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PubMed | Niguarda Hospital, University of Strasbourg, Moscow Research and Clinical Center for Neuropsychiatry, Vilnius University and 22 more.
Type: | Journal: Epilepsia | Year: 2017

We explored the current practice with respect to the neuropsychological assessment of surgical epilepsy patients in European epilepsy centers, with the aim of harmonizing and establishing common standards. Twenty-six epilepsy centers and members of E-PILEPSY (a European pilot network of reference centers in refractory epilepsy and epilepsy surgery), were asked to report the status of neuropsychological assessment in adults and children via two different surveys. There was a consensus among these centers regarding the role of neuropsychology in the presurgical workup. Strong agreement was found on indications (localization, epileptic dysfunctions, adverse drugs effects, and postoperative monitoring) and the domains to be evaluated (memory, attention, executive functions, language, visuospatial skills, intelligence, depression, anxiety, and quality of life). Although 186 different tests are in use throughout these European centers, a core group of tests reflecting a moderate level of agreement could be discerned. Variability exists with regard to indications, protocols, and paradigms for the assessment of hemispheric language dominance. For the tests in use, little published evidence of clinical validity in epilepsy was provided. Participants in the survey reported a need for improvement concerning the validity of the tests, tools for the assessment of everyday functioning and accelerated forgetting, national norms, and test co-normalization. Based on the present survey, we documented a consensus regarding the indications and principles of neuropsychological testing. Despite the variety of tests in use, the survey indicated that there may be a core set of tests chosen based on experience, as well as on published evidence. By combining these findings with the results of an ongoing systematic literature review, we aim for a battery that can be recommended for the use across epilepsy surgical centers in Europe.


Brainin M.,Danube University Krems | Tuomilehto J.,Danube University Krems | Heiss W.-D.,Max Planck Institute for Neurological Research | Bornstein N.M.,Tel Aviv Sourasky Medical Center | And 15 more authors.
European Journal of Neurology | Year: 2015

The close relationship between stroke and dementia is an important health issue. Ischaemic stroke can facilitate the onset of vascular dementia as well as aggravate pre-existing cognitive decline. The onset of cognitive decline may become manifest immediately following the onset of ischaemic stroke, but often there is a delay in the development of cognitive decline after a stroke. This delay can be seen as a therapeutic time window allowing interventions to be applied to preserve cognition following stroke. Both neurodegenerative and vascular mechanisms are activated and probably result in overlapping processes within the neurovascular unit. This review focuses on the incidence and prevalence of cognitive decline following stroke, predisposing stroke aetiologies, pre-stroke decline, imaging factors and biomarkers. Outcomes are discussed in relation to timing of assessment and neuropsychological tests used for evaluation of cognitive decline in ischaemic stroke patients. Including such tests in routine evaluations of stroke patients after some weeks or months is recommended. Finally, an outlook on ongoing and planned intervention trials is added and some recommendations for future research are proposed. © 2014 EAN.


Bryukhin A.E.,Peoples' Friendship University of Russia | Sologub M.B.,Moscow Research and Clinical Center for Neuropsychiatry | Abdraeva N.K.,Peoples' Friendship University of Russia
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2015

A case of comorbid anorexia nervosa and kleptomania is reported in a female patient aged 31 years old. Personality pathology and kleptomanic behavior developed since childhood together with dysmorphophobia related to the congenital chest defect. Later on, the distinct association between the severity of dysmorphophobia, affective disorder and appearances of pathological drives was identified. The patient received several ICD-10 diagnoses (F61.0, F50.0, F62.3, F33.1). The patient’s condition was improved after pharmacotherapy in the combination with psychotherapy. © 2015, Media Sphera. All rights reserved.


Guekht A.,Russian National Research Medical University | Mizinova M.,Russian National Research Medical University | Kaimovsky I.,Russian National Research Medical University | Danilenko O.,Moscow Research and Clinical Center for Neuropsychiatry | And 2 more authors.
Epilepsy and Behavior | Year: 2016

