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  • 1.
    Berntsson, Shala G.
    et al.
    Uppsala Univ, Sweden.
    Gauffin, Helena
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Melberg, Atle
    Uppsala Univ, Sweden.
    Holtz, Anders
    Uppsala Univ, Sweden.
    Landtblom, Anne-Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Neurologiska kliniken. Uppsala Univ, Sweden.
    Inherited Ataxia and Intrathecal Baclofen for the Treatment of Spasticity and Painful Spasms2019Ingår i: Stereotactic and Functional Neurosurgery, ISSN 1011-6125, E-ISSN 1423-0372, Vol. 97, nr 1, s. 18-23Artikel i tidskrift (Refereegranskat)
    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.

  • 2.
    Börjesson, L.
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Linköpings universitet, Hälsouniversitetet.
    Stockhaus, J.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Linköpings universitet, Hälsouniversitetet.
    Gauffin, Helena
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Ragnehed, Mattias
    Linköpings universitet, Institutionen för medicin och vård, Medicinsk radiologi. Linköpings universitet, Hälsouniversitetet.
    Lundberg, Peter
    Linköpings universitet, Institutionen för medicin och vård, Medicinsk radiofysik. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Söderfeldt, Birgitta
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Linköpings universitet, Hälsouniversitetet.
    Comparison between fMRI and Wada test2004Ingår i: Epilepsia, ISSN 0013-9580, E-ISSN 1528-1167, Vol. 45, nr Suppl. 3, s. 84-84Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Language lateralisation in patients with epilepsy is more often atypical compared to a normal population. The Wada procedure for testing language and memory has some shortcomings; it is invasive and there is always a risk that the patient becomes too sedated, leading to difficulties in performing the tests. fMR1have shown promising results, showing good correlation to the Wadaprocedure concerning language-lateralisation. The aim of this studywas to investigate if fMRI could be used to determine which hemisphere was language dominant and compare the fMR1 results with the Wada-tests with a focus on patients with a complicated lateralisation.

    Method: 4 subjects were tested and they had a heterogeneous (I left handed, I ambidexter and 2 right handed) lateralisation and one had a severe dyslexia. A standard Wada procedure was used and compared with a fMRl investigation using a language paradigm.

    Results: The patients studied showed different language lateralisation patterns (2 left hemisphere and 2 bilateral). In two patients the two tests were fully concordant, in the others the fMRI showed a more bilateral pattern.

    Conclusion: fMR1 adds valuable information in the pre-surgical investigation for patients with a complex language lateralisation.

  • 3.
    Gauffin, Helena
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet.
    Epilepsy in young adulthood: medical, psychosocial and functional aspects2012Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    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.

    Delarbeten
    1. Medical outcome in epilepsy patients of young adulthood-A 5-year follow-up study
    Öppna denna publikation i ny flik eller fönster >>Medical outcome in epilepsy patients of young adulthood-A 5-year follow-up study
    2009 (Engelska)Ingår i: SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, ISSN 1059-1311 , Vol. 18, nr 4, s. 293-297Artikel i tidskrift (Refereegranskat) 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.

     

    Nyckelord
    Epilepsy, Medical outcome, Quality-of-life, Young adults
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-18136 (URN)10.1016/j.seizure.2008.11.009 (DOI)
    Tillgänglig från: 2009-05-09 Skapad: 2009-05-08 Senast uppdaterad: 2012-08-24
    2. Self-esteem and sense of coherence in young people with uncomplicated epilepsy: A 5-year follow-up
    Öppna denna publikation i ny flik eller fönster >>Self-esteem and sense of coherence in young people with uncomplicated epilepsy: A 5-year follow-up
    2010 (Engelska)Ingår i: EPILEPSY and BEHAVIOR, ISSN 1525-5050, Vol. 17, nr 4, s. 520-524Artikel i tidskrift (Refereegranskat) 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.

    Ort, förlag, år, upplaga, sidor
    Elsevier Science B.V., Amsterdam, 2010
    Nyckelord
    Epilepsy, Seizure-frequency, Self-esteem, Sense of coherence, Young adults, Psychosocial aspects
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-56533 (URN)10.1016/j.yebeh.2010.01.167 (DOI)000277446000017 ()
    Tillgänglig från: 2010-05-21 Skapad: 2010-05-21 Senast uppdaterad: 2012-08-24
    3. Living with epilepsy accompanied by cognitive difficulties: Young adults experiences
    Öppna denna publikation i ny flik eller fönster >>Living with epilepsy accompanied by cognitive difficulties: Young adults experiences
    2011 (Engelska)Ingår i: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 22, nr 4, s. 750-758Artikel i tidskrift (Refereegranskat) 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.

