Common Neurological Condition Research Articles

Ionized hypocalcemia as a prognostic factor of early mortality in traumatic brain injury

ABSTRACT Traumatic brain injury (TBI) is a common neurological condition. It can affect mental, physical, and cognitive functions and is a common cause of mortality. Electrolytes imbalance is common in those patients. Effective therapy of electrolytes abnormalities improves neurological outcome and reduces mortality. Therefore, we studied the predictive significance of ionized hypocalcemia for early mortality in TBI patients. Patients and method This observational study in the intensive care units of the Ain Shams University hospitals was done on sixty adult patients with TBI of both sexes, divided into two groups: group A (ionized hypocalcemic patients), and group B (normocalcemic patients). On admission, medical history, physical examination including neurological evaluation, and appropriate investigations were performed. Ionized calcium was measured at the start of the 28-day study and then every five days after that. Results There was no statistically significant difference between the two groups for demographic data, brain injury type, or the number of intubated patients (p > 0.05). There was a statistically significant difference for diffuse axonal damage, subdural hemorrhage, cerebral edema, GCS, and mean blood pressure (p < 0.001). Serum ionized calcium in group A was significantly lower than in group B on the day of admission and day five (p < 0.001). On the day of admission, there was a significant difference in serum sodium (p < 0.05). In both groups, there was a significant difference in the ICU stay as regards survivors (p < 0.001). There was a statistically significant difference in 28-day mortality between the two groups (p = 0.001). Conclusion In TBI patients, ionized hypocalcemia on admission and on day five, hypernatremia and disturbed conscious level are strongly linked to greater fatality rates.

Underrepresented and Underserved Populations in Neurological Research.

Underserved and underrepresented populations have historically been excluded from neurological research. This lack of representation has implications for translation of research findings into clinical practice given the impact of social determinants of health on neurological disease risk, progression, and outcomes. Lack of inclusion in research is driven by individual-, investigator-, and study-level barriers as well as larger systemic injustices (e.g., structural racism, discriminatory practices). Although strategies to increase inclusion of underserved and underrepresented populations have been put forth, numerous questions remain about the most effective methodology. In this article, we highlight inclusivity patterns and gaps among the most common neurological conditions and propose best practices informed by our own experiences in engagement of local community organizations and collaboration efforts to increase underserved and underrepresented population participation in neurological research.

Mir155hg Accelerates Hippocampal Neuron Injury in Convulsive Status Epilepticus by Inhibiting Microglial Phagocytosis.

Convulsive status epilepticus (CSE) is a common critical neurological condition that can lead to irreversible hippocampal neuron damage and cognitive dysfunction. Multiple studies have demonstrated the critical roles that long non-coding RNA Mir155hg plays in a variety of diseases. However, less is known about the function and mechanism of Mir155hg in CSE. Here we investigate and elucidate the mechanism underlying the contribution of Mir155hg to CSE-induced hippocampal neuron injury. By applying high-throughput sequencing, we examined the expression of differentially expressed genes in normal and CSE rats. Subsequent RT-qPCR enabled us to measure the level of Mir155hg in rat hippocampal tissue. Targeted knockdown of Mir155hg was achieved by the AAV9 virus. Additionally, we utilized HE and Tunel staining to evaluate neuronal injury. Immunofluorescence (IF), Golgi staining, and brain path clamping were also used to detect the synaptic plasticity of hippocampal neurons. Finally, through IF staining and Sholl analysis, we assessed the degree of microglial phagocytic function. It was found that the expression of Mir155hg was elevated in CSE rats. HE and Tunel staining results showed that Mir155hg knockdown suppressed the hippocampal neuron loss and apoptosis followed CSE. IF, Golgi staining and brain path clamp data found that Mir155hg knockdown enhanced neuronal synaptic plasticity. The results from IF staining and Sholl analysis showed that Mir155hg knockdown enhanced microglial phagocytosis. Our findings suggest that Mir155hg promotes CSE-induced hippocampal neuron injury by inhibiting microglial phagocytosis.

