Comment diagnostique-t-on l'épilepsie partielle complexe ?

Le diagnostic repose sur l'historique médical, l'EEG et l'imagerie cérébrale.

Quels tests sont utilisés pour confirmer le diagnostic ?

L'EEG et l'IRM sont essentiels pour visualiser l'activité cérébrale et les anomalies.

Les symptômes peuvent-ils varier d'un patient à l'autre ?

Oui, les symptômes peuvent différer selon la localisation de l'activité épileptique.

Quel rôle joue l'historique médical dans le diagnostic ?

L'historique médical aide à identifier les antécédents de crises et les facteurs déclenchants.

Peut-on diagnostiquer l'épilepsie partielle complexe chez les enfants ?

Oui, elle peut se manifester chez les enfants, nécessitant une évaluation spécialisée.

Quels sont les symptômes typiques des crises ?

Les symptômes incluent des mouvements involontaires, des hallucinations et des troubles de la conscience.

Les crises peuvent-elles affecter la mémoire ?

Oui, les crises peuvent entraîner des pertes de mémoire temporaires ou des confusions.

Comment se manifestent les comportements automatisés ?

Les comportements automatisés incluent des gestes répétitifs sans conscience de l'environnement.

Les crises peuvent-elles être précédées d'aura ?

Oui, certaines personnes ressentent une aura, un signe avant-coureur de la crise.

Les symptômes peuvent-ils persister après la crise ?

Oui, des symptômes comme la fatigue ou la confusion peuvent persister après la crise.

Peut-on prévenir les crises d'épilepsie partielle complexe ?

Bien qu'il soit difficile de prévenir, éviter les déclencheurs connus peut aider.

Quels sont les déclencheurs courants des crises ?

Le stress, le manque de sommeil et l'alcool sont des déclencheurs fréquents.

L'éducation des proches est-elle importante ?

Oui, informer les proches sur les crises et les premiers secours est crucial.

Les activités physiques sont-elles sûres ?

Certaines activités peuvent être sûres, mais il est important de consulter un médecin.

Comment gérer le stress pour prévenir les crises ?

Des techniques de relaxation comme la méditation peuvent aider à gérer le stress.

Quels médicaments sont couramment prescrits ?

Les anticonvulsivants comme la carbamazépine et la lamotrigine sont souvent utilisés.

La chirurgie est-elle une option de traitement ?

Oui, la chirurgie peut être envisagée si les médicaments ne contrôlent pas les crises.

Quelles sont les alternatives aux médicaments ?

Les thérapies comportementales et la stimulation cérébrale peuvent être des options.

Comment évaluer l'efficacité du traitement ?

L'efficacité est évaluée par la fréquence des crises et les effets secondaires des médicaments.

Les changements de mode de vie peuvent-ils aider ?

Oui, un mode de vie sain, incluant sommeil et gestion du stress, peut aider.

Quelles sont les complications possibles de l'épilepsie ?

Les complications incluent les blessures lors des crises et des problèmes psychologiques.

L'épilepsie peut-elle affecter la vie sociale ?

Oui, elle peut entraîner des difficultés sociales et des stigmates associés.

Y a-t-il un risque accru de dépression ?

Oui, les personnes épileptiques présentent un risque plus élevé de dépression et d'anxiété.

Les crises peuvent-elles entraîner des blessures graves ?

Oui, les chutes ou les accidents pendant une crise peuvent causer des blessures graves.

Comment les complications peuvent-elles être gérées ?

Une prise en charge multidisciplinaire est essentielle pour gérer les complications.

Quels sont les facteurs de risque de l'épilepsie partielle complexe ?

Les antécédents familiaux, les traumatismes crâniens et les infections cérébrales sont des facteurs de risque.

L'âge influence-t-il le risque d'épilepsie ?

Oui, l'épilepsie peut survenir à tout âge, mais elle est plus fréquente chez les jeunes enfants et les personnes âgées.

Les maladies neurologiques augmentent-elles le risque ?

Oui, des maladies comme la sclérose en plaques peuvent augmenter le risque d'épilepsie.

Les facteurs environnementaux jouent-ils un rôle ?

Oui, des facteurs comme l'exposition à des toxines peuvent contribuer au risque d'épilepsie.

Le stress peut-il être un facteur de risque ?

Oui, le stress chronique peut déclencher des crises chez certaines personnes épileptiques.

Épilepsie partielle complexe - Informations médicales vérifiées

The "Medicare effect" on head and neck cancer diagnosis and survival.

