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1. Risk factors for unprovoked epileptic seizures in multiple sclerosis: a systematic review and meta-analysis

Author

Gasparini, Sara, Ferlazzo, Edoardo, Ascoli, Michele, Sueri, Chiara, Cianci, Vittoria, Russo, Concetta, Pisani, Laura Rosa, Striano, Pasquale, Elia, Maurizio, Beghi, Ettore, Colica, Carmela, Aguglia, Umberto, Belcastro, V., Bianchi, A., Calabrò, S., De Falco, F., De Maria, G., Galimberti, C. A., Gambardella, A., Iudice, A., Labate, A., La Neve, A., Le Piane, E., Monti, F., Mumoli, L., Paladin, F., Pisani, F., Pizza, V., Provinciali, L., Sofia, V., Specchio, L. M., Specchio, N., Striano, S., Villani, F., Zaccara, G., and On behalf of the Epilepsy Study Group of the Italian Neurological Society

Published
2017
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2. Comorbidities in patients with epilepsy: Frequency, mechanisms and effects on long-term outcome

Author

Giussani, G, Bianchi, E, Beretta, S, Carone, D, Difrancesco, J, Stabile, A, Zanchi, C, Pirovano, M, Trentini, C, Padovano, G, Colombo, M, Cereda, D, Tinti, L, Scanziani, S, Gasparini, S, Bogliun, G, Ferrarese, C, Beghi, E, Romeo, A, Viri, M, Specchio, L, Trivisano, M, Mecarelli, O, Zarabla, A, Capovilla, G, Beccaria, F, Sasanelli, F, Galimberti, C, Tartara, E, Zamponi, N, Cappanera, S, Aguglia, U, Ferlazzo, E, La Neve, A, Luisi, C, Pontrelli, G, Cantisani, A, De Maria, G, Albanese, Y, Giussani G., Bianchi E., Beretta S., Carone D., DiFrancesco J. C., Stabile A., Zanchi C., Pirovano M., Trentini C., Padovano G., Colombo M., Cereda D., Tinti L., Scanziani S., Gasparini S., Bogliun G., Ferrarese C., Beghi E., Romeo A., Viri M., Specchio L., Trivisano M., Mecarelli O., Zarabla A., Capovilla G., Beccaria F., Sasanelli F., Galimberti C. A., Tartara E., Zamponi N., Cappanera S., Aguglia U., Ferlazzo E., La Neve A., Luisi C., Pontrelli G., Cantisani A. T., De Maria G., Albanese Y., Giussani, G, Bianchi, E, Beretta, S, Carone, D, Difrancesco, J, Stabile, A, Zanchi, C, Pirovano, M, Trentini, C, Padovano, G, Colombo, M, Cereda, D, Tinti, L, Scanziani, S, Gasparini, S, Bogliun, G, Ferrarese, C, Beghi, E, Romeo, A, Viri, M, Specchio, L, Trivisano, M, Mecarelli, O, Zarabla, A, Capovilla, G, Beccaria, F, Sasanelli, F, Galimberti, C, Tartara, E, Zamponi, N, Cappanera, S, Aguglia, U, Ferlazzo, E, La Neve, A, Luisi, C, Pontrelli, G, Cantisani, A, De Maria, G, Albanese, Y, Giussani G., Bianchi E., Beretta S., Carone D., DiFrancesco J. C., Stabile A., Zanchi C., Pirovano M., Trentini C., Padovano G., Colombo M., Cereda D., Tinti L., Scanziani S., Gasparini S., Bogliun G., Ferrarese C., Beghi E., Romeo A., Viri M., Specchio L., Trivisano M., Mecarelli O., Zarabla A., Capovilla G., Beccaria F., Sasanelli F., Galimberti C. A., Tartara E., Zamponi N., Cappanera S., Aguglia U., Ferlazzo E., La Neve A., Luisi C., Pontrelli G., Cantisani A. T., De Maria G., and Albanese Y.

Abstract

Objective: To assess frequency, types, and mechanisms of comorbidities in people with epilepsy and verify their association with disease features and outcome. Methods: This cohort study was performed in 13 Italian epilepsy centers with nationwide distribution and accurate records. Eligible patients were children and adults diagnosed before December 31, 2005, and followed for a minimum of 10 years. Two pairs of raters independently reviewed patients’ records and classified each comorbidity. In case of disagreement, a third reviewer made the final decision. Comorbidities were classified according to type (organ/system) and underlying mechanism (causal, shared risk factors, chance association). Comorbidity types and mechanisms were described in the entire sample and according to epilepsy prognostic patterns (sustained remission, relapsing-remitting course, no remission). Results: Of 1006 included patients, 266 (26.4%) had at least one comorbidity. The most common were developmental/perinatal (7.5% of cases), psychiatric (6.2%), cardiovascular (5.3%), and endocrine/metabolic (3.8%). Among 408 reported comorbidities, the underlying mechanisms were, in decreasing order, chance association (42.2%), shared risk factors (31.1%), and causal (26.7%). Psychiatric diseases were present in 13.3% of patients with no remission, 5.9% of patients with relapsing-remitting course, and 4.8% of patients with sustained remission (p =.016). The corresponding numbers for endocrine/metabolic diseases were respectively, 9.6%, 3.4%, and 2.9% (p =.013); for respiratory diseases were 3.6%,.3%, and.3% (p =.001), and for urogenital diseases were 3.6%,.7%, and 1.6% (p =.048). The association of endocrine/metabolic, psychiatric, and respiratory comorbidities with epilepsy prognosis was confirmed by multivariable analysis adjusted for the main demographic and clinical variables, with patients with these comorbidities showing a lower probability of achieving remission. Signifi

Published
2021

3. Comorbidities in patients with epilepsy: Frequency, mechanisms and effects on long-term outcome

Author

Giussani G., Bianchi E., Beretta S., Carone D., DiFrancesco J. C., Stabile A., Zanchi C., Pirovano M., Trentini C., Padovano G., Colombo M., Cereda D., Tinti L., Scanziani S., Gasparini S., Bogliun G., Ferrarese C., Beghi E., Romeo A., Viri M., Specchio L., Trivisano M., Mecarelli O., Zarabla A., Capovilla G., Beccaria F., Sasanelli F., Galimberti C. A., Tartara E., Zamponi N., Cappanera S., Aguglia U., Ferlazzo E., La Neve A., Luisi C., Pontrelli G., Cantisani A. T., De Maria G., Albanese Y., Giussani, G, Bianchi, E, Beretta, S, Carone, D, Difrancesco, J, Stabile, A, Zanchi, C, Pirovano, M, Trentini, C, Padovano, G, Colombo, M, Cereda, D, Tinti, L, Scanziani, S, Gasparini, S, Bogliun, G, Ferrarese, C, Beghi, E, Romeo, A, Viri, M, Specchio, L, Trivisano, M, Mecarelli, O, Zarabla, A, Capovilla, G, Beccaria, F, Sasanelli, F, Galimberti, C, Tartara, E, Zamponi, N, Cappanera, S, Aguglia, U, Ferlazzo, E, La Neve, A, Luisi, C, Pontrelli, G, Cantisani, A, De Maria, G, and Albanese, Y

Subjects
Adult, medicine.medical_specialty, comorbiditie, mechanism, Comorbidity, Disease, Urogenital diseases, Cohort Studies, Epilepsy, Risk Factors, Internal medicine, cohort study, Humans, Endocrine system, Medicine, In patient, Child, business.industry, Mental Disorders, medicine.disease, Neurology, epilepsy, Neurology (clinical), Sustained remission, business, prognosi, Cohort study
Abstract

Objective: To assess frequency, types, and mechanisms of comorbidities in people with epilepsy and verify their association with disease features and outcome. Methods: This cohort study was performed in 13 Italian epilepsy centers with nationwide distribution and accurate records. Eligible patients were children and adults diagnosed before December 31, 2005, and followed for a minimum of 10years. Two pairs of raters independently reviewed patients’ records and classified each comorbidity. In case of disagreement, a third reviewer made the final decision. Comorbidities were classified according to type (organ/system) and underlying mechanism (causal, shared risk factors, chance association). Comorbidity types and mechanisms were described in the entire sample and according to epilepsy prognostic patterns (sustained remission, relapsing-remitting course, no remission). Results: Of 1006 included patients, 266 (26.4%) had at least one comorbidity. The most common were developmental/perinatal (7.5% of cases), psychiatric (6.2%), cardiovascular (5.3%), and endocrine/metabolic (3.8%). Among 408 reported comorbidities, the underlying mechanisms were, in decreasing order, chance association (42.2%), shared risk factors (31.1%), and causal (26.7%). Psychiatric diseases were present in 13.3% of patients with no remission, 5.9% of patients with relapsing-remitting course, and 4.8% of patients with sustained remission (p=.016). The corresponding numbers for endocrine/metabolic diseases were respectively, 9.6%, 3.4%, and 2.9% (p=.013); for respiratory diseases were 3.6%,.3%, and.3% (p=.001), and for urogenital diseases were 3.6%,.7%, and 1.6% (p=.048). The association of endocrine/metabolic, psychiatric, and respiratory comorbidities with epilepsy prognosis was confirmed by multivariable analysis adjusted for the main demographic and clinical variables, with patients with these comorbidities showing a lower probability of achieving remission. Significance: Comorbidities in epilepsy are not uncommon and reflect differing underlying mechanisms. Psychiatric, endocrine/metabolic, and respiratory disorders are associated with a worse long-term epileptological outcome.

Published
2021

8. Does screening for adverse effects improve health outcomes in epilepsy? A randomized trial

Author

Franco, V., Canevini, M. P., De Sarro, G., Fattore, C., Fedele, G., Galimberti, C. A., Gatti, G., La Neve, A., Rosati, E., Specchio, L. M., Striano, S., Striano, P, Tinuper, P., Perucca, E., Franco V., Canevini M.P., De Sarro G., Fattore C., Fedele G., Galimberti C.A., Gatti G., La Neve A., Rosati E., Specchio L.M., Striano S., Tinuper P., and Perucca E.

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, Adolescent, Drug-Related Side Effects and Adverse Reactions, Follow-Up Studie, law.invention, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Quality of life, Randomized controlled trial, Retrospective Studie, law, Internal medicine, Anticonvulsant, medicine, Humans, Mass Screening, Prospective Studies, Adverse effect, Mass screening, Aged, Retrospective Studies, Epilepsy, business.industry, Anticonvulsants, Female, Follow-Up Studies, Middle Aged, Treatment Outcome, medicine.disease, Clinical trial, Prospective Studie, 030104 developmental biology, Observational study, Neurology (clinical), Drug-Related Side Effects and Adverse Reaction, business, 030217 neurology & neurosurgery, Adverse drug reaction, Human, Cohort study
Abstract

ObjectiveTo determine whether systematic screening for adverse effects of antiepileptic drugs (AEDs) reduces toxicity burden and improves health-related quality of life in patients with epilepsy.MethodsConsecutive patients with uncontrolled seizures aged ≥16 years and a high Adverse Event Profile (AEP) score were randomized to 2 groups and followed up for 18 months at 11 referral centers. AEP scores were made available to treating physicians at all visits in the intervention group, but not in the control group. Co–primary endpoints were changes in AEP scores and Quality of Life Inventory for Epilepsy-31 (QOLIE–31) scores.ResultsOf 809 enrolled patients able to complete the AEP questionnaire, 222 had AEP scores ≥45 and were randomized to the intervention (n = 111) or control group (n = 111). A total of 206 patients completed the 18-month follow-up. Compared with baseline, AEP scores decreased on average by 7.2% at 6 months, 12.1% at 12 months, and 13.8% at 18 months in the intervention group (p < 0.0001), and by 7.7% at 6 months, 9.2% at 12 months, and 12.0% at 18 months in controls (p < 0.0001). QOLIE-31 scores also improved from baseline to final visit, with a mean 20.7% increase in the intervention group and a mean 24.9% increase in the control group (p < 0.0001). However, there were no statistically significant differences in outcomes between groups for the 2 co–primary variables.ConclusionsContrary to findings from a previous study, systematic screening for adverse effects of AEDs using AEP scores did not lead to a reduced burden of toxicity over usual physician treatment.Italian Medicines Agency (AIFA) identifierFARM52K2WM_003.Clinicaltrials.gov identifierNCT03939507 (registered retrospectively in 2019; the study was conducted during the 2006–2009 period and registration of clinical trials was not a widely established practice when this study was initiated).Classification of evidenceThis study provides Class II evidence that the additional collection of formal questionnaires regarding adverse effects of AEDs does not reduce toxicity burden over usual physician treatment.