Bouldering & chronic traumatic encephalopathy – That is repeated mild traumatic brain injury from climbing

Mild traumatic brain injury (mTBI) is one of the most common neurological conditions resulting from linear accelerations in the range of 60 gravity. Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative syndrome. Its etiopathology is attributed to repeated blows to the head and the transmission of acceleration and deceleration forces to the brain. There are several types of climbing, the most popular are lead climbing, speed climbing and bouldering. Athletes involved in the latter sub-discipline (bouldering) appear to be most at risk of mTBI. Bouldering takes place on artificial walls or natural rock and involves climbing without a rope on routes up to several metres in height. We hypothesised that climbers in the bouldering sub-discipline are at risk of frequent mTBI and, as a consequence, may suffer from chronic traumatic encephalopathy. In the paper we presented physical formula to support our thesis, a verification of this formula and a survey of boulder climbers. The physical model was verified in a practical test. Differences in the range of ≈ 2g were demonstrated (MAE = 1.86, RMSE = 2.51). There is evidence in the form of a physiological model that boulderers are able to achieve accelerations that cause mTBI. The study population had a 12 % incidence of repeated falls and reported symptoms associated with mTBI during bouldering training sessions. Given the diagnosis of CTE, which can only be made after death, future research should focus on diagnosing and treating symptoms of mTBI and CTE (including depression, progressive memory loss, suicidal behaviour, cognitive impairment) in boulder climbers.

Integrated Care in Epilepsy Management: A Scoping Review of the Models and Components of Health and Social Care Delivery.

Epilepsy is the most common neurological condition globally. Integrating health and social care is fundamental in epilepsy management, but the scope of progress in this area is unclear. This scoping review aimed to capture the range and type of integrated care components and models in epilepsy management. Four databases were searched for articles published since 2010 that reported on integrated care in epilepsy. Data were extracted and synthesised into components of integrated care that had been implemented or recommended only. Models of integrated care were identified, and their components tabulated. Fifteen common and interrelated components of integrated care emerged that were aligned with four broad areas: healthcare staff and pathways (e.g., epilepsy nurses); tasks and services (e.g., care coordination); education and engagement (e.g., shared decision making); and technology for diagnosis and communication (e.g., telehealth). Twelve models of integrated care were identified; seven were implemented and five were recommended. There is a growing evidence-base supporting integrated, person-centred epilepsy care, but implementation is challenged by entrenched silos, underdeveloped pathways for care, and deficits in epilepsy education. Integrating epilepsy care relies on changes to workforce development and policy frameworks to support whole-of-system vision for improving care.

Review of cellular therapies provides new insights into the potential treatment of diverse neurologic diseases in horses and dogs.

Neurological diseases and injuries in veterinary patients (horses, dogs, and cats) are complex, and effective treatment options are limited. Neuronal loss, damage to nerve conduction pathways, and inflammation and scarring associated with spinal cord injury pose major challenges in managing many neurological diseases. Furthermore, most of these neuropathologies lack definitive pharmacological treatments, driving interest and research into novel interventions. Our objective is to provide a narrative review of the current literature surrounding cellular therapies including neuronal and glial stem cells, neurotrophic factors, mesenchymal stem or stromal cells, and cells derived from induced pluripotent stem cells for the treatment of diverse neurological pathologies. Cellular therapies have the potential for cellular replacement, immune modulation, and paracrine signaling and the flexibility of being used alone or alongside surgical intervention. Mesenchymal stem or stromal cells are arguably the most researched cellular therapy and have been administered intrathecally, IV, intra-arterially, intranasally, and intraspinally with few adverse reactions. Limited clinical and experimental studies have suggested efficacy in diseases including acute spinal cord injury and intervertebral disc disease. Little is currently known about the safety and efficacy of neural stem cells, precursor cell administration, and induced pluripotent stem cell-derived treatments. Further research is necessary to determine the efficacy and long-term safety of cellular therapies. Future aims should include larger controlled clinical trials in companion animals for common neurologic conditions including acute spinal cord injury, intervertebral disc disease, peripheral nerve injury, degenerative neuropathies, and age-associated cognitive decline.

