History Of Febrile Convulsions Research Articles

Two-Year Follow-up Outcomes of Non-lesional Epilepsy Surgery in Iran

Background: Despite treatment with anti-epileptic drugs, 30% of epileptic patients continue to experience seizures, making surgery a viable option. Surgery has shown efficacy even in non-lesional epileptic individuals, although there is limited research on this topic. Objectives: This study aimed to investigate surgical outcomes in individuals with drug-resistant epilepsy (DRE) who undergo surgery despite having non-lesional magnetic resonance imaging (MRI) findings. Methods: This observational longitudinal study was conducted between 2017 and 2020 at a referral hospital in Tehran, Iran. Using census sampling, we screened 750 epilepsy cases and enrolled 80 patients (42 women and 38 men) with DRE and non-lesional MRI findings who underwent epilepsy surgery. We collected patients' demographics and seizure characteristics. A 2-year follow-up was conducted to assess the seizure freedom rate. We compared seizure-free and non-seizure-free patients who underwent temporal epilepsy surgery, extratemporal epilepsy surgery, corpus callosotomy, and Vagus nerve stimulation (VNS) using chi-square, Fisher exact, and binary logistic regression tests. Results: The seizure freedom rate was 62.7% for temporal surgery, 83.33% for extratemporal surgery, 26.66% for corpus callosotomy, and none for patients who underwent VNS. There was no difference between seizure-free and non-seizure-free patients in terms of their baseline characteristics, seizure semiology, lesion features, and post-operative findings (P-values > 0.05), except that patients without a history of febrile convulsions tended to experience more seizure freedom after extratemporal surgery (P = 0.007). Additionally, older patients tended to experience more seizure freedom after temporal surgery (P = 0.03). Conclusions: This study underscores the potential benefits of epilepsy surgery in non-lesional DRE patients. Further research is needed to establish criteria for patient selection in this context.

Has the Incidence of Febrile Convulsions in Childhood Changed During the SARS-CoV-2 Pandemic?

Introduction: SARS-CoV-2 infection in children is usually asymptomatic or only mild symptoms are typical. The aim of our study was to assess the incidence of febrile convulsions in our own patients with COVID-19. Patients and Methods: In our retrospective study, we reviewed the data of children who presented at our University Hospital from March 2020 to March 2022 with febrile convulsion. The control group were children admitted to the hospital because of febrile convulsions from January 2018 to January 2020. Results: During the coronavirus pandemic, 51 patients were examined with febrile convulsions. The majority (86.3%) of children had their first febrile convulsion during this period. We diagnosed simple febrile convulsions in 40 cases and complicated ones in 11 cases. The family history of febrile convulsion or epilepsy was present in 12 (23.5%) patients. In addition to febrile convulsion, SARS-CoV-2 infection was confirmed by laboratory testing in 4 cases (7.8%). Three of them had febrile convulsion during the Omicron variant period. Conclusions: During the coronavirus pandemic, the number of children examined because of having febrile convulsions was not higher than in the control period. The coronavirus is unlikely to increase the risk of febrile convulsions.

Analysis of related factors for neuropsychiatric comorbidities in children with epilepsy

ObjectiveTo analyze the risk factors affecting psychiatric behavior and study the psychobehavioral conditions of children with epilepsy.MethodWe randomly selected and enrolled 294 children with epilepsy who visited and were hospitalized in the pediatric clinic of Hebei General Hospital between January 2017 and January 2022, as the study participants. We comprehensively assessed their cognitive functions using the Gesell development schedule or Wechsler Intelligence Scales. The participants were divided into the study group (n = 123) with cognitive impairment and the control group (n = 171) with normal cognitive functions, for analysis.ResultsThere were statistically significant differences between the two groups in disease course, frequency of epilepsy, status epilepticus, and the number of antiseizure medications (ASMs) used (P < 0.05), while there were no statistically significant differences in age, gender, age of onset, form of onset, interictal epileptiform discharge, history of febrile convulsion, and the time from onset to initial visit (P > 0.05). Based on multivariate logistic regression analysis, the course of disease, frequency of onset, status epilepticus and number of ASMs used were identified as high-risk factors for cognitive impairment in children with epilepsy. Similarly, early onset, long course of disease, known etiology, and combination of multiple drugs have a negative impact on behavioral problems, school education, and social adaptability.ConclusionThe course of disease, the frequency of onset, status epilepticus, and the number of ASMs used are high-risk factors for cognitive impairment in children with epilepsy, which can be prevented and controlled early. When selecting ASMs, their advantages and disadvantages should be weighed. Moreover, the availability of alternative treatment options must be considered. With the help of genomic technology, the causes of epilepsy should be identified as early as possible, and precision medicine and gene therapy for children with epilepsy should be actively developed.