Published
2019

9. Prognostic patterns and predictors in epilepsy: A multicentre study (PRO-LONG)

Author

Beghi, E, Beretta, S, Carone, D, Zanchi, C, Bianchi, E, Pirovano, M, Trentini, C, Padovano, G, Colombo, M, Cereda, D, Scanziani, S, Giussani, G, Gasparini, S, Bogliun, G, Ferrarese, C, PRO-LONG Study Group: Romeo, A, Viri, M, Lodi, M, Specchio, L, Trivisano, M, Mecarelli, O, Zarabla, A, Capovilla, G, Beccaria, F, Sasanelli, F, Andrea Galimberti, C, Tartara, E, Zamponi, N, Cappanera, S, Aguglia, U, Pustorino, G, Ferlazzo, E, La Neve, A, Luisi, C, Pontrelli, G, Basso, P, Pozzi, A, Cantisani, At, Papetti, R, De Maria, G, Di Francesco, J, Albanese, J., Beghi, E, Beretta, S, Carone, D, Zanchi, C, Bianchi, E, Pirovano, M, Trentini, C, Padovano, G, Colombo, M, Cereda, D, Scanziani, S, Giussani, G, Gasparini, S, Bogliun, G, and Ferrarese, C

Subjects
Neurological signs, Adult, Male, Pediatrics, medicine.medical_specialty, Complete data, Neurology, Adolescent, prognostic patterns, Early remission, Electroencephalography, long-term prognosi, 03 medical and health sciences, Epilepsy, Psychiatric comorbidity, Young Adult, 0302 clinical medicine, Recurrence, Risk Factors, prognostic pattern, medicine, Humans, long-term prognosis, Child, 030304 developmental biology, Aged, epilepsy, prognostic predictors, 0303 health sciences, medicine.diagnostic_test, business.industry, Remission Induction, Infant, Middle Aged, medicine.disease, Prognosis, prognostic predictor, Drug Utilization, Psychiatry and Mental health, Child, Preschool, Etiology, Surgery, Anticonvulsants, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

ObjectivesTo describe the long-term prognosis of epilepsy and prognostic patterns in a large cohort of newly diagnosed patients and identify prognostic factors.MethodsStudy participants were 13 Italian epilepsy centres with accessible records dating back to 2005 or earlier, complete data on seizure outcome and treatments, precise epilepsy diagnosis, and follow-up of at least 10 years. Records were examined by trained neurology residents for demographics, seizure characteristics, neurological signs, psychiatric comorbidity, first electroencephalogram (EEG) and MRI/CT, epilepsy type and aetiology, antiepileptic drugs (AEDs), and 1-year, 2-year, 5-year and 10-year seizure remissions. Five predefined prognostic patterns were identified: early remission, late remission, relapsing-remitting course, worsening course and no remission. Prognostic factors were assessed using multinomial logistic regression models.Results1006 children and adults were followed for 17 892 person-years (median 16 years; range 10–57). During follow-up, 923 patients (91.7%) experienced 1-year remission. 2-year, 5-year and 10-year remissions were present in 89.5%, 77.1% and 44.4% of cases. 5-year remission was associated with one to two seizures at diagnosis, generalised epilepsy, no psychiatric comorbidity, and treatment with one or two AEDs during follow-up. 10-year remission was associated with one or two AEDs. The most common prognostic pattern was relapsing-remitting (52.2%), followed by early remission (24.5%). 8.3% of cases experienced no remission. Predictors of a relapsing-remitting course were ConclusionsFew seizures at diagnosis, generalised epilepsy and no psychiatric comorbidity predict early or late seizure freedom in epilepsy. Achieving remission at any time after the diagnosis does not exclude further relapses.

Published
2019

10. Use of plasma levels for antiepileptic drug monitoring in clinical practice

Author

Beghi E., Trevisan D., Tognoni G., Arrigoni S., Bogliun G., Bongiovanni L. G., Borgheresi S., Benedetti M., Beretta G., Bianchi A., Bocci U., Buti D., Buttiglione M., Cagnin G., Cardinali C., Chiodelli G., Ciampi C., Colangelo U., Crespi V., De Fanti C. A., Ferri P., Galeone D., Giuliani G., La Neve A., Lenti C., Lepore V., Lini M., Ortenzi A., Perniola T., Piattella L., Porazzi D., Quattrini A., Rottoli M. R., Silvestri R., Specchio L. M., Spinogatti F., Toso V., Trizio M., Zaccara G., Zagnoni P., Zamponi N., Zolo P., and Gruppo Collaborativo per lo Studio dell'Epilessia

Published
1992
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15. Defining the electroclinical phenotype and outcome of PCDH19-related epilepsy: A multicenter study

Author

Trivisano, M., Pietrafusa, N., Terracciano, A., Marini, C., Mei, D., Darra, F., Accorsi, P., Battaglia, Domenica Immacolata, Caffi, L., Canevini, M. P., Cappelletti, S., Cesaroni, E., de Palma, L., Costa, Paolo, Cusmai, R., Giordano, Liliana, Ferrari, A., Freri, E., Fusco, L., Granata, T., Martino, T., Mastrangelo, Marica, Bova, S. M., Parmeggiani, L., Ragona, F., Sicca, F., Striano, P., Specchio, L. M., Tondo, I., Zambrelli, E., Zamponi, N., Zanus, C., Boniver, C., Vecchi, M., Avolio, C., Dalla Bernardina, B., Bertini, Enrico Silvio, Guerrini, R., Vigevano, F., Specchio, N., Battaglia D. (ORCID:0000-0003-0491-4021), Costa P., Giordano L., Mastrangelo M., Bertini E., Trivisano, M., Pietrafusa, N., Terracciano, A., Marini, C., Mei, D., Darra, F., Accorsi, P., Battaglia, Domenica Immacolata, Caffi, L., Canevini, M. P., Cappelletti, S., Cesaroni, E., de Palma, L., Costa, Paolo, Cusmai, R., Giordano, Liliana, Ferrari, A., Freri, E., Fusco, L., Granata, T., Martino, T., Mastrangelo, Marica, Bova, S. M., Parmeggiani, L., Ragona, F., Sicca, F., Striano, P., Specchio, L. M., Tondo, I., Zambrelli, E., Zamponi, N., Zanus, C., Boniver, C., Vecchi, M., Avolio, C., Dalla Bernardina, B., Bertini, Enrico Silvio, Guerrini, R., Vigevano, F., Specchio, N., Battaglia D. (ORCID:0000-0003-0491-4021), Costa P., Giordano L., Mastrangelo M., and Bertini E.

Abstract

Objective: PCDH19-related epilepsy is an epileptic syndrome with infantile onset, characterized by clustered and fever-induced seizures, often associated with intellectual disability (ID) and autistic features. The aim of this study was to analyze a large cohort of patients with PCDH19-related epilepsy and better define the epileptic phenotype, genotype-phenotype correlations, and related outcome-predicting factors. Methods: We retrospectively collected genetic, clinical, and electroencephalogram (EEG) data of 61 patients with PCDH19-related epilepsy followed at 15 epilepsy centers. All consecutively performed EEGs were analyzed, totaling 551. We considered as outcome measures the development of ID, autistic spectrum disorder (ASD), and seizure persistence. The analyzed variables were the following: gender, age at onset, age at study, genetic variant, fever sensitivity, seizure type, cluster occurrence, status epilepticus, EEG abnormalities, and cognitive and behavioral disorders. Receiver operating characteristic curve analysis was performed to evaluate the age at which seizures might decrease in frequency. Results: At last follow-up (median = 12 years, range = 1.9-42.1 years), 48 patients (78.7%) had annual seizures/clusters, 13 patients (21.3%) had monthly to weekly seizures, and 12 patients (19.7%) were seizure-free for ≥2 years. Receiver operating characteristic analysis showed a significant decrease of seizure frequency after the age of 10.5 years (sensitivity = 81.0%, specificity = 70.0%). Thirty-six patients (59.0%) had ID and behavioral disturbances. ASD was present in 31 patients. An earlier age at epilepsy onset emerged as the only predictive factor for ID (P = 0.047) and ASD (P = 0.014). Conversely, age at onset was not a predictive factor for seizure outcome (P = 0.124). Significance: We found that earlier age at epilepsy onset is related to a significant risk for ID and ASD. Furthermore, long-term follow-up showed that after the age of 10 years, seizur

Published
2018

16. Italian Frontotemporal Dementia Network (FTD Group-SINDEM): sharing clinical and diagnostic procedures in Frontotemporal Dementia in Italy

