Biomedical subjects

E González-Goizueta

Publications and source records attributed to E González-Goizueta.

2 recordsLinked to original sources

PubMedDate not supplied

[Depression and epilepsy].

AIMS: To review the literature on the frequency, aetiology, risk factors, diagnosis and treatment of depression in epileptic illness with a view to clarifying certain controversial issues in a clinically relevant subject. METHOD: Work published on this subject over the last three years was analysed and the data combined in order to achieve a scientific approach to the clinical handling of these patients. We analyse papers, especially reviews of literature on the subject, we compare postures and attempt to highlight the most popular. We point out the aspects that are still in need of study and the gaps to be filled in handling protocols, and we propose characteristics required for future research. CONCLUSIONS: Interictal depression is frequent, and appears in some moment in the evolution in one out of every three epileptics, especially in cases of severe epilepsy with frequent seizures. There are aetiological factors and risk indicators, both of a biological and a psychosocial nature, that point to a more likely appearance of depression. Treatment includes the control of epileptic seizures with a reappraisal of the established pharmacological antiepileptic treatment; the use of antidepressants is, however, nearly always necessary. Choice of the antidepressant must be based on knowledge of pharmacological interactions, the side effects, possible effects on the convulsion threshold and efficiency. Among all the antidepressants, the new ones, especially citalopram and some other SSRIs, seem to offer less convulsant risk and maprotiline, amoxapine and bupropion are clearly unadvisable. Electroconvulsive therapy can be a good therapeutic option.

Anticonvulsants↗

PubMedDate not supplied

[Non epileptic psychogenic seizures].

INTRODUCTION: Non epileptic psychogenic seizures (NEPS) is a pathological condition that arouses the interest of many specialists due to the fact that, every day, it gives rise to problems in different fields especially in diagnosis and therapeutics. This means that sometimes the right diagnosis is reached after a period of explorations and treatment which later turn out to be unnecessary, and have important repercussions on the patient s family and social life, and, financially, on the health care system. METHOD: We review the literature on the subject that has been published over the last five years, with the aim of contrasting and integrating the different positions that are currently held. We draw attention to the better known aspects, on which there is a more general agreement, and others that are still subject to controversy and debate; we also attempt to lay down a set of guidelines, bearing in mind the gaps that are still to be filled, to aid future research. CONCLUSIONS: 1. NEPS is very difficult to diagnose. It is important to have a good clinical history to be able to identify possible stressors. Video EEG can be of great help, although it is very expensive and not available to all Neurology services. 2. Before deciding on the final diagnosis, frontal, frontomesial and temporal lobe seizures must be taken into account since they sometimes present symptoms that are similar to those of NEPS. 3. The association with different psychiatric pathologies has been shown to exist, and more than one psychopathogenic mechanism may be involved as a mediator in the appearance of NEPS. 4. Therapy begins with the presentation of the diagnosis, which must be performed with due care and attention, and is aided by a multidisciplinary treatment.

Humans↗