COMPARATIVE ANALYSIS OF NEUROPHYSIOLOGICAL FEATURES IN YOUNG WOMEN AND MEN SUFFERING FROM EPILEPSY

The definition of epilepsy via the concept of neuronal discharge indicates the crucial importance of electroencephalography (EEG) in epileptology. This pathology is a certain problem for each sex, that requires gender−specific approaches when managing and treating such patients. To investigate them, 30 men and 30 women aged 18−44 years with a reliable diagnosis of epilepsy were examined. A comprehensive clinical, neurological and neurophysiological study of patients was performed, taking into account the data of clinical case and life history. Each patient was assessed for neurological status according to traditional methods, electrophysiological method of examination (routine EEG) was used. On the results of electroencephalography in individuals of both sexes with epilepsy, there was a decrease in the amplitude of the α−rhythm, but a significant slowdown in this rhythm was not detected. Most patients had high−amplitude (> 20 μV) and low−frequency β1−rhythm. Low−frequency high−amplitude slow−wave activity was regarded as an EEG reflection of degenerative−dystrophic processes in brain. Photostimulation caused paroxysms of bilaterally synchronous sharp and slow waves, complexes of "acute−slow" wave. Hyperventilation led to an increase in the θ−rhythm amplitude, appearance of δ−waves, higher expression of true epileptiform phenomena: adhesions, "acute wave−slow wave" complexes, "spike−slow wave" complexes. A comparative analysis of the obtained results allowed to conclude that the changes in bioelectrical activity in epilepsy occur according to the general mechanisms of epileptogenesis, regardless of gender. Key words: epilepsy, electroencephalogram, comparative analysis, young men and women.

Effect of carbamazepine on emotional intelligence and mindfulness in patients with partial epilepsy

Objective: To assess the effectiveness of carbamazepine on emotional intelligence and mindfulness in patients with epilepsy. Method: The repeated-measure case-control study was conducted at the Nishter Hospital, Multan, Bahawal Victoria Hospital, Bahawalpur, and Civil Hospital, Bahawalpur, Pakistan, from April 2017 to March 2018, and comprised patients with partial epilepsy and healthy controls. Baseline data was collected using BarOn Emotional Quotient Inventory and Cognitive and Affective Mindfulness Scale-Revised. Subsequent data was collected twice in titration and maintenance phases during carbamazepine therapy for patients, while the controls were on no medication. . Data was analysed using SPSS 20. Results: Of the 80 subjects, 40(50%) were cases with a mean age of 37.92±9.09 years, and 40(50%) were controls with a mean age of 37.80±9.00 years. The patients had significantly lower emotional intelligence and mindfulness compared to the controls (p<0.001). Patients showed improved emotional intelligence and mindfulness after the therapy compared to their baseline scores (p<0.05). Conclusion: Carbamazepine was found to be effective in improving emotional intelligence and mindfulness in patients with epilepsy. Key Words: Epilepsy, Carbamazepine, Mindfulness, Cognition, Continuous...

Prevalence and factors associated with non-adherence to antiepileptic drugs among children with epilepsy in Jos, Nigeria

Background: Childhood epilepsy causes a tremendous burden for the child, the family, society as well as the healthcare system. Adherence toantiepileptic drugs (AEDs) is key to treatment success, one of the main causes of unsuccessful treatment for epilepsy is poor adherence to medications. Nonadherence in children with epilepsy presents a potential ongoing challenge for achieving a key therapeutic goal of seizure control.Aim: To determine the prevalence and factors associated with nonadherence to AEDs among children with epilepsy at Jos University Teaching Hospital, Jos, Nigeria.Methodology: This cross sectional study was done to assess the prevalence and factors associated with non-adherence to AEDs among children with epilepsy from November 2019 to February 2020. A structured questionnaire was used to collect relevant information on the adherence of studysubjects to AEDs based on self/ caregiver report. Part of the questionnaire was derived from Morisky Medication Adherence Scale (MMAS-8).Results: One hundred and ninety four subjects were recruited for the study. The prevalence of nonadherence to AEDs was 44.8%. Factors significantly associated with non-adherence were low socioeconomic status, multiple drug therapy and long duration of treatment. The main reasons for nonadherence were financial constraint, forgetfulness, lack of improvement and medication side effects.Conclusion: Non-adherence to medication is common among children with epilepsy and it hampers the key therapeutic goal of seizure control. Improving per capita income of families, providing universal health insurance, medication reminders and appropriate education/counseling will reduce non-adherence and improve the long term outcome of childhood epilepsy in our region. Key words: Epilepsy, Children, Ant i -epilept ic drugs, Nonadherence, Prevalence, Associated factors, Jos, Nigeria.