Author

Borroni, B, Turrone, R, Galimberti, D, Nacmias, B, Alberici, A, Benussi, A, Caffarra, P, Caltagirone, C, Cappa, S, Frisoni, G, Ghidoni, R, Marra, C, Padovani, A, Rainero, I, Scarpini, E, Silani, V, Sorbi, S, Tagliavini, F, Tremolizzo, L, Bruni, A, Agosta, F, Alberoni, M, Appollonio, I, Arighi, A, Avanzi, S, Baglio, F, Benussi, L, Bianchetti, A, Binetti, G, Bonanni, L, Bottacchi, E, Bruno, G, Canevelli, M, Canu, E, Cerami, C, Chiari, A, Conti, M, Costa, A, Costa, M, Cotelli, M, Cupidi, C, Daniele, A, D'Anna, S, de Caro, M, De Togni, L, Dell'Osa, M, Di Stefano, F, Ferrarese, C, Ferrari, C, Filastro, F, Floris, G, Franceschi, M, Gennuso, M, Ghidoni, E, Giordana, M, Gragnaniello, D, Grimaldi, L, Lanari, A, Le Pira, F, Lombardi, G, Lorusso, S, Ludovico, L, Luzzi, S, Magnani, G, Manfredi, L, Marano, P, Marcone, A, Marrosu, M, Martorana, A, Mascia, M, Masullo, C, Mauri, M, Mazzone, A, Mela, A, Merlo, P, Micheli, A, Milia, A, Mina, C, Montella, P, Mura, G, Murru, M, Nemni, R, Paci, C, Pantieri, R, Panza, F, Parnetti, L, Perini, M, Pettenati, C, Piccininni, M, Piccoli, T, Pilia, G, Pinessi, L, Piras, M, Realmuto, S, Ricca, I, Rizzetti, M, Rozzini, L, Rubino, E, Sambati, L, Seripa, D, Siano, P, Sinforiani, E, Sorrentino, G, Specchio, L, Stracciari, A, Susani, E, Talarico, G, Tartaglione, B, Tessitore, A, Thomas, A, Tiezzi, A, Tiraboschi, P, Tognoni, G, Tondelli, M, Trebbastoni, A, Turla, M, Ursini, F, Valluzzi, F, Vista, M, Zannino, G, Zanusso, G, Borroni B., Turrone R., Galimberti D., Nacmias B., Alberici A., Benussi A., Caffarra P., Caltagirone C., Cappa S. F., Frisoni G. B., Ghidoni R., Marra C., Padovani A., Rainero I., Scarpini E., Silani V., Sorbi S., Tagliavini F., Tremolizzo L., Bruni A. C., Agosta F., Alberoni M., Appollonio I., Arighi A., Avanzi S., Baglio F., Benussi L., Bianchetti A., Binetti G., Bonanni L., Bottacchi E., Bruno G., Canevelli M., Canu E., Cerami C., Chiari A., Conti M. Z., Costa A., Costa M., Cotelli M., Cotelli M. S., Cupidi C., Daniele A., D'Anna S., de Caro M. F., De Togni L., Dell'Osa M. T., Di Stefano F., Ferrarese C., Ferrari C., Filastro F., Floris G., Franceschi M., Gennuso M., Ghidoni E., Giordana M. T., Gragnaniello D., Grimaldi L., Lanari A., Le Pira F., Lombardi G., Lorusso S., Ludovico L., Luzzi S., Magnani G., Manfredi L. G., Marano P., Marcone A., Marrosu M. G., Martorana A., Mascia M. G., Masullo C., Mauri M., Mazzone A., Mela A., Merlo P., Micheli A., Milia A., Mina C., Montella P., Mura G., Murru M. R., Nemni R., Paci C., Pantieri R., Panza F., Parnetti L., Perini M., Pettenati C., Piccininni M., Piccoli T., Pilia G., Pinessi L., Piras M. R., Realmuto S., Ricca I., Rizzetti M. C., Rozzini L., Rubino E., Sambati L., Seripa D., Siano P., Sinforiani E., Sorrentino G., Specchio L. M., Stracciari A., Susani E., Talarico G., Tartaglione B., Tessitore A., Thomas A., Tiezzi A., Tiraboschi P., Tognoni G., Tondelli M., Trebbastoni A., Turla M., Ursini F., Valluzzi F., Vista M., Zannino G., Zanusso G., Borroni, B, Turrone, R, Galimberti, D, Nacmias, B, Alberici, A, Benussi, A, Caffarra, P, Caltagirone, C, Cappa, S, Frisoni, G, Ghidoni, R, Marra, C, Padovani, A, Rainero, I, Scarpini, E, Silani, V, Sorbi, S, Tagliavini, F, Tremolizzo, L, Bruni, A, Agosta, F, Alberoni, M, Appollonio, I, Arighi, A, Avanzi, S, Baglio, F, Benussi, L, Bianchetti, A, Binetti, G, Bonanni, L, Bottacchi, E, Bruno, G, Canevelli, M, Canu, E, Cerami, C, Chiari, A, Conti, M, Costa, A, Costa, M, Cotelli, M, Cupidi, C, Daniele, A, D'Anna, S, de Caro, M, De Togni, L, Dell'Osa, M, Di Stefano, F, Ferrarese, C, Ferrari, C, Filastro, F, Floris, G, Franceschi, M, Gennuso, M, Ghidoni, E, Giordana, M, Gragnaniello, D, Grimaldi, L, Lanari, A, Le Pira, F, Lombardi, G, Lorusso, S, Ludovico, L, Luzzi, S, Magnani, G, Manfredi, L, Marano, P, Marcone, A, Marrosu, M, Martorana, A, Mascia, M, Masullo, C, Mauri, M, Mazzone, A, Mela, A, Merlo, P, Micheli, A, Milia, A, Mina, C, Montella, P, Mura, G, Murru, M, Nemni, R, Paci, C, Pantieri, R, Panza, F, Parnetti, L, Perini, M, Pettenati, C, Piccininni, M, Piccoli, T, Pilia, G, Pinessi, L, Piras, M, Realmuto, S, Ricca, I, Rizzetti, M, Rozzini, L, Rubino, E, Sambati, L, Seripa, D, Siano, P, Sinforiani, E, Sorrentino, G, Specchio, L, Stracciari, A, Susani, E, Talarico, G, Tartaglione, B, Tessitore, A, Thomas, A, Tiezzi, A, Tiraboschi, P, Tognoni, G, Tondelli, M, Trebbastoni, A, Turla, M, Ursini, F, Valluzzi, F, Vista, M, Zannino, G, Zanusso, G, Borroni B., Turrone R., Galimberti D., Nacmias B., Alberici A., Benussi A., Caffarra P., Caltagirone C., Cappa S. F., Frisoni G. B., Ghidoni R., Marra C., Padovani A., Rainero I., Scarpini E., Silani V., Sorbi S., Tagliavini F., Tremolizzo L., Bruni A. C., Agosta F., Alberoni M., Appollonio I., Arighi A., Avanzi S., Baglio F., Benussi L., Bianchetti A., Binetti G., Bonanni L., Bottacchi E., Bruno G., Canevelli M., Canu E., Cerami C., Chiari A., Conti M. Z., Costa A., Costa M., Cotelli M., Cotelli M. S., Cupidi C., Daniele A., D'Anna S., de Caro M. F., De Togni L., Dell'Osa M. T., Di Stefano F., Ferrarese C., Ferrari C., Filastro F., Floris G., Franceschi M., Gennuso M., Ghidoni E., Giordana M. T., Gragnaniello D., Grimaldi L., Lanari A., Le Pira F., Lombardi G., Lorusso S., Ludovico L., Luzzi S., Magnani G., Manfredi L. G., Marano P., Marcone A., Marrosu M. G., Martorana A., Mascia M. G., Masullo C., Mauri M., Mazzone A., Mela A., Merlo P., Micheli A., Milia A., Mina C., Montella P., Mura G., Murru M. R., Nemni R., Paci C., Pantieri R., Panza F., Parnetti L., Perini M., Pettenati C., Piccininni M., Piccoli T., Pilia G., Pinessi L., Piras M. R., Realmuto S., Ricca I., Rizzetti M. C., Rozzini L., Rubino E., Sambati L., Seripa D., Siano P., Sinforiani E., Sorrentino G., Specchio L. M., Stracciari A., Susani E., Talarico G., Tartaglione B., Tessitore A., Thomas A., Tiezzi A., Tiraboschi P., Tognoni G., Tondelli M., Trebbastoni A., Turla M., Ursini F., Valluzzi F., Vista M., Zannino G., and Zanusso G.

Abstract

In the prospect of improved disease management and future clinical trials in Frontotemporal Dementia, it is desirable to share common diagnostic procedures. To this aim, the Italian FTD Network, under the aegis of the Italian Neurological Society for Dementia, has been established. Currently, 85 Italian Centers involved in dementia care are part of the network. Each Center completed a questionnaire on the local clinical procedures, focused on (1) clinical assessment, (2) use of neuroimaging and genetics; (3) support for patients and caregivers; (4) an opinion about the prevalence of FTD. The analyses of the results documented a comprehensive clinical and instrumental approach to FTD patients and their caregivers in Italy, with about 1,000 newly diagnosed cases per year and 2,500 patients currently followed by the participating Centers. In analogy to other European FTD consortia, future aims will be devoted to collect data on epidemiology of FTD and its subtypes and to provide harmonization of procedures among Centers.

Published
2015

17. Long-term applicability of the new ILAE definition of epilepsy. Results from the PRO-LONG study

Author

Beretta, S, Carone, D, Zanchi, C, Bianchi, E, Pirovano, M, Trentini, C, Padovano, G, Colombo, M, Cereda, D, Scanziani, S, Giussani, G, Gasparini, S, Bogliun, G, Ferrarese, C, Beghi, E, Romeo, A, Viri, M, Lodi, M, Specchio, L, Trivisano, M, Mecarelli, O, Zarabla, A, Capovilla, G, Beccaria, F, Sasanelli, F, Andrea Galimberti, C, Tartara, E, Zamponi, N, Cappanera, S, Aguglia, U, Pustorino, G, Ferlazzo, E, La Neve, A, Luisi, C, Pontrelli, G, Basso, P, Pozzi, A, Cantisani, A, Papetti, R, De Maria, G, Difrancesco, J, Albanese, Y, Beretta, Simone, Carone, Davide, Zanchi, Clara, Bianchi, Elisa, Pirovano, Marta, Trentini, Claudia, Padovano, Giada, Colombo, Matteo, Cereda, Diletta, Scanziani, Sofia, Giussani, Giorgia, Gasparini, Sara, Bogliun, Graziella, Ferrarese, Carlo, Beghi, Ettore, Romeo, Antonino, Viri, Maurizio, Lodi, Monica, Specchio, Luigi, Trivisano, Marina, Mecarelli, Oriano, Zarabla, Alessia, Capovilla, Giuseppe, Beccaria, Francesca, Sasanelli, Francesco, Andrea Galimberti, Carlo, Tartara, Elena, Zamponi, Nelia, Cappanera, Silvia, Aguglia, Umberto, Pustorino, Giuseppe, Ferlazzo, Edoardo, La Neve, Angela, Luisi, Concetta, Pontrelli, Giuseppe, Basso, Pierfranco, Pozzi, Annalisa, Cantisani, Anna Teresa, Papetti, Rossella, De Maria, Giovanni, DiFrancesco, Jacopo C., Albanese, Yasmin, Beretta, S, Carone, D, Zanchi, C, Bianchi, E, Pirovano, M, Trentini, C, Padovano, G, Colombo, M, Cereda, D, Scanziani, S, Giussani, G, Gasparini, S, Bogliun, G, Ferrarese, C, Beghi, E, Romeo, A, Viri, M, Lodi, M, Specchio, L, Trivisano, M, Mecarelli, O, Zarabla, A, Capovilla, G, Beccaria, F, Sasanelli, F, Andrea Galimberti, C, Tartara, E, Zamponi, N, Cappanera, S, Aguglia, U, Pustorino, G, Ferlazzo, E, La Neve, A, Luisi, C, Pontrelli, G, Basso, P, Pozzi, A, Cantisani, A, Papetti, R, De Maria, G, Difrancesco, J, Albanese, Y, Beretta, Simone, Carone, Davide, Zanchi, Clara, Bianchi, Elisa, Pirovano, Marta, Trentini, Claudia, Padovano, Giada, Colombo, Matteo, Cereda, Diletta, Scanziani, Sofia, Giussani, Giorgia, Gasparini, Sara, Bogliun, Graziella, Ferrarese, Carlo, Beghi, Ettore, Romeo, Antonino, Viri, Maurizio, Lodi, Monica, Specchio, Luigi, Trivisano, Marina, Mecarelli, Oriano, Zarabla, Alessia, Capovilla, Giuseppe, Beccaria, Francesca, Sasanelli, Francesco, Andrea Galimberti, Carlo, Tartara, Elena, Zamponi, Nelia, Cappanera, Silvia, Aguglia, Umberto, Pustorino, Giuseppe, Ferlazzo, Edoardo, La Neve, Angela, Luisi, Concetta, Pontrelli, Giuseppe, Basso, Pierfranco, Pozzi, Annalisa, Cantisani, Anna Teresa, Papetti, Rossella, De Maria, Giovanni, DiFrancesco, Jacopo C., and Albanese, Yasmin

Abstract

Objective: The new epilepsy definition adopted by the International League Against Epilepsy (ILAE) includes patients with one unprovoked seizure with a probability of further seizures, similar to the general recurrence risk after two unprovoked seizures, occurring in a 10-year period. Long-term follow-up of patients diagnosed after a single seizure is needed to assess the applicability of the new epilepsy definition in clinical practice. Methods: Patients with newly diagnosed epilepsy were recruited retrospectively with a minimum follow-up of 10 years. Patients were stratified in two groups depending on the occurrence of one (new definition, ND) or two or more unprovoked seizures (traditional definition, TD) at the time of epilepsy diagnosis and compared for disease characteristics and factors predicting seizure recurrence. The primary outcome was the occurrence of a new unprovoked seizure during follow-up in the ND group. The secondary outcome was the achievement of an early remission in both groups. Results: Among 1,006 patients with newly diagnosed epilepsy, 152 (15.1%) were diagnosed after a single seizure. Compared to patients diagnosed using the TD, patients diagnosed according to the ND showed a higher proportion of subjects with an abnormal neurologic examination (19.9% vs. 13.7%, p = 0.0504) and with focal seizures (69.3% vs. 60.4%, p = 0.0021). The two samples differed in the presence of at least one of the factors predicting seizure recurrence (focal seizures or abnormal findings in at least one among the following: neurologic examination, electroencephalography [EEG], and neuroimaging) (94.6% vs. 89.1%, p = 0.0376). Long-term recurrence in patients diagnosed with the new definition was 83.6% at 10 years and 89.1% at 15 years. The probability of early remission did not differ between the two groups. Significance: Our results support the applicability of the new epilepsy definition in clinical practice. Individual patient characteristics and a personalized

