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Gauffin, Helena
Alternative names
Publications (10 of 12) Show all publications
Berntsson, S. G., Gauffin, H., Melberg, A., Holtz, A. & Landtblom, A.-M. (2019). Inherited Ataxia and Intrathecal Baclofen for the Treatment of Spasticity and Painful Spasms. Stereotactic and Functional Neurosurgery, 97(1), 18-23
Open this publication in new window or tab >>Inherited Ataxia and Intrathecal Baclofen for the Treatment of Spasticity and Painful Spasms
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2019 (English)In: Stereotactic and Functional Neurosurgery, ISSN 1011-6125, E-ISSN 1423-0372, Vol. 97, no 1, p. 18-23Article in journal (Refereed) Published
Abstract [en]

Background: Intrathecal baclofen (ITB) treatment is considered a powerful tool in the management of severe spasticity in neurological conditions such as multiple sclerosis, cerebral palsy, and traumatic spinal cord and brain injury. 

Objectives: The objective of this study was to assess the effectiveness of the ITB in patients with inherited ataxia suffering from severe painful spasms and/or spasticity. 

Method: A total of 5 patients with spinocerebellar ataxia 3 or 7 or Friedreich’s ataxia were included in this observational multicenter study. The patients were interviewed and completed outcome measures assessing pain (The Brief Pain Inventory), fatigue (Fatigue Severity Scale), and life satisfaction (LiSAT-9) before and 1 year after the treatment. Spasticity (Modified Ashworth Scale) and spasm frequency (SPFS) were measured objectively for each patient. 

Results: The mean treatment time was 1.9 years. Evaluation of established standard forms revealed symptomatic relief from spasticity, spasms, pain, and fatigue in addition to improved body posture, sleep, and life satisfaction after ITB treatment. 

Conclusions: We report the potential beneficial effects of ITB treatment in patients with inherited ataxia who also suffer from spasticity/spasms. ITB treatment indication in neurological disorders allows for extension to the treatment of spasticity/ spasms in patients with hereditary ataxia.

Place, publisher, year, edition, pages
S. Karger, 2019
Keywords
Intrathecal baclofen treatment; Inherited ataxia; Spasms; Spasticity; Pain
National Category
Neurology
Identifiers
urn:nbn:se:liu:diva-157571 (URN)10.1159/000497165 (DOI)000467683300003 ()30870851 (PubMedID)2-s2.0-85063459883 (Scopus ID)
Available from: 2019-06-22 Created: 2019-06-22 Last updated: 2019-06-24Bibliographically approved
Jonsson Gauffin, H., Flensner, G. & Landtblom, A.-M. (2015). Being parents with epilepsy: thoughts on its consequences and difficulties affecting their children. Neuropsychiatric Disease and Treatment, 11, 1291-1298
Open this publication in new window or tab >>Being parents with epilepsy: thoughts on its consequences and difficulties affecting their children
2015 (English)In: Neuropsychiatric Disease and Treatment, ISSN 1176-6328, E-ISSN 1178-2021, Vol. 11, p. 1291-1298Article in journal (Refereed) Published
Abstract [en]

Objective: Parents with epilepsy can be concerned about the consequences of epilepsy affecting their children. The aim of this paper is to describe aspects of what it means being a parent having epilepsy, focusing the parents perspectives and their thoughts on having children. Methods: Fourteen adults aged 18-35 years with epilepsy and subjective memory decline took part in focus-group interviews. The interviews were conducted according to a semi-structured guideline. Material containing aspects of parenthood was extracted from the original interviews and a secondary analysis was done according to a content-analysis guideline. Interviews with two parents for the Swedish book Leva med epilepsi [To live with epilepsy] by AM Landtblom (Stockholm: Bilda ide; 2009) were analyzed according to the same method. Results: Four themes emerged: (1) a persistent feeling of insecurity, since a seizure can occur at any time and the child could be hurt; (2) a feeling of inadequacy - of not being able to take full responsibility for ones child; (3) acknowledgment that ones children are forced to take more responsibility than other children do; and (4) a feeling of guilt - of not being able to fulfill ones expectations of being the parent one would like to be. Conclusion: The parents with epilepsy are deeply concerned about how epilepsy affects the lives of their children. These parents are always aware that a seizure may occur and reflect on how this can affect their child. They try to foresee possible dangerous situations and prevent them. These parents were sad that they could not always take full responsibility for their child and could not live up to their own expectations of parenthood. Supportive programs may be of importance since fear for the safety of the child increases the psychosocial burden of epilepsy. There were also a few parents who did not acknowledge the safety issue of their child - the authors believe that it is important to identify these parents and provide extra information and support to them.