07 2023

DOI: 10.1002/hed.27379 PMID: 37096786

Uninsured individuals age 55-64 experience disproportionately poor outcomes compared to their insured counterparts. Adequate coverage may prevent these delays. This study investigates a "Medicare-effe... The Surveillance, Epidemiology, and End Results (SEER) database was queried for persons ages 60-70 years in the United States from 2000 to 2016 with HNSCC. A "Medicare effect" was defined as an increa... Compared to their Medicaid or uninsured counterparts, patients age 65 have an increased incidence of HNSCC diagnosis, reduction in advanced stage presentation, decrease in cancer-specific mortality, a... Patients age 65 with Medicare have decreased incidence of HNSCC, less hazard of late-stage diagnosis, and lower cancer-specific mortality than their Medicaid or uninsured counterparts, supporting the ...

Humans Aged United States Middle Aged Medicare +4 autres

Do urgent care centers reduce Medicare spending?

05 2023

DOI: 10.1016/j.jhealeco.2023.102753 PMID: 37011520

We ask how urgent care centers (UCCs) impact healthcare costs and utilization among nearby Medicare beneficiaries. When residents of a zip code are first served by a UCC, total Medicare spending rises...

Aged Humans United States Medicare Health Expenditures +3 autres

The cost of opioid use disorder-related conditions in Medicare.

01 03 2023

DOI: 10.1016/j.drugalcdep.2023.109778 PMID: 36701935

Medicare coverage excludes some levels of substance use disorder (SUD) care, such as intensive outpatient and residential treatment. Expanding access to SUD treatment could increase Medicare spending.... This study estimated cost savings from expanding access to SUD treatment for persons with opioid use disorders (OUD) using three methods. First, we compared total Medicare fee-for-service spending on ... Beneficiaries with OUD but no MOUD totaled $15.8 billion more than beneficiaries without OUD. Beneficiaries with OUD but no MOUD totaled $12.1 billion more than individuals with OUD and MOUD. Lastly, ... Expanding Medicare coverage of appropriate levels of care could improve access to effective treatment and reduce the costs associated with untreated OUD. This will likely result in substantial Medicar...

Aged Humans United States Medicare Opioid-Related Disorders +4 autres

Evaluation of Prior Authorization in Medicare Nonemergent Ambulance Transport.

07 2022

DOI: 10.1001/jamahealthforum.2022.2093 PMID: 35977218

Some Medicare-reimbursed services are overused or improperly used, resulting in payments for unnecessary services.... To determine if prior authorization of services vulnerable to improper use is associated with reduced use and costs without changing patient access or health outcomes.... This study involved repeated cross-sectional evaluation with a state-level matched control group construction and inverse propensity score weighting at the Medicare beneficiary level. Eight states plu... Ambulance suppliers were directed to request prior authorization for Repetitive, Scheduled, Non-Emergent Ambulance Transport (RSNAT) services; failure to do so resulted in prepayment claim review. The... Primary outcomes included total cost of care, RSNAT use rates and expenditures, unplanned hospital admission, emergency department admission, and emergency ambulance use per beneficiary-year. All meas... Approximately 1.7 million Medicare beneficiaries were observed in the study (mean [SD] age, 71 [15] years; 50% female beneficiaries; 30% Black beneficiaries, 64% White beneficiaries; 20% rural residen... In this difference-in-differences analysis of Medicare beneficiaries, the results suggest that the RSNAT Prior Authorization Model was associated with reduced costs with little or no change in the qua...

Aged Ambulances Cross-Sectional Studies Female Humans +6 autres

Impact of Medicare eligibility on informal caregiving for surgery and stroke.

02 2023

DOI: 10.1111/1475-6773.14019 PMID: 35791447

To assess whether the intensity of family and friend care changes after older individuals enroll in Medicare at age 65.... Health and Retirement Study survey data (1998-2018).... We compared informal care received by patients hospitalized for stroke, heart surgery, or joint surgery and who were stratified into propensity-weighted pre- and post-Medicare eligibility cohorts. A r... Not applicable.... A total of 2270 individuals were included; 1674 (73.7%) stroke, 240 (10.6%) heart surgery, and 356 (15.7%) joint surgery patients. Mean (SD) care received was 20.0 (42.1) weekly hours. Of the 1214 (53... Medicare coverage was associated with a substantial decrease in family and friend caregiving use for stroke patients. Informal care may substitute for rather than complement restorative care, given th...

Male Humans Aged United States Caregivers +4 autres

Two Decades of Declining Medicare Reimbursement in Cardiac Surgery.