Published
2017

18. Italian Frontotemporal Dementia Network (FTD Group-SINDEM): sharing clinical and diagnostic procedures in Frontotemporal Dementia in Italy

Author

Borroni B., Turrone R., Galimberti D., Nacmias B., Alberici A., Benussi A., Caffarra P., Caltagirone C., Cappa S. F., Frisoni G. B., Ghidoni R., Marra C., Padovani A., Rainero I., Scarpini E., Silani V., Sorbi S., Tagliavini F., Tremolizzo L., Bruni A. C., Agosta F., Alberoni M., Appollonio I., Arighi A., Avanzi S., Baglio F., Benussi L., Bianchetti A., Binetti G., Bonanni L., Bottacchi E., Bruno G., Canevelli M., Canu E., Cerami C., Chiari A., Conti M. Z., Costa A., Costa M., Cotelli M., Cotelli M. S., Cupidi C., Daniele A., D'Anna S., de Caro M. F., De Togni L., Dell'Osa M. T., Di Stefano F., Ferrarese C., Ferrari C., Filastro F., Floris G., Franceschi M., Gennuso M., Ghidoni E., Giordana M. T., Gragnaniello D., Grimaldi L., Lanari A., Le Pira F., Lombardi G., Lorusso S., Ludovico L., Luzzi S., Magnani G., Manfredi L. G., Marano P., Marcone A., Marrosu M. G., Martorana A., Mascia M. G., Masullo C., Mauri M., Mazzone A., Mela A., Merlo P., Micheli A., Milia A., Mina C., Montella P., Mura G., Murru M. R., Nemni R., Paci C., Pantieri R., Panza F., Parnetti L., Perini M., Pettenati C., Piccininni M., Piccoli T., Pilia G., Pinessi L., Piras M. R., Realmuto S., Ricca I., Rizzetti M. C., Rozzini L., Rubino E., Sambati L., Seripa D., Siano P., Sinforiani E., Sorrentino G., Specchio L. M., Stracciari A., Susani E., Talarico G., Tartaglione B., Tessitore A., Thomas A., Tiezzi A., Tiraboschi P., Tognoni G., Tondelli M., Trebbastoni A., Turla M., Ursini F., Valluzzi F., Vista M., Zannino G., Zanusso G., Piccoli, T, B. Borroni, R. Turrone, D. Galimberti, B. Nacmia, A. Alberici, A. Benussi, P. Caffarra, C. Caltagirone, S. F. Cappa, G. B. Frisoni, R. Ghidoni, C. Marra, A. Padovani, I. Rainero, E. Scarpini, V. Silani, S. Sorbi, F. Tagliavini, L. Tremolizzo, A. C. Bruni, The FTD Group-SINDEM, Borroni, B, Turrone, R, Galimberti, D, Nacmias, B, Alberici, A, Benussi, A, Caffarra, P, Caltagirone, C, Cappa, Sf, Frisoni, Gb, Ghidoni, R, Marra, C, Padovani, A, Rainero, I, Scarpini, E, Silani, V, Sorbi, S, Tagliavini, F, Tremolizzo, L, Bruni, Ac, The FTD, Group-SINDEM, Agosta, F, Cappa, S, Frisoni, G, Bruni, A, Alberoni, M, Appollonio, I, Arighi, A, Avanzi, S, Baglio, F, Benussi, L, Bianchetti, A, Binetti, G, Bonanni, L, Bottacchi, E, Bruno, G, Canevelli, M, Canu, E, Cerami, C, Chiari, A, Conti, M, Costa, A, Costa, M, Cotelli, M, Cupidi, C, Daniele, A, D'Anna, S, de Caro, M, De Togni, L, Dell'Osa, M, Di Stefano, F, Ferrarese, C, Ferrari, C, Filastro, F, Floris, G, Franceschi, M, Gennuso, M, Ghidoni, E, Giordana, M, Gragnaniello, D, Grimaldi, L, Lanari, A, Le Pira, F, Lombardi, G, Lorusso, S, Ludovico, L, Luzzi, S, Magnani, G, Manfredi, L, Marano, P, Marcone, A, Marrosu, M, Martorana, A, Mascia, M, Masullo, C, Mauri, M, Mazzone, A, Mela, A, Merlo, P, Micheli, A, Milia, A, Mina, C, Montella, P, Mura, G, Murru, M, Nemni, R, Paci, C, Pantieri, R, Panza, F, Parnetti, L, Perini, M, Pettenati, C, Piccininni, M, Pilia, G, Pinessi, L, Piras, M, Realmuto, S, Ricca, I, Rizzetti, M, Rozzini, L, Rubino, E, Sambati, L, Seripa, D, Siano, P, Sinforiani, E, Sorrentino, G, Specchio, L, Stracciari, A, Susani, E, Talarico, G, Tartaglione, B, Tessitore, A, Thomas, A, Tiezzi, A, Tiraboschi, P, Tognoni, G, Tondelli, M, Trebbastoni, A, Turla, M, Ursini, F, Valluzzi, F, Vista, M, Zannino, G, and Zanusso, G

Subjects
Counseling, Male, medicine.medical_specialty, Neurology, Network, Frontotemporal dementia, Frontotemporal lobar degeneration, Genetics, Survey, Aged, Aged, 80 and over, Caregivers, Female, Frontotemporal Dementia, Humans, Italy, Prevalence, Community Networks, Information Dissemination, Medicine (all), 2708, Neurology (clinical), Psychiatry and Mental Health, Dermatology, ddc:616.89, Caregivers/psychology, Epidemiology, mental disorders, medicine, 80 and over, Dementia, Disease management (health), Psychiatry, MED/26 - NEUROLOGIA, Italian network, FRONTO Temporal dementia, business.industry, Frontotemporal dementia, Frontotemporal lobar degeneration, Network, Survey, Genetics, Counseling, General Medicine, Frontotemporal Dementia/diagnosis/epidemiology, medicine.disease, Clinical trial, Settore MED/26 - Neurologia, Neurosurgery, business
Abstract

In the prospect of improved disease management and future clinical trials in Frontotemporal Dementia, it is desirable to share common diagnostic procedures. To this aim, the Italian FTD Network, under the aegis of the Italian Neurological Society for Dementia, has been established. Currently, 85 Italian Centers involved in dementia care are part of the network. Each Center completed a questionnaire on the local clinical procedures, focused on (1) clinical assessment, (2) use of neuroimaging and genetics; (3) support for patients and caregivers; (4) an opinion about the prevalence of FTD. The analyses of the results documented a comprehensive clinical and instrumental approach to FTD patients and their caregivers in Italy, with about 1,000 newly diagnosed cases per year and 2,500 patients currently followed by the participating Centers. In analogy to other European FTD consortia, future aims will be devoted to collect data on epidemiology of FTD and its subtypes and to provide harmonization of procedures among Centers.

Published
2014

19. Patterns of prescription of antiepileptic drugs in patients with refractory epilepsy at tertiary referral centres in Italy

Author

Malerba A., Ciampa C., De Fazio S., Fattore C., Frassine B., La Neve A., Pellacani S., Specchio L. M., Tiberti A., Perucca E., LICCHETTA, LAURA, TINUPER, PAOLO, Malerba A., Ciampa C., De Fazio S., Fattore C., Frassine B., La Neve A., Pellacani S., Specchio L.M., Tiberti A., Tinuper P., and Perucca E.

Subjects
Adult, Male, Topiramate, medicine.medical_specialty, Pediatrics, Adolescent, medicine.medical_treatment, Population, Lamotrigine, Young Adult, Epilepsy, medicine, Humans, antiepileptic drugs, Child, Psychiatry, education, Referral and Consultation, Aged, Aged, 80 and over, education.field_of_study, business.industry, Infant, Carbamazepine, Middle Aged, medicine.disease, Prescriptions, Anticonvulsant, Italy, Neurology, Child, Preschool, Epilepsy syndromes, Anticonvulsants, Drug Therapy, Combination, Female, Neurology (clinical), Levetiracetam, business, medicine.drug
Abstract

Summary Purpose To evaluate the pattern of prescription of antiepileptic drugs (AEDs) and other medications in a representative population of patients with refractory epilepsy attending tertiary referral centres in Italy. Methods Descriptive analysis of data obtained at baseline from 933 adults and 191 children with refractory epilepsy enrolled consecutively in an observational study at 11 tertiary referral centres in Italy. Multivariate logistic regression analysis was used to assess predictors of utilization of the most commonly prescribed AEDs. Results Polytherapy was used in 79% of adults and 75% of children, with over one-third of adults and children being prescribed ≥3 AEDs. In adults, the most commonly used AEDs were levetiracetam (35%), carbamazepine (34%) and lamotrigine (30%). In children, valproic acid was by far the most commonly used AED (46%), followed by carbamazepine (27%), topiramate (21%), and phenobarbital (20%). The most common AED in partial epilepsy was carbamazepine (331 out of 893 patients, 37%), followed by levetiracetam (33%) and lamotrigine (26%). In generalized or undetermined epilepsies, the AEDs most commonly used were valproic acid (139 out of 223 patients, 62%), lamotrigine (33%) and levetiracetam (28%). Second generation AEDs were prescribed in 81% of adults and 54% of children. Comedications used for indications other than epilepsy were used by 32% of adults and 17% of children. Conclusions Prescription patterns were consistent with current evidence about the spectrum of efficacy of individual AEDs in different epilepsy syndromes. The high prevalence of polytherapy, including combinations of three or more AEDs, is a cause for concern.

Published
2010

20. Psychiatric events in epilepsy

Author

Cornaggia, Cesare Maria, Beghi, Massimiliano, Beghi, Ettore, Cornaggia, C. M., Airoldi, L., Beghi, M., Bogliun, G., Brambilla, E., Fiordelli, E., Mascarini, A., Moltrasio, L., Primati, C., Hauser, W. A., Loeber, J. N., De Boer, H., Thorbecke, R., Steuernagel, E., Wolf, P., Sonnen, A. E. H., Severi, S., Zolo, P., Specchio, L. M., Specchio, N., Pasolini, M. P., Antonini, L., Aguglia, U., Russo, C., Gambardella, A., Giubergia, S., Zagnoni, P. G., Cosottini, Mirco, Zaccara, G., Trio, R., Pisani, F., Russo, M., Oteri, G., Cavestro, C. E., Tonini, C., Avanzini, G., Arienti, F., Defanti, C. A., Tartara, A., Manni, R., Castelnuovo, G., Murelli, R., Galimberti, C. A., Zanotta, N., Di Viesti, P., Zarrelli, M., Apollo, F., Runge, U., de Krom, M. C. T. F. M., van Heijden, C., Griet, J., Brown, S. W., Coyle, H., Lopez Lima, J. M., Beleza, P., Ferreira, E., Talvik, T., Beilmann, A., Belousova, E., Levart, T., Zupancic, N., Gromov, S., Lipatova, L. V., Mikhailov, V., Cornaggia, C, Beghi, M, Beghi, E, and Rest, 1

Subjects
Adult, Male, medicine.medical_specialty, Neurology, Adolescent, Referral, Population, Clinical Neurology, Comorbidity, Anxiety, Epilepsy, medicine, Humans, epilepsy, psychiatry, Occupations, Psychiatry, Prospective cohort study, education, Depression (differential diagnoses), education.field_of_study, Depression, business.industry, Mental Disorders, Case-control study, General Medicine, Case-control, medicine.disease, Psychiatric, Case-Control Studies, Female, Follow-Up Studies, Hospitalization, Socioeconomic Factors, Neurology (clinical), MED/25 - PSICHIATRIA, Case–control, business
Abstract

Psychiatric events are thought to be more frequent in people with epileptic seizures than in the general population. However, inter-ictal psychiatric events attributable to epilepsy remain controversial. The aim of the present study was to evaluate the occurrence of psychiatric events in a population of fairly unselected patients with epilepsy and in the general population, and the correlation between psychiatric complaints and selected demographic and disease characteristics. The survey was part of a multicentre prospective cohort study of everyday life risks conducted in eight European countries and comparing referral children and adults with epilepsy referred to secondary/tertiary centers to age- and sex-matched non-epileptic controls. Nine hundred and fifty-one patients with epilepsy and 909 controls were studied. Each patient and his/her control received a diary to record any accident or illness, with severity, circumstances, causes, consequences, and (for the cases) the possible relation to a seizure. The follow-up period ranged between 1 and 2 years. Fifty-eight psychiatric events occurred in 25 patients (2.6%) and 88 in 19 controls (2.1%). Housewives (9.3%) and unemployed persons (4.1%) were mostly affected. 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. © 2007 British Epilepsy Association.

