complex partial seizures
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Author(s):  
Neena S. Sawant ◽  
Suraj S. Singh ◽  
Sachin Mahajan ◽  
Sangeeta H. Ravat

Abstract Background Epilepsy being one of the most prevalent neurological diseases in children is associated with psychopathology and academic concerns. Epilepsy surgery is considered for refractory epilepsy at some centers in India and hence this study was undertaken to find out prevalence and type of psychopathology in children and adolescents with refractory epilepsy before epilepsy surgery. Methods All data were analyzed from the records of patients undergoing preepilepsy surgery protocol workup in comprehensive center of epilepsy care at a general municipal hospital in Mumbai. A record of 150 children and adolescents in the age group of 3 to 18 years over a period of 10 years was taken and all details of demographics, epilepsy, and psychopathology were recorded. Results The mean age for our sample was 11.4 ± 3.4 years and a male preponderance was seen. Majority (80%) of the children were pursuing education. The duration of seizure disorder was approximately 4.41 + 2.36 years and complex partial seizures were seen commonly in 50% of the children. Both magnetic resonance imaging (MRI) and video electroencephalography (VEEG) findings revealed right sided lateralization followed by left in majority of the patients. Psychopathology was seen in 70 (46%) patients with mental retardation, hyperkinetic disorders affecting attention and activity and oppositional defiant disorder, and unspecified mental disorder due to underlying brain damage being the type of International Classification of Disease-10th Revision (ICD-10) disorders seen. Patients with psychopathology showed a left-sided predominance on their MRI and VEEG findings for laterality of the epileptogenic focus as compared with right side. Conclusion Refractory seizures and associated psychopathology impact family life, friendships, and academics and worsen prognosis and quality of life. Screening for psychopathology in children with epilepsy would therefore lead to better outcomes especially prior to epilepsy surgery.


Author(s):  
Ossama Maadarani ◽  
Zouheir Bitar ◽  
Abdelaziz Ashkanani ◽  
Mahmoud Elzoueiry ◽  
Mohamad Elhabibi ◽  
...  

Drugs that inhibit voltage-dependent sodium channels are commonly used to treat epilepsy. Old and novel antiepileptic drugs are used either as monotherapy or in combination to control epilepsy. For a long time, carbamazepine has been used as the first choice for the treatment of simple and complex partial seizures. In the USA, lacosamide was approved in October 2008 as an adjunctive treatment for partial-onset seizures. We describe the effect of two sodium channel blockers on the heart of a patient with epilepsy.


2021 ◽  
Author(s):  
Nandini Priyanka Balasubramani ◽  
Elangovan S ◽  
Thangaraj M

Background: Epilepsy is the second most common and frequently encountered neurological disorder which poses huge threat to known healthcare systems worldwide also causing financial, socio economic burden to the community. Complex Partial Seizures are a form of focal epileptic seizures that may impair consciousness. Aim and objectives: Our motivation for the study was to understand the extent of patients with complex partial seizures associated with medial temporal lobe sclerosis. Materials and methods: We performed a cross sectional study about patients with complex partial seizures in Thanjavur medical college and hospital about their clinical profile and neuro-radiological correlation. Statistical analysis and results: Through our multimodal study with EEG, MRI on N=118 (female / male, age range, Most common age group- 10-20 years, mean age of 23 years, SD- 14 years, 66% males), we observed that atypical febrile seizures and fever provoked seizures has more association (18%) to complex partial seizures and to medial temporal lobe sclerosis in comparison to 12% in an earlier study. Conclusion: We believe this study summarizes the complex partial seizure features, origin, and their link to Medial Temporal lobe Sclerosis in our subject pool from Thajavur, India. Limitation: There are some limitations to our study, especially with no video EEG monitoring and no invasive EEG recording. We aim to improve them in our future studies.


2021 ◽  
pp. 1-6
Author(s):  
Beliyu Ejo Kebede ◽  
◽  
Meseret Adugna Geleta ◽  

Information is yet scanty concerning current antiepileptic drugs prescribing patterns for women of childbearing age with epilepsy. Most women with epilepsy can give birth to perfectly healthy children after uneventful pregnancies. Best approach to management of epilepsy in pregnancy requires knowledge of the teratogenic effects of antiepileptic drugs, of the risks with uncontrolled seizures. Understanding the effects of pregnancy on seizure control and of gestational effects on antiepileptic drugs disposition is useful in early clinical diagnosis and patient management systems. We evaluated utilization of antiepileptic drugs among women of childbearing age against pre-set standards in epilepsy clinic of Tikur Anbessa Special and Referral Hospital from May 2017 to May 2018. The mean age of the women were 24.92± 6.54, where majority 217 (56.5%) of them aged between 15-25. Eighty-five (22.1%) of the women diagnosed with epilepsy were found to be pregnant, among them 20(5.2%) were breast-feeding. Generalized tonic clonic seizure (62.8%) was found to be the commonest seizure type diagnosed followed by unidentified or uncategorized seizures (16.7%), focal seizures (11.5%), and complex partial seizures (6.3%). Among the variety of anti-epileptic drug regimen or combinations used to treat epilepsy in 384 mothers, monotherapy 259 (67.4%) was the commonest drug regimen prescribed followed by dual therapy 97 (25.3%), and polytherapy 28 (7.3%). We here concluded that Valproic acid 44(51.8%) followed by phenytoin 36(42.4%) and phenobarbital 17(20%) were commonly given for breast-feeding women at Tikur Anbessa hospital.


