جستجوی مقالات مرتبط با کلیدواژه « Epilepsy » در نشریات گروه « پزشکی »

Celosia leptostachya is classified under the Amaranthaceae family. C. leptostachya possesses numerous medicinal uses. Traditional medicine practitioners exploit C. leptostachya mainly on curing illnesses such as boils, fever, snake bites, scorpion stings, eye infections, wounds and pain and most notably, epilepsy.

This study was designed to evaluate the anticonvulsant properties of the ethyl acetate (EAF) and n-hexane fractions (NHF) of C. leptostachya leaf extract in mice and determine the most active extract between EAF and NHF.

The acute toxicity was carried out to determine lethal dose (LD50) using Lorke’s method. Pentylenetetrazole (PTZ), brucine and maximal electroshock (MES) were used to induce seizures in mice. We used Swinyard’s method of using an animal model of epilepsy. Thirty mice of both genders weighing 20-25 g were divided into five groups. Groups 1 and 5 are negative and positive controls, respectively. Groups 2, 3 and 4 were pre-treated with C. leptostachya extracts (100, 150 and 200 mg). Then, 30 minutes later, PTZ (90 mg/kg body weight) was administered. This method was repeated with brucine (110 mg/kg body weight). Regarding MES, after 30 minutes of administration of C. leptostachya leaf extract, an alternating current of 50 Hz and 35 mA was delivered to the animals in each group through ear-electrodes for 0.2 s.

Regarding MES, EAF (150 and 200 mg/kg) protected the animals against seizure, while NHF (150 and 200 mg/kg) could not prevent seizures. However, EAF and NHF (150 and 200 mg/kg) significantly decreased mean recovery time (P<0.05). In brucine-induced seizures, EAF (150 and 200 mg/kg) protected the mice against death and significantly (P<0.05) decreased mean recovery time. For PTZ-induced seizures, 200 mg/kg of EAF offered 100% protection against the mortality of mice and significantly reduced mean onset and recovering time (P<0.05). 

Based on the results, C. leptostachya has anticonvulsant properties and EAF extract has the highest potency.

A 27-year-old female patient was referred to Basir Eye Clinic in Tehran, Iran, following sudden total blindness in both eyes. She had a history of receiving various medications for different illnesses, including epilepsy. She reported sudden self-withdrawal of Levetiracetam. Within one week after discontinuing the medication, she completely lost vision in both eyes. A complete examination of the patient including visual evoked potential examination led to a diagnosis of cortical blindness.

Unexpected seizures significantly decrease the quality of life in epileptic patients. Seizure attacks are caused by hyperexcitability and anatomical lesions of special regions of the brain, and cognitive impairments and memory deficits are their most common concomitant effects. In addition to seizure reduction treatments, medical rehabilitation involving brain–computer interfaces and neurofeedback can improve cognition and quality of life in patients with focal epilepsy in most cases, in particular when resective epilepsy surgery has been considered treatment in drug‑resistant epilepsy. Source estimation and precise localization of epileptic foci can improve such rehabilitation and treatment. Electroencephalography (EEG) monitoring and multimodal noninvasive neuroimaging techniques such as ictal/interictal single‑photon emission computerized tomography (SPECT) imaging and structural magnetic resonance imaging are common practices for the localization of epileptic foci and have been studied in several kinds of researches. In this article, we review the most recent research on EEG‑based localization of seizure foci and discuss various methods, their advantages, limitations, and challenges with a focus on model‑based data processing and machine learning algorithms. In addition, we survey whether combined analysis of EEG monitoring and neuroimaging techniques, which is known as multimodal brain data fusion, can potentially increase the precision of the seizure foci localization. To this end, we further review and summarize the key parameters and challenges of processing, fusion, and analysis of multiple source data, in the framework of model‑based signal processing, for the development of a multimodal brain data analyzing system. This article has the potential to be used as a valuable resource for neuroscience researchers for the development of EEG‑based rehabilitation systems based on multimodal data analysis related to focal epilepsy.

