Non-epileptic Children Research Articles

EEG findings and clinical severity and quality of life in non-epileptic patients with autism spectrum disorders

ABSTRACT Electroencephalogram (EEG) abnormalities could be seen in up to 60% of non-epileptic children with autism spectrum disorder (ASD). They have been used as biomarkers of ASD severity. The objective of our study is to identify EEG abnormalities in children with different degrees of ASD severity based on the Autism Treatment Evaluation Checklist (ATEC). We also want to assess the quality of life for children with ASD. All of the children underwent at least one hour of sleep-deprived EEG. Forty-five children were enrolled, of whom 42 were male. EEG abnormalities were found in 10 (22.2%) children, predominantly in the bilateral frontal areas. There were no differences in EEG findings among the mild, moderate, and severe ASD groups. The severity of ASD was associated with female sex (p-value = 0.013), ASD with attention deficit hyperactivity disorder (ADHD) (p-value = 0.032), ASD children taking medications (p-value = 0.048), and a lower Pediatric Quality of Life Inventory (PedsQL) (p-value <0.001). Social and emotional domains were the most problematic for health-related quality of life in ASD children, according to parent reports of PedsQL. Further studies with a larger sample size will help to clarify the potential associations between EEG abnormalities and the severity of ASD, as well as the impact on quality of life.

Electroencephalographic findings in autistic non-epileptic children

Despite the well-acknowledged link between autism spectrum disorders (ASDs) and epilepsy, the prevalence and significance of electroencephalogram (EEG) changes in epileptic children in the absence of clinical seizures remains underdetermined. Aim. The primary goal of this study is to report the prevalence of EEG abnormalities in non-epileptic or pre-epileptic autistic children, investigate their association with a set of pre-determined risk factors, speculate on their significance, and direct future research efforts. Methods. A case-based sampling for children diagnosed with autism was done. Only patients without a history of epilepsy and those under the age of 15 were included. All patients underwent an EEG study. Children with abnormal EEG findings (case group) were compared to age-matched controls with normal EEG findings using a set of pre-determined factors. Results. A total of 38 patients were enrolled in our study, of whom 31.6% (n=12) had abnormal EEG readings. Of those, the presence of the following EEG abnormalities were noted – each being present in two patients: frontal sharp waves, frontal slowing, temporal slowing, bitemporal slowing, frontal sharp waves, and generalized sharp waves, Frontal intermittent rhythmic delta activity (FIRDA). Patients with abnormal EEG findings were more likely to have a positive family history of epilepsy and/or autism, with odd ratios of 28.05, and 12.62, accordingly. Conclusion. Aberrant brain connectivity patterns have been observed in non-epileptic ASD patients, and our findings support these findings. Furthermore, we believe that gender, mother's age, mode of delivery, and speech abnormalities could all have an impact on the EEG results. However, more research is needed to expand on these findings.

Serum folate levels in children with epilepsy seen in a tertiary health care facility in north central Nigeria.

Children suffering from epilepsy are maintained on antiepileptic drugs (AED) to ensure a reasonable quality of life. These drugs, however, are not without side effects. Notable among which is interference with the metabolism of folate with its attendant clinical implications such as megaloblastic anemia and bleeding diathesis. This study was carried out to determine the serum folate levels of children with epilepsy, compare the folate levels of these children with that of controls, the levels in subjects on different AED, and to investigate the possible effect of duration of AED use on serum folate levels. It was a comparative cross-sectional study involving children with epilepsy aged 2-14 years attending the paediatric neurology clinic of University of Ilorin Teaching Hospital (UITH), Ilorin. A total of 140 epileptic and 140 age-and-sex-matched nonepileptic children as controls were recruited into the study. Mean serum folate levels in subjects of 6.3 ± 1.6 ng/mL was significantly lower than 7.5 ± 1.5 ng/mL in controls (P = 0.001). The mean serum folate level in subjects on AED was comparable with the value in AED naïve subjects. The mean serum folate level was also comparable among subjects on carbamazepine, phenobarbitone, and valproate as monotherapy. There was no correlation between the duration of AED use and the mean serum folate levels (r = -0.180; P = 0.069). The mean serum folate level in subjects was significantly lower than the value in controls; but was comparable in subjects on carbamazepine, phenobarbitone, and valproate as monotherapy. There was no correlation between the duration of AED use and mean serum folate levels.

Study of EEG Changes Among Sample Of Egyptian Children With Attention Deficit Hyperactivity Disorder

Background: Attention Deficit Hyperactivity Disorder(ADHD) is a mental Neuro-developmental type, Up to 5% of primary school-age children have ADHD, characterized by Inattention, Hyperactivity ,and Impulsivity, Relation between Encephalography (EEG) and (ADHD) is ambiguous, Guidelines recommend that (EEG) indicated only in the clinical suggestions of seizure disorder or a presence of focal signs. Aim: To Study the Relation Between (ADHD) children and Their (EEG) changes, Further study of the Efficacy of AtomoxetineAntipsychotic and Antiepileptic on ADHD children. Subjects and Methods: 60 Egyptian children (age 6-18) with No previous history of seizures. They had been attending to Neuropsychiatry clinic for treatment and fulfilling the criteria for (ADHD) according to (DSM-IV), Conner's scale for (ADHD) and (EEG) was applied for 60 children. Follow up study was conducted from September 2018 to January 2021, included, Follow up of all children with their treatment of all types of (ADHD) using Atomoxetine, Atomoxetine/Antipsychotic combination ,and Antiepileptic. Results: Out of 60(ADHD) children, only 6 children showed (EEG) Abnormalities, Atomoxetine showed superior efficacy on(ADHD) inattention type , Atomoxetine/Antipsychotic Combination Showed Superior efficacy on(ADHD)Hyperactivity type and(ADHD)Combined type. while Antiepileptic Showed a frustrating improvement on NON- epileptic(ADHD)regardless the type of it. Conclusion: There is NO correlation observed between NON-epileptic (ADHD) children and their EEG abnormalities, In addition, there were NO improvement noticed for Antiepileptic on NON- epileptic(ADHD)children.

EDUCATIONAL IMPACT OF EPILEPSY IN CHILDREN

Introduction: Epilepsy can interfere with a child's cognitive development and may result in academic difficulty. Our objective is to identify and estimate the link between epilepsy and academic difficulties. &#x0D; Methods: This is a prospective descriptive and analytical case-control study carried out at the Antsakaviro Laboratory of Neurosciences and Mental Health for the cases and in the four Public Primary Schools of the rural commune of Anjepy for the controls from 1st October 2014 to 31st January 2015. The frequency of school difficulties in epileptic and non-epileptic children, the relationship between epilepsy and school difficulties were evaluated. &#x0D; Results: The frequency of school difficulty in children with epilepsy was 49.13% compared to 25% in