scholarly journals Epilepsy in Down Syndrome: A Highly Prevalent Comorbidity

2021 ◽  
Vol 10 (13) ◽  
pp. 2776
Author(s):  
Miren Altuna ◽  
Sandra Giménez ◽  
Juan Fortea
Keyword(s):  
Down Syndrome ◽  
Functional Outcomes ◽  
Clinical Presentation ◽  
Late Onset ◽  
Current Knowledge ◽  
Epileptic Seizures ◽  
Myoclonic Epilepsy ◽  
Increased Risk ◽  
Number Of Individuals

Individuals with Down syndrome (DS) have an increased risk for epilepsy during the whole lifespan, but especially after age 40 years. The increase in the number of individuals with DS living into late middle age due to improved health care is resulting in an increase in epilepsy prevalence in this population. However, these epileptic seizures are probably underdiagnosed and inadequately treated. This late onset epilepsy is linked to the development of symptomatic Alzheimer’s disease (AD), which is the main comorbidity in adults with DS with a cumulative incidence of more than 90% of adults by the seventh decade. More than 50% of patients with DS and AD dementia will most likely develop epilepsy, which in this context has a specific clinical presentation in the form of generalized myoclonic epilepsy. This epilepsy, named late onset myoclonic epilepsy (LOMEDS) affects the quality of life, might be associated with worse cognitive and functional outcomes in patients with AD dementia and has an impact on mortality. This review aims to summarize the current knowledge about the clinical and electrophysiological characteristics, diagnosis and treatment of epileptic seizures in the DS population, with a special emphasis on LOMEDS. Raised awareness and a better understanding of epilepsy in DS from families, caregivers and clinicians could enable earlier diagnoses and better treatments for individuals with DS.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

scholarly journals Sleep Disorders in Adults with Down Syndrome

2021 ◽  
Vol 10 (14) ◽  
pp. 3012
Author(s):  
Sandra Giménez ◽  
Miren Altuna ◽  
Esther Blessing ◽  
Ricardo M. Osorio ◽  
Juan Fortea
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Down Syndrome ◽  
Sleep Disorders ◽  
Negative Impact ◽  
Current Knowledge ◽  
Sleep Disruption ◽  
Physical And Mental Health ◽  
Future Directions

Sleep disorders, despite being very frequent in adults with Down syndrome (DS), are often overlooked due to a lack of awareness by families and physicians and the absence of specific clinical sleep guidelines. Untreated sleep disorders have a negative impact on physical and mental health, behavior, and cognitive performance. Growing evidence suggests that sleep disruption may also accelerate the progression to symptomatic Alzheimer’s disease (AD) in this population. It is therefore imperative to have a better understanding of the sleep disorders associated with DS in order to treat them, and in doing so, improve cognition and quality of life, and prevent related comorbidities. This paper reviews the current knowledge of the main sleep disorders in adults with DS, including evaluation and management. It highlights the existing gaps in knowledge and discusses future directions to achieve earlier diagnosis and better treatment of sleep disorders most frequently found in this population.

scholarly journals A case of pneumonia and sepsis in cirrhosis as paradigm of the problems in the management of bacterial infections in cirrhosis and of the limitations of current knowledge

2013 ◽  
pp. 209-214
Author(s):  
Manuel Tufoni ◽  
Alessandra Tovoli ◽  
Caterina Maggioli ◽  
Lucia Napoli ◽  
Carmen Serena Ricci ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Hepatitis C ◽  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Bacterial Infections ◽  
Clinical Presentation ◽  
Current Knowledge ◽  
Empirical Antibiotic Therapy ◽  
Increased Risk

Bacterial infections are a major problem in the management of liver cirrhosis. They represent the first precipitating cause of death since patients with cirrhosis carry an increased risk of sepsis, sepsis-induced organ failure and death. Although the clinical presentation is often misleading, the presence of bacterial infection should always be actively searched and ruled out with certainty whenever a cirrhotic patient is admitted to the hospital with an acute clinical deterioration. Major changes in the epidemiology of bacterial infections have also occurred in the last decade making the choice of empirical antibiotic therapy a challenge. We report a paradigmatic case of a 54-year old man with hepatitis C-related cirrhosis admitted to the hospital for worsening of his ascites and onset of hepatic encephalopathy, an excellent example for the difficulties of management of sepsis in cirrhosis and the limits of current knowledge.

scholarly journals Childhood epileptic seizures imitating migraine and encephalitis

