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Dear Colleagues,

Epilepsy is a chronic disabling neurological disorder that affects people of all ages. In North America and Europe, the epilepsy prevalence is approximately 1%, and of most concern is that over 30% of people with epilepsy will fail medication, so-called medically intractable or drug resistant, which will be the focus of this special issue. Individuals with medically intractable seizures have reduced quality of life due to many factors including stigma, loss of independence, the cognitive side effects of medication, and recurring seizures. Additionally, intractable epilepsy is dangerous with mortality over 4 times that of age matched controls. Individuals with medically intractable epilepsy should be evaluated in a comprehensive epilepsy program. Appropriate characterization of epilepsy can improve seizure control as well as identify surgical candidates. In many cases, surgery can cure this chronic, disabling, and often deadly neurological disease. Cure from epilepsy significantly elevates the quality of life and erases the increased mortality risk.

In this special issue of the Journal of Personalized Medicine, the topics of pathogenesis, treatment, and precision medicine of medically intractable epilepsy will be explored. Both original research and review articles are welcome.

We look forward to receiving your contributions.

Prof. Dr. Warren W. Boling
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

drug resistant
medically intractable
surgery
pharmacoresistant
epilepsy
seizures

Published Papers (3 papers)

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Review

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13 pages, 270 KiB

Open AccessEditor’s ChoiceReview

State of the Art and Challenges in Epilepsy—A Narrative Review

by Aida Mihaela Manole, Carmen Adella Sirbu, Mihaela Raluca Mititelu, Octavian Vasiliu, Lorenzo Lorusso, Octavian Mihai Sirbu and Florentina Ionita Radu

J. Pers. Med. 2023, 13(4), 623; https://doi.org/10.3390/jpm13040623 - 01 Apr 2023

Cited by 4 | Viewed by 2850

Abstract

Epilepsy is a common condition worldwide, with approximately 50 million people suffering from it. A single seizure does not mean epilepsy; almost 10% of the population can have a seizure during their lifetime. In particular, there are many other central nervous system disorders other than epilepsy in which seizures occur, either transiently or as a comorbid condition. The impact of seizures and epilepsy is, therefore, widespread and easily underestimated. It is estimated that about 70% of patients with epilepsy could be seizure-free if correctly diagnosed and treated. However, for patients with epilepsy, quality of life is influenced not only by seizure control but also by antiepileptic drug-adverse reactions, access to education, mood, employment, and transportation. Full article

(This article belongs to the Special Issue Epilepsy: Pathogenesis, Treatment, and Precision Medicine)

Other

Jump to: Review

7 pages, 231 KiB

Open AccessBrief Report

Psychogenic Nonepileptic Seizures—High Mortality Rate Is a ‘Wake-Up Call’

by Catherine A. Carlson

J. Pers. Med. 2023, 13(6), 892; https://doi.org/10.3390/jpm13060892 - 25 May 2023

Viewed by 4594

Abstract

Patients with epilepsy have an elevated mortality rate compared to the general population and now studies are showing a comparable death ratio in patients diagnosed with psychogenic nonepileptic seizures. The latter is a top differential diagnosis for epilepsy and the unexpected mortality rate in these patients underscores the importance of an accurate diagnosis. Experts have called for more studies to elucidate this finding but the explanation is already available, embedded in the existing data. To illustrate, a review of the diagnostic practice in epilepsy monitoring units, of the studies examining mortality in PNES and epilepsy patients, and of the general clinical literature on the two populations was conducted. The analysis reveals that the scalp EEG test result, which distinguishes a psychogenic from an epileptic seizure, is highly fallible; that the clinical profiles of the PNES and epilepsy patient populations are virtually identical; and that both are dying of natural and non-natural causes including sudden unexpected death associated with confirmed or suspected seizure activity. The recent data showing a similar mortality rate simply constitutes more confirmatory evidence that the PNES population consists largely of patients with drug-resistant scalp EEG-negative epileptic seizures. To reduce the morbidity and mortality in these patients, they must be given access to treatments for epilepsy. Full article

(This article belongs to the Special Issue Epilepsy: Pathogenesis, Treatment, and Precision Medicine)

7 pages, 247 KiB

Open AccessBrief Report

Influence of Clinical Factors on the Quality of Life in Romanian People with Epilepsy—A Follow-Up Study in Real-Life Clinical Practice

by Ionut-Horia Cioriceanu, Dan-Alexandru Constantin, Elena Bobescu, Luigi Geo Marceanu and Liliana Rogozea

J. Pers. Med. 2023, 13(5), 752; https://doi.org/10.3390/jpm13050752 - 28 Apr 2023

Viewed by 979

Abstract

Background: This study aimed to assess the influence of various clinical factors on the quality of life perception of patients with epilepsy over a follow-up period in current clinical practice. Methods: Thirty-five PWE evaluated via video-electro-encephalography in the Clinical Hospital of Psychiatry and Neurology in Brasov, Romania, were included, and the quality of life was assessed using the Romanian version of the QOLIE-31-P questionnaire. Results: At baseline, the mean age was 40.03 (±14.63) years; the mean duration of epilepsy was 11.46 (±12.90) years; the mean age at the first seizure was 28.57 (±18.72); and the mean duration between evaluations was 23.46 (±7.54) months. The mean (SD) QOLIE-31-P total score at the initial visit (68.54 ±15.89) was lower than the mean (SD) QOLIE-31-P total score at the follow-up (74.15 ± 17.09). Patients with epileptiform activity recorded via video-electro-encephalography, using polytherapy, those with uncontrolled seizures, and those with one or more seizures per month had statistically significantly lower QOLIE-31-P total scores at baseline and follow-up. Multiple linear regression analyses revealed seizure frequency as a significant inverse predictor of quality of life in both evaluations. Conclusions: The QOLIE-31-P total score was improved during the follow-up period, and medical professionals should use instruments to evaluate quality of life and identify patterns while trying to improve the outcomes of patients with epilepsy. Full article

(This article belongs to the Special Issue Epilepsy: Pathogenesis, Treatment, and Precision Medicine)

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