2021 ◽  
pp. 1-6
Author(s):  
Beliyu Ejo Kebede ◽  
◽  
Meseret Adugna Geleta ◽  

Information is yet scanty concerning current antiepileptic drugs prescribing patterns for women of childbearing age with epilepsy. Most women with epilepsy can give birth to perfectly healthy children after uneventful pregnancies. Best approach to management of epilepsy in pregnancy requires knowledge of the teratogenic effects of antiepileptic drugs, of the risks with uncontrolled seizures. Understanding the effects of pregnancy on seizure control and of gestational effects on antiepileptic drugs disposition is useful in early clinical diagnosis and patient management systems. We evaluated utilization of antiepileptic drugs among women of childbearing age against pre-set standards in epilepsy clinic of Tikur Anbessa Special and Referral Hospital from May 2017 to May 2018. The mean age of the women were 24.92± 6.54, where majority 217 (56.5%) of them aged between 15-25. Eighty-five (22.1%) of the women diagnosed with epilepsy were found to be pregnant, among them 20(5.2%) were breast-feeding. Generalized tonic clonic seizure (62.8%) was found to be the commonest seizure type diagnosed followed by unidentified or uncategorized seizures (16.7%), focal seizures (11.5%), and complex partial seizures (6.3%). Among the variety of anti-epileptic drug regimen or combinations used to treat epilepsy in 384 mothers, monotherapy 259 (67.4%) was the commonest drug regimen prescribed followed by dual therapy 97 (25.3%), and polytherapy 28 (7.3%). We here concluded that Valproic acid 44(51.8%) followed by phenytoin 36(42.4%) and phenobarbital 17(20%) were commonly given for breast-feeding women at Tikur Anbessa hospital.


Author(s):  
Tokareva N.G. ◽  
Ignatieva O.I.

Epilepsy is a common neuropsychiatric disease in which a number of personality characteristics change. Motivation takes one of the main places in the structure of the patient's personality. Motivation largely determines human behavior, is an important component, since it helps to understand the features and directions of human activity. A motive is an impulse to activity, which is associated with the goal of satisfying the arisen desires. Only by understanding how the patient's motivational-need sphere is arranged, it is possible to determine the patient's role, the degree of his participation in treatment-and-prophylactic measures, as well as influence the formation of motivation, motivate the sick person for educational activities, labor, production activities, etc. The study of the characteristics of the patient's motivational-need sphere is necessary in order to understand how the patient's motivation is formed in the treatment process, how important it is in his life and whether the patient will be able to effectively manage life, enjoy reality, successfully look and plan the future, precisely based on his own motive. That is why the problem of motivation is very relevant at the present time. This work analyzes the features of the motivational-need-related sphere of patients with epilepsy. The study included 317 patients aged 18 to 65 years with focal forms of epilepsy, whose structure was dominated by simple, complex partial seizures. Verification of the diagnosis in the examined patients was carried out on the basis of the results of clinical neurological, psychopathological, pathopsychological, electroencephalographic examination and computed tomography of the brain. The study used a methodology for assessing the level of claims: V. Gerbachevsky's questionnaire. Clinical and psychological research of patients with epilepsy made it possible to substantiate the choice of 2 clusters: the first cluster included able-bodied working patients – n=131 (41.3%), the second cluster - non-working patients – n=186 (58.7%). In the 1st cluster, indicators on the scales "Level of mobilization of efforts", "Regularity of results", "Cognitive motive" prevail, in the 2nd cluster indicators on the scale "Avoidance" prevail. Taking into account the motivational-need-oriented orientation of the patient is an important component in the construction of therapeutic programs aimed at improving the quality of medical care.


2021 ◽  
Vol 28 (1) ◽  
pp. 15-26
Author(s):  
Mohd Harizal Senik ◽  
Izuddin Fahmy Abu ◽  
Widad Fadhullah