Published
2007

21. Accidents in Patients with Epilepsy: Types, Circumstances, and Complications: A European Cohort Study

Author

van den Broek, Mariska, Beghi, Ettore, Cornaggia, C. M., Beghi, M., Bogliun, G., Fiordelli, E., Airoldi, L., Frigeni, B., Mascarini, A., Mapelli, L., Moltrasio, L., Biagi, E., Hauser, W. A., Loeber, J. N., Thorbecke, R., Di Viesti, P., Zarrelli, M., Apollo, F., Giovanni Rotondo, S., Steuernagel, E., Wolf, P., Sonnen, A. E. H., Specchio, L. M., Specchio, N., Boati, E., Defanti, C. A., Pinto, P., Breviario, E., Pasolini, M. P., Antonini, L., Aguglia, U., Russo, C., Gambardella, A., Giubergia, S., Zagnoni, P., Cosottini, Mirco, Zaccara, G., Pisani, F., Oteri, G., Cavestro, C. E., David, A., Tonini, C., Avanzini, G., Arienti, F., Tartara, A., Manni, R., Castelnovo, G., Murelli, R., Galimberti, C. A., Zanotta, N., Runge, U., Dekrom, M. C. T. F. M., Vanheijden, C., Griet, J., van denBroek, M. W. C., Brown, S. W., Coyle, H., Edge, Nr Alderley, Lopes Lima, J. M., Beleza, P., Ferreira, E., Talvik, T., Beilmann, A., Belousova, E., Nikanorowa, M., Ravnik, I. M., Levart, T., Zupancic, N., Gromov, S., Lipatova, L. V., Mikhailov, V., Van den Broek, M, Beghi, E, and Cornaggia, C

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Adolescent, Poison control, Cohort Studies, Epilepsy, Risk Factors, Injury prevention, Accidents, Occupational, Humans, Medicine, Prospective Studies, Preschool, Child, Prospective cohort study, Injuries, business.industry, epilepsy, complications, types, circumstances, Accidents, Accidents, Home, Child, Preschool, Europe, Female, Follow-Up Studies, Hospitalization, Patient Acceptance of Health Care, Wounds and Injuries, Neurology, Neurology (clinical), medicine.disease, Occupational, Relative risk, Cohort, Home, business, Risk assessment, Cohort study
Abstract

Purpose: To investigate the risk of accidents in a cohort of patients with epilepsy and in matched nonepilepsy controls. by type, circumstances, and complications. Methods: A total of 95 1 children and adults with idiopathic, cryptogenic, or remote symptomatic epilepsy and 904 matched controls seen in secondary and tertiary centers in eight European Countries (England. Estonia, Germany, Italy, the Netherlands, Portugal. Russia. and Slovenia) were followed Lip prospectively for 17,484 and 17.206 person-months and asked to report any accident requiring medical attention. its site, and complications. Risk assessment was done by using actuarial methods, relative risks (RRs). and 95% confidence intervals (CIs). Results: During the study period, 199 (21%) patients and 123 (14%) controls reported all accident (p < 0.0001); 24% were seizure related. The Cumulative probability of accidents at 12 and 24 months was 17 and 27% in the cases and 12 and 17% in the controls. The risk was highest for concussions (RR, 2.6; 95% Cl, 1.2-5.8), abrasions (RR, 2.1; 95% Cl, 1.1-4.0), and Wounds (RR, 1.9; Cl, 1.2-3.1). Domestic accidents prevailed in both groups, followed by street and work accidents, and were more common among cases. Compared with controls, patients with epilepsy reported more hospitalization, complications, and medical action. Disease characteristics associated with an increased risk of accidents included generalized epilepsy (conclusions), active epilepsy, and at least monthly seizures (abrasions). Most risks decreased, becoming nonsignificant after excluding, seizure-related events. 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

Published
2004

22. Family study of epilepsy in first degree relatives: data from the Italian Episcreen Study

Author

Bianchi, A., Viaggi, S., Chiossi, E., Giallonardo, Anna Teresa, Montagnini, A., Berloffa, S., Cogo, S., Vignoli, A., Saltarelli, A., Zambreli, E., Cusani Visconti, E., Beffa Negrini, P., Cardinale, F., Viri, M., Croce, C., Fittipaldi, F., Di Bonaventura, C., Muzzi, F., Izzi, F., Pachatz, C., Cilio, R., Del Priore, D., Piacenti, A., Pulitano, P., Sartori, I., Politini, L., Zanotta, N., Tripodi, M., Gattuso, C., Riguzzi, P., Cerullo, A., Bisulli, F., Meo, R., Caravaglios, G., Buzzi, G., Magnani, F., Panozzo, M. T., Garofalo, P., Mastrangelo, M., Pastorino, G., Zucca, C., Radice, L., Spreafico, G., Laneve, A., Mazzeo, M. R., Specchio, L. M., Vetro, A., Amodeo, G., Calzolari, S., De Marco, P., Piccinelli, P., Balottin, U., Romano, V., Paciello, M., Girelli, L., Germano, M., Jussi, M. I., Lazzaro, A. T., Bellini, A., Moretti, P., Minicucci, F., Comi, G., Cavaliere, B., Scarpa, P., Gessaroli, M., Rasi, F., Tripaldelli, B., Gigante, N., Interno, S., Cocuzza, D., Pavone, L., Vanadia, F., Consolo, F., D'Agostino, V., Rasmini, P., Besana, D., Paci, C., Buongarzone, M. P., Onofri, M., De Maria, G., Parola, S., Antonini, L., Vecchi, M., Boniver, C., Pezzella, F., Colicchio, G., Vaccario, M. L., Mazza, S., Brinciotti, Mario, Benedetti, P., Acquafondata, C., Battaglia, D., Guzzetta, F., Panzetta, A., and Bacchi, O.

Subjects
Adult, Male, Proband, Pediatrics, medicine.medical_specialty, Adolescent, Offspring, Clinical Neurology, Epilepsy, medicine, Humans, epilepsy, family history, standardised morbidity ratio, Family, First-degree relatives, Family history, Child, Aged, business.industry, Infant, Newborn, Infant, General Medicine, Middle Aged, medicine.disease, Italy, Neurology, Child, Preschool, Etiology, Lower prevalence, Female, Observational study, Neurology (clinical), business
Abstract

Objective: To evaluate the family history of epilepsy in first degree relatives of probands with epilepsy. Methods: A sample of 10787 patients with epilepsy with complete information about first degree relatives (parents, siblings and offspring) was selected from the database of the Episcreen Project, the largest Italian observational study on epilepsy. Family history was assessed by: (1) prevalence estimates of epilepsy among proband's relatives, (2) modified cumulative risks (MCR), adjusted using proband's age as censoring time in life tables, (3) standardised morbidity ratios (SMR), using a sub-group of symptomatic epilepsies as control group. Results: Patients (9.1%) had a family history of epilepsy. The overall prevalence of epilepsy among first degree relatives was 2.6%. Idiopathic generalised epilepsies had the highest prevalence (5.3%). Cryptogenetic epilepsies had a lower prevalence (2.1%) than idiopathic epilepsies, but higher then symptomatic epilepsies (1.5%), both in generalised and focal forms (3.8% vs. 2.0% and 1.8% vs. 1.3%). A similar tendency was detected using MCR and SMR, with the higher values of risks/ratios for idiopathic and generalised epilepsies. Probands with idiopathic generalised epilepsies were highly concordant with respect to their relatives' type of epilepsy. Considering other strata factors, risks were higher in proband's epilepsies with an onset less then 14 years of age, while sex played no definite role in differentiating the family history. Conclusions: The Episcreen model permits a variety of stratification factors to measure family risk, including age at onset, epilepsy localisation and aetiology with a large sample of more than 10000 probands and 1065/40544 relatives affected and classified.

Published
2003

23. Progressive myoclonus epilepsy in Down syndrome patients with dementia

Author

D'Orsi, G., Specchio, L. M., Apulian Study Group on Senile Myoclonic Epilepsy: d'Orsi, G, Specchio, Lm, Carapelle, E, Di Claudio MT, Lopopolo, A, Pacillo, F, Pascarella, Mg, Trivisano, M, Falcone, M, Grilli, FIORENZA GERMANA, Salatto, P, De Stefano, G, Meola, F, Seripa, D, Demaio, V, Minervini, M, Ottaviano, S, Francavilla, T, La Neve, A, and Luisi, C.

Subjects
Adult, Male, medicine.medical_specialty, Down syndrome, Pediatrics, Neurology, PSEN2 gene, Myoclonic Jerk, Apolipoprotein E4, Video-EEG/polygraphy, tau Proteins, Progressive myoclonus epilepsy, Neuropsychological Tests, PSEN 1 gene, Progressive, Myoclonic Epilepsies, medicine, Dementia, Humans, APP gene, Psychiatry, CSF biomarkers, Aged, Cerebral atrophy, Amyloid beta-Peptides, Brain, Electroencephalography, Alzheimer's disease, Middle Aged, medicine.disease, Myoclonic Epilepsies, Progressive, Brain Waves, Magnetic Resonance Imaging, Peptide Fragments, APOE, Senile myoclonic epilepsy, Down Syndrome, Female, Follow-Up Studies, Mutation, Myoclonic epilepsy, Neurology (clinical), medicine.symptom, Psychology, Myoclonus
Abstract

This study aimed to elucidate the natural history of senile myoclonic epilepsy, a type of myoclonic epilepsy associated with Alzheimer’s disease in adult Down syndrome patients. Twelve Down syndrome patients over the age of 40 years with myoclonic epilepsy and Alzheimer’s disease underwent clinical, neuropsychological, neurophysiological, and neuroradiological study. The kariotypes, APOE polymorphisms, all exons in the PSEN1 and PSEN2 genes, and exons 16 and 17 in the APP gene were determined for all patients. CSF Aβ42, p-tau181, and t-tauAg were determined for two patients. Three main stages appeared during the course of the syndrome. The first stage was characterized by dementia onset (mean age: 51 ± 6.6 years), diffuse EEG abnormalities during sleep, and cerebral atrophy determined using neuroimaging. During the second stage, myoclonic epilepsy manifested (mean age: 51.4 ± 7.2 years) with myoclonic jerks time-locked to diffuse epileptiform abnormalities upon awakening, which was controlled with antiepileptic drugs. During the third stage (mean age: 54.8 ± 7.6 years), myoclonic seizures were replaced with nonepileptic myoclonus, and cerebellar signs, severe dementia, and photosensitivity developed. All patients showed complete trisomy 21. Mutations were ruled out on the APP, PSEN1, and PSEN2 genes, and APOE analysis revealed e3/e3 homozygosity. CSF biomarkers showed a decrease in Aβ42 and an increase in p-tau181. The natural history of senile myoclonic epilepsy is consistent with progressive myoclonus epilepsy. Chromosome 21 is implicated in its pathophysiology; however, other genetic and/or environmental risk factors cannot be excluded. The absence of the APOE type 4 allele could predict its progression.

