions and changes are further described more in detail. Next chapters describe epilepsy from medical and social aspects such as Etiology of epilepsy, epileptic seizures classification, its diagnostics and treatment are mentioned there. First aid during epileptic seizures and role of social workers are not missing. Further diploma thesis covers problematics such as social stigmatization and myths connected with epilepsy. From wider perspective impact of epilepsy on social and personal life is revealed to readers. Research part of the diploma thesis was created by quantitative method using questionnaire survey. The aim of...
187

Rehabilitace dětských epileptochirurgických pacientů s pooperačními motorickými deficity / Rehabilitation of Pediatric Patients after Epilepsy Surgery with Postoperative Motor Deficits.

Duchoslav, Anna January 2021 (has links)
In its general section, the thesis 'Rehabilitation of Pediatric Patients after Epilepsy Surgery with Postoperative Motor Deficits' discusses epilepsy, treatment of intractable epilepsy and epilepsy surgery. Furthermore, a chapter on possible complications of epilepsy surgery in relation to the locomotor apparatus is included in the general section. The special section deals with rehabilitation in neurology, selected physiotherapy concepts and the relationship between epilepsy and movement activity. The aim of this thesis is to assess the effectiveness of the chosen rehabilitation procedure in five pediatric patients with post-operative motor deficiency. The Gross Motor Function Measure - 88, the Barthel Index and the Box and Blocks Test were used for objective motor assessment.
188

Executive Function In Pediatric Patients With Intractable Epilepsy Following Hemispherectomy

Lundmark, Jennifer 01 January 2010 (has links)
Hemispherectomy has gained widespread endorsement as a useful technique for treating seizures in patients with cerebral hemispheric dysfunction. Following this procedure, most patients experience seizure-freedom or a substantial decrease in the number of seizures occurring. Regarding other areas of functioning, patients generally maintain the same level of intelligence, language abilities, motor functioning, and visual ability, and experience improvements in behavioral disturbances and social skills. However, the current outcome literature lacks information regarding the effect of hemispherectomy on executive function. The purpose of this study is to evaluate executive function in pediatric patients with intractable epilepsy following a hemispherectomy. The parents of children who had undergone this surgical intervention completed the Behavior Rating Inventory of Executive Function (BRIEF; Gioia, Isquith, Guy, and Kenworthy, 2002) and their children's scores were compared to those of children with epilepsy treated with anticonvulsant medications (AEDs) only. The impact of clinical variables (i.e. age at time of surgery, lateralization of hemispherectomy, and amount of time since surgery) on BRIEF scores were also examined. Results indicated that children undergoing a hemispherectomy produced lower scores (less impaired) on several of the BRIEF scales as compared to those taking AEDs only. The left and right hemispherectomy group differed only on a subscale measuring behavioral inhibition, with the right hemispherectomy group producing a higher mean (meaning more impairment). Several BRIEF scores in the aggregate hemispherectomy group were positively correlated with time since surgery, such that longer post-operative periods were associated with poorer performances on the BRIEF. Several BRIEF measures were negatively correlated with age at time of surgery, suggesting that younger patients fared worse on the BRIEF than older patients.
189

Copingstrategier hos vuxna personer med diagnosen epilepsi : En litteraturstudie / Coping strategies in adults diagnosed with epilepsy : A literature study