Risk Factors of Seizure in Childhood Shigellosis.

Shigellosis is one of the common causes of bacterial diarrhea in children. Seizures are common in shigellosis. It is essential to identify the risk factors of seizure in this disease. This study was conducted on 224 children with shigellosis. The patients were divided into: With (case groups = 63 cases) and without seizures (control group = 161 cases). Groups were compared regarding different variables such as age, gender, clinical symptoms, and laboratory findings. Data analysis was done using statistical tests and SPSS software. Logistic regression analysis was used to determine the risk factors of seizures. Out of 224 cases of children with shigellosis, 107 (47.8%) were male and 117 (52.2%) female. Significant differences were observed between the two groups in terms of age, history of febrile convulsions, frequency of bloody diarrhea, frequency of fever, duration of diarrhea before hospitalization, abdominal pain, increase in BUN, hyponatremia, hypocalcemia, and red blood cell count in stool (P<0.05). Logistic regression analysis showed that a history of febrile seizure, fever, and hyponatremia are the risk factors for seizures in shigellosis. This study concluded that a history of febrile seizure, fever, and hyponatremia are risk factors for seizure in childhood shigellosis, thus rapid diagnosis and treatment of childhood shigellosis with risk factors is very important.

Predictive Effect of Preoperative Abdominal and Emotional Aura on Temporal Lobe Epilepsy Surgery

Objective: Temporal lobe epilepsy surgery is the most common type of epilepsy surgery. This study evaluates the relationship between preoperative auras and surgical prognosis. Materials and Methods: The follow-up data of 100 patients who underwent anterior temporal lobectomy surgery after 2 years was reviewed. The patients were divided into two groups based on the presence or absence of abdominal-emotional (AE) aura. Each patient was evaluated with a detailed history, video-electroencephalography (EEG), neuroimaging, and postsurgical outcomes according to Engel classification to predict postsurgical seizure freedom. Results: After 2 years of follow-up, 71 patients were seizure-free, Based on aura types, univariate analysis showed that the age of disease onset and history of febrile convulsion were higher in the AE (+) group (p=0.013, p&lt;0.001). Additionally, MTS was more frequently observed in the MRI, MRS, and pathology results (p= &lt;0.001, p=0.01, p=0.009). No correlation was found between the presence or type of aura and postoperative seizure-free state. Conclusion: Our results showed that the presence or type of aura had no prognostic significance for seizure freedom after TLE surgery. However, further studies with larger patient numbers are needed to confirm these findings.

Outcome of Iron Deficiency Anemia in patients presenting with Breath Holding Spellsat Lady Reading Hospital Peshawar

Aim: To ascertain the course of iron deficiency anemia in patients who presented to OPD and wards with breath-holding episodes. Methodology: From June 19 through December 18, 2019, the pediatrics department of Lady Reading Hospital in Peshawar conducted this study with ethical committee approval. The study included all kids aged 1 to 5 years, both genders, and those who had Cyanotic Breath spell lasting two or more episodes. Children with Cyanotic congenital heart disease, a history of febrile convulsions or epilepsy, anticonvulsive therapy currently being used, delayed children, and malnutrition in the past were not included in the study. Results: In our 161 patients, the average age was 2.671.811, the average weight was 12.913.33kg, and the average length of illness was 6.834.24 months. Males made up 94(58.4%) and females 67 (41.6%) of the patient population, while PICA children made up 72(44.7%). Iron deficiency anemia was present in 87(54%) of the patient population, but not in 74(46%), who had it. PICA children and children who were breastfed exclusively had a significantly higher correlation with iron deficient anemia. Conclusion: It is highly typical for patients who experience breath holding spells to have iron deficient anemia. These patients should receive an accurate diagnosis of iron deficiency anemia and treatment to soothe the parents' concerns and limit the frequency of unneeded hospital visits. Key words: iron deficiency anemia, breath holding spells, PICA child

Distinctive electro-clinical, neuroimaging and histopathological features of temporal encephaloceles associated to epilepsy.