Migraine and epilepsy belong to the category of chronic paroxysmal neurological disorders and share numerous clinical features, as well as potential treatment options. This narrative review emphasizes the similarities between pediatric migraine and epilepsy, exploring epidemiology, pathophysiology, genetics, clinical presentation, and pharmacology. Although various syndromes exhibit symptoms common to both conditions, further research is needed to clarify the underlying pathophysiological and genetic connections contributing to their coexistence. Prophylactic medications used in the management of both migraines and epilepsy exhibit similar pharmacological characteristics. The review assesses treatment strategies for epilepsy and migraines, emphasizing antiseizure medications alongside nonpharmacological interventions like ketogenic diet, supplements, and vagal nerve stimulation. It aims to highlight how these interventions, originally targeted for epilepsy, may also show promise in preventing migraines. The urgent need for further randomized, controlled clinical trials investigating both pharmacological and nonpharmacological interventions for treating both disorders is emphasized, aiming to pave the way for innovative therapeutic strategies.

Migraine is one of the common diseases of children, which can disrupt their quality of life. Some studies have shown the effect of melatonin in reducing migraine headaches. This study aims to investigate the effect of melatonin administration in reducing headaches in children with migraine without sleep disorders.

In this clinical trial study, fifty-five children aged five to 15 years with migraines who had no sleep disorder were enrolled. The control group (twenty-seven patients) was treated with propranolol tablets, and the intervention group (thirty patients) was treated with propranolol tablets plus melatonin tablets for three months. Patients were visited before, one month, and three months after the start of treatment, and their data was collected and recorded.

The number of headache attacks decreased significantly in the intervention group compared to the control group three months after the treatment (P=0.006). The number of patients with a good response to treatment in the intervention group was significantly more than the control group (p=0.023). Parents’ satisfaction with the treatment in the intervention group was significantly higher than the control group (P=0.026). There was no significant difference in the intensity of disability caused by headaches after treatment in the two groups. No significant drug side effects were seen in any of the two groups.

Adding melatonin to the treatment of children with migraine without sleep disorders significantly reduces the frequency of headache attacks and increases satisfaction with the treatment

The rapid distribution of the novel coronavirus disease 2019 (COVID-19) led to an increased prevalence of mental problems. Also, patients with epilepsy (PWE) are more prone to mental illnesses, and approximately 25% of them have psychopathological comorbidities. On the other hand, cancellation of the patient’s appointment, decreased medical care services and strict isolation affect both the mental health and epilepsy care of the patients. 

This study aimed to compare depression, psychopathological distress, and sleep disturbances between PWE and a normal group during COVID-19 pandemic. 

A total of 76 PWE, who were consecutively referred to the Neurology Clinics of 22 Bahman Hospital, Khorasan Razavi, Iran, were recruited. Also, 76 age- and gender-matched healthy persons were included as the normal group. Demographic and epilepsy-related information was collected from the 6-item Kessler questionnaire, Beck depression inventory, and Pittsburgh sleep quality index questionnaire. The obtained data were used to assess psychopathological distress, depression, and sleep quality, respectively. 

PWE had significantly higher levels of psychopathological distress (P=0.04), depression (P=0.02), and sleep disorders (P=0.01) than healthy individuals. Results showed that duration of disease was significantly associated with depression level and sleep disorders (P<0.05). According to multivariate logistic regression results, disease duration had significant associations with Beck depression inventory scores (OR:1.128; 95% CI, 1.110%, 1.729%) and Pittsburgh sleep quality index scores (OR: 1.860; 95% CI, 1.363%, 1.922%). 

The significant disparities in psychopathological distress, depression and sleep disorders between PWE and healthy individuals highlight the vulnerability of PWE to mental health challenges during crises.

Epilepsy is a chronic disorder affecting a broad spectrum of individuals. Recently, there has been increased interest in the role of oxidative stress in epilepsy; adjuvant antiepileptic medicines aimed at reducing oxidative stress may serve as a novel therapeutic approach. In the present study, we investigated the effects of zingerone, a phenolic compound, on maximal electroshock (MES) and pentylenetetrazole (PTZ)-induced seizures and oxidant/antioxidant biomarkers in mice.