LncRNA-MIAT rs9625066 polymorphism could be a potential biomarker for ischemic stroke.

Ischemic stroke (IS) is a common and serious neurological condition that is highly fatal but so far no early diagnostic markers are available. Myocardial infarction-associated transcript (MIAT) is a long non-coding RNA (lncRNA) that could lead to IS by inducing autophagy and apoptosis in neuronal cells. However, there has been no report on the link between susceptibility to IS and the single-nucleotide polymorphisms (SNPs) of MIAT. This study aimed to investigate the association between MIAT gene polymorphisms and IS risk. A total of 320 IS patients and 310 age-, sex- and race-matched controls were included in this study. Four polymorphisms (rs2157598, rs5761664, rs1894720, and rs9625066) were genotyped by using SNPscan technique. Among the 4 polymorphisms of MIAT, only rs9625066 was associated with IS risk (CA vs. CC: adjusted OR = 0.55, 95% CI, 0.37-0.85, P = 0.006; AA vs. CC: adjusted OR = 0.39, 95% CI, 0.16-0.94, P = 0.036; (AA + CA vs. CC: adjusted OR = 0.53, 95% CI, 0.35-0.80, P = 0.002; A vs. C adjusted OR = 0.59, 95% CI, 0.42-0.82, P = 0.002). Haplotype analysis showed a 1.32-fold increase (95% CI, 1.05-1.67, P = 0.017) in IS risk for rs2157598-rs5761664-rs1894720-rs9625066 (A-C-G-C). Logistic regression analysis identified some independent impact factors for IS including rs9625066 AA/AC, TC, TG, HDL-C (P < 0.05). The rs9625066 polymorphism of MIAT might be associated with IS susceptibility in Chinese population, in which AA/CA plays a protective role in IS, whereas the CC genotype increases the risk of developing IS, suggesting it might be a marker predictive of IS risk.

Behavioural change for Parkinson's Disease: A randomised controlled feasibility study to promote physical activity and exercise adherence among people with Parkinson's: study protocol.

Parkinson's is a common progressive neurological condition characterized by motor and non-motor deficits. Physical activity and exercise can improve health, but many people with Parkinson's (PwP) have trouble reaching the recommended dosage. Our recent literature review found improvements in exercise adherence with behavioural change interventions, but it remains unclear which are most effective. Further qualitative research and patient and public involvement has informed a novel behavioural change intervention to be tested alongside an existing exercise program. To examine the feasibility of behavioural change techniques delivered alongside an exercise programme to improve physical activity, function, and self-efficacy in PwP (and study procedures) to inform a future pilot RCT trial. A parallel-arm single blinded randomised feasibility study. Twenty participants with Parkinson's (Hoehn and Yahr stage 1-3) will be recruited from a physiotherapy primary-care waiting list. Following written consent, and baseline assessment, the participants will be randomly allocated to the intervention (n=10) or the control group (n=10). Both groups will receive usual care, which includes a weekly program of a multidisciplinary education, a supervised exercise class and a prescribed home exercise program. The intervention group will receive additional behavioural change techniques, targeting behaviour regulation, belief about capabilities and social influences. Class and home exercise adherence, behavioural component uptake and adherence, and negative events will be recorded. Outcomes will include enrolment and maintenance rates, physical function, falls, physical activity, and exercise self-efficacy measured pre- and post- the 12-week program (in-person). Surveys will be used to compare experiences and satisfaction between groups. Exit interviews will be completed with the intervention group only, exploring their experience of the behavioural change techniques. The results will help inform a future pilot RCT, based on the intervention acceptability, consent rate, maintenance, and protocol integrity. ClincialTrials.gov NCT06192628.

