著者

Shinako Inaida Kousuke Kanemoto Shiro Tanaka Yoko Gouji Tomohiro Oshima Riki Matsumoto Akio Ikeda Koji Kawakami

出版者

JAPAN EPILEPSY SOCIETY

雑誌

Epilepsy & Seizure (ISSN:18825567)

巻号頁・発行日

vol.10, no.1, pp.73-86, 2018 (Released:2018-09-08)

参考文献数

35

被引用文献数

3

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Purpose: Psychogenic non-epileptic seizures (PNES) are psychogenic disorders that often resemble epileptic seizures. Herein, we describe the recent clinical trends of PNES by using the data from a large, claims-based Japanese database obtained from the Japan Medical Data Center.Methods: A 10-year epidemiological study of patients of all ages with newly diagnosed PNES was conducted. Data were extracted using the International Classification of Diseases 10th Revision (ICD-10) diagnostic codes. Prevalence in new epilepsy patients and period of the diagnostic delay of PNES after epilepsy diagnosis were retrieved from the data. The study endpoint was change in frequency of hospital visits. Data of 413 patients with PNES were retrieved using the criterion of “PNES diagnosis after epilepsy diagnosis.”Results: The highest PNES prevalence in new epilepsy patients was observed in the 40-49 year age group (4.3%) for males, and in the 30-39 age group (4.9%) for females. The ratio of the prevalence in males to that in females was 1:2 for 0-9, 10-19, and >60 age groups, and 1:1 for the other age groups. A significant and positive correlation was found between the frequency of hospital visits and duration of the diagnostic delay of PNES. After PNES diagnosis, the average number of monthly hospital visits decreased over time.Discussion: The differences in the duration of diagnostic delay of PNES among cases and also a decrease in the frequency of hospital visits after PNES diagnosis highlight the importance of early differentiation between epilepsy and PNES.

著者

Mihoko Kawai Kousuke Kanemoto Yukai Tadokoro Hiroko Goji

出版者

JAPAN EPILEPSY SOCIETY

雑誌

Epilepsy & Seizure (ISSN:18825567)

巻号頁・発行日

vol.10, no.1, pp.68-72, 2018 (Released:2018-09-08)

参考文献数

11

被引用文献数

1 1

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We examined the effects of switching from carbamazepine to lacosamide on plasma concentrations of risperidone and its active metabolite 9-hydroxyrisperidone in two patients with partial epilepsy manifesting epileptic psychosis. Within 1 week of switch, increases of 52.5-347% in plasma levels of risperidone and 9-hydroxyrisperidone were observed, along with improvements in psychiatric symptoms as shown by Positive and Negative Syndrome Scale scores (PANSS). Neither of the patients showed extrapyramidal symptoms or seizures during 3 months after switching. The present results support the notion that carbamazepine (CBZ) administration induces hepatic microsomal enzyme systems that regulate inactivation of antipsychotic drugs. When CBZ and psychotropic agents are used in combination, a switch from CBZ to lacosamide may be effective in patients with treatment-resistance epileptic psychosis.