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174, p = 0.023). Rates of anxiety and depression did not differ across epilepsy subtypes and no gender differences were found. Those with left-sided epilepsy had higher rates of externalizing problems (33.2%) than those with right (14.0%; χ2[1, 88] = 4.55, p = 0.03), with rule-breaking behaviors (15.4%) being more common in left-hemisphere epilepsy (15.4% versus 2.3%; χ2[1,88] = 4.66, p = 0.03). In summary, while no significant differences were found across epilepsy groups, the current study adds to the literature regarding lateralization effects and mood/behavior, with more externalizing problems in those with left hemisphere epilepsy.

We determined whether neuroticism and extraversion are associated with health-related quality of life (HRQoL) independently from other psychological factors in persons with epilepsy.

This was a cross-sectional study of 357 adults with epilepsy. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31), short form of the Eysenck Personality Questionnaire-Revised, Hospital Anxiety Depression Scale, Rosenberg Self-esteem Scale, and Stigma Scale for Epilepsy were used. A hierarchical linear regression analysis and Sobel test were performed.

The final model explained 64.2% of the variance in the QOLIE-31. Demographic factors, entered in step 1 of the hierarchical linear regression, explained <1% of the variance. Social factors entered in step 2 and epilepsy-related factors in step 3 explained an additional 9.3% and 9.6% of the variance, respectively. Psychological factors, entered in the final step, explained 44.7% of the variance. Except for extraversion, all psychological factors assessed were independently associated with QOLIE-31 scores. When entered in step 1 of the regression analysis, neuroticism explained 36.1% of the variance, following only depression (49.0%) and anxiety (44.9%) according to the Hospital Anxiety Depression Scale. Both neuroticism (B = -0.264, p = 0.001) and extraversion (B = 0.189, p = 0.009) had indirect effects on QOLIE-31 scores mediated by depressive symptoms.

Neuroticism is the third most important factor for HRQoL of persons with epilepsy, following depressive symptoms and anxiety. Both neuroticism and extraversion indirectly affect HRQoL through depressive symptoms.

Neuroticism is the third most important factor for HRQoL of persons with epilepsy, following depressive symptoms and anxiety. Both neuroticism and extraversion indirectly affect HRQoL through depressive symptoms.We conducted a systematic review of anti-seizure medications (ASMs) and their efficacy for the control of focal to bilateral tonic-clonic seizures (FBTCS). FBTCS, especially when nocturnal, are recognized as one of the major risk factors for Sudden Unexpected Death in Epilepsy (SUDEP). We searched different online databases for all the randomized, double-blinded, and placebo-controlled clinical trials of ASMs that were FDA-approved after 1990 and that reported specifically on the reduction in FBTCS; when possible, this was compared to reduction in focal impaired awareness (FIA) seizures. The ASMs that yielded the most data (3 or more studies) were topiramate (TPM), followed by tiagabine (TGB), brivaracetam (BRV), and lamotrigine (LTG). TPM trials showed a reduction in FBTCS of 44.8% to 100% (4.5-99% over placebo); TGB 21.8% to 46.7% (21.8-61% over placebo); BRV 33.9% to 82.1% (11.6-57.4% over placebo); and LTG 55.2% (20.3-52% over placebo). Promising results, but with data from only one or two studies, were seen with cenobamate (18-59% efficacy above placebo), lacosamide (45.1-78.7%), levetiracetam (40.1-60.3%), oxcarbazepine (58.5-81.5%), and gabapentin (50-53.8%). Higher responses were often seen at higher doses, including at doses above those currently approved by the FDA. Results specific to nocturnal FBTCS were never reported for any ASM. Moreover, complete freedom from FBTCS specifically was very rarely reported, despite its relevance for SUDEP prevention. In conclusion, there are few data specifically comparing the efficacy of ASMs for prevention of FBTCS despite the known strong association of BTCS with SUDEP. This review was our attempt at filling a gap in the literature and calling for universal reporting of data specific to BTC seizure reduction in all future studies, preferably including specific reporting on nocturnal BTCS. This will help enable rational ASM selection to minimize BTC seizures and thereby decrease the risk of SUDEP.

To assess the influence of race on short-term patient outcomes in a pituitary tumor surgery population.

Coarsened exact matching was used to retrospectively analyze consecutive patients (n = 567) undergoing pituitary tumor resection over a six-year period (June 07, 2013 to April 29, 2019) at a single, multi-hospital academic medical center. Black/African American and white patients were exact matched based on twenty-nine (29) patient, procedure, and hospital characteristics. Entinostat mw Matching characteristics included surgical costs, American Society of Anesthesiologists grade, duration of surgery, and Charlson Comorbidity Index, amongst others. Outcomes studied included unplanned 90-day readmission, emergency room (ER) evaluation, and unplanned reoperation.

Ninety-two (n = 92) patients were exact matched and analyzed. There was no significant difference in 90-day readmission (p = 0.267, OR (black/AA vs white) = 0.500, 95% CI = 0.131-1.653) or ER evaluation within 90 days (p = 0.092, OR = 3.000, 95% CI = 0.848-13.737) between the two cohorts. Furthermore, there was no significant difference in the rate of unplanned reoperation throughout the duration of the follow up period between matched black/African American and white patients (p = 0.607, OR = 0.750, 95% CI = 0.243-2.211).

This study suggests that the effect of race on post-operative outcomes is largely mitigated when equal access is attained, and when race is effectively isolated from socioeconomic factors and comorbidities in a population undergoing pituitary tumor resection.

This study suggests that the effect of race on post-operative outcomes is largely mitigated when equal access is attained, and when race is effectively isolated from socioeconomic factors and comorbidities in a population undergoing pituitary tumor resection.