Epilepsy care and outcome in low- and middle-income countries: A scoping review.

Epilepsy is a common neurological condition in low- and middle-income countries (LMICs). This study aims to systematically review, analyze, evaluate, and synthesize information on the current state of medical and surgical management and outcomes of epilepsy in LMICs. Systematic searches were conducted on MEDLINE, EMBASE, World Health Organization Global Index Medicus, African Journals Online, WOS, and Scopus, covering the period from the inception of the databases to August 18th, 2021, focusing on studies reporting management and outcomes of epilepsy in LMICs. A total of 2298 unique studies were identified, of which, 48 were included (38035 cases). The mean age was 20.1 ± 19.26 years with a male predominance in 60.92% of cases. The type of seizure commonly reported in most of the studies was absence seizures (n = 8302, 21.82%); partial focal seizure (n = 3891, 10.23%); and generalized tonic-clonic seizures (n = 3545, 9.32%) which were the next most common types of seizures. Mesiotemporal epilepsy was less frequently reported (n = 87, 0.22%). Electroencephalogram was commonly used (n = 2516, 6.61%), followed by computed tomography scan (n = 1028, 2.70%), magnetic resonance imaging (n = 638, 1.67%), and video telemetry (n = 484, 1.27%) in the care of patients with seizures. Primary epilepsy was recorded in 582 patients (1.53%) whereas secondary epilepsy was present in 333 patients (0.87%). Carbamazepine was the most used anti-epileptic drug (n = 2121, 5.57%). Surgical treatment was required for 465 (1.22%) patients. In LMICs, epilepsy is underreported. There is still a lack of adequate tools for the diagnosis of primary or secondary epilepsy as well as adequate access to medical management of those reported.

Prevalence and Course of Idiopathic Hypersomnia in the Wisconsin Sleep Cohort Study.

Idiopathic hypersomnia (IH) is a CNS disorder of hypersomnolence of unknown etiology. Due to the requirement for objective sleep testing to diagnose the disorder, there are currently no population-based estimates of the prevalence of IH nor data regarding the longitudinal course of IH in naturalistic settings. Subjective and objective data from the Wisconsin Sleep Cohort study were used to identify cases with probable IH from participants with polysomnography and multiple sleep latency test data. Demographic, polysomnographic, and symptom-level data were compared between those with and without IH. Longitudinal trajectories of daytime sleepiness among those with IH were assessed to evaluate symptom persistence or remission over time. From 792 cohort study participants with available polysomnography and multiple sleep latency test data, 12 cases with probable IH were identified resulting in an estimated prevalence of IH of 1.5% (95% CI 0.7-2.5, p < 0.0001). Consistent with inclusion/exclusion criteria, cases with IH had more severe sleepiness and sleep propensity, despite similar or longer sleep times. Longitudinal data (spanning 12.1 ± 4.3 years) demonstrated a chronic course of sleepiness for most of the cases with IH, though pathologic somnolence remitted in roughly 40% of cases. These results demonstrate IH is more common in the working population than generally assumed with a prevalence on par with other common neurologic and psychiatric conditions. Further efforts to identify and diagnose those impaired by unexplained daytime somnolence may help clarify the causes of IH and the mechanisms underlying symptomatic remission.