    Ort, förlag, år, upplaga, sidor
    Elsevier, 2011
    Nyckelord
    Epilepsy, Young adults, Cognition, Memory problems, Focus group interviews, Qualitative study, Daily life
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-74162 (URN)10.1016/j.yebeh.2011.09.007 (DOI)000298067600020 ()
    Tillgänglig från: 2012-01-20 Skapad: 2012-01-20 Senast uppdaterad: 2017-12-08
    4. Cognitive problems in young adults with epilepsy: Language deficits correlate to brain activation and self-esteem
    Öppna denna publikation i ny flik eller fönster >>Cognitive problems in young adults with epilepsy: Language deficits correlate to brain activation and self-esteem
    Visa övriga...
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    People with epilepsy often display cognitive decline. Language function in epilepsy has been most thoroughly studied in temporal lobe epilepsy, but the impact of language deficits in epilepsy is not fully understood. The aim of this study was to evaluate the effect of epilepsy on language function with functional magnetic resonance imaging of brain activation, with behavioral methods and to relate language performance to demographic data, self-esteem and Quality of life. We specifically aimed to investigate if variation in epilepsy origin would relate to differences in language performance and if these differences could be associated with specific language activation patterns in the brain. We recruited people with epilepsy (29 in total), with focal onset seizures in either the left or right hemispheres or with generalized epilepsy; and 27 matching healthy controls. The participants’ language skills were measured with a phonemic word fluency test and a broader test measuring higher language functions. Functional magnetic resonance images of the brain were obtained during a word fluency and a sentence reading paradigm. Questionnaires on self-esteem and quality of life were collected. People with epilepsy of both focal and generalized origin had impaired function in semantic and verbal fluency tasks compared to the controls. The causes of language impairment were multifactorial; the most important determinants were education and onset age of epilepsy. Impaired language function was correlated to low self-esteem for participants with focal onset seizures; however Quality of life did not seem to be affected by language impairment. The functional magnetic resonance imaging investigation demonstrated altered functional activity during language tasks for participants with epilepsy compared to healthy 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 left anterior ventral insula, indicating a compensational functional reorganization. In generalized epilepsy, the functional language network showed an imbalance expressed as an inadequate  suppression of activation in the left anterior temporal lobe during semantic processing. Our study shows not only that reduced language functioning is present in people with epilepsy other than in the temporal lobe, but also that frequency of convulsive seizures correlates to language impairment. For patients with focalized seizures, low self esteem correlated also to language impairment. Our results highlight the importance of addressing the negative consequences of language decline in people with epilepsy of both focal and generalized origin.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-80385 (URN)
    Tillgänglig från: 2012-08-24 Skapad: 2012-08-24 Senast uppdaterad: 2015-09-22Bibliografiskt granskad
  • 4.
    Gauffin, Helena
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi.
    Flensner, Gullvi
    University of West, Trollhattan, Sweden .
    Landtblom, Anne-Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Medicinska specialistkliniken .
    Living with epilepsy accompanied by cognitive difficulties: Young adults experiences2011Ingår i: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 22, nr 4, s. 750-758Artikel i tidskrift (Refereegranskat)
    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.

  • 5.
    Gauffin, Helena
    et al.
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neurovetenskap. Linköpings universitet, Hälsouniversitetet.
    Landtblom, Anne-Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neurovetenskap. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Medicinska specialistkliniken .
    Epilepsy and violence: case series concerning physical trauma in children of persons with epilepsy2014Ingår i: Neuropsychiatric Disease and Treatment, ISSN 1176-6328, E-ISSN 1178-2021, Vol. 10, s. 2183-2189Artikel i tidskrift (Refereegranskat)
    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.

  • 6.
    Gauffin, Helena
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Landtblom, Anne-Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Medicinska specialistkliniken .
    Raty, Lena
    Karlstad University.
    Self-esteem and sense of coherence in young people with uncomplicated epilepsy: A 5-year follow-up2010Ingår i: EPILEPSY and BEHAVIOR, ISSN 1525-5050, Vol. 17, nr 4, s. 520-524Artikel i tidskrift (Refereegranskat)
    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.

  • 7.
    Gauffin, Helena
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Raty, Lena
    Karlstad University.
    Soderfeldt , Birgitta
    Karlstad University.
    Medical outcome in epilepsy patients of young adulthood-A 5-year follow-up study2009Ingår i: SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, ISSN 1059-1311 , Vol. 18, nr 4, s. 293-297Artikel i tidskrift (Refereegranskat)
    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.