Encephaloceles (ENCs) may cause clinical complications, including drug-resistant epilepsy that can be cured with epilepsy surgery. We describe clinical, diagnostic, and neuropathological findings of 12 patients with temporal ENC and epilepsy evaluated for surgery and compare them with a control group of 26 temporal lobe epilepsy (TLE) patients. Six patients had unilateral and 6 bilateral temporal ENCs. Compared to TLEs, ENCs showed i) later epilepsy onset, ii) higher prevalence of psychiatric comorbidities, iii) no history of febrile convulsions, and iv) ictal semiology differences. Seven patients had MRI signs of gliosis, and 9 of intracranial hypertension. Interictal EEG analysis in ENCs demonstrated significant differences with controls: prominent activity in the beta/gamma frequency bands in frontal regions, interictal short sequences of low-voltage fast activity, and less frequent and more localized interictal epileptiform discharges. Ictal EEG patterns analyzed in 9 ENCs showed delayed and slower contralateral spread compared to TLEs. All ENCs that underwent surgery (7 lobectomies and 1 lesionectomy) are in Engel class I. Neuropathological examination revealed 4 patterns: herniated brain fragments, focal layer I distortion, white matter septa extending into the cortex, and altered gyral profile. The described peculiarities might help clinicians to suspect the presence of largely underdiagnosed ENCs.

Variants in BSN gene associated with epilepsy with favourable outcome

BackgroundBSN gene encodes Bassoon, an essential protein to assemble the cytomatrix at the active zone of neurotransmitter release. This study aims to explore the relationship between BSN variants and epilepsy.MethodsWhole-exome...

Clinical characteristics of MRI-negative temporal lobe epilepsy.

To investigate the characteristics of patients with MRI-negative temporal lobe epilepsy (TLE) (1.5T brain MRI) in comparison with: (i) patients with hippocampal sclerosis (HS)-TLE; (ii) persons with non-HS structural TLE; and (iii) patients with dual pathology. This was a retrospective study. All patients with an electro-clinical diagnosis of TLE were studied at the outpatient epilepsy clinic at Shiraz University of Medical Sciences, Shiraz, Iran, from 2008 until 2020. Six hundred and forty-one patients were studied [273 (42.6%) HS, 154 (24.0%) non-HS structural TLE, 174 (27.1%) MRI-negative TLE, and 40 (6.2%) dual pathology]. The groups differed significantly. Important dissimilarities included: (i) compared with HS-TLE group, patients with MRI-negative TLE more often had a family history of epilepsy and less often had a history of febrile convulsion; (ii) compared with non-HS structural TLE group, patients with MRI-negative TLE more often had focal to bilateral tonic-clonic seizures, less often had focal seizures with impaired awareness, and more often had a family history of epilepsy; (iii) compared with the dual pathology group, patients with MRI-negative TLE less often were male and less often had a history of febrile convulsion. Patients with MRI-negative TLE are not a homogenous group of people and it is not necessarily a distinct entity from other forms of TLE either. With the emergence of advanced imaging technologies, the underlying pathologies of MRI-negative TLE may be revealed.

