Grande Eleonora, Tufo Tommaso, Ciavarro Marco, Di Muccio Ines, Fuggetta Filomena, Silvestri Martina, Bevacqua Giuseppina, Lanzone Jacopo, Assenza Giovanni
Department of Neuroscience, Imaging and Clinical Sciences, University "Gabriele d'Annunzio" of Chieti-Pescara, Chieti, Italy.
Neurosurgery, Policlinico A. Gemelli Foundation Istituto di Ricovero e Cura a Carattere Scientifico, Catholic University, Rome, Italy.
Front Neurol. 2021 Feb 26;12:640581. doi: 10.3389/fneur.2021.640581. eCollection 2021.
Restrictive measures adopted during the COVID-19 pandemic, in order to limit contagion, have had a severe impact on mental health. The burden of lockdown has been particularly heavy on patients with chronic neurologic diseases such as People with Epilepsy (PwE). Our survey aims to describe the struggles and needs of Drug-Resistant (DR) PwE with implanted Vagal Nerve Stimulator (VNS) during the first wave of the COVID-19 lockdown in order to find strategies that help patients cope with present or future periods of restriction. We collected answers from 30 respondents who underwent an online survey including socio-demographic and clinical information and COVID-19-related information. Depression, anxiety symptoms, and sleep quality were investigated in patients through BDI II, GAD-7, and the PSQI scale. In all, 46% of our sample reported an increase in the number of seizures; the entire sample complained of epilepsy-related issues (medication availability, VSN adjustments, anxiety, sleep disturbance); one out of three participants reported major epilepsy issues felt urgent; 30% had to postpone scheduled examination. Significantly higher scores for depression and anxiety scales were found in patients who perceived seizure frequency worsening and reported major epilepsy-related issues. Preliminary findings showed that the first lockdown influenced the clinical and psychological status of PwE and was related to seizures worsening. The lack of medical assistance and control on VNS therapy left patients to cope with the situation without a chance to contact a specialist. We discuss how a wider implementation of telemedicine programs could facilitate remote assistance of PwE with a VNS implant.
为限制新冠病毒传播而在疫情期间采取的限制措施，对心理健康产生了严重影响。封锁措施给癫痫患者（PwE）等慢性神经疾病患者带来的负担尤为沉重。我们的调查旨在描述在新冠疫情第一波封锁期间，植入迷走神经刺激器（VNS）的耐药性癫痫患者（DR PwE）的挣扎与需求，以便找到帮助患者应对当前或未来限制期的策略。我们收集了30名受访者的答案，他们参与了一项在线调查，内容包括社会人口统计学和临床信息以及与新冠病毒相关的信息。通过贝克抑郁量表第二版（BDI II）、广泛性焦虑障碍量表（GAD - 7）和匹兹堡睡眠质量指数（PSQI）量表对患者的抑郁、焦虑症状和睡眠质量进行了调查。总体而言，我们样本中有46%的人报告癫痫发作次数增加；整个样本都抱怨与癫痫相关的问题（药物供应、迷走神经刺激器调整、焦虑、睡眠障碍）；三分之一的参与者表示感到紧急的重大癫痫问题；30%的人不得不推迟预定的检查。在那些认为癫痫发作频率恶化并报告有重大癫痫相关问题的患者中，抑郁和焦虑量表得分显著更高。初步研究结果表明，首次封锁影响了癫痫患者的临床和心理状态，并与癫痫发作恶化有关。迷走神经刺激器治疗缺乏医疗援助和管控，使患者在无法联系专科医生的情况下应对这种情况。我们讨论了更广泛地实施远程医疗项目如何能够促进对植入迷走神经刺激器的癫痫患者的远程援助。