2012 ◽  
Vol 140 (9-10) ◽  
pp. 558-562
Author(s):  
Ruzica Kravljanac ◽  
Milena Djuric
Keyword(s):  
Antiepileptic Drugs ◽  
Clinical Presentation ◽  
Late Onset ◽  
Clinical Manifestations ◽  
Epileptic Seizures ◽  
Childhood Epilepsy ◽  
Visual Hallucinations ◽  
Seizure Recurrence ◽  
Acute Therapy ◽  
Epileptic Discharges

Introduction. Paroxismal events can resemble epileptic seizures, however, some epileptic seizures, especially benign occipital childhood epilepsies can imitate migraine, cycling vomiting or encephalitis. Objective. The aim of this study was evaluation of clinical and electroencephalographic (EEG) features and outcome in children with benign occipital childhood epilepsies. Methods. Investigation included 18 patients with benign occipital childhood epilepsies hospitalized in the period from 2007 to 2010. The diagnosis was based on clinical and EEG characteristics of seizures, while treatment included acute therapy for seizures and chronic antiepileptic drugs. Prognosis was analyzed in terms of neurological outcome and seizure recurrence rate. Results. Benign occipital childhood epilepsy with early onset was diagnosed in 15 children. Vegetative symptoms, mostly ictal vomiting (13), eye deviation and loss of consciousness (13) dominated in the clinical presentation. The most frequent EEG findings showed occipital epileptic discharges. Benign occipital childhood epilepsy with late onset was diagnosed in three cases. Seizures were manifested by visual hallucinations, headache and secondary generalized convulsions. All three patients were administered chronic antiepileptic drugs and had good outcome. Conclusion. In our patients, clinical manifestations of benign occipital epilepsies had some similarities with clinical features of migraine and encephalitis. It could explain misdiagnosis in some of them. Knowledge about main features and differences between each of these disorders is crucial for making appropriate diagnosis.

Senile myoclonic epilepsy of Genton: Two cases in Down syndrome with dementia and late onset epilepsy

2007 ◽  
Vol 77 (2-3) ◽  
pp. 165-168 ◽  
Author(s):  
Arielle Crespel ◽  
Victoria Gonzalez ◽  
Philippe Coubes ◽  
Philippe Gelisse
Keyword(s):  
Down Syndrome ◽  
Late Onset ◽  
Myoclonic Epilepsy

scholarly journals Cancer and Aging: Two Tightly Interconnected Biological Processes

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1400
Author(s):  
Lieze Berben ◽  
Giuseppe Floris ◽  
Hans Wildiers ◽  
Sigrid Hatse
Keyword(s):  
Older Patients ◽  
Current Knowledge ◽  
Geriatric Oncology ◽  
Individual Treatment ◽  
Treatment Regimens ◽  
Patients With Cancer ◽  
Increased Risk ◽  
The Impact

Age is one of the main risk factors of cancer; several biological changes linked with the aging process can explain this. As our population is progressively aging, the proportion of older patients with cancer is increasing significantly. Due to the heterogeneity of general health and functional status amongst older persons, treatment of cancer is a major challenge in this vulnerable population. Older patients often experience more side effects of anticancer treatments. Over-treatment should be avoided to ensure an optimal quality of life. On the other hand, under-treatment due to fear of toxicity is a frequent problem and can lead to an increased risk of relapse and worse survival. There is a delicate balance between benefits of therapy and risk of toxicity. Robust biomarkers that reflect the body’s biological age may aid in outlining optimal individual treatment regimens for older patients with cancer. In particular, the impact of age on systemic immunity and the tumor immune infiltrate should be considered, given the expanding role of immunotherapy in cancer treatment. In this review, we summarize current knowledge concerning the mechanistic connections between aging and cancer, as well as aging biomarkers that could be helpful in the field of geriatric oncology.

scholarly journals Clinical Diagnosis and Perioperative Management of Glioma-Related Epilepsy

2021 ◽  
Vol 10 ◽  
Author(s):  
Gan You ◽  
Zhiyi Sha ◽  
Tao Jiang
Keyword(s):  
Perioperative Management ◽  
Seizure Control ◽  
Clinical Presentation ◽  
Epileptic Seizures ◽  
High Grade Glioma ◽  
Low Grade ◽  
Tumor Treatment ◽  
Multiple Factors ◽  
Close Relationship

Gliomas account for more than half of all adult primary brain tumors. Epilepsy is the most common initial clinical presentation in gliomas. Glioma related epilepsy (GRE) is defined as symptomatic epileptic seizures secondary to gliomas, occurring in nearly 50% in high-grade glioma (HGG) patients and up to 90% in patients with low-grade glioma (LGG). Uncontrolled seizures, which have major impact on patients’ quality of life, are caused by multiple factors. Although the anti-seizure medications (ASMs), chemotherapy and radiation therapy are also beneficial for seizure treatment, the overall seizure control for GRE continue to be unsatisfactory. Due to the close relationship between GRE and glioma, surgical resection is often the treatment of choice not only for the tumor treatment, but also for the seizure control. Despite aggressive surgical treatment, there are about 30% of patients continue to have poor seizure control postoperatively. Furthermore, the diagnostic criteria for GRE is not well established. In this review, we propose an algorithm for the diagnosis and perioperative management for GRE.