Inherited Pediatric Neurotransmitter Disorders: Case Studies and Long-Term Outcomes

AbstractPrimary pediatric neurotransmitter disorders include genetic defects of neurotransmitter metabolism that may mimic common neurological conditions in children. Our objective was to evaluate the clinical experience and outcomes of affected patients. Five patients with primary neurotransmitter defects were identified in the neurometabolic database between 2004 and 2022. Two patients with 6-pyruvoyltetrahydropterin synthase deficiency and one with pyridoxine-dependent epilepsy (PDE) presented in the neonatal period. One patient with succinic semialdehyde dehydrogenase (SSADH) deficiency and one with aromatic l-amino acid decarboxylase (AADC) deficiency presented in later life. A diagnosis of cerebral palsy was revised following biochemical confirmation of SSADH deficiency. AADC deficiency was confirmed via exome sequencing and reduced activity on enzyme assay. Late diagnosis in the latter two cases was likely due to a low index of suspicion and lack of access to diagnostic tests in the country of origin. In two children with tetrahydrobiopterin deficiency, newborn screening results and atypical clinical features prompted investigations. An early diagnosis of PDE was established based on presenting features, a high index of suspicion, the presence of an identifiable biochemical marker and molecular genetic testing. Pediatric neurotransmitter disorders can be diagnosed based on a high clinical index of suspicion, availability of biochemical markers, and molecular genetic testing. These disorders, though rare, need to be included in the differential diagnosis of common neurological presentations in children as they may be potentially treatable. Outcomes and influencing factors in the present series are discussed in comparison to published data.

A Comprehensive Review on the Development of Transdermal Patches for Sustained Release of Medication in Migraine Therapy

This extensive review study focuses on the developments and difficulties in the creation of transdermal patches for the treatment of migraines. Migraine is a common neurological condition marked by crippling headaches and frequently need early and effective treatment. A potential method for sustaining medication administration, transdermal patches provide regular dose and boost patient compliance. The composition of transdermal patches, the method of drug release, benefits, drawbacks, and potential applications in the treatment of migraines are all covered in this article.

Stacked Denoising Autoencoder Based Parkinson’s Disease Classification using Improved Pigeon-Inspired Optimization Algorithm

One of the most common neurological conditions caused by gradual brain degeneration is Parkinson's disease (PD). Although this neurological condition has no known treatment, early detection and therapy can help patients improve their quality of life. An essential patient's health record is made of medical images used to control, manage, and treat diseases. However, in computer-based diagnostics, disease classification is a difficult task. To overcome this problem, this paper introduces a stacked denoising Autoencoder (SDA) for Parkinson's disease classification. The main aim of this paper is to derive an optimal feature selection design for an effective PD classification. Improved Pigeon-Inspired Optimization (IPIO) algorithm is introduced to enhance the performance of the classifier. Thus, the classification result improved by the optimal features and also increased the sensitivity, accuracy, and specificity in the medical image diagnosis. The proposed scheme is implemented in PYTHON and compared with traditional feature selection models and other classification approaches. The experimental outcomes show that the proposed method yields a superior classification of PD than the current state-of-the-art method

The Spectrum of First-onset Seizures in Children Presenting at a Tertiary Care Centre

Abstract Introduction: Seizure is the most common paediatric neurological condition with an increased predilection for early childhood. The recent definition of epilepsy includes first-onset seizures with an increased probability of future episodes. Thus, stringent evaluation of the initial episode of seizure is essential. Hence, this study estimated the aetiology, clinical profile, treatment and outcome of the first seizure episode in children at a tertiary hospital. Materials and Methods: This prospective observational study was carried out at a tertiary hospital in Barabanki, India. Children in the age group of 1 month to 12 years who presented with the first seizure episode and those admitted for other illnesses and developed the first seizure episode during hospital stay were included. Data collected were sociodemographics, clinical presentations, laboratory tests, brain imaging studies, electroencephalography (EEG), diagnosis, treatment and short-term outcomes. Results: A total of 113 patients were enrolled presenting with first-onset seizures. There were 78 (69%) males, 86 (76.1%) were below 5 years of age and 60 (53.1%) presented with fever. Most seizures had a generalised onset (58.4%). Febrile seizures (29.2%) were the most common type, followed by neurocysticercosis (20.3%). Central nervous system (CNS)-infective aetiology (58.7%) was the most common etiological classification. Abnormal findings were observed in cerebrospinal fluid examination of 24 out of 56, in brain imaging of 53 out of 80 and in EEG of 70 out of 113 cases examined. Anti-seizure medication (ASM) was prescribed to 68 patients, of which 10 had a recurrence in the 6-month follow-up period. Conclusion: The first episode of seizure in children usually had a generalised onset, with younger children of the male sex at an increased risk. CNS infections and febrile seizures were common causes. Complete history and neurological evaluation can guide the relevant investigations. ASM tailored to the aetiology controls the seizures in most cases.