Objective The objective of this study was to investigate prospectively the direct costs of epilepsy in Russia, taking a patient perspective and a bottom-up approach. Methods The study was conducted in adolescents and adults with epilepsy seen in the ambulatory services of a city hospital in Moscow. Patients were assigned to different prognostic categories: newly diagnosed epilepsy; epilepsy in remission for 2 + years; epilepsy in remission for < 2 years or with occasional seizures; active, nondrug-resistant epilepsy; drug-resistant epilepsy; and drug-resistant epilepsy in surgical candidates. Patients were followed prospectively for 12 months. Demographic and clinical features at admission were collected and correlated with costs. Cost estimates were based on the Russian National Health Service perspective and its implementation in Moscow. Cost items included drugs and laboratory/instrumental tests. The costs per patient were calculated for the entire sample and for each prognostic category separately. Univariate and multivariate analyses were performed. Results Included were 738 patients (393 men, 345 women aged 14–85 years). The median annual cost/patient was €955 (IQR 521–2134; range 51–10,904). The median cost of drugs was €643 (IQR 288–1866; range 0–9960), and the median cost of laboratory/instrumental testing was €202 (IQR 160–270; range 20–1217). Mean costs varied across prognostic categories ranging from €782 in newly diagnosed patients to €3777 in patients with drug-resistant epilepsy. Mean (SD) hospital costs ranged from €646.7 (109.0) in patients with occasional seizures to €950.0 (28.3) in surgical candidates. Independent predictors of total costs were younger age at diagnosis, disability status, generalized seizures, multiple seizure types, seizure severity, and etiology. Significance The cost of epilepsy in Moscow varies significantly depending on disease characteristics and response to drug treatment. © 2016 Elsevier Inc.


PubMed | Mario Negri Institute for Pharmacological Research, Russian National Research Medical University and Moscow Research and Clinical Center for Neuropsychiatry
Type: Journal Article | Journal: Epilepsia | Year: 2015

To verify the net effect of seizures after stroke on the use of in-hospital health care resources.Consecutive patients with first-ever stroke were admitted to the stroke unit of a Moscow hospital and followed prospectively until death or discharge. Each patient experiencing seizures was matched for age, sex, stroke type, National Institutes of Health Stroke Scale score at admission, and stroke risk factors to 2+ patients with no seizures, as controls. Resources consumed included length of hospital stay, admission to the intensive care unit (ICU), diagnostic tests, medical consultations and treatments. Cost estimates were based on the Russian National Health Service perspective.The sample comprised 30 patients with in-hospital seizures and 70 matched controls. Patients dying in hospital were 15 of 30 (50%) versus 4 of 70 (5.7%) (p<0.001). The overall cost of hospital stay was only slightly (nonsignificantly) higher in patients with seizures, but the cost was significantly higher in patients who died than in patients who were discharged alive. Compared to the controls, patients with seizures spent more intensive care unit (ICU) days and required more computed tomography (CT) scans, x-rays, endoscopies, and specialist consultations, causing higher in-hospital costs.In patients with first-ever stroke, seizures per se do not increase the overall in-hospital costs. However, the higher than expected mortality in patients with seizures is associated with additional hospital costs.


PubMed | Mario Negri Institute for Pharmacological Research, Russian National Research Medical University and Moscow Research and Clinical Center for Neuropsychiatry
Type: Journal Article | Journal: Epilepsy & behavior : E&B | Year: 2016

The objective of this study was to investigate prospectively the direct costs of epilepsy in Russia, taking a patient perspective and a bottom-up approach.The study was conducted in adolescents and adults with epilepsy seen in the ambulatory services of a city hospital in Moscow. Patients were assigned to different prognostic categories: newly diagnosed epilepsy; epilepsy in remission for 2+years; epilepsy in remission for <2years or with occasional seizures; active, nondrug-resistant epilepsy; drug-resistant epilepsy; and drug-resistant epilepsy in surgical candidates. Patients were followed prospectively for 12months. Demographic and clinical features at admission were collected and correlated with costs. Cost estimates were based on the Russian National Health Service perspective and its implementation in Moscow. Cost items included drugs and laboratory/instrumental tests. The costs per patient were calculated for the entire sample and for each prognostic category separately. Univariate and multivariate analyses were performed.Included were 738 patients (393 men, 345 women aged 14-85years). The median annual cost/patient was 955 (IQR 521-2134; range 51-10,904). The median cost of drugs was 643 (IQR 288-1866; range 0-9960), and the median cost of laboratory/instrumental testing was 202 (IQR 160-270; range 20-1217). Mean costs varied across prognostic categories ranging from 782 in newly diagnosed patients to 3777 in patients with drug-resistant epilepsy. Mean (SD) hospital costs ranged from 646.7 (109.0) in patients with occasional seizures to 950.0 (28.3) in surgical candidates. Independent predictors of total costs were younger age at diagnosis, disability status, generalized seizures, multiple seizure types, seizure severity, and etiology.The cost of epilepsy in Moscow varies significantly depending on disease characteristics and response to drug treatment.

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