Department of Neurology, Ibn Sina Hospital, Sabah Medical Area, Kuwait, Kuwait.
Department of Neurology, Minia University, Minia, Egypt.
Acta Neurol Belg. 2022 Feb;122(1):59-66. doi: 10.1007/s13760-021-01609-1. Epub 2021 Feb 8.
During the unprecedented COVID-19 pandemic in 2020, the whole world faced an unusual health emergency. Medical care of chronic neurological diseases, such as Epilepsy, is being neglected. In this survey, we aimed to evaluate the impact of the COVID-19 pandemic on the care of people with Epilepsy (PwE) and to identify their risk factors for seizure worsening to direct better future medical care. We administered a web-based survey (submitted on August 5, 2020). It included socio-demographic, Epilepsy-related, and psychometric data (The Depression, Anxiety, and Stress Scale-21 Items(DASS21) and The Pittsburgh Sleep Quality Index (PSQI). Regression analysis identified predictors of seizure worsening. We collected responses from an online survey of PwE during the pandemic. Out of 151 responders, 71 patients complained of issues related to Epilepsy management and all of whom reached the treating physician and solved their problems. Sleep quality was compromised in 84 patients (55.6%). Two-thirds of the patients in our cohort (66.2%) reported depression, 72.2% reported anxiety, and 75.5% reported stress. Eight patients (5.3%) got COVID-19 infection, and only one patient suffered from mild worsening of the seizure. The main concerns were shortage of medications for 46 (30.5%) patients, getting Coronavirus infection for 67 (44.4%) patients, and seizure worsening for 32 (21.3%) patients. Thirty-five patients (23.2%) reported seizure worsening, which was best explained by retirement or jobless state, having moderate or severe stress, poor sleep quality, vagus nerve stimulation (VNS), fear of getting COVID-19 infection, fear of worsening of seizures, or shortage of medication. During the current COVID-19 pandemic, a significant percentage of PwE experienced worsening of their seizures. This unusual, challenging experience clarifies the urgent need to establish telemedicine services and home-based management of Epilepsy, including ambulatory EEG, home video, and medication delivery to patients' homes to provide continuous medical care.
在 2020 年这场史无前例的 COVID-19 大流行期间，全世界都面临着一场不同寻常的卫生紧急情况。癫痫等慢性神经疾病的医疗保健受到了忽视。在这项调查中，我们旨在评估 COVID-19 大流行对癫痫患者（PwE）护理的影响，并确定导致癫痫发作恶化的风险因素，以便为未来的医疗护理提供指导。我们进行了一项基于网络的调查（于 2020 年 8 月 5 日提交）。它包括社会人口统计学、癫痫相关和心理计量学数据（21 项抑郁、焦虑和压力量表（DASS21）和匹兹堡睡眠质量指数（PSQI）。回归分析确定了癫痫发作恶化的预测因素。我们从大流行期间的癫痫患者在线调查中收集了回复。在 151 名应答者中，有 71 名患者抱怨与癫痫管理有关的问题，他们都与主治医生联系并解决了问题。84 名患者（55.6%）的睡眠质量受到影响。我们队列中的三分之二患者（66.2%）报告有抑郁，72.2%报告有焦虑，75.5%报告有压力。8 名患者（5.3%）感染了 COVID-19，只有 1 名患者癫痫发作轻度恶化。主要关注点是 46 名患者（30.5%）药物短缺，67 名患者（44.4%）感染冠状病毒，32 名患者（21.3%）癫痫发作恶化。35 名患者（23.2%）报告癫痫发作恶化，这主要归因于退休或失业状态、中度或重度压力、睡眠质量差、迷走神经刺激（VNS）、害怕感染 COVID-19、害怕癫痫发作恶化或药物短缺。在当前的 COVID-19 大流行期间，相当一部分癫痫患者经历了癫痫发作的恶化。这种不寻常的、具有挑战性的经历清楚地表明，迫切需要建立远程医疗服务和基于家庭的癫痫管理，包括动态脑电图、家庭视频以及向患者家中提供药物输送，以提供持续的医疗护理。