Background: Kainic acid (KA)-induced seizures may be a valuable tool in the assessment of anti-epileptic drug efficacy in complex partial seizures. This study investigated the effects of KA on ATP-sensitive K+ (KATP) channels opening probability (NPo), which plays a crucial role in neuronal activities. Methods: For the optimisation and validation protocol, β-cells were plated onto 35 mm plastic petri dishes and maintained in RPMI-1640 media supplemented with 10 mM glucose, 10% FCS and 25 mM of N-2-hydroxyethylpiperazine-N-ethanesulfonic acid (HEPES). The treatment effects of 10 mM glucose and 30 μM fluoxetine on KATP channels NPo of β–cells were assessed via cell-attached patch-clamp recordings. For hippocampus cell experiments, hippocampi were harvested from day 17 of maternal Lister-hooded rat foetus, and then transferred to a Ca2+ and Mg2+-free HEPES-buffered Hank’s salt solution (HHSS). The dissociated cells were cultured and plated onto a 25 mm round cover glasses coated with poly-d-lysine (0.1 mg/mL) in a petri dish. The KATP channels NPo of hippocampus cells when perfused with 1 mM and 10 mM of KA were determined. Results: NPo of β-cells showed significant decreasing patterns (P < 0.001) when treated with 10 mM glucose 0.048 (0.027) as well as 30 μM fluoxetine 0.190 (0.141) as compared to basal counterpart. In hippocampus cell experiment, a significant increase (P < 0.001) in mean NPo 2.148 (0.175) of neurons when applied with 1 mM of KA as compared to basal was observed. Conclusion: The two concentrations of KA used in the study exerted contrasting effects toward the mean of NPo. It is hypothesised that KA at lower concentration (1 mM) opens more KATP channels, leading to hyperpolarisation of the neurons, which may prevent neuronal hyper excitability. No effect was shown in 10 mM KA treatment, suggesting that only lower than 10 mM KA produced significant changes in KATP channels. This implies further validation of KA concentration to be used in the future.


2020 ◽  
Vol 20 (1) ◽  
pp. E37-E38
Author(s):  
Daniel D Cavalcanti ◽  
Nader Delavari ◽  
Howard A Riina ◽  
Adam Arthur ◽  
Mark Bain ◽  
...  

Abstract Sidewall aneurysm treatment often requires complex management strategies. These can include advanced clipping techniques or stent-assisted coiling techniques. Endovascular coiling alone has been associated with high recurrence rates and is often not feasible.1-4 Flow-diversion embolization has recently become a standard of care for many aneurysms, demonstrating high occlusion rates.4,5 However, the third generation of coil-assist stents can be delivered with 0.0165” microcatheters, being an ideal adjunct to manage this group of aneurysms in more distal locations. In this video, a 16-yr-old teenager with Parry-Romberg syndrome and congenital adrenal hyperplasia had an incidental finding of a 6.5-mm sidewall aneurysm arising off the angular branch of the left middle cerebral artery, found during the work-up of complex partial seizures. The patient consented to the procedure. Due to his young age and aneurysm size, a decision was made to treat the aneurysm through an endovascular approach. Under general anesthesia, a transfemoral approach was carried out using a 6-French short sheath. A 6-French guiding catheter was left in the distal cervical left internal carotid artery; a 0.0165” microcatheter was used to first deploy a 3.0 × 15 mm Neuroform Atlas stent, completely covering the length of the aneurysm. Then, the stent was traversed with the microcatheter to coil the aneurysm. Follow-up cerebral angiogram confirmed complete occlusion of the aneurysm.


2020 ◽  
Vol 19 (2) ◽  
pp. 23-30
Author(s):  
Mezher M Kadhim ◽  
◽  
Jalil I Kadhim ◽  
Haitham H Basee ◽  
Ammar A Mohammed ◽  
...  

Background: Partial seizure is well-defined as sudden extreme, profligate, and limited electrical discharges by gray matter from some portions of the brain due to certain structural & metabolic abnormalities. Objective: To distinguish the etiologies of partial seizures and to clarify its association with the age of affected patients. Patients and Methods: A prospective study, done on all patients with neurological consultation in Al- Batool Teaching Hospital, Baqubah Teaching Hospital and Al Yarmouk teaching Hospital from Nov, 2016 to Dec, 2018. Patients with partial seizures and/with secondary generalization were merged. This was fortified through a full history, physical checkup, EEG, and MRI of the brain. The study’s sample comprising 106 patients with partial seizures, the age ranged from 6-75 years, with 52 males and 54 females. Results: Atypical neuroimaging was found in (61%) of patients. Tumors occurred in (19.7%) of patients, the highest of them below 40 years of age while infarctions comprised 25.5% of patients outside this age. Complex partial seizures(CPS) patients with temporal lobe foci comprised 83.7 % and (16.2%) had frontal lobe problems, while (49%) of Simple partial seizures (SPS) patients had frontal lobe foci, 22% frontoparietal and 13% had parietal lobe foci and had brain lesions were spotted in 75.4% of patients with SPS and (35.1%) with complex partial seizures. Conclusion: Infarction is a common reason for partial seizures in patients above 40 years while below this age the tumor is common etiology. A partial seizure is connected mostly with brain lesions. Keywords: Partial seizures, comorbid factors, brain lesions


Seizure ◽  
2020 ◽  
Vol 81 ◽  
pp. 292-294
Author(s):  
Hyunjin Jo ◽  
Hwa Reung Lee ◽  
Dongyeop Kim ◽  
Yoonha Hwang ◽  
Young-Min Shon ◽  
...  

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