Acute dizziness and mental alteration associated with Moderna COVID-19 vaccine: a case report

BackgroundDue to a rising number of COVID-19 cases, the Indonesian government implemented public health programs to lower the rate. Since January 2021, one of the government’s primary policies has been the COVID-19 immunization program. Recently, the Moderna messenger ribonucleic acid (mRNA) vaccine is one of the COVID-19 vaccines used in Indonesia. Based on some research, Moderna has possible side effects throughout the body, including neurological symptoms.Case presentationWe describe a 39-year-old female with uncontrolled hypertension who showed behavioral change, communication difficulty, social withdrawal, and a confused state within 7 days from getting her first dose of the Moderna vaccine. The patient had a history of febrile convulsion in childhood. An increase of neutrophil-to-lymphocyte ratio (16.9) and C-reactive protein level (31.75 mg/L) indicates ongoing inflammation. Head CT scan shows no abnormalities. She received ceftriaxone, citicoline, and methylprednisolone. The patient was discharged on the seventh day and completely recovered 1 week later. This study is the first case report of encephalopathy following the administration of the Moderna COVID-19 vaccine reported in Indonesia up to our knowledge.ConclusionEncephalopathy related to the Moderna COVID-19 vaccine should be acknowledged as an adverse effect of the Moderna COVID-19 vaccine.

The Association between Hyponatremia and Recurrent Febrile Convulsion

Background: Febrile seizures are a common pediatric problem, yet there is a great deal of disagreement about the appropriate diagnostic evaluation of a child with this disorder. Different predisposing factors have suggested enhancing the susceptibility to febrile seizure and its recurrence. Objective: To determine the effect of hyponatremia in recurrent febrile convulsions. Materials and Methods: A case-control study was carried out at Al-Zahraa teaching hospital in Al-Najaf city during the period between 1 January and the end of October 2021. One hundred fifty children in the age range between six months and six years old were studied. We classified the patients into three groups: Group (A) included 50 children who presented with fever without seizure; group (B) included 50 children who presented with simple febrile convulsion; and group (C) included 50 children who presented with recurrent febrile convulsions. Group A was considered as the control group. The serum level of sodium Na+ was estimated in these three groups by Na kits. Results: There was no significant difference between males and females, in all age groups. Also, it was shown that a family history of febrile convulsion represented 20%, 50%, and 50% in groups A, B, and C, respectively; a family history of recurrent febrile convulsion represented 4%, 4%, and 10%, in groups A, B, and C, respectively; and a family history of epilepsy represented 0%, 4%, and 0% in groups A, B, and C, respectively. A value of P in family history of febrile convulsion was 0.002, in family history of recurrent febrile convulsion was 0.345, and in family history of epilepsy was 0.132. Therefore, there was no significant difference in all parameters except a family history of febrile convulsion that was significant in all three groups. Also, the study will show no significant difference in age, white blood cell count, and random blood surge whereas there is a significant difference in temperature. A significant difference in serum sodium level was the lowest in group C. Regarding calcium level, there was a significant difference between groups A and B. Conclusion: There is a significant association between recurrent febrile convulsion and lower level of serum sodium, in which serum sodium concentration is lower in those patients with recurrent febrile convulsion.

Clinical Analysis of the Relationship between Convulsion and Blood Electrolyte in Children

Objective: Febrile convulsion in children is age-dependent and genetic predisposition. However, mild electrolyte disturbances are not uncommon in such children. This study was to investigate the effect of electrolyte disturbance on febrile convulsion and to screen for febrile convulsion-related genes. Methods: This retrospective cohort study included children who admitted to the Pediatric Emergency Department of Guangzhou Women and Children’s Medical Center due to fever and febrile convulsion between May to December 2020. Clinical manifestations and serum electrolyte levels were recorded and analyzed by binary logistic regression on risk factors of convulsion, and children with family histories were screened for febrile convulsion-related genes. Results: This study included 322 children with fever: 161 in the febrile convulsion group (FC Group) including 71 in the single convulsion group (SC Group) and 90 in the multiple convulsion group (MC Group), and the control group consisted of 161 children with fever without convulsion and nervous system disease. Serum sodium, potassium and calcium in FC Group were lower than those in the control group (p Conclusion: Hyponatremia may be a relative risk factor in febrile convulsion, and for children with a family history of febrile convulsion and serum sodium lower than 133 mmol/L, related gene analysis can be performed.

