IMPACT OF SEIZURE CLUSTERING ON ADULT EPILEPSY

此应用程序适用于以患者为导向的辅导式RCDA(K23)。这位候选人接受过临床神经学和神经生理学方面的培训，目前在阿尔伯特·爱因斯坦医学院(AECOM)任教。候选人的主要兴趣是癫痫的神经生理学、流行病学和预后问题，特别是癫痫发作模式和诱因。候选人的长期目标是发展研究的复杂性和技术，以允许在癫痫或其他神经疾病领域进行高质量的临床研究。职业发展建议包括完成AECOM临床研究培训计划的理学硕士学位，然后在蒙特菲奥里医学中心/AECOM设计、实施和分析拟议的癫痫聚集研究项目，这是一个广泛、成功的临床研究场所，对候选人的长期目标来说是理想的。癫痫发作聚集可能会影响癫痫的治疗和预后，但尚未得到广泛研究。我们的目标是招募300名成年癫痫患者，并前瞻性地跟踪他们几个月。我们将癫痫发作集群定义为在24小时内发生三次或更多癫痫发作。我们计划研究丛集性发作的发生率、危险因素和诱因，以及丛集性发作对各种癫痫结局的影响。我们假设癫痫丛集性发作的发生率很高，癫痫发作丛集性与癫痫持续状态(SE)的定位相关因素和危险因素有关，而STUB的患者患SE的风险将会增加。识别有聚集性风险的患者可能会改善他们的治疗，特别是他们患有SE的风险增加。此外，我们假设我们将确定癫痫聚集的潜在可改变的诱发因素，特别是需要紧急干预的癫痫聚集。这可能会减少聚集性疾病的发生率，并降低由此导致的发病率。最后，我们在我们的队列中检查癫痫的结果指标，包括对药物治疗的反应，生活质量，以及对护理的反应，并检查癫痫发作聚集对这些结果指标的影响。如果有丛集性癫痫发作的患者的癫痫结果更差，制定专门的癫痫护理计划，包括更积极的药物治疗和更早的心理社会干预，可能是合适的。我们预计，这项研究既将确定癫痫发作聚集在成人癫痫中的作用，也将增加对大量市中心成年患者癫痫的医疗、社会和经济影响的认识。

This application is for a Mentored Patient-oriented RCDA (K23). The candidate is trained in clinical neurology and neurophysiology, and is currently on the faculty at the Albert Einstein College of Medicine (AECOM). The ma interests of the candidate are neurophysiologic, epidemiologic, and outcome issues in epilepsy, with a special f on seizure patterns and precipitants. The long term goals of the candidate are to develop the research sophistication and techniques to allow for high quality clinical research in the field of epilepsy or other neurologic disorders. career development proposal includes completion of a Masters of Science in the AECOM Clinical Research Training Program, followed by the design, implementation and analysis of the proposed research project on seizure clusting at Montefiore Medical Center/AECOM, which is a site of extensive, successful clinical research, and is ideally for the candidate's long term goals. Seizure clustering may affect treatment and outcome of epilepsy, but has not been widely studied. We aim recruit a cohort of 300 adult, predominantly inner-city patients with epilepsy, and follow them prospectively for months. We will define seizure clustering as three or more seizures occurring within 24 hours. We plan to examine the incidence, risk factors and precipitants for clustered seizures, as well as the impact of clustering on various epilepsy outcomes. We hypothesize that the incidence of clustering will be high ,that seizure clustering will be associated with localization-related factors and risk factors for status epilepticus (SE), and that patients with club will be at increased risk for SE. Identifying patients at risk for clustering may improve their treatment, especial they are at an increased risk of SE. Furthermore, we hypothesize that we will identify potentially modifiable precipitating factors for seizure clustering, and specifically, seizure clustering which requires emergency intervention. This may allow for a reduction in the incidence of clustering and a decrease in resultant morbidity. Finally, we examine outcome measures of epilepsy in our cohort,, including response to medical therapy, quality of life, an of care, and examine the impact of seizure clustering on these outcome measures. If outcome of epilepsy is demonstrated to be worse in patients with clustered seizures, development of a specialized epilepsy care program these patients, including more aggressive medical therapy and earlier psychosocial intervention, may be appropriate. We anticipate that this study will both define the role of seizure clustering in adult epilepsy, and increase o appreciation of the medical, social and financial impact of epilepsy in a large cohort of inner city adult patients.