Published
2014

24. Morbidity in Patients with Epilepsy: Type and Complications: A European Cohort Study

Author

van den Broek, M, Beghi, E, Cornaggia, C, Hauser, W, Loeber, J, Thorbecke, R, Sonnen, A, Specchio, L, Specchio, N, Boati, E, Defanti, C, Pinto, P, Breviario, E, Pasolini, M, Antonini, L, Aguglia, U, Russo, C, Gambardella, A, Giubergia, S, Zagnoni, P, Cosottini, M, Zaccara, G, Pisani, F, Oteri, G, Cavestro, M, David, A, Tonini, C, Avanzini, G, Arienti, F, Beghi, M, Bogliun, G, Fiordelli, E, Frigeni, B, Mascarini, A, Mapelli, L, Moltrasio, L, Biagi, E, Tartara, A, Manni, R, Castelnovo, G, Murelli, R, Galimberti, C, Zanotta, N, Di Viesti, P, Zarrelli, M, Apollo, F, Giovanni Rotondo, S, Steuernagel, E, Wolf, P, Runge, U, de Krom, M, van Heijden, C, Griet, J, Brown, S, Coyle, H, Edge, N, Lopes-Lima, J, Beleza, P, Ferreira, E, Talvik, T, Beilmann, A, Belousova, E, Nikanorowa, M, Ravnik, I, Levart, T, Zupancic, N, Gromov, S, Lipatova, L, Mikhailov, V, van den Broek M., Beghi E., Cornaggia C. M., Hauser W. A., Loeber J. N., Thorbecke R., Sonnen A. E. H., Specchio L. M., Specchio N., Boati E., Defanti C. A., Pinto P., Breviario E., Pasolini M. P., Antonini L., Aguglia U., Russo C., Gambardella A., Giubergia S., Zagnoni P., Cosottini M., Zaccara G., Pisani F., Oteri G., Cavestro M. C. E., David A., Tonini C., Avanzini G., Arienti F., Beghi M., Bogliun G., Fiordelli E., Frigeni B., Mascarini A., Mapelli L., Moltrasio L., Biagi E., Tartara A., Manni R., Castelnovo G., Murelli R., Galimberti C. A., Zanotta N., Di Viesti P., Zarrelli M., Apollo F., Giovanni Rotondo S., Steuernagel E., Wolf P., Runge U., de Krom M. C. T. F. M., van Heijden C., Griet J., van den Broek M. W. C., Brown S. W., Coyle H., Edge N. A., Lopes-Lima J. M., Beleza P., Ferreira E., Talvik T., Beilmann A., Belousova E., Nikanorowa M., Ravnik I. M., Levart T., Zupancic N., Gromov S., Lipatova L. V., Mikhailov V., van den Broek, M, Beghi, E, Cornaggia, C, Hauser, W, Loeber, J, Thorbecke, R, Sonnen, A, Specchio, L, Specchio, N, Boati, E, Defanti, C, Pinto, P, Breviario, E, Pasolini, M, Antonini, L, Aguglia, U, Russo, C, Gambardella, A, Giubergia, S, Zagnoni, P, Cosottini, M, Zaccara, G, Pisani, F, Oteri, G, Cavestro, M, David, A, Tonini, C, Avanzini, G, Arienti, F, Beghi, M, Bogliun, G, Fiordelli, E, Frigeni, B, Mascarini, A, Mapelli, L, Moltrasio, L, Biagi, E, Tartara, A, Manni, R, Castelnovo, G, Murelli, R, Galimberti, C, Zanotta, N, Di Viesti, P, Zarrelli, M, Apollo, F, Giovanni Rotondo, S, Steuernagel, E, Wolf, P, Runge, U, de Krom, M, van Heijden, C, Griet, J, Brown, S, Coyle, H, Edge, N, Lopes-Lima, J, Beleza, P, Ferreira, E, Talvik, T, Beilmann, A, Belousova, E, Nikanorowa, M, Ravnik, I, Levart, T, Zupancic, N, Gromov, S, Lipatova, L, Mikhailov, V, van den Broek M., Beghi E., Cornaggia C. M., Hauser W. A., Loeber J. N., Thorbecke R., Sonnen A. E. H., Specchio L. M., Specchio N., Boati E., Defanti C. A., Pinto P., Breviario E., Pasolini M. P., Antonini L., Aguglia U., Russo C., Gambardella A., Giubergia S., Zagnoni P., Cosottini M., Zaccara G., Pisani F., Oteri G., Cavestro M. C. E., David A., Tonini C., Avanzini G., Arienti F., Beghi M., Bogliun G., Fiordelli E., Frigeni B., Mascarini A., Mapelli L., Moltrasio L., Biagi E., Tartara A., Manni R., Castelnovo G., Murelli R., Galimberti C. A., Zanotta N., Di Viesti P., Zarrelli M., Apollo F., Giovanni Rotondo S., Steuernagel E., Wolf P., Runge U., de Krom M. C. T. F. M., van Heijden C., Griet J., van den Broek M. W. C., Brown S. W., Coyle H., Edge N. A., Lopes-Lima J. M., Beleza P., Ferreira E., Talvik T., Beilmann A., Belousova E., Nikanorowa M., Ravnik I. M., Levart T., Zupancic N., Gromov S., Lipatova L. V., and Mikhailov V.

Abstract

Purpose: To investigate the risk of illnesses in a cohort of patients with epilepsy and in matched nonepilepsy controls, by type and complications. Methods: A total of 951 children and adults with idiopathic, cryptogenic, or remote symptomatic epilepsy and 904 matched controls seen in secondary and tertiary centers in eight European countries (England, Estonia, Germany, Italy, the Netherlands, Portugal, Russia, Slovenia) were followed prospectively for 17,484 and 17,206 person-months and asked to report any spontaneous complaint requiring medical attention (illness), its type and complications (hospitalization, absence from work or school, medical action). Risk assessment was done by actuarial methods, relative risks (RR), and 95% confidence intervals (CIs). Results: During the study period 644 patients (68%) and 504 controls (56%) reported an illness (p<0.0001); 30% were seizure related. The cumulative probability of illness at 12 and 24 months was 49 and 86% in the cases and 39 and 75% in the controls (p<0.0001). The largest differences regarded disorders affecting the nervous system (NS) (RR, 3.3; 95% CI, 2.3-4.2) and ear, nose, and throat (ENT) (RR, 1.3; 95% CI, 1.0-1.6). In patients with epilepsy, an NS illness was more likely to be followed by hospital admission, work absence, or medical intervention. All risks were significantly reduced after excluding seizure-related events. 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

Published
2004

25. Accidents in patients with epilepsy: types, circumstances, and complications: a European cohort study

Author

van den Broek, M, Beghi, E, Cornaggia, C, Beghi, M, Bogliun, G, Fiordelli, E, Airoldi, L, Frigeni, B, Mascarini, A, Mapelli, L, Moltrasio, L, Biagi, E, Hauser, W, Loeber, J, Thorbecke, R, Di Viesti, P, Zarrelli, M, Apollo, F, Giovanni Rotondo, S, Steuernagel, E, Wolf, P, Sonnen, A, Specchio, L, Specchio, N, Boati, E, Defanti, C, Pinto, P, Breviario, E, Pasolini, M, Antonini, L, Aguglia, U, Russo, C, Gambardella, A, Giubergia, S, Zagnoni, P, Cosottini, M, Zaccara, G, Pisani, F, Oteri, G, Cavestro, C, David, A, Tonini, C, Avanzini, G, Arienti, F, Tartara, A, Manni, R, Castelnovo, G, Murelli, R, Galimberti, C, Zanotta, N, Runge, U, Dekrom, M, Vanheijden, C, Griet, J, van denBroek, M, Brown, S, Coyle, H, Edge, N, Lopes-Lima, J, Beleza, P, Ferreira, E, Talvik, T, Beilmann, A, Belousova, E, Nikanorowa, M, Ravnik, I, Levart, T, Zupancic, N, Gromov, S, Lipatova, L, Mikhailov, V, van den Broek M., Beghi E., Cornaggia C. M., Beghi M., Bogliun G., Fiordelli E., Airoldi L., Frigeni B., Mascarini A., Mapelli L., Moltrasio L., Biagi E., Hauser W. A., Loeber J. N., Thorbecke R., Di Viesti P., Zarrelli M., Apollo F., Giovanni Rotondo S., Steuernagel E., Wolf P., Sonnen A. E. H., Specchio L. M., Specchio N., Boati E., Defanti C. A., Pinto P., Breviario E., Pasolini M. P., Antonini L., Aguglia U., Russo C., Gambardella A., Giubergia S., Zagnoni P., Cosottini M., Zaccara G., Pisani F., Oteri G., Cavestro C. E., David A., Tonini C., Avanzini G., Arienti F., Tartara A., Manni R., Castelnovo G., Murelli R., Galimberti C. A., Zanotta N., Runge U., deKrom M. C. T. F. M., vanHeijden C., Griet J., van denBroek M. W. C., Brown S. W., Coyle H., Edge N. A., Lopes-Lima J. M., Beleza P., Ferreira E., Talvik T., Beilmann A., Belousova E., Nikanorowa M., Ravnik I. M., Levart T., Zupancic N., Gromov S., Lipatova L. V., Mikhailov V., van den Broek, M, Beghi, E, Cornaggia, C, Beghi, M, Bogliun, G, Fiordelli, E, Airoldi, L, Frigeni, B, Mascarini, A, Mapelli, L, Moltrasio, L, Biagi, E, Hauser, W, Loeber, J, Thorbecke, R, Di Viesti, P, Zarrelli, M, Apollo, F, Giovanni Rotondo, S, Steuernagel, E, Wolf, P, Sonnen, A, Specchio, L, Specchio, N, Boati, E, Defanti, C, Pinto, P, Breviario, E, Pasolini, M, Antonini, L, Aguglia, U, Russo, C, Gambardella, A, Giubergia, S, Zagnoni, P, Cosottini, M, Zaccara, G, Pisani, F, Oteri, G, Cavestro, C, David, A, Tonini, C, Avanzini, G, Arienti, F, Tartara, A, Manni, R, Castelnovo, G, Murelli, R, Galimberti, C, Zanotta, N, Runge, U, Dekrom, M, Vanheijden, C, Griet, J, van denBroek, M, Brown, S, Coyle, H, Edge, N, Lopes-Lima, J, Beleza, P, Ferreira, E, Talvik, T, Beilmann, A, Belousova, E, Nikanorowa, M, Ravnik, I, Levart, T, Zupancic, N, Gromov, S, Lipatova, L, Mikhailov, V, van den Broek M., Beghi E., Cornaggia C. M., Beghi M., Bogliun G., Fiordelli E., Airoldi L., Frigeni B., Mascarini A., Mapelli L., Moltrasio L., Biagi E., Hauser W. A., Loeber J. N., Thorbecke R., Di Viesti P., Zarrelli M., Apollo F., Giovanni Rotondo S., Steuernagel E., Wolf P., Sonnen A. E. H., Specchio L. M., Specchio N., Boati E., Defanti C. A., Pinto P., Breviario E., Pasolini M. P., Antonini L., Aguglia U., Russo C., Gambardella A., Giubergia S., Zagnoni P., Cosottini M., Zaccara G., Pisani F., Oteri G., Cavestro C. E., David A., Tonini C., Avanzini G., Arienti F., Tartara A., Manni R., Castelnovo G., Murelli R., Galimberti C. A., Zanotta N., Runge U., deKrom M. C. T. F. M., vanHeijden C., Griet J., van denBroek M. W. C., Brown S. W., Coyle H., Edge N. A., Lopes-Lima J. M., Beleza P., Ferreira E., Talvik T., Beilmann A., Belousova E., Nikanorowa M., Ravnik I. M., Levart T., Zupancic N., Gromov S., Lipatova L. V., and Mikhailov V.

