Epilepsia
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Male and female sexuality and reproductive functions are complex systems with cortical, limbic system, hypothalamic, pituitary, and end organ interactions. Sexual steroids are produced in the sexual glands, the adrenals, and the brain. They undergo interconversion in the brain, bind to different brain areas, and have multiple effects behaviorally and neurophysiologically. ⋯ AEDs alter contraceptive hormone treatments. Information on the effects of new AEDs is being gathered by the National Pregnancy Registry. Catamenial epilepsy and some sexual dysfunction in men may be treatable.
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Epilepsy surgery (ES) is addressed in relation to economic classifications of national resources and welfare in developing countries. A decade ago, ten developing countries conducted ES; now 26 such countries have reported results of ES. A number of international authorities define indicators of national economic welfare. ⋯ The surgical outcomes achieved are similar to those in the developed world, but at a fractional cost. To internationalize ES, outcome, cost, and savings from care, evolution of assessment methodology is needed. Also needed is general support from the developed world.
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Comparative Study
Cost minimization analysis of antiepileptic drugs in newly diagnosed epilepsy in 12 European countries.
A recent United Kingdom cost minimization analysis (CMA) of four antiepileptic drugs (AEDs) used to treat newly diagnosed adult epilepsy demonstrated that a new drug, lamotrigine (LTG), incurred higher costs than carbamazepine (CBZ), phenytoin (PHT), and valproate (VPA), whose costs were similar. This analysis took account of each drug's side-effect and tolerability profile. The present analysis investigated the costs of treatment with LTG, CBZ, PHT, and VPA in 12 European countries. ⋯ Only direct medical costs were considered. In each country considered, LTG was twofold to threefold more expensive than the other drugs considered. A sensitivity analysis demonstrated that varying each of the assumptions (range defined by expert panels) did not significantly alter the results obtained.
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Comparative Study
Reliability and validity of a Norwegian version of the quality of life in epilepsy inventory (QOLIE-89).
To develop a Norwegian version of the Quality of Life in Epilepsy Inventory (QOLIE-89) and to confirm its psychometric properties. ⋯ In this cross-sectional survey, the Norwegian version of the QOLIE-89 was reliable and showed properties supporting construct validity, at a level comparable with the original U.S. version.