Effect of Whole-body Vibration on Muscle Tone, Function, and Quality of Life in Children with Spastic Cerebral Palsy: A Systematic Review with Meta-analysis

Cerebral palsy (CP) is a common nonprogressive neurological condition. One of the important signs of CP is the spasticity which can be treated by different methods. Whole-body vibration (WBV) is an example of these treatments. However, its efficacy needs to be accurately studied. This study investigates the effects of WBV on muscle tone, function, and quality of life in children with spastic CP. Systematic review and meta-analysis were performed. We searched the literature using the following electronic databases: Scopus (via Science Direct), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO), PubMed, and PEDro and included articles from the year of their inception up to September 2023. The included articles were randomized controlled trials that used WBV on patients with spastic CP in which the outcomes were spasticity, function, and quality of life. Two reviewers independently selected the included trials. The pooled mean differences (PMDs) and 95% confidence intervals (CIs) were calculated using the Rev Man software. Ten trials involving 206 CP patients were included in this meta-analysis. All trials were of fair to good methodological quality as per the PEDro scale. Five trials compared the effect of adding WBV to standard physical therapy compared to standard physical therapy alone on motor function measured by Gross Motor Function Measure (GMFM-88) with both domains D and E. The current meta-analysis showed that the standard physical therapy treatment was statistically significantly better than WBV plus standard physical therapy on both D values (z = 2.39, P = 0.02, PMD = 3.02, CI: 0.54, 5.49) and E values (z = 3.04, P = 0.002, PMD = 4.06, CI: 1.44, 6.68). Adding WBV to the standard physical therapy was not superior to standard physical therapy alone in favor of gross motor function in patients with CP. However, it remains imperative to conduct high-quality research examining the effectiveness of whole-body vibration on children diagnosed with spastic CP exhibiting motor dysfunction and evaluating its impact on their quality of life.