In the MES model, the first and second groups received saline and phenytoin (25 mg/kg i.p.), respectively. Groups three to five received zingerone (5, 10, and 30 mg/kg). Thirty minutes later, the digital electroconvulsiometer developed seizures. In the PTZ model, the first and second groups received saline, whereas the others received diazepam (3 mg/kg, i.p.) or zingerone (5, 10, and 30 mg/kg). On day five, PTZ (80 mg/kg, i.p.) was administered to all groups. After behavioral experiments, the activity of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT), and the level of thiobarbituric acid reactive substances (TBARS) in the brain tissue of PTZ model mice were measured.

Our findings suggest that zingerone may have anticonvulsant effects by increasing latency and decreasing the duration of clonic convulsion, tonic hindlimb extension, and mortality rate. Additionally, zingerone administration increased SOD and CAT activities and decreased TBARS levels in the brain tissue of PTZ model mice.

This study suggests that zingerone protects against epileptic seizures and alleviates the oxidative stress associated with epilepsy pathogenesis.

Electrical kindling is a popular model for studying epilepsy, which is similar to complex focal seizures in humans. In this method, by implanting metal electrodes in the brain and subthreshold stimulation, the animal acquires chronic convulsions. We aimed to compare the development of rapid electrical kindling, using steel and copper electrodes. Adult male Wistar rats were used. Three polar steel or copper electrodes and two unipolar electrodes were stereotaxically embedded in the basolateral nucleus of the amygdala or the skull surface, respectively. One week later, the threshold current intensity was determined. Twenty-four hours afterward, animals received six stimulations per day with the threshold intensity until showing three consecutive stage five seizures. Then, the animals were perfused and their brains were fixed, stained, and examined histologically. The results showed that the animals with the steel electrode had a significantly lower threshold compared to the animals that had a copper electrode. In addition, the number of stimulations for seizure generalization was significantly lower in the steel group. The amount of tissue damage in the experimental groups was not significantly different; however, the number of dead cells in the steel groups was significantly lower than in the copper groups. In conclusion, although the animals were kindled with copper electrodes, they may not be used for laboratory evaluations due to the neurotoxic effects of copper, which led to tissue damage, and delay in seizure parameters, and the results of such studies can be misleading.

Novel antiepileptic drugs (AED) are now available. However, many epileptic patients still find the condition difficult to handle. Drug therapy does not work for about one-third of the cases and not all people who will benefit from surgery. The use of electric current as a treatment option has emerged since the late twentieth century. Inhibition of synapse activity is a way that low-frequency stimulation (LFS) prevents epileptic activity. It will enhance the endocytosis of AMPA-type glutamate receptors and activate calcineurin, thereby leading to long-term depression (LTD). High-frequency stimulation (HFS) also contributes to the control of epilepsy by increasing the membrane permeability of neurons. Nonetheless, the detailed mechanisms responsible for these effects are still unknown. More research is required to fine-tune electrical stimulation parameters and yield better results in epilepsy patient care.

Deep brain stimulation (DBS) stands as an alternative treatment for drug-resistant temporal lobe epilepsies. In this study, we investigated the effects of both low- and high-frequency stimulation (LFS and HFS) of the olfactory bulb on locomotor activity and preferences for spending time in the central or border regions. Rats underwent a kindling procedure involving semi-rapid electrical stimulation (6 stimulations per day) of the hippocampal CA1 region. Fully kindled animals received LFS (1 Hz) or HFS (130 Hz) at four time points: 5 min, 6 h, 24 h, and 30 h after the last kindling stimulation. Subsequently, rats were placed in the open field chamber and allowed free, uninterrupted movement within the respective quadrant of the maze for a single 10-minute period. During this time, tracking software recorded movement, and locomotor activity as well as preferences for spending time in the central or border regions were evaluated. Overall, applying DBS in the olfactory bulb at both low and high frequencies decreased exploration time in the center and increased exploration time in the border for the rats. Furthermore, a higher intensity of HFS was more effective than a lower intensity of HFS in reducing anxiety or altering locomotor behavior. According to the results of the present study it may be suggested that applying DBS affects some aspects of the animals’ activity and therefore, the activity monitoring tests have to be done following DBS application.

