Ali A. Asadi-Pooya

Self-perception of seizure precipitants and their relation to anxiety level, depression, and health locus of control in epilepsy

BACKGROUNDnThe aim of this study was to determine the prevalence and nature of self-perceived seizure precipitants in epilepsy patients, and evaluate whether anxiety level, depression, or health locus of control influence self-perception of seizure precipitants.nnnMETHODSnAdults aged 18 and older who had epilepsy for at least 1 year were recruited in either the inpatient epilepsy monitoring unit or the outpatient epilepsy clinic at Thomas Jefferson University in 2006. Patients anonymously filled out a questionnaire, which included data about age, sex, education, seizure control, and three questionnaires including identification of seizure precipitants, Hospital anxiety and depression (HAD) scale, and Form C of the multidimensional health locus of control (MHLC). Discriminant function analysis was used for statistical analysis.nnnRESULTSnTwo hundred patients participated, with a mean age of 40.3+/-16 years. One hundred thirty (65%) patients reported one or more seizure precipitants. Stress (49.5%), lack of sleep (35.5%), and fatigue (32.5%) were the most common seizure triggers reported. Seizure control, anxiety level, and powerful others subscale in HLC scores were significantly related to self-perception of seizure precipitants. Subjective seizure triggers (stress, lack of sleep) were related to psychological factors.nnnCONCLUSIONSnThe perception that certain triggers precipitate seizures is related to anxiety, health locus of control, and seizure control. Hence, seizures might be misattributed to irrelevant precipitants because of an underlying psychological predisposition. Alternatively, there may be a physiological relationship between seizures and the triggers. Prospective studies are required to clarify the relationship between seizure precipitants and seizure occurrence.

Health locus of control in patients with epilepsy and its relationship to anxiety, depression, and seizure control.

OBJECTIVEnA persons health locus of control orientation is one of several factors that determine which health-related behaviors a person will perform. The aim of this study was to determine the health locus of control in patients with epilepsy and its relationship to anxiety, depression, and seizure control.nnnMETHODSnAdults aged 18 and older who had had epilepsy for at least 1 year were recruited in either the inpatient epilepsy monitoring unit or the outpatient epilepsy clinic at Thomas Jefferson University in 2006. Patients anonymously filled out a questionnaire, which elicited data on age, sex, education, and seizure control. The Hospital Anxiety and Depression (HAD) scale was used to evaluate anxiety level and depression, and Form C of the Multidimensional Health Locus of Control (MHLC) scales was used to evaluate the health locus of control. Statistical analyses were performed using regression analyses to determine potentially significant associations.nnnRESULTSnTwo hundred patients with a mean age of 40.3 +/- 16 participated. Patients had low mean scores on the Internal, medium mean scores on the Chance, and high mean scores on the Powerful Others MHLC subscales. Patients with epilepsy with higher Internal MHLC scores more frequently had controlled seizures. Patients with higher Powerful Others MHLC scores had higher scores on the Anxiety subscale of the HAD scale.nnnCONCLUSIONSnPatients with epilepsy in our study had weak perceptions of internal and strong perceptions of external health locus of control. This probably means patients with epilepsy might adapt less effectively to their illness and have lower levels of engagement in beneficial health behaviors and active coping strategies.

Do foods precipitate seizures? A cross-cultural comparison

OBJECTIVESnIt has been reported that a common belief of the families of the patients with epilepsy in Iran is that foods provoke seizures. Our aim in the present study was to ascertain whether a culturally different population of patients with epilepsy in the United States believe that foods precipitate seizures.nnnMETHODSnAdults aged 18 and older with epilepsy were recruited in either the inpatient epilepsy monitoring unit or the outpatient epilepsy clinic at Thomas Jefferson University from September to December 2006. Patients completed a questionnaire asking their age, sex, education, seizure control, and beliefs about the relationship between foods and seizures.nnnRESULTSnOne hundred ninety-three patients participated, with a mean age of 40.3 +/- 16. Only 11 (5.7%) patients reported foods as a precipitating factor for seizures. The difference between the results of the Iranian study, in which 55.2% of the families of children with epilepsy reported a relationship between specific foods and seizures, and the present results is significant (P=0.0001).nnnCONCLUSIONnThe perception of foods as a seizure precipitant differs greatly between a Middle Eastern country (Iran) and a Western country (United States). This discordance suggests that cultural factors may play a large role in the perception of probable precipitating factors related to seizures. Some commonly reported seizure precipitants may represent cultural beliefs, and this raises a question as to whether foods truly precipitate seizures.

Mesial temporal lobe epilepsy with childhood febrile seizure.

To evaluate the demographic and clinical manifestations of patients with mesial temporal sclerosis and temporal lobe epilepsy (MTS‐TLE) with childhood febrile seizure (FS) and establishing the potential differences as compared to those without FS. We also investigated the surgery outcome in these two groups of patients.

Seasonality of birth in patients with temporal lobe epilepsy.

We investigated the seasonal pattern in births of patients with temporal lobe epilepsy and mesial temporal sclerosis. We hypothesized that the seasonal pattern in births of these patients is different from that in the general population.