Quantitative evaluation of gray matter alterations in patients with mesial temporal lobe epilepsy (MTLE)

Objective: The purpose of this study was to evaluate the gray matter (GM) alterations in patients with mesial temporal lobe epilepsy (MTLE) based on statistical models. Methods: High-resolution MRI data were collected from 64 adult MTLE patients and 100 healthy participants. Voxel Based Morphometry (VBM) and Surfaced Based Morphometry (SBM) analysis were used to detect the alterations of cerebral GM of MTLE. We also built general linear models (GLM) for quantitatively evaluating regions of interest (ROIs) from the corrected VBM, SBM analysis. Results: The corrected VBM and SBM analyses identified discriminable GM alterations in the left and right MTLE groups located in the ipsilateral hippocampus, the perisylvian cortex in the left MTLE group and the bilateral orbitofrontal cortex in the right MTLE group. We extracted the ipsilateral hippocampal volume GLM of both unilateral MTLE groups. History of febrile convulsions and an increased number of AEDs were recognized as risk factors for ipsilateral hippocampus atrophy of unilateral MTLE. Moreover, early onset age was also considered a risk factor for left hippocampus atrophy in left MTLE. Significance: The current study established a quantitative assessment of unilateral MTLE based solely on GM alterations, without any influence of demographic risk factors. By using this GM-based protocol, we found that regions both inside and outside of the temporal lobes may be associated with the epileptic network of MTLE.

Анализ осведомленности врачей относительно принципов коррекции лихорадки у детей

Актуальность. Лихорадка у детей является одной из наиболее частых причин обращения родителей к врачу. Цель: проанализировать состояние осведомленности врачей относительно принципов лечения лихорадки у детей, методов оптимальной дозировки жаропонижающих препаратов и особенностей применения жаропонижающей терапии у отдельных категорий пациентов по специально разработанным анкетам. Материалы и методы. В опросе принимало участие 108 врачей. Анкета состояла из 20 вопросов. Результаты. Врачи отмечают, что для снижения температуры тела у ребенка только 66,0 % родителей используют средства, рекомендованные врачом, остальные опираются на личный опыт и рекомендации провизоров. 64,2 % респондентов в качестве жаропонижающего препарата первой линии указали ибупрофен. Показанием к применению жаропонижающих препаратов 90,6 % врачей считали повышение температуры тела до 38,5 °С и более. Вместе с тем 26,4 % врачей применяют эту группу препаратов после вакцинации; 17,0 % респондентов допускают применение жаропонижающих препаратов при температуре тела у ребенка меньше 38,5 °С, прежде всего при фебрильных судорогах в анамнезе, а также при болевом синдроме и плохом самочувствии. 50,9 % респондентов комбинируют применение ацетаминофена и ибупрофена в случае неэффективности одного из них, используя второй препарат в промежутках между приемами первого. Наиболее сложными вопросами для врачей были особенности применения жаропонижающих препаратов у детей с сопутствующей патологией. Выводы. С учетом полученных данных считаем необходимым проводить дальнейшую работу среди врачей относительно осведомленности о принципах и показаниях к использованию антипиретической терапии у детей.

Is Preterm Birth a Risk Factor for Subsequent Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder in Children with Febrile Seizure?-A Retrospective Study.

Febrile seizure (FS) is the most prevalent childhood seizure; it is significantly related to subsequent epilepsy and has possible links to childhood neurodevelopmental disorders. Separately, premature births are believed to increase the risk of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Therefore, this study investigated whether preterm birth is a risk factor for subsequent epilepsy, ASD, and ADHD in children with FS. We retrospectively collected data for children aged < 5 years with FS from 1 January 2005, to 31 December 2013. We divided these children into two groups—the premature birth group and the full-term group—and compared their incidence rates of epilepsy, ASD and ADHD. The data of 426 patients with history of febrile convulsion were retrospectively collected. The premature birth group (FS+/preterm+) had 108 patients and the full-term group (FS+/preterm−) had 318 patients. The overall epilepsy risk in the FS+/preterm+ group was higher than in the FS+/preterm− group (odds ratio [OR], 2.52; 95% confidence interval [CI], 1.14–5.58; p = 0.02). The overall risk of ADHD in the FS+/preterm+ group was higher than that in the FS+/preterm− group (OR, 6.41; 95% CI, 3.39–12.09; p = 0.0001). In addition, children with FS+/preterm+ had 16.9 times (95% CI, 4.79–59.7; p = 0.0001) higher odds of having ASD compared with those with FS+/preterm−. Preterm birth may be a risk factor for subsequent epilepsy, ASD and ADHD in children with FS.