Svensson, Emma, Månsson, Sofie January 2016 (has links)
Antalet personer som får diagnosen epilepsi ökar för varje år. Med sjukdomen uppkommer problem som varje person ställs inför. För att vuxna personer med diagnosen epilepsi ska kunna hantera sina problem kan de ta hjälp av copingstrategier. Syftet med studien var att undersöka copingstrategier hos vuxna personer med diagnosen epilepsi. Studien genomfördes som en litteraturstudie där artikelsökning, granskning och urval genomfördes på ett strukturerat och systematiskt tillvägagångsätt. Resultatet grundades på åtta vetenskapliga artiklar. Efter analys av artiklarna framkom tre huvudkategorier: Inre copingstrategier, Yttre copingstrategier och Fördelning och användning av copingstrategier. Inre copingstrategier utmynnade i ytterligare två underkategorier: Kontroll över situationen och Kontroll över känslorna. Resultatet visar att de vanligaste copingstrategierna är anpassning, förnekelse och religion. Resultatet visar även på att liknande copingstrategier används i många olika länder och att skillnader går att finna kring olika användning av copingstrategier hos kvinnor respektive män. Ytterligare forskning kring copingstrategier behövs för att förståelsen kring olika copingstrategier i sin tur ska kunna utmynna i bättre omvårdnad för vuxna personer med diagnosen epilepsi. Detta genom att sjuksköterskan lättare ska kunna vägleda och förstå vuxna personer med diagnosen epilepsi. / The number of people who are diagnosed with epilepsy increases each year and what is more each person stricken by the disease also experiences different issues all related to the illness. To be able handle the problems generated from epilepsy they can use different coping strategies. The aim of this study was to examine coping strategies among adults diagnosed with epilepsy and it was made as a literary study where article search, examination and selection was done according to a structural and methodical approach. The result was based upon eight scholarly articles. After an analysis of the articles three main categories emerged: Internalized coping strategy, external coping strategy and allocation and use of coping strategies. Internalized coping strategy gave rise to two additional lower categories: situation-focused coping and emotion-focused coping. The result shows that the most common coping strategies are adaption, denial and religion. Furthermore it is also shown that similar strategies are used among many countries, whereas there is a difference between men and women. Additional research is needed within this field to increase the knowledge about coping strategies among people with epilepsy. The effect of this knowledge is that it will be easier for nurses to guide and understand people diagnosed with epilepsy.
190

Investigation of cardiac dysfunction and hypoxaemia during epileptic seizures

Brotherstone, Ruth Elizabeth January 2012 (has links)
Epileptic seizures are often un-witnessed and can result in hypoxic brain damage or can be fatal due to injuries, status epilepticus or sudden unexpected death in epilepsy (SUDEP). The first aim of this thesis was to investigate some of the physiological parameters that accompany an epileptic seizure and may be useful in a seizure alarm system. The second aim was to investigate aspects of cardiac dysfunction during clinical and sub-clinical seizures that may be potential contributing factors in SUDEP. Percentage heart rate change and oxygen saturation were studied prospectively during 527 epileptic seizures in 50 patients aged from one-day full term neonate to 60 years with a variety of seizure types (absences, generalised tonic clonic seizures, myoclonic seizures, tonic seizures and focal seizures) and in normal physiological events (e.g. coughing, turning in bed). Higher percentage heart rate change occurred during epileptic seizures (21.8%) than during normal physiological events (16.4%) p<0.001. Diagnostic testing of clinically significant seizures i.e seizures that could potentially lead to serious consequences if left undetected (n=61) had a sensitivity of 91% and specificity of 75% when percentage heart rate change and hypoxaemia parameters were combined. Percentage heart rate change and oxygen saturation could be used as reliable indicators of a seizure when set at specific levels and distinguish clinically significant seizures from normal physiological events. These parameters can now be used to develop a reliable alarm system to detect epileptic seizures at night. Prolongation of QTc and increased vagal tone may be possible mechanisms underlying SUDEP. Corrected Q-T cardiac repolarisation time 5 minutes before and throughout 156 epileptic seizures were analysed using four corrective formulae (Bazett, Hodge, Fridericia and Framingham). All formulae indicated statistically significant lengthening of the corrected Q-T during epileptic seizures (p<0.001) compared to pre-seizure values. All formulae agreed that the greatest lengthening of the corrected QT beyond normal limits occurred during right temporal lobe seizures in two patients. Reflex and tonic vagal activity utilising R-R intervals was assessed in 33 sub-clinical seizures occurring during stages 3 or 4 sleep and was compared to matched counts of R-R interval non-ictal baseline studies from the same stage of sleep in each patient. Altered vagal activity occurred during total sub-clinical seizures compared to baseline studies (p<0.001). Lengthening of the corrected Q-T and changes in cardiac vagal tone during epileptic seizures may have a role in the patho-physiology of SUDEP.

Page generated in 0.0254 seconds