Place, publisher, year, edition, pages
Dove Medical Press, 2015
Keywords
focus group interviews; qualitative research; secondary analysis; guilt; feeling of inadequacy; insecurity
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-119598 (URN)10.2147/NDT.S74222 (DOI)000355122200001 ()26064047 (PubMedID)
Note

Funding Agencies|Cyberonics; Eisai; GlaxoSmithKline; Grunenthal; UCB

Available from: 2015-06-22 Created: 2015-06-22 Last updated: 2017-12-04
Gauffin, H. & Landtblom, A.-M. (2014). Epilepsy and violence: case series concerning physical trauma in children of persons with epilepsy. Neuropsychiatric Disease and Treatment, 10, 2183-2189
Open this publication in new window or tab >>Epilepsy and violence: case series concerning physical trauma in children of persons with epilepsy
2014 (English)In: Neuropsychiatric Disease and Treatment, ISSN 1176-6328, E-ISSN 1178-2021, Vol. 10, p. 2183-2189Article in journal (Refereed) Published
Abstract [en]

Historically, epilepsy has been associated with violence, but more recent studies have emphasized genetic and psychosocial factors as more important. The case series presented here aim to highlight the difficult situation the affected children are in. We report on three cases when children have been traumatized and, in one case, even been killed by their parent who was diagnosed with epilepsy. In the first case, we describe a woman with juvenile myoclonic epilepsy who was sentenced to forensic psychiatry care for killing her child. She lived under difficult psychosocial circumstances and a suicide attempt contributed to what happened. The second case describes a man with post-traumatic seizures who was sentenced for child abuse. Ictal or postictal violence was considered in these two cases but a causal link between the violence and epilepsy has not been established. In the third case, we describe a woman with focal epilepsy and psychogenic non-epileptic seizures (PNESs). Her child was hurt and frightened in relation to violent seizures, which were regarded as PNESs. This case series demonstrates that children of parents with epilepsy can be in a vulnerable situation. No causality has been established between the seizures and these events, so consequently other factors such as psychosocial stress, low cognitive function, and a suicide attempt must also be considered as important. When a child is hurt by a parent with epilepsy the patient must be closely examined to determine the role of the seizures. Children can also be affected by PNESs. It is essential to notice especially those children of parents with epilepsy who live under difficult psychosocial circumstances and offer extra support when necessary.

Place, publisher, year, edition, pages
Dove Medical Press, 2014
Keywords
homicide; epilepsy; child abuse; children; psychosocial; crime; law
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-112846 (URN)10.2147/NDT.S68438 (DOI)000344930400001 ()25484586 (PubMedID)
Available from: 2015-01-08 Created: 2014-12-17 Last updated: 2017-12-05
Gauffin, H., van Ettinger-Veenstra, H., Landtblom, A.-M., Ulrici, D., McAllister, A., Karlsson, T. & Engström, M. (2013). Impaired language function in generalized epilepsy: Inadequate suppression of the default mode network. Epilepsy & Behavior, 28(1), 26-35
Open this publication in new window or tab >>Impaired language function in generalized epilepsy: Inadequate suppression of the default mode network
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2013 (English)In: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 28, no 1, p. 26-35Article in journal (Refereed) Published
Abstract [en]

We aimed to study the effect of a potential default mode network (DMN) dysfunction on language performance in epilepsy. Language dysfunction in focal epilepsy has previously been connected to brain damage in language-associated cortical areas. In this work, we studied generalized epilepsy (GE) without focal brain damage to see if the language function was impaired. We used functional magnetic resonance imaging (fMRI) to investigate if the DMN was involved. Eleven persons with GE and 28 healthy controls were examined with fMRI during a sentence-reading task. We demonstrated impaired language function, reduced suppression of DMN, and, specifically, an inadequate suppression of activation in the left anterior temporal lobe and the posterior cingulate cortex, as well as an aberrant activation in the right hippocampal formation. Our results highlight the presence of language decline in people with epilepsy of not only focal but also generalized origin.