Abstract

Purpose: To investigate the risk of accidents in a cohort of patients with epilepsy and in matched nonepilepsy controls, by type, circumstances, and complications. Methods: A total of 951 children and adults with idiopathic, cryptogenic, or remote symptomatic epilepsy and 904 matched controls seen in secondary and tertiary centers in eight European countries (England, Estonia, Germany, Italy, the Netherlands, Portugal, Russia, and Slovenia) were followed up prospectively for 17,484 and 17,206 person-months and asked to report any accident requiring medical attention, its site, and complications. Risk assessment was done by using actuarial methods, relative risks (RRs), and 95% confidence intervals (CIs). Results: During the study period, 199 (21%) patients and 123 (14%) controls reported an accident (p < 0.0001); 24% were seizure related. The cumulative probability of accidents at 12 and 24 months was 17 and 27% in the cases and 12 and 17% in the controls. The risk was highest for concussions (RR, 2.6; 9.5% CI, 1.2-5.8), abrasions (RR, 2.1; 95% CI, 1.1-4.0), and wounds (RR, 1.9; CI, 1.2-3.1). Domestic accidents prevailed in both groups, followed by street and work accidents, and were more common among cases. Compared with controls, patients with epilepsy reported more hospitalization, complications, and medical action. Disease characteristics associated with an increased risk of accidents included generalized epilepsy (concussions), active epilepsy, and at least monthly seizures (abrasions). Most risks decreased, becoming nonsignificant after excluding seizure-related events. 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.

Published
2004

26. Determinants of health-related quality of life in pharmacoresistant epilepsy: results from a large multicenter study of consecutively enrolled patients using validated quantitative assessments

Author

Luoni C., Canevini M. P., De Sarro G., Fattore C., Galimberti C. A., Gatti G., La Neve A., Muscas G., Specchio L. M., Striano S., Perucca E., Baruzzi A., SOPHIE study group, BISULLI, FRANCESCA, TINUPER, PAOLO, Luoni C., Bisulli F., Canevini M.P., De Sarro G., Fattore C., Galimberti C.A., Gatti G., La Neve A., Muscas G., Specchio L.M., Striano S., Perucca E., Baruzzi A., Tinuper P., and SOPHIE study group.

Subjects
Depression, Adverse event profile, Pharmacoresistance, humanities, Antiepileptic drug
Abstract

PURPOSE: To evaluate the relative contribution of demographic and epilepsy-related variables, depressive symptoms, and adverse effects (AEs) of antiepileptic drugs (AEDs) to health-related quality of life (HRQOL) in adults with pharmacoresistant epilepsy. METHODS: Individuals with epilepsy whose seizures failed to respond to at least one AED were enrolled consecutively at 11 tertiary referral centers. HRQOL was assessed by the Quality of Life in Epilepsy Inventory-31 (QOLIE-31), AEs by the Adverse Event Profile (AEP), and depressive symptoms by the Beck Depression Inventory-II (BDI-II). Multivariate linear regression models were used to identify variables associated with QOLIE-31 total score and subscale scores. KEY FINDINGS: Of 933 enrolled individuals aged 16 years or older, 809 (87%) were able to complete the self-assessment instruments and were included in the analysis. Overall, 61% of the variance in QOLIE-31 scores was explained by the final model. The strongest predictors of HRQOL were AEP total scores (β = -0.451, p < 0.001) and BDI-II scores (β = -0.398, p < 0.001). These factors were also the strongest predictors of scores in each of the seven QOLIE-31 subscales. Other predictors of HRQOL were age (β = -0.060, p = 0.008), lack of a driving license (β = -0.053, p = 0.018), pharmacoresistance grade, with higher HRQOL in individuals who had failed only one AED (β = 0.066, p = 0.004), and location of the enrolling center. Epilepsy-related variables (seizure frequency, occurrence of tonic-clonic seizures, age of epilepsy onset, disease duration) and number of AEDs had no significant predictive value on HRQOL. The AEP total score was the strongest negative predictor of HRQOL in the subgroup of 362 patients without depressive symptoms (BDI-II score

Published
2011

28. Characteristics of a large population of patients with refractory epilepsy attending tertiary referral centers in Italy

Author

Alexandre V. J.r., Capovilla G., Fattore C., Franco V., Gambardella A., Guerrini R., La Briola F., Ladogana M., Rosati E., Specchio L. M., Striano S., Perucca E., LICCHETTA, LAURA, BISULLI, FRANCESCA, TINUPER, PAOLO, Alexandre V. Jr., Capovilla G., Fattore C., Franco V., Gambardella A., Guerrini R., La Briola F., Ladogana M., Rosati E., Specchio L.M., Striano S., Perucca E., Bisulli F., Tinuper P., (on behalf of the SOPHIE Study Group), Alexandre V., Jr, Capovilla, G, Fattore, C, Franco, V, Gambardella, A, Guerrini, R, La Briola, F, Ladogana, M, Rosati, E, Specchio, Lm, Striano, Salvatore, and Perucca, E.

Subjects
Adult, Aged, 80 and over, Male, Epilepsy, Adolescent, Epidemiology, Community Health Centers, Syndrome, Middle Aged, Treatment Outcome, Italy, Clinical feature, Drug resistance, Prevalence, Humans, Anticonvulsants, Drug Therapy, Combination, Female, Prospective Studies, Child, Referral and Consultation, Aged
Abstract

The characteristics of 1,124 consecutive adults and children with refractory epilepsy attending 11 tertiary referral centers in Italy were investigated at enrollment into a prospective observational study. Among 933 adults (age 16-86 years), the most common syndromes were symptomatic (43.7%) and cryptogenic (39.0%) focal epilepsies, followed by idiopathic (8.1%) and cryptogenic/symptomatic generalized (6.2%) epilepsies. The most common syndrome among 191 children was symptomatic focal epilepsy (35.1%), followed by cryptogenic focal (18.8%), cryptogenic/symptomatic generalized (18.3%), undetermined whether focal or generalized (16.8%), and idiopathic generalized (7.3%). Primarily and secondarily generalized tonic-clonic seizures were reported in 27.8% of adults and 16.8% of children. The most commonly reported etiologies were mesial temporal sclerosis (8.0%) and disorders of cortical development (6.2%) in adults, and disorders of cortical development (14.7%) and nonprogressive encephalopathies (6.8%) in children. More than three-fourths of subjects in both age groups were on antiepileptic drug (AED) polytherapy.

Published
2010

29. Comprehensive educational plan for patients with epilepsy and comorbidity (EDU-COM): A pragmatic randomised trial

Author

Beretta, S, Beghi, E, Messina, P, Gerardi, F, Pescini, F, La Licata, A, Specchio, L, Ferrara, M, Canevini, M, Turner, K, La Briola, F, Franceschetti, S, Binelli, S, Giglioli, I, Galimberti, C, Fattore, C, Zaccara, G, Tramacere, L, Sasanelli, F, Pirovano, M, Ferrarese, C, BEGHI, ETTORE, FERRARESE, CARLO, Beretta, S, Beghi, E, Messina, P, Gerardi, F, Pescini, F, La Licata, A, Specchio, L, Ferrara, M, Canevini, M, Turner, K, La Briola, F, Franceschetti, S, Binelli, S, Giglioli, I, Galimberti, C, Fattore, C, Zaccara, G, Tramacere, L, Sasanelli, F, Pirovano, M, Ferrarese, C, BEGHI, ETTORE, and FERRARESE, CARLO

Abstract

Background: The impact of educational strategies in the management of adverse treatment effects and drug interactions in adult patients with epilepsy with comorbidities remains undetermined. Objective: The EDU-COM study is a randomised, pragmatic trial investigating the effect of a patient-tailored educational plan in patients with epilepsy with comorbidity. Methods: 174 adult patients with epilepsy with chronic comorbidities, multiple-drug therapy and reporting at least one adverse treatment effect and/or drug interaction at study entry were randomly assigned to the educational plan or usual care. The primary endpoint was the number of patients becoming free from adverse treatment events and/or drug interactions after a 6-month follow-up. The number of adverse treatment events and drug interactions, health-related quality of life (HRQOL) summary score changes and the monetary costs of medical contacts and drugs were assessed as secondary outcomes. Results: The primary endpoint was met by 44.0% of patients receiving the educational plan versus 28.9% of those on usual care (p=0.0399). The control group reported a significantly higher risk not to meet successfully the primary endpoint at the end of the study: OR (95% CI) of 2.29 (1.03 to 5.09). A separate analysis on drug adverse effects and drug interactions showed that the latter were more sensitive to the effect of educational treatment. Quality of life and costs were not significantly different in the two groups. Conclusions: A patient-tailored educational strategy is effective in reducing drug-related problems (particularly drug interactions) in epilepsy patients with chronic comorbidities, without adding significant monetary costs. Registered at ClinicalTrials.gov, identifier NCT01804322, (http://www.clinicaltrials.gov)

Published
2014

30. Long-term safety and effectiveness of zonisamide in the treatment of epilepsy: a review of the literature

Author

Zaccara, Gaetano and Specchio,L M

Subjects
Neuropsychiatric Disease and Treatment
Abstract

Gaetano Zaccara1, Luigi M Specchio21Unit of Neurology, Palagi Hospital, Firenze, Italy; 2University of Foggia, Ospedali Riuniti, Foggia, ItalyAbstract: Zonisamide (ZNS) efficacy and safety in epilepsy have been demonstrated in four double-blind, placebo-controlled studies. In the present article, we examined all long-term studies performed with this drug. Nine open-label studies, in which ZNS had been administered as an add-on or as monotherapy to epileptic patients for at least 6 months, were selected for our analysis. Four outcome measures were searched. Retention of this drug after 1 year varied between 45% and 65%. The percentages of patients achieving a 50% seizure reduction, with respect to baseline, ranged between 37% and 65%. In patients with drug-resistant forms of epilepsy, the percentage of patients reaching a 6-month seizure freedom period was 9%. The percentages of patients who discontinued the experimental drug due to adverse effects ranged between 4% and 24%. Somnolence and dizziness were the most frequently reported adverse effects. Long-term studies demonstrate that ZNS has a good efficacy and tolerability profile, and support its use as adjunctive therapy for epileptic patients.Keywords: antiepileptic drugs, zonisamide, long-term treatment, review, epilepsy

Published
2009

31. CONCORDANCE OF CLINICAL FORMS OF EPILEPSY IN FAMILIES WITH SEVERAL AFFECTED MEMBERS

Author

BIANCHI A, AVANZINI G, DALLA BERNARDINA B, CANGER R, TASSINARI CA, VIGEVANO F, TIEZZI A, BUZZI G, FANI C, DEVERMANDOIS ROSSI C, ZOLO P, ANTONELLI A, BINELLI S, BUTI D, CANEVINI MP, CARULLO A, CIARMATORI C, COPPOLA G, D'ALESSANDRO P, DE FEO MR, DI DONATO S, DURISOTTI C, ROSO FILATI C, FRANCIA A, GALIMBERTI CA, GALLI R, GAROFALO P, GIOVANARDI ROSSI P, IANI C, MAIER R, MANFREDI M, MARGIOTTA N, MASSETANI R, MAZZA S, MECARELLI O, PARMEGGIANI A, RICCI S, ROCCHI R, ROMANO G, SALTARELLI A, SANTUCCI M, SIDERI G, SPECCHIO L, TARTARA A, TIACCI C., PASCOTTO, Antonio, Bianchi, A, Avanzini, G, DALLA BERNARDINA, B, Canger, R, Tassinari, Ca, Vigevano, F, Tiezzi, A, Buzzi, G, Fani, C, DEVERMANDOIS ROSSI, C, Zolo, P, Antonelli, A, Binelli, S, Buti, D, Canevini, Mp, Carullo, A, Ciarmatori, C, Coppola, G, D'Alessandro, P, DE FEO, Mr, DI DONATO, S, Durisotti, C, ROSO FILATI, C, Francia, A, Galimberti, Ca, Galli, R, Garofalo, P, GIOVANARDI ROSSI, P, Iani, C, Maier, R, Manfredi, M, Margiotta, N, Massetani, R, Mazza, S, Mecarelli, O, Parmeggiani, A, Pascotto, Antonio, Ricci, S, Rocchi, R, Romano, G, Saltarelli, A, Santucci, M, Sideri, G, Specchio, L, Tartara, A, and Tiacci, C.