10 2023

DOI: 10.1016/j.athoracsur.2023.06.023 PMID: 37423345

Given the uncertainty of US health care finances, an understanding of reimbursement trends has become increasingly important in the field of cardiac surgery. We aimed to assess Medicare reimbursement ... Reimbursement data were extracted from the Centers for Medicare and Medicaid Services Physician Fee Schedule Look-Up Tool during the study period for 6 common cardiac operations: aortic valve replacem... Inflation-adjusted reimbursement decreased by 34.1% during the study period. The overall compound annual growth rate was -1.8%. Reimbursement trends differed by procedure (P < .001), with all reimburs... Medicare reimbursement significantly decreased for most cardiac surgical procedures. These trends justify further advocacy by The Society of Thoracic Surgeons to maintain access to quality cardiac sur...

Aged Humans United States Medicare Cardiac Surgical Procedures +4 autres

The effect of medicare and screening guidelines on colorectal cancer outcomes.

Feb 2023

DOI: 10.1016/j.jnma.2022.09.006 PMID: 36470707

Colorectal cancer screening has been shown effective at reducing stage at presentation, but there is differential uptake of screening based on insurance status. We sought to determine the population-l... Data on Black and white patients with colorectal cancer were obtained from the SEER database. Regression discontinuity was used to assess the causal effect of near-universal health insurance (represen... In the Southern United States, Black patients saw a significant decrease in advanced stage at presentation at age 65 (coefficient -0.12, p = 0.003), while white patients did not (coefficient -0.03, p ... Our data highlight the significant impact that near-universal insurance has on reducing colorectal cancer stage at presentation in areas with poor baseline insurance coverage, particularly for Black p...

Humans Aged United States Middle Aged Medicare +5 autres

Incident depression among Medicare beneficiaries with disabilities and HIV.

15 07 2022

DOI: 10.1097/QAD.0000000000003268 PMID: 35608114

Despite disproportionally high prevalence of HIV and depression in persons with disabilities, no data have been published on the incidence and correlates of depression in Medicare beneficiaries with d... We conducted a retrospective matched cohort study using a 5% sample of Medicare beneficiaries who qualified for disability coverage (1996-2015).... Beneficiaries with incident ( n = 2438) and prevalent ( n = 5758) HIV were individually matched with beneficiaries without HIV (HIV-, n = 20 778). Fine-Gray models with death as a competing risk were ... Beneficiaries with HIV had a higher risk of developing depression within 5 years ( P < 0.0001). Sex differences were observed ( P < 0.0001), with higher subdistribution hazard ratios (sHR) in males wi... Medicare enrollees with disabilities and HIV had an increased risk of developing depression compared to those without HIV, especially among males and within the first year of HIV diagnosis. The HIV-de...

Aged Cohort Studies Depression Disabled Persons Female +7 autres

Utilization outcomes of direct oral anticoagulants in Medicare patients.

11 2023

DOI: 10.1016/j.sapharm.2023.07.002 PMID: 37429747

To compare the adherence, persistence, discontinuation and switching rates of direct oral anticoagulants (DOACs) for Medicare patients with non-valvular atrial fibrillation (NVAF) or venous thromboemb... This was retrospective observational cohort study design. Medicare Part D claims files were used for the study duration (2015-2018). Inclusion-exclusion criteria were applied to identify the NVAF and ... Of all the DOACs, patients with NVAF or VTE were most adherent to apixaban (PDC = 76.88). Among all the DOACs, non-persistence and discontinuation rates were highest for warfarin. Majority of the swit... Medicare plans need to consider adherence, persistence, discontinuation and switching rates of DOACs to make the coverage decisions....

Aged Humans United States Warfarin Rivaroxaban +7 autres

Effects of Medicare wellness visits on health promotion outcomes.

01 Feb 2023

DOI: 10.1097/JXX.0000000000000795 PMID: 36716446

The American older adult population has the highest historical prevalence of chronic disease and underuses wellness visit benefits. Little is known about how Medicare wellness visits (MWVs) affect hea... The aim of this retrospective case-control study was to examine how MWVs affect health outcomes by measuring two kinds of data for case and control groups at baseline versus 15 months: (1) the differe... Informed by Pender's Health Promotion Model, this design used purposively matched samples from a large American Midwestern Medicare population active between January 2013 and January 2016, with a tota... A doubly repeated multivariate analysis of variance (MANOVA) and descriptive statistics revealed significant differences between the case and control group for three of the four health outcomes. The c... Additional research controlling for more variables is warranted to better understand MWV efficacy on health outcomes.... Primary care providers need to study how MWVs affect longitudinal health outcomes....

Humans Aged United States Retrospective Studies Case-Control Studies +3 autres

Épilepsie partielle complexe : Questions médicales fréquentes

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