Contemporary issues in neuro rehabilitation

Stroke is prevailing as the third most common neurological condition on a global scale and an estimated 25.7 million people are those who have survived it. Stroke is one of the overburdening conditions in about 33% of all individuals affected by permanent disability. Because of the high incidence of risk factors especially in Asia (including Pakistan) with an approximation of 250 cases per one lac persons. Occurrence is mostly seen in the older population and is often found with certain other co-morbidities such as dementia. To enhance the post-stroke quality of life in the geriatric population, especially the ones with existing co-morbidities. Physical rehabilitation of stroke plays a vital role[1]. Studies have demonstrated that the rehabilitation of patients with stroke is a lifelong process during which the survivors sequentially develop new physical habits, and transform their activities of daily living[2]. Stroke rehabilitation treatment protocol lasts quite a long. Therefore, it is sometimes tiresome for the patients and their families because of frequent visits to healthcare settings. Additionally, due to a shortage of skilled and specialized rehabilitation professionals, there is a scarcity of quality treatment protocols and as a result, the objectives of most of the rehab programs are not practical and achievable. Thus, preventing the patients from making a significant recovery[3]. The evidence does not support guidelines that are being followed in the healthcare systems of our country regarding stroke management. While working with individuals recovering from stroke and other neurological disorders, rehabilitation generally focuses on strength training[4]. Despite the fact, that the urban population in developing nations like Pakistan has now access to medical facilities such as stroke rehabilitation, the country's rising population is resulting in an overburdening of the healthcare system leading to sloppiness of all the medical services including rehabilitation[3]. Although most rehabilitation professionals and physical therapists know the fact that the traditional techniques used in neuro rehab are not always effective, still they use them on their patients, this lack of evidence-based practice may be due to inaccessibility to authentic clinical practice guidelines and other physiotherapy databases[4]. For instance, relying on outdated techniques such as range of motion exercises and stretching exercises for treating stroke patients is not as effective as using proprioceptive neuromuscular facilitation exercises to improve the coordination and functional ability of patients, thereby improving motor function along with balance and gait[5]. Conventional approaches in rehabilitation management particularly in the domain of neurology are becoming ineffective due to the huge demand that chronic neurological illnesses are placing on our healthcare system. New creative techniques, including integrated care pathways, are needed to obtain better outcomes[6]. The process of governing skillful clinical and administrative pathways is needed to overcome situations associated with a rise in the number of admissions and long stays in hospitals or healthcare resources. Implementing more innovative approaches by management can achieve better outcomes with a reduction in admissions and shortened hospital stays. It will cohesively lead to effective treatment guidelines, greater patient satisfaction, and improved quality of life. Most of European countries are regulated by integrated rehabilitation services to help patients navigate healthcare services more effectively for an impressive, person-centered approach to rehabilitation care[6]. Unified rehabilitation at the current regional and national level with updated approaches and action plans along with evidence-based clinical practice guidelines is required to safeguard the delivery of person-centred rehabilitation care. Thus, we can conclude that there is a dire need to promote the development and implementation of standardized care in neuro-rehabilitation centers for enhancement in the quality of rehabilitation services. In addition to the use of digital media platforms for spreading awareness among the general masses, regulation and periodic reviews of rehabilitation services are also required.

FREQUENCY OF IRON DEFICIENCY ANEMIA AMONG CHILDREN PRESENTING WITH FEBRILE SEIZURES

Febrile seizures are a common neurological condition in young children, affecting around 2-5% of those under the age of 5 worldwide. Although they are usually harmless and resolve independently, they can cause significant distress for parents and caregivers. A recent study aimed to investigate the prevalence of iron deficiency anemia (IDA) in children with febrile seizures to determine whether iron status has an impact on these seizures. This cross-sectional study was conducted at the Department of Pediatrics, Hayatabad Medical Complex, Peshawar, between January 2022 and January 2023. The study included 115 children between the ages of 6 months and 5 years who had experienced febrile seizures. Detailed clinical histories and blood samples were taken to measure hemoglobin, serum iron, ferritin, and complete blood counts. The children were divided into two groups based on their iron deficiency anemia status. The study found that 34.8% of the 115 participants had iron deficiency anemia (IDA), and the remaining 65.2% did not have IDA. The IDA group had significantly lower hemoglobin, serum iron, and ferritin levels than the non-IDA group. The average hemoglobin concentration in the IDA group was 9.8 g/dL, while it was 11.2 g/dL in the non-IDA group. The study suggests that a significant percentage of children who experience febrile seizures may also have iron deficiency anemia. This information can be helpful for healthcare providers in managing and treating these children.

Integrated care in epilepsy: A scoping review of the key components of health and social care delivery