Place, publisher, year, edition, pages
Elsevier, 2013
Keywords
generalized epilepsy, functional Magnetic Resonance Imaging (fMRI), language performance, sentence reading, verbal fluency, default mode network, hippocampus, temporal lobe, posterior cingulate cortex
National Category
Radiology, Nuclear Medicine and Medical Imaging Neurology
Identifiers
urn:nbn:se:liu:diva-91043 (URN)10.1016/j.yebeh.2013.04.001 (DOI)000320423500007 ()23648277 (PubMedID)
Available from: 2013-04-12 Created: 2013-04-12 Last updated: 2017-12-06Bibliographically approved
Gauffin, H. (2012). Epilepsy in young adulthood: medical, psychosocial and functional aspects. (Doctoral dissertation). Lin: Linköping University Electronic Press
Open this publication in new window or tab >>Epilepsy in young adulthood: medical, psychosocial and functional aspects
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to describe the medical, cognitive and psychosocial consequences of epilepsy in young adulthood. Four studies were carried out with this patient group. The first two papers were based on a follow-up study regarding young adults with epilepsy that investigated medical and psychosocial aspects and compared the present results with those five years earlier. We then conducted focus group interviews with young adults with epilepsy and subjective cognitive decline to assess the deeper meaning of living with epilepsy accompanied by cognitive difficulties. In the fourth study we studied cognitive dysfunction further, choosing the language function in young adults with epilepsy. We firstly examined whether language impairments were associated to functional brain alterations and secondly related the language performance to demographics, clinical data, Quality of Life (QoL) and self-esteem.

The five-year follow up of 97 young adults with uncomplicated epilepsy revealed no improvement regarding seizure frequency or side effects from anti-epileptic drugs (AEDs) over time, even though many new-generation AEDs had been established during this period. During the study period 21% had recovered from epilepsy, Seizure frequency among those who still had epilepsy had not improved, and 42% had experienced seizures during the past year. New-generation anti-epileptic drugs (AEDs) had been introduced to PWE, especially to women. There is still need for new and more effective treatment options for this group in the future. It is essential to find alternative approaches to develop better treatment options for this group in the future. However QoL was normal compared to the general population, indicating that new options regarding treatment can have made an impact. Lower QoL was correlated to high seizure frequency and to cognitive side effects. Self-esteem and Sence of Coherence were impaired compared to the situation at adolescence. Self-esteem was correlated to seizure frequency and to side-effects of antiepileptic drugs. Sence of Coherence was not correlated to epilepsy-related factors in the same way as QoL, but mirrored the phenomenon of epilepsy.

The qualitative study showed that the consequences of epilepsy are not only restricted to the consequences of seizures, but also concerns many other aspects of life. The interviews revealed four themes: “affecting the whole person“, “influencing daily life”, ”affecting relations” and ”meeting ignorance in society”. Another important factor was language function; when one loses some language ability, this gives a feeling of losing one’s capability.

The fourth study examined language by neuropsychological methods and correlated this function to brain activation measured by fMRI. Language functions measured in verbal fluency and abstract language comprehension were impaired in participants with both generalized epilepsy and epilepsy of focal onset. Age at onset of epilepsy and education are the most important factors correlating to language function. An additional factor that impacts abstract language comprehension is the frequency of convulsive seizures, while use of topiramate /zonisamide affect verbal fluency negatively. QoL was not correlated to language impairments, but for patients with focal onset seizures there was a correlation between self-esteem and abstract language comprehension. The fMRI investigation revealed altered activity during language tasks in participants with epilepsy compared to controls. In epilepsy with focal seizures originating in the left hemisphere, we found increased bilateral activation of supporting areas, in the anterior mid-cingulate cortex and the anterior ventral insulae, indicating a compensational functional reorganization. In generalized epilepsy, the functional language network showed an imbalance, as this group expressed an inadequate suppression of activation in the anterior temporal lobe during semantic processing. Subtle language impairment can, even if it does not occur in everyday dialogue, be of importance and have consequences for the person affected. The negative consequences of language decline must be addressed in people with epilepsy of different etiology. Young adults with epilepsy are still substantially affected by the condition. The consequences are not only restricted to the seizures, but concern many aspects of life and there is a great need for new treatment options for this group in the future.