The Search for Biomarkers of Alzheimer's Disease in Down Syndrome

2020 ◽  
Vol 125 (2) ◽  
pp. 97-99 ◽  
Author(s):  
Benjamin L. Handen
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Down Syndrome ◽  
Longitudinal Study ◽  
High Risk ◽  
Amyloid Precursor Protein ◽  
Current Knowledge ◽  
Amyloid Β ◽  
Chromosome 21 ◽  
Increased Risk

Abstract Adults with Down syndrome are at high risk for Alzheimer's disease (AD), with most individuals developing clinical dementia by their late 60s. This increased risk for AD has been attributed, at least in part, to triplication and overexpression of the gene for amyloid precursor protein (APP) on chromosome 21, leading to elevated levels of amyloid β peptides. This article offers a brief overview of our current knowledge of AD in the DS population. In addition, information on a NIA/NICHD-funded, multicenter longitudinal study of biomarkers of AD in adults with DS is provided.

Psychosocial and Trauma-Related Stress and Risk of Dementia: A Meta-Analytic Systematic Review of Longitudinal Studies

2020 ◽  
pp. 089198872097375
Author(s):  
Anastasia Bougea ◽  
Maria Anagnostouli ◽  
Efthalia Angelopoulou ◽  
Ioanna Spanou ◽  
George Chrousos
Keyword(s):  
Systematic Review ◽  
Longitudinal Studies ◽  
Psychosocial Stress ◽  
Late Onset ◽  
Economic Status ◽  
Later Life ◽  
Brain Health ◽  
Increased Risk ◽  
Related Stress

Stress has deleterious effects on brain health and yet, the prognostic value of psychosocial stress regarding the most common types of dementias, including Alzheimer disease, is still unclear. The primary aim of this systematic review was to explore the association between psychosocial stress and late onset dementia. We classified 24articles from Medline, PsycINFO, CINAHL, and Web of Science, as pertaining toxic categories of psychosocial and trauma-related stress (low socio-economic status [SES] related inequalities, marital status, posttraumatic stress disorder, work stress, “vital exhaustion” [VE], and, combined stressors). Using the Quality of Prognosis Studies in Systematic Reviews tool, we judged the quality of evidence to be low. This systematic review provided some non-robust, yet suggestive evidence that the above psychosocial types of stress are associated with increased risk of dementia in later life. Future robust, longitudinal studies with repeated validated measures of psychosocial stress and dementiaare required to strengthen or refute these findings.

scholarly journals Epilepsy in the end of life phase of brain tumor patients: a systematic review

2014 ◽  
Vol 1 (3) ◽  
pp. 134-140 ◽  
Author(s):  
Johan A.F. Koekkoek ◽  
Linda Dirven ◽  
Jaap C. Reijneveld ◽  
Tjeerd J. Postma ◽  
Robin Grant ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Tumor ◽  
End Of Life ◽  
Current Knowledge ◽  
Epileptic Seizures ◽  
High Grade Glioma ◽  
Malignant Brain Tumor ◽  
Tumor Patients ◽  
Swallowing Difficulties

Abstract Epileptic seizures are common in patients with primary or secondary malignant brain tumor. However, current knowledge on the occurrence of seizures during the end of life (EOL) phase of brain tumor patients is limited. Because symptom management with preservation of quality of life is of major importance for patients with a malignant brain tumor, particularly in the EOL, it is necessary to gain a deeper understanding of seizures and their management during this phase. We performed a systematic review of literature related to epilepsy in the EOL phase of brain tumor patients, based on the electronic resources PubMed, Embase, and Cinahl. The search yielded 442 unique records, of which 11 articles were eligible for further analysis after applying predefined inclusion criteria. Seizures occur relatively frequently in the EOL phase, particularly in patients with high-grade glioma. However, seizure management is often hampered by swallowing difficulties and impaired consciousness. Treatment decisions are largely dependent on expert opinion because a standardized approach for treating seizures in the terminal stage of brain tumor patients is still lacking.

Sign in / Sign up

Export Citation Format

Share Document