Published
1993

32. Comprehensive educational plan for patients with epilepsy and comorbidity (EDU-COM): a pragmatic randomised trial

Author

Beretta, S., primary, Beghi, E., additional, Messina, P., additional, Gerardi, F., additional, Pescini, F., additional, La Licata, A., additional, Specchio, L., additional, Ferrara, M., additional, Canevini, M. P., additional, Turner, K., additional, La Briola, F., additional, Franceschetti, S., additional, Binelli, S., additional, Giglioli, I., additional, Galimberti, C. A., additional, Fattore, C., additional, Zaccara, G., additional, Tramacere, L., additional, Sasanelli, F., additional, Pirovano, M., additional, and Ferrarese, C., additional

Published
2014
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34. The THRombolysis and STatins (THRaST) study

Author

Cappellari, M, Bovi, P, Moretto, G, Zini, A, Nencini, P, Sessa, M, Furlan, M, Pezzini, A, Orlandi, G, Paciaroni, M, Tassinari, T, Procaccianti, G, Di Lazzaro, V, Bettoni, L, Gandolfo, C, Silvestrelli, G, Rasura, M, Martini, G, Melis, M, Calloni, M, Chiodo Grandi, F, Beretta, S, Guarino, M, Altavista, M, Marcheselli, S, Galletti, G, Adobbati, L, Del Sette, M, Mancini, A, Orrico, D, Monaco, S, Cavallini, A, Sciolla, R, Federico, F, Scoditti, U, Brusaferri, F, Grassa, C, Specchio, L, Bongioanni, M, Sparaco, M, Zampolini, M, Greco, G, Colombo, R, Passarella, B, Adami, A, Consoli, D, Toni, D, Toni, D., BERETTA, SIMONE, Cappellari, M, Bovi, P, Moretto, G, Zini, A, Nencini, P, Sessa, M, Furlan, M, Pezzini, A, Orlandi, G, Paciaroni, M, Tassinari, T, Procaccianti, G, Di Lazzaro, V, Bettoni, L, Gandolfo, C, Silvestrelli, G, Rasura, M, Martini, G, Melis, M, Calloni, M, Chiodo Grandi, F, Beretta, S, Guarino, M, Altavista, M, Marcheselli, S, Galletti, G, Adobbati, L, Del Sette, M, Mancini, A, Orrico, D, Monaco, S, Cavallini, A, Sciolla, R, Federico, F, Scoditti, U, Brusaferri, F, Grassa, C, Specchio, L, Bongioanni, M, Sparaco, M, Zampolini, M, Greco, G, Colombo, R, Passarella, B, Adami, A, Consoli, D, Toni, D, Toni, D., and BERETTA, SIMONE

Abstract

Objective: To assess the impact on stroke outcome of statin use in the acute phase after IV thrombolysis. Methods: Multicenter study on prospectively collected data of 2,072 stroke patients treated with IV thrombolysis. Outcome measures of efficacy were neurologic improvement (NIH Stroke Scale [NIHSS] ≤ 4 points from baseline or NIHSS = 0) and major neurologic improvement (NIHSS ≤ 8 points from baseline or NIHSS = 0) at 7 days and favorable (modified Rankin Scale [mRS] ≤ 2) and excellent functional outcome (mRS ≤ 1) at 3 months. Outcome measures of safety were 7-day neurologic deterioration (NIHSS ≥ 4 points from baseline or death), symptomatic intracerebral hemorrhage type 2 with NIHSS ≥ 4 points from baseline or death within 36 hours, and 3-month death. Results: Adjusted multivariate analysis showed that statin use in the acute phase was associated with neurologic improvement (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.26-2.25; p < 0.001), major neurologic improvement (OR 1.43, 95% CI 1.11-1.85; p = 0.006), favorable functional outcome (OR 1.63, 95% CI 1.18-2.26; p = 0.003), and a reduced risk of neurologic deterioration (OR: 0.31, 95% CI 0.19-0.53; p < 0.001) and death (OR 0.48, 95% CI 0.28-0.82; p = 0.007). Conclusion: Statin use in the acute phase of stroke after IV thrombolysis may positively influence short- and long-term outcome. © 2013 American Academy of Neurology.

Published
2013

35. Incidence and predictors of acute symptomatic seizures after stroke

Author

Beghi, E, D'Alessandro, R, Beretta, S, Consoli, D, Crespi, V, Delaj, L, Gandolfo, C, Greco, G, La Neve, A, Manfredi, M, Mattana, F, Musolino, R, Provinciali, L, Santangelo, M, Specchio, L, Zaccara, G, Ferrarese, C, BERETTA, SIMONE, FERRARESE, CARLO, Beghi, E, D'Alessandro, R, Beretta, S, Consoli, D, Crespi, V, Delaj, L, Gandolfo, C, Greco, G, La Neve, A, Manfredi, M, Mattana, F, Musolino, R, Provinciali, L, Santangelo, M, Specchio, L, Zaccara, G, Ferrarese, C, BERETTA, SIMONE, and FERRARESE, CARLO

Abstract

Objective: To assess incidence and predictors of acute symptomatic seizures in a prospective cohort of patients with first stroke. Methods: Patients with first stroke hospitalized in 31 Italian centers were recruited. Relevant demographic data, disease characteristics, and risk factors were collected. Acute symptomatic seizures (≤7 days) were recorded and correlated to age, gender, family history of epilepsy, and vascular risk factors. Results: A total of 714 patients (315 women, 399 men; age 27-97 years) were enrolled. A total of 609 (85.3%) had cerebral infarction (32 cerebral infarction with hemorrhagic transformation [CIHT]) and 105 (14.7%) primary intracerebral hemorrhage (PIH). A total of 141 (19.7%) had a large lesion (>3 cm) and 296 (41.5%) cortical involvement. Twelve patients reported family history of seizures. Forty-five patients (6.3%) presented acute symptomatic seizures, 24 with cerebral infarction (4.2%), 4 with CIHT (12.5%), and 17 (16.2%) with PIH. In multivariate analysis, compared to cerebral infarction, PIH carried the highest risk (odds ratio [OR] 7.2; 95% confidence interval [CI] 3.5-14.9) followed by CIHT (OR 2.7; 95% CI 0.8-9.6). Cortical involvement was a risk factor for PIH (OR 6.0; 95% CI 1.8-20.8) and for CI (OR 3.1; 95% CI 1.3-7.8). Hyperlipidemia (OR 0.2; 95% CI 0.03-0.8) was a protective factor for IPH. Conclusion: The incidence of acute symptomatic seizures is the highest reported in patients with first stroke with prospective follow-up. Hemorrhagic stroke and cortical lesion were independent predictors of acute symptomatic seizures. Hyperlipidemia was a protective factor for hemorrhagic stroke. Copyright © 2011 by AAN Enterprises, Inc.

Published
2011

36. The THRombolysis and STatins (THRaST) study

Author

Cappellari, M., primary, Bovi, P., additional, Moretto, G., additional, Zini, A., additional, Nencini, P., additional, Sessa, M., additional, Furlan, M., additional, Pezzini, A., additional, Orlandi, G., additional, Paciaroni, M., additional, Tassinari, T., additional, Procaccianti, G., additional, Di Lazzaro, V., additional, Bettoni, L., additional, Gandolfo, C., additional, Silvestrelli, G., additional, Rasura, M., additional, Martini, G., additional, Melis, M., additional, Calloni, M. V., additional, Chiodo-Grandi, F., additional, Beretta, S., additional, Guarino, M., additional, Altavista, M. C., additional, Marcheselli, S., additional, Galletti, G., additional, Adobbati, L., additional, Del Sette, M., additional, Mancini, A., additional, Orrico, D., additional, Monaco, S., additional, Cavallini, A., additional, Sciolla, R., additional, Federico, F., additional, Scoditti, U., additional, Brusaferri, F., additional, Grassa, C., additional, Specchio, L., additional, Bongioanni, M. R., additional, Sparaco, M., additional, Zampolini, M., additional, Greco, G., additional, Colombo, R., additional, Passarella, B., additional, Adami, A., additional, Consoli, D., additional, and Toni, D., additional

Published
2013
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37. Felbamate in therapy-resistant epilepsy: An Italian experience

Author

Avanzini, G, Canger, R, Dallabernardina, B, Vigevano, F, Aguglia, U, Albano, C, Antonini, L, Battaglia, S, Battino, D, Benna, P, Besana, D, Antonelli, C, Binelli, S, Biondi, R, Boniver, C, Buti, D, Canziani, F, Capovilla, G, Casara, G, Casazza, M, Cernibori, A, Chindemi, A, Cianchetti, C, Cilio, Mr, Coppola, G, Cremonte, M, Dagostino, V, Daniele, O, Demarco, P, Demaria, G, Dicosmo, F, Diperri, R, Durisotti, C, Elia, M, Fois, A, Fontana, E, Franceschetti, S, Gaggero, R, Galeone, D, Gallitto, Giuseppe, Gianelli, L, Rossi, Pg, Giubergia, S, Gobbi, G., Guarneri, B., La Selva, L., Lanzi, G., Laurienzo, P., Lenti, C., Lunardi, G., Magaudda, A., Mangano, S., Marchini, C., Mecarelli, O., Michelucci, R., Muscas, G. C., Musetti, L., Musolino, R., Mutani, R., Parmeggiani, A., Pascotto, A., Pasquinelli, A., Pelliccia, A., Perniola, T., Pisani, F., Porta, M., Radice, L., Ricci, G. F., Ricci, S., Romeo, A., Rozza, L., Rozzi, N., Santucci, M., Sardella, M., Sasso, E., Severi, S., Sgrò, V., Sofia, V., Specchio, L., Spreafico, R., Striano, S., Tassinari, C., Tiacci, C., Tiberti, A., Tinuper, P., Torelli, D., Tortorella, G., Valseriati, D., Veggiotti, P., Viani, F., Vignoli, A., Viri, M., Volpi, L., Zaccara, G., Zagnoni, P., Zambrino, A., Zappoli, R., Zucca, C., Zuddas, A., Bonardi, R., Jensen, P, Kwan, R., and Teoh, N.

Published
1996

38. Childhood refractory focal epilepsy following acute febrile encephalopathy

Author

Specchio, N., primary, Fusco, L., additional, Claps, D., additional, Trivisano, M., additional, Longo, D., additional, Cilio, M. R., additional, Valeriani, M., additional, Cusmai, R., additional, Cappelletti, S., additional, Gentile, S., additional, Fariello, G., additional, Specchio, L. M., additional, and Vigevano, F., additional

Published
2010
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43. Pathological gambling plus hypersexuality in restless legs syndrome: a new case.

Author

d'Orsi, Giuseppe, Demaio, Vincenzo, and Specchio, L.

Subjects
HYPERSEXUALITY, RESTLESS legs syndrome, DOPAMINE antagonists, OLDER patients, DRUG withdrawal symptoms, PRAMIPEXOLE, PARKINSON'S disease
Abstract

Emerging clinical data indicate that dopaminergic agonists used to treat restless legs syndrome may be associated with dopamine dysregulation syndrome, particularly pathological gambling. We report a new case with pathological gambling plus hypersexuality and impotence in an old patient treated with a small dose (0.18 mg daily at bedtime) of pramipexole for restless legs syndrome for 5 months. The time relationship and the resolution upon discontinuation of dopaminergic agonists suggest a causative association. Our new case confirms that restless legs syndrome patients should be cautioned about potential dopamine dysregulation syndrome coinciding with dopaminergic agonists, as it can be reversed by drug withdrawal. [ABSTRACT FROM AUTHOR]

Published
2011
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