Treatment of infantile spasms in resource limited settings: Arandomized controlled trial

Objective: To compare the outcome of ACTH with oral prednisolone for treatment of infantile spasms. Methodology: This is a randomized controlled trial conducted at department of paediatric neurology, The Children Hospital, Lahore, Pakistan after ethical approval from January 1st 2014 to December 31st 2017. (Four years). Seventy patients with infantile spasms were randomized in two equal groups of 35 patients in each group. Patients in group A received prednisolone and in group B received ACTH. The two groups were compared for the spasms free period. Statistical significant determined by chi-square test (p< 0.05 was taken as significant). Non-probability purposive sampling was used and an inclusion criterion was children up to age of one year with infantile spasms. Exclusion criteria include children who had been previously treated with steroids or ACTH. Seventy patients fulfilling inclusion criteria were enrolled through neurology department of Children Hospital, Lahore. History, informed consent was taken by parents and was divided in two groups by lottery method. All the information was collected on a specially designed proforma. Results: In group A, 29 (83%) patients were spasms free, while in group B, 31 (88%) patients were spasms free. Conclusion: Significant number of patients with IS were spasms free with prednisolone which is very cost effective drug as compared to ACTH. Developing counties should considered this treatment option as a first line therapy. Key words: Epilepsy, ACTH, Prednisolone, Infantile spasms, Hypsarthymia.

Personality of a patient in forming depressions in epilepsy

In order to determine the psychological characteristics of the personality of patients with epilepsy and comorbidity depressions, were analised of characterological features, personality characteristics defining socio-psychological adaptation, forms of manifestation of aggressiveness in patients with organic, psychogenic and endogenous depressions in the interictal period of epilepsy. It has been established that patients with epilepsy and depression are characterized by the anadaptive nature of personal organization: persistent pessimism, decreased contact tendencies, rigidity of affective reactions, propensity to develop and accumulate hostile reactions with insuffi cient active realization of aggressive tendencies. The results of the study should be taken into account as targets in psychotherapeutic and psychoprophylactic work with patients with epilepsy. Key words: epilepsy, organic depressions, psychogenic depressions, endogenous depressions, interictal period, characterological features, sociopsychological adaptation, manifestations of aggression

Features of the psychopathological condition of patients with epilepsy and depression in an interictal period

The paper presents the results of a comprehensive study of the characteristics of the psychopathological state of patients with epilepsy and depressions of various genesis (organic, psychogenic and endogenous) in the interi ctal period. Were investigated the severity and structure of psychopathological manifestations, as well as separately the level and structure of anxiety in patients with epilepsy depending on the form of depression in a comparative aspect with patients with epilepsy without signs of depression. According to the selected forms of depression, are analyzed the severity and structural features of depressive symptoms. Was established that patients with depressions are characterized by more pronounced and diverse psychopathological manifestations, in the structure of which, apart from depressive manifestations, anxious and psychosomatic symptoms are formed (with organic and psychogenic depressions); as well as asthenic manifestations, a decrease in the level of interpersonal interaction and obsessive-compulsive symptoms (with endogenous depressions). Is determined the highest level of psychopathological distress in patients with epilepsy with endogenous depressions. Key words: epilepsy, organic depression, psychogenic depression, endogenous depression, interictal period, psychopathological condition, anxiety, depressive manifestations.