Hippocampal atrophy and quantitative EEG markers in mild cognitive impairment in temporal lobe epilepsy versus extra-temporal lobe epilepsy.

Cognitive impairment in temporal lobe epilepsy is widely acknowledged as one of the most well-known comorbidities. This study aimed to explore cognitive impairment and to determine the potential clinical, radiological, and quantitative electroencephalography markers for cognitive impairment in temporal lobe epilepsy patients versus extra-temporal lobe epilepsy. Forty-five patients with temporal lobe epilepsy and forty-five patients with extra-temporal lobe epilepsy were recruited for an administered digit span test, verbal fluency test, mini-mental state examination, digital symbol test, and Montreal cognitive assessment. Also, they were subjected to magnetic resonance imaging assessment for hippocampal atrophy and a quantitative electroencephalography assessment for electroencephalography markers (median frequency, peak frequency, and the alpha-to-theta ratio). Patients with extra-temporal lobe epilepsy showed non-significant higher epilepsy durations and a higher frequency of seizures. Temporal lobe epilepsy patients showed a more statistically significant family history of epilepsy (37.7%), more history of febrile convulsions (13.3%), higher hippocampal atrophy (17.8%), and lower cognitive scales, especially mini-mental state examination and Montreal cognitive assessment; lower digital symbol test, verbal fluency test, and backward memory of digit span test. Also, temporal lobe epilepsy patients had a strong negative correlation with electroencephalography markers: median frequency, peak frequency, and the alpha-to-theta ratio (r = - 0.68, P < 0.005 and r = - 0.64, P < 0.005 and r = - 0.66, P < 0.005 respectively). Cognitive impairment in patients with temporal lobe epilepsy was correlated with hippocampal atrophy and quantitative electroencephalography abnormalities, especially peak frequency, median frequency, and alpha-to-theta ratio that could be used alone for the identification of early cognitive impairment. Clinicaltrials.gov: NCT04376671.

A cohort study of mild encephalitis/encephalopathy with a reversible splenial lesion in children.

PurposeTo investigate the clinical features, imaging features, and prognosis of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in childrenMethodsThe clinical and imaging data of a cohort of 28 children diagnosed as MERS from January 2019 to October 2020 were retrospectively analyzedResultsOf the 28 patients, 17 were males and 11 were females. The onset age ranged from 8 months to 12 years old, with an average age of 4 years and 2 months. All children developed normally before onset, and three of them had a history of febrile convulsion. More than half of the patients (62.9%) had preceding infections of gastrointestinal tract. All the cases developed seizures, and most (71.4%) had more than one time. Other neurological symptoms included dizziness/headache, consciousness disorder, limb weakness, blurred vision, and dysarthria. Cranial magnetic resonance imaging (MRI) showed lesions in the splenium of the corpus callosum in all, extending to other areas of the corpus callosum, bilateral semi‐ovoid center, and adjacent periventricular in two cases. The clinical symptoms were relieved after steroids, intravenous immunogloblin, and symptomatic treatment, without abnormal neurodevelopment during the followed‐up (2 months–2 years). Complete resolution of the lesions was observed 8–60 days after the initial MRI examinationsConclusionMERS in children is related to prodromal infection mostly, with a wide spectrum of neurologic symptoms, characteristic MRI manifestations, and good prognosis.