Introduction: Epilepsy is the most common neurological condition globally, and is associated with significant behavioural, physical, and psychological burden. People living with epilepsy and their families often face extreme difficulty receiving timely and efficient healthcare due to the fragmented nature of epilepsy care delivery and the predominance of hospital-based services. The need to integrate epilepsy care services across healthcare sectors and shift care into community settings has become increasingly clear, but the range and type of integration that has occurred worldwide is unknown. This scoping review aimed to identify recommended and/or implemented models of integrated care for epilepsy, or common elements of integrated care models, to broaden current understanding of the progress toward integrated care in epilepsy.&#x0D; Methods: Three literature searches were conducted (in 2020 and 2022) across four databases (PubMed, Medline, Embase, and Web of Science) for integrated, shared, coordinated, or person-centred care models and approaches with a focus on epilepsy. Recommended, developed, or implemented models of integrated care for epilepsy were identified, and data were synthesised into the common elements of integrated care featured in the literature.&#x0D; Results: A total of 295 studies were identified across the three searches, from which 35 studies were deemed eligible and were included in this scoping review. Most studies were conducted in the USA or Ireland, and qualitative study designs were most common. Fourteen models of integrated care were identified; eight had been implemented, and six were advocated for implementation. Twelve common elements of integrated care were synthesised, associated with cross-sector collaboration and training, transition and self-management services, and technological advancements to optimise communication between healthcare providers.&#x0D; Discussion: There is a growing evidence base supporting the need for an integrated, holistic, and person- and family-centred approach to epilepsy care delivery. Substantial progression has been made design and develop integrated care services for epilepsy, but significant challenges are associated with implementing these services. Lack of readiness for change can stifle efforts toward shifting epilepsy care from hospital to community settings, and governance structures across sectors can prevent continuity and coordination of care. Clearer guidelines for epilepsy care and educational interventions in community settings are needed, as well as greater resources to balance workload targets with tailored, patient-centred care.

Chronic subdural haematoma: a case series of uncommon presentations of a common disease

Abstract Chronic subdural haematoma is a common neurological condition especially among the elderly population. Its presentation can be unspecific but often attributed to pressure, cortical irritation, and/or vascular compromise. In the patients’ cohort presented below, we have a series of cases where clinical history and examination did not result in an initial clinical diagnosis or suspicion of chronic subdural haematoma, with the diagnosis made only after brain imaging. We reviewed the literature regarding the aetiopathogenesis and clinical features of our patient cohort, which included a young woman with isolated right ptosis and pupillary dilatation, an elderly man with paraplegia, another elderly man with isolated right foot drop, and a young military man with no history of trauma. Our series re-emphasizes the sometimes non-specific and varied clinical presentation of chronic subdural haematoma. We reiterate the need for early brain imaging in patients who present with neurological disorder.

Study of Anticonvulsant effect of Simvastatin in Maximal Electroshock and Pentylenetetrazole Induced Seizure Model In Albino Mice

Epilepsy is a common neurological condition affecting people of all ages and both sexes. Most of the currently used antiepileptic drugs have neurotoxic and teratogenic effects. There are scanty reports of anticonvulsant activity with statins. The present study was undertaken to evaluate the anticonvulsant effect of simvastatin using MES and PTZ models in mice and compare it with the standard drugs phenytoin and diazepam respectively.64 albino mice of either sex weighing 25-35g were divided into 8 groups of 8 mice each – 4 group each for MES and PTZ model. In MES model, seizures were induced via trans auricular electrodes with a current of 80mA for 0.2 second. Each mouse was pretreated with drugs 30 minutes before in both models. The different groups 1 to 4 were administered polyethylene glycol (0.5ml/Kg), phenytoin (20mg/kg), simvastatin (10mg/Kg) and simvastatin (20mg/Kg) respectively. In PTZ model, seizures were induced by giving PTZ 80mg/Kg. The different groups 5 to 8 were administered polyethylene glycol (0.5ml/Kg), diazepam (2mg/kg), simvastatin (10mg/Kg) and simvastatin (20mg/Kg) respectively. Statistical analysis was doneby ANOVA followed by Tukey’s post hoc analysis for group wise comparison. Results indicated that the anticonvulsant effect of simvastatin (10 and 20mg/Kg) was comparable to phenytoin in the MES model. In the PTZ model, simvastatin (10mg/Kg) produced a reduction in seizure duration but did not provide seizure protection as compared to that of the diazepam. The present study demonstrated the anticonvulsant effect of simvastatin. Further studies may explore the potential of this as an add-on drug in patients with dyslipidemia and epilepsy.