Cutaneous adverse reactions (CARs) are one of the most important reasons for anti-seizure medication (ASM) discontinuation in epilepsy. However, such discontinuations can cause an increase in seizures. This study investigates the risk factors for ASM-related rash recurrence in children. This retrospective case-control study consisted of the patient group with a single rash due to ASMs (group 1), the patient group with rash recurrence (group 2), and the control group. While the demographic and clinical features of group 1 and the control group were compared in terms of a single rash, group 1 and group 2 were compared for rash recurrence. Group 1, group 2, and control group consisted of 112, 33, and 166 patients, respectively. Female gender was a risk factor for a single rash (P < 0.001) but not for recurrence (P = 0.439). Presence of atopic disease [odds ratio (OR): 9.5, 95% confidence interval (CI): 3.8-23.1, P < 0.001], family history of drug allergy (OR: 26.3, 95% CI: 9.6-72.1, P < 0.001), and polytherapy (OR: 23.5, 95% CI: 8.7-62.9, P < 0.001) were risk factors for rash recurrence. Aromatic nature of both the ASMs associated with the first rash (OR: 14.4, 95% CI: 3.2-63.2, P < 0.001) and rash recurrence (OR: 11.3, 95% CI: 4.6-27.5, P < 0.001) were determined as risk factors separately. Careful use of aromatic drugs may prevent recurrence of ASM-related CAR in children, particularly in cases of personal history of allergic disease and family history of drug allergy.

The approach to dual pathology in drug-resistant epilepsy is a challenging issue for clinicians. The main aim is to precisely determine and resect the epileptogenic focus, which is commonly complicated by the limitations of scalp-EEG monitoring, the restricted availability of intracranial EEG recording, the indecision to select between staged surgery and dual lesionectomy, and encountering with the possible postsurgical deficits. Previous studies with a focus on the management of dual pathology have certain limitations, such as the enrolment of mixed groups of patients, imprecise reports of EEG findings, a lack of control groups, short-term follow-ups, and limited reports of postsurgical neuropsychological evaluations and deficits. In this manuscript, I have suggested a classification that has mainly addressed dual pathologies containing hippocampal sclerosis —the most common dilemma for epileptologists — and I have tried to divide them in a practical way for both clinicians and researchers. Lesions other than hippocampal sclerosis have also been considered to show the essential need to revise the definition of dual pathology and to encourage researchers to approach them as a distinct and important category. Moreover, the classification has mentioned multiple pathologies and categorized them into commonly encountered subgroups. It seems that using this classification to categorize dual and multiple pathologies based on anatomical characteristics and findings of presurgical evaluation might be helpful to design more targeted studies on homogenous groups of patients and simplify uniformplanning.

Long-term video-EEG monitoring (LTM) is a new technique to assess and track fluctuations, classify seizures, identify epileptic syndromes, and determine the number of seizures and epilepsy-simulating disorders. The present study aims to evaluate the concordance of traditional EEG and LTM in assessing childhood epilepsy.

This cross-sectional before-after study was performed on 120 children with epilepsy who were referred to the Epilepsy Monitoring Unit (EMU) at the Children’s Medical Center between September 2021 and September 2022 and were monitored for at least eight hours in this unit. The source of the study information collection was the patients’ recorded files. A neurologist reviewed the primary EEGs, and two experts blindly reviewed and interpreted the patients’ LTMs under a clinical neurophysiologist’s supervision.

The diagnoses changed after employing LTM in most children with epilepsy. Based on the diagnostic agreement analysis between EEG and LTM, the coefficient value for LTM was calculated at -0.37 (p = 0.229), showing that LTM has significantly expanded patients’ diagnoses and care plans.

The use of LTM improves the diagnosis, classification, and monitoring of epilepsy in affected children and can be a reliable supplement to EEG in some instances.

 Post-traumatic epilepsy (PTE) is one of the types of epilepsy, which is a complication of traumatic brain injury (TBI) that occurs after TBI or 7 days later.

 The present study aimed to determine the risk factors for PTE in patients with TBI.