A community-Based Epidemiological Study of Epilepsy among Students of Primary and Preparatory School Stages in New Damietta City

Background:Even though Epilepsy is a common neurological disorder globally, developing countries still have insufficient epidemiological data regarding epilepsy. Aim of the Work:We aimed to estimate the prevalence of epilepsy in primary and preparatory school students in New Damietta city, Damietta governorate, Egypt. Patients and Methods:A cross-sectional community-based study that was conducted over a period of six months from February to July 2020. All students from conventional schools were screened using a special validated Arabic translated questionnaire. Students with positive questionnaire findings were subjected to a detailed history, neurological examination, Electroencephalography [EEG], and Magnetic resonance imaging [MRI] whenever possible. Data were coded and analyzed. Result:Lifetime prevalence was 7.5/1000 in conventional schools. Male: Female ratio was 2:1 with statistical significance [95% Confidence Interval= 0.276 to 0.963]. Low socioeconomic class students had a statistically significant higher prevalence of epilepsy. Prenatal and neonatal insults, history of febrile convulsions, and family history of epilepsy were the risk factors with statistical significance. Generalized seizures were more frequent than focal and 62.2% of children were receiving treatment. EEG detected epileptiform discharges in 33.3% of students. Conclusion: The prevalence of overall epilepsy among primary and preparatory school students was similar to that of other Egyptian districts within the same age group. Being male and low socioeconomic status was associated with a high prevalence of epilepsy. The reported prevalence is similar to the prevalence of epilepsy in other Egyptian Governorates and other Arab countries, but lower than the prevalence in Upper Egypt and most developing countries.

The strategies for coping with stress of epilepsy patients.

This study aims to compare the styles of coping with stress between patients with epilepsy and healthy individuals and to examine the effects of clinical features on methods of coping with stress. The study enrolled 120 patients diagnosed with epilepsy. Forty healthy individuals were included as control group. Sociodemographic and clinical characteristics of the patients were recorded. The patients and controls completed the Coping Strategies with Stress Inventory (COPE), which comprises 60 items distributed into 15 scales. The COPE scores of the patients and controls were compared. Comparing the COPE scores of the patients and controls, the substance use score was higher in the controls. In terms of gender, seeking instrumental social support, active coping, seeking emotional social support, acceptance, and emotion-focused total coping scores were higher in women among patients. In terms of marital status, the positive reinterpretation and growth score of single patients was significantly higher than that of married patients. In patients with a history of febrile convulsions, the active coping, seeking emotional social support, and denial scores were higher. In terms of treatment, for the patients receiving polytherapy, the suppression of competing activities, focus on and venting of emotions, and dysfunctional total coping scores were higher than in patients receiving monotherapy. Epilepsy and stress are intertwined conditions. Epilepsy patients, confronted with stress, avoided using alcohol and substances compared to healthy individuals. There were differences among epilepsy patients according to gender, marital status, febrile convulsion history, number of medications, and approaches to coping with stress.

Risk Factors of Recurrent Febrile Convulsions in Children in AL-batool Teaching Hospital

Background: Febrile seizures are the most common convulsive disorder in infants and children. Its occurbetween the age of 6 and 60 mo.There are two type of febrile convulsion simple and complex; A simplefebrile seizure is a primary generalized, usually tonic-clonic, attack associated with fever, lasting for amaximum of 15 min, and not recurrent within a 24-hour period. A complex febrile seizure is more prolonged(&gt;15 min), focal, and/or recurs within 24 hr .Aim of the study: To identify the risk factors for recurrence of febrile convulsions in children.Materials and Methods: This was a case-controlled study done at Al Batool teaching hospital .Studyconducted over a period of five months , from August 2018 to December 2018 . All children with febrileseizure belonging to age group of 6 months to 6 years were included in the study.Results : Compared to children with first attack of febrile convulsion, children with recurrent seizures wereyounger at onset (12_24mo.) (26% vs. 54%), mainly male (72% vs. 62%) and had more often family history(second degree relative), low degree of temperature (78% vs. 36%),simple febrile convulsion (52% vs.68%),duration of fever less than12 hours (78% vs. 70%), and frequent febrile illnesses (74% vs. 20%). firstdegree family history of febrile convulsion and family history of epilepsy were not significant risk factors.Conclusions: The risk factors associated with increased incidence of recurrence FC are: male sex, agebetween12_24 months at the onset of the first FC, family history of FC in a second degree relative, durationof fever &lt;12 hours ,simple type of convulsion &amp;frequent attack of febrile illness(&gt;4per year).