     

  • 8.
    Gauffin, Helena
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet.
    van Ettinger-Veenstra, Helene
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiofysik. Linköpings universitet, Hälsouniversitetet.
    Landtblom, Anne-Marie
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurobiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Ulrici, Daniel
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet.
    McAllister, Anita
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    Karlsson, Thomas
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Filosofiska fakulteten.
    Engström, Maria
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Linköpings universitet, Hälsouniversitetet.
    Cognitive problems in young adults with epilepsy: Language deficits correlate to brain activation and self-esteemManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    People with epilepsy often display cognitive decline. Language function in epilepsy has been most thoroughly studied in temporal lobe epilepsy, but the impact of language deficits in epilepsy is not fully understood. The aim of this study was to evaluate the effect of epilepsy on language function with functional magnetic resonance imaging of brain activation, with behavioral methods and to relate language performance to demographic data, self-esteem and Quality of life. We specifically aimed to investigate if variation in epilepsy origin would relate to differences in language performance and if these differences could be associated with specific language activation patterns in the brain. We recruited people with epilepsy (29 in total), with focal onset seizures in either the left or right hemispheres or with generalized epilepsy; and 27 matching healthy controls. The participants’ language skills were measured with a phonemic word fluency test and a broader test measuring higher language functions. Functional magnetic resonance images of the brain were obtained during a word fluency and a sentence reading paradigm. Questionnaires on self-esteem and quality of life were collected. People with epilepsy of both focal and generalized origin had impaired function in semantic and verbal fluency tasks compared to the controls. The causes of language impairment were multifactorial; the most important determinants were education and onset age of epilepsy. Impaired language function was correlated to low self-esteem for participants with focal onset seizures; however Quality of life did not seem to be affected by language impairment. The functional magnetic resonance imaging investigation demonstrated altered functional activity during language tasks for participants with epilepsy compared to healthy 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 left anterior ventral insula, indicating a compensational functional reorganization. In generalized epilepsy, the functional language network showed an imbalance expressed as an inadequate  suppression of activation in the left anterior temporal lobe during semantic processing. Our study shows not only that reduced language functioning is present in people with epilepsy other than in the temporal lobe, but also that frequency of convulsive seizures correlates to language impairment. For patients with focalized seizures, low self esteem correlated also to language impairment. Our results highlight the importance of addressing the negative consequences of language decline in people with epilepsy of both focal and generalized origin.

  • 9.
    Gauffin, Helena
    et al.
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet.
    van Ettinger-Veenstra, Helene
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Linköpings universitet, Hälsouniversitetet.
    Landtblom, Anne-Marie
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Ulrici, Daniel
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet.
    McAllister, Anita
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    Karlsson, Thomas
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten.
    Engström, Maria
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Linköpings universitet, Hälsouniversitetet.
    Impaired language function in generalized epilepsy: Inadequate suppression of the default mode network2013Ingår i: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 28, nr 1, s. 26-35Artikel i tidskrift (Refereegranskat)
    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.

  • 10.
    Jonsson Gauffin, Helena
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Medicinska fakulteten.
    Flensner, Gullvi
    University of West, Sweden.
    Landtblom, Anne-Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Region Östergötland, Närsjukvården i centrala Östergötland, Neurologiska kliniken. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Medicinska fakulteten. Uppsala University, Sweden.
    Being parents with epilepsy: thoughts on its consequences and difficulties affecting their children2015Ingår i: Neuropsychiatric Disease and Treatment, ISSN 1176-6328, E-ISSN 1178-2021, Vol. 11, s. 1291-1298Artikel i tidskrift (Refereegranskat)
    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.

  • 11.
    van Ettinger-Veenstra, Helene
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Gauffin, Helena
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    McAllister, Anita
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi. Linköpings universitet, Hälsouniversitetet.
    Lundberg, Peter
    Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiofysik. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Radiofysikavdelningen US.
    Karlsson, Thomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande.
    Engström, Maria
    Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Language deficits in Epilepsy, an fMRI study2012Ingår i:  , 2012Konferensbidrag (Refereegranskat)
  • 12.
    van Ettinger-Veenstra, Helene
    et al.
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Linköpings universitet, Hälsouniversitetet.
    Gauffin, Helena
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet.
    McAllister, Anita
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    Lundberg, Peter
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiofysik. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Radiofysikavdelningen US.
    Ulrici, Daniel
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Landtblom, Anne-Marie
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet.
    Karlsson, Thomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Engström, Maria
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Linköpings universitet, Hälsouniversitetet.
    Language deficits in Epilepsy, an fMRI study2012Konferensbidrag (Övrigt vetenskapligt)
    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).

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