Neurologic Diseases in Pregnancy

Neurologic conditions commonly affect women during pregnancy. The severity of some chronic conditions, such as headaches, epilepsy, and multiple sclerosis, may be affected by pregnancy. Due to teratogenicity, some medications used prior to pregnancy should be avoided or used at a lower dose during pregnancy. The physiologic changes of pregnancy put women at risk for new neurologic conditions, including posterior reversible encephalopathy syndrome, venous sinus thrombosis, and restless legs syndrome. Compression neuropathies may arise during pregnancy or delivery. Increased experience with neuroimaging has provided reassurance that magnetic resonance imaging may be used safely during pregnancy. This review contains 7 figures, 7 tables, and 30 references Key Words: epilepsy, headache, multiple sclerosis, myasthenia gravis, neurology, neuropathy, pregnancy, posterior reversible encephalopathy syndrome, stroke, venous sinus thrombosis

STUDY OF TOXOPLASMA GONDII INFECTION IN EPILEPTIC CHILDREN

Objective: Epilepsy is a chronic neurological disorder that affects many people of all ages. Some recent studies showed that cerebral toxoplasmosis is one of the causes’ acquired epilepsy in developing countries. In this study, we investigated the frequency of Toxoplasma gondii infection in epileptic children and some clinical characteristics difference with between seropositive and seronegative of T.gondii. Material and methods: We selected 62 pediatric patients with epilepsies that were treatment at Pediatric center (Hue Center Hospital) and tested them for evidence of T. gondii IgM, IgG antibodies by the enzyme-linked immunesorbent assay (ELISA). We studied some clinical characteristics differences between T.gondii seropositive and seronegative groups. Results: The seropositive proportion of antibodies to Toxoplasma gondii in epileptic children was 25.8% (25% IgM(+)IgG(-), 56,25% IgG(+)IgM(-) and 18.75% IgM(+)IgG(+)) and the over 10 age group accounted for the highest percentage of T.gondii positive (43.8%). The seropositive group had a significant different than seronegative group about ages, frequency of seizures and period of disease. There had no significant different between two groups about sex, residency and the type of seizures. Conclusion: Toxoplasma gondii had a high proportion in epileptic children. Key words: Epilepsy, Toxoplasma gondii

Lennox Gastaut Syndrome: A Case Report

Lennox-Gastaut syndrome (LGS) is a severe form of childhood epilepsy that is defined by generalized multiple type seizures, slowness of intellectual growth, and a specific EEG disturbance. Children affected might previously have infantile spasms or underlying brain disorder but etiology can be idiopathic. LGS seizures are often treatment resistant and the long term prognosis is poor. Key words: epilepsy, intellectual growth DOI: 10.3126/jnps.v30i1.2461Journal of Nepal Paediatric Society Vol.30(1) 2010 50-52

Recurrence Risk of Febrile Seizures in Children

Introduction: Febrile seizure is a common paediatric problem. Identifying children with febrile seizure who are at risk for recurrence is important so that special attention can be given to them. The objective of this study was to identify the risk factors for recurrence of febrile seizures in children. Materials and Methods: This was a prospective cohort study done at Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal. This study is a continuation of a previous study which looked at the leucocytosis in peripheral blood of children with febrile seizure. A detailed history including the risk factors for febrile seizure recurrence was obtained from the caregiver during follow up on subsequent days after discharge of children from the hospital who were previously admitted for febrile seizure. All children with febrile seizure belonging to age group of 6 months to 6 years were included in the study. Those with afebrile seizures or on anticonvulsants and those who refused to give consent were excluded. Each child was also examined and investigated for the cause of fever. Results: A total of 115 children with febrile seizure admitted for febrile seizure during the study period and all of them were followed up at outpatient department. Males accounted 62% and females 38%. Simple Febrile Seizures were seen in 80% of the cases and complex febrile seizures were seen in 20%. Out of all the cases 68(59%) had symptoms of viral prodrome. 59(51%) had recurrent febrile seizure. Low temperature at onset of Febrile Seizure (p=0.001), short duration of fever before onset of Febrile Seizure (0.026) and atypical Febrile Seizure (p=0.022) were the risk factors for recurrent febrile seizure. Conclusion: Febrile Seizure is a common paediatric problem commonly seen in males. Almost half of children with Febrile Seizure are at risk for recurrence in later date. The risk factors for these recurrences are modest rise in body temperature at the onset of febrile seizure, onset of seizure within 12 hours of fever and atypical presentation. Key words: Epilepsy; Febrile Seizure; Typical Febrile Seizure; Recurrence DOI: http://dx.doi.org/10.3126/jnps.v32i1.5947 J. Nepal Paediatr. Soc. Vol.32(1) 2012 33-36