Place, publisher, year, edition, pages
Lin: Linköping University Electronic Press, 2012. p. 66
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1309
Keywords
Epilepsy, young adult, Quality of Life, self-esteem, daily life, antiepileptic drugs, cognition, language, fMRI, Sence of Coherence
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-80388 (URN)978-91-7519-893-4 (ISBN)
Public defence
2012-09-13, Linden, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2012-08-24 Created: 2012-08-24 Last updated: 2013-09-04Bibliographically approved
van Ettinger-Veenstra, H., Gauffin, H., McAllister, A., Lundberg, P., Karlsson, T. & Engström, M. (2012). Language deficits in Epilepsy, an fMRI study. In:  . Paper presented at Human Brain Mapping, Beijing.
Open this publication in new window or tab >>Language deficits in Epilepsy, an fMRI study
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2012 (English)In:  , 2012Conference paper, Oral presentation with published abstract (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-80753 (URN)
Conference
Human Brain Mapping, Beijing
Available from: 2012-08-29 Created: 2012-08-29 Last updated: 2015-09-22
van Ettinger-Veenstra, H., Gauffin, H., McAllister, A., Lundberg, P., Ulrici, D., Landtblom, A.-M., . . . Engström, M. (2012). Language deficits in Epilepsy, an fMRI study. Paper presented at 18th Annual Meeting of the Organization for Human Brain Mapping, June 10-14, 2012, Beijing, China.
Open this publication in new window or tab >>Language deficits in Epilepsy, an fMRI study
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2012 (English)Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Cognitive functions in people with epilepsy are affected by focality, number of generalized seizures, side effects of antiepileptic drugs (AEDs) or the underlying disease (Kwan, 2001). Newly diagnosed patients have cognitive deficits even before starting on AEDs. Performance declines already in the first year after diagnosis and the impairment continues in the following years (Taylor, 2010; Baker, 2011). In mesial temporal lobe epilepsy (TLE) the hippocampal damage seems to be progressive and accompanied by thinning of neocortex (Briellmann, 2002; Bernhardt, 2009). Widespread structural and functional abnormalities in left TLE can affect more distant networks (Bonilha, 2009); a damage pattern also seen in right TLE (Karunanayaka, 2011).

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-75913 (URN)
Conference
18th Annual Meeting of the Organization for Human Brain Mapping, June 10-14, 2012, Beijing, China
Available from: 2012-03-16 Created: 2012-03-16 Last updated: 2015-09-22
Gauffin, H., Flensner, G. & Landtblom, A.-M. (2011). Living with epilepsy accompanied by cognitive difficulties: Young adults experiences. Epilepsy & Behavior, 22(4), 750-758
Open this publication in new window or tab >>Living with epilepsy accompanied by cognitive difficulties: Young adults experiences
2011 (English)In: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 22, no 4, p. 750-758Article in journal (Refereed) Published
Abstract [en]

Objective: Epilepsy can sometimes be followed by memory impairment. This can result from the underlying cause of epilepsy or from recurrent seizures, or can be a side effect of antiepileptic drugs or a symptom of another disease such as depression. The aim of the study described here was to explore the experience of living with epilepsy and subjective cognitive decline. less thanbrgreater than less thanbrgreater thanMethod: To better understand the deeper meaning of the phenomenon, a qualitative design was chosen. Fourteen adults aged 18-35 took part in focus group interviews. The participants were divided into four groups, two groups of women and two groups of men, and the interviews were conducted according to a semistructured protocol. Transcripts were analyzed in accordance with the content analysis guidelines. less thanbrgreater than less thanbrgreater thanResults: Four themes emerged: "affecting the whole person," "influencing daily life," "affecting relationships," and "meeting ignorance in society." less thanbrgreater than less thanbrgreater thanConclusions: Cognitive decline has a heavy impact on young adults with intractable epilepsy. In contrast to seizures, the cognitive decline is persistent. The themes reflected different hardships faced by the participants. The consequences of living with epilepsy and cognitive impairment concerned education, employment, social life, self-esteem, and hope for the future. The participants were already using strategies to cope with their cognitive decline, but may benefit from help in developing new strategies to better adjust to their memory problems. Development of more educational programs for both people with epilepsy and their relatives could improve their difficult situations. With help, people can learn to adjust their goals in life and live a fulfilling life despite the disease.