 The computed tomography (CT)-scan results of all TBI patients were investigated in this retrospective study. At first, initial evaluation, including the examination of airways, vital signs, and breathing, was performed, and the level of consciousness was checked according to the Glasgow Coma Scale (GCS) for all traumatic patients. Then, the results of all CT scans were evaluated by a neurologist. If the patient had PTE, she/he was included in the study. Data analysis was carried out using descriptive statistics in SPSS software (version 16).

 The results showed that mild, moderate, and severe GCS scores were reported in 8 (14.3%), 30 (52.5%), and 18 (32.2%) participants, respectively. Vehicle accidents were the main cause of TBI (n = 34, 60%), and the lowest TBI rate was due to other cases (n = 4, 7.2%). The most and least frequent CT-scan finding was epidural hemorrhage (EH) (n = 24, 42.3%) and midline shift and intracerebral hemorrhage (n = 6, 10.8%), respectively. A total of 24 patients (42.3%) had tonic epilepsy, and 10 patients (17.9%) had epilepsy duration of more than 10 minutes.

 The most frequent risk factors included vehicles, falling from a height, and strikes, respectively. Additionally, the most common CT scan findings included EH and subarachnoid hemorrhage (SH). Motor vehicle accidents account for the highest rate of TBI-related PTE. For this reason, it is necessary to take preventive measures in this regard.

For patients with epilepsy and their family caregivers, epilepsy risk awareness (ERA) can affect various aspects of health. They need effective education to improve their quality of life.

This study aims to compare the effect of self-care education on ERA in patients with epilepsy and their family caregivers using the face-to-face method and pamphlets.

In this quasi-experimental study, participants were patients with epilepsy referred to a neurological outpatient clinic in Tabriz, Iran and their family caregivers. They were randomly assigned to the intervention (60 patients and 60 caregivers) and control (60 patients and 60 caregivers) groups. The ERA scales for patients and family caregivers were completed before and one month after the education. The intervention group received ERA-based self-care education in a 60-minute session using the face-to-face method. The pamphlet group received the same education using pamphlets. Data were analyzed using descriptive statistics, paired t-test, independent t-test, Fisher’s exact test, chi-square test, and ANCOVA.

Most of the patients (70%) and caregivers (53.3%) in the intervention group were female, and their mean age was 28.07 and 40.75 years, respectively. In the pamphlet group, most of the patients (68.67%) and caregivers (63.3%) were female, with a mean age of 30.28 and 42.32 years, respectively. After education, mean ERA scores increased significantly in both intervention and pamphlet groups (P=0.001). Except for the two domains of physical and mental health, the mean scores of ERA domains were higher in the intervention group than in the pamphlet group (P=0.01). These results were confirmed by ANCOVA results (P<0.01).

Self-care education with the face-to-face method or pamphlets both can increase the ERA of patients with epilepsy and their family caregivers. Depending on the conditions and available facilities, nurses can use these methods to facilitate patient education and the learning process.

Alterations in hematological and renal parameters have been reported with antiepileptic drugs. This study evaluates the effects of lamotrigine (LTG) and levetiracetam (LEV) on these parameters in children with epilepsy.

This randomized clinical trial included children with a first-time diagnosis of epilepsy referred to Bandar Abbas Children’s Hospital, Bandar Abbas, Iran, from 2017 to 2018. The participants’ age, gender, and family history of epilepsy were recorded. The patients in the LTG group received 0.6 mg/kg oral LTG in two divided doses for two weeks which continued with 1.2 mg/kg for another two weeks and then with a maintenance dose of 5-15 mg/kg daily. The patients in the LEV group received 10 mg/kg oral LEV twice a day. When necessary, the dosage is increased to a maximum of 30 mg/kg twice a day. The treatment continued until seizures were controlled. Hematological and renal parameters were measured at baseline and 3 months after treatment. The total duration of treatment with each drug was also noted.

From the 66 children evaluated in this study with a mean age of 8.51±2.11 years, 31 (47%) were male. Age, gender, family history of epilepsy, treatment duration, and baseline hematological and renal parameters did not differ between the LTG group (n=26) and the LEV group (n=40). The patients in both groups were comparable in terms of all the parameters after treatment. Also, no significant change was observed after treatment compared to baseline in either group. 

LTG and LEV have no significant effect on the hematological and renal parameters of children with epilepsy.