Place, publisher, year, edition, pages
Elsevier, 2011
Keywords
Epilepsy, Young adults, Cognition, Memory problems, Focus group interviews, Qualitative study, Daily life
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-74162 (URN)10.1016/j.yebeh.2011.09.007 (DOI)000298067600020 ()
Available from: 2012-01-20 Created: 2012-01-20 Last updated: 2017-12-08
Gauffin, H., Landtblom, A.-M. & Raty, L. (2010). Self-esteem and sense of coherence in young people with uncomplicated epilepsy: A 5-year follow-up. EPILEPSY and BEHAVIOR, 17(4), 520-524
Open this publication in new window or tab >>Self-esteem and sense of coherence in young people with uncomplicated epilepsy: A 5-year follow-up
2010 (English)In: EPILEPSY and BEHAVIOR, ISSN 1525-5050, Vol. 17, no 4, p. 520-524Article in journal (Refereed) Published
Abstract [en]

Objective: It is not clear how the psychosocial well-being of young people with epilepsy is affected by growing up with the condition. We studied self-esteem and sense of coherence in a group of young adults with epilepsy and compared the results with those obtained 5 years earlier. Methods: The participants (n = 97) answered questionnaires regarding self-esteem, sense of coherence, and medical characteristics. Results: Self-esteem and sense of coherence both decreased during the 5-year study period. Self-esteem was correlated to epilepsy-related variables. Participants who were seizure free scored higher on sense of coherence, but there was no association between seizure frequency and sense of coherence among participants who still experienced seizures. Conclusion: We found that there was a decline in both sense of coherence and self-esteem over time for young adults with epilepsy. Growing up with epilepsy can lead to impairment of sense of coherence. Sense of coherence does not significantly correlate with epilepsy-related factors, but mirrors the phenomenon of epilepsy. Self-esteem is associated with such epilepsy-related factors as seizure frequency.

Place, publisher, year, edition, pages
Elsevier Science B.V., Amsterdam, 2010
Keywords
Epilepsy, Seizure-frequency, Self-esteem, Sense of coherence, Young adults, Psychosocial aspects
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-56533 (URN)10.1016/j.yebeh.2010.01.167 (DOI)000277446000017 ()
Available from: 2010-05-21 Created: 2010-05-21 Last updated: 2012-08-24
Gauffin, H., Raty, L. & Soderfeldt , B. (2009). Medical outcome in epilepsy patients of young adulthood-A 5-year follow-up study. SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, 18(4), 293-297
Open this publication in new window or tab >>Medical outcome in epilepsy patients of young adulthood-A 5-year follow-up study
2009 (English)In: SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, ISSN 1059-1311 , Vol. 18, no 4, p. 293-297Article in journal (Refereed) Published
Abstract [en]

The appearance of new anti-epileptic drugs (AED) during the last decade has provided neurologists and their patients with a greater choice, but the proof for their superiority over traditional AEDs is sparse, especially their use in adolescence and Young adulthood. We studied a group Of Young adults (18-27 years) with epilepsy and compared their Situation in 2004 with those 5 years earlier.

Materials and methods: The participants (n = 97) answered questionnaires regarding seizure-frequency, AED, side-effects and quality-of-life. Information was also taken from medical records.

Results: The use of new generation AEDs increased during the 5-year study period, particularly among women. However seizure frequency had not changed significantly over time, and compared to men the effectiveness in controlling seizures Was lower in women. The participants reported normal quality-of-life (QOL), which may indicate that the increase in number of AEDs to choose from actually improved the situation for these Young adults with epilepsy. Frequency of seizures and cognitive side-effects of AEDs were associated with a lower QOL.

Conclusions: More women than men seem to be treated with new AEDs, and that the increase in use of new AEDs does not reduce seizure frequency in young adulthood. The effectiveness in controlling seizures seems to be lower in women in the age group Studied. Further Studies are required to better understand how epilepsy related factors interact.

 

Keywords
Epilepsy, Medical outcome, Quality-of-life, Young adults
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-18136 (URN)10.1016/j.seizure.2008.11.009 (DOI)
Available from: 2009-05-09 Created: 2009-05-08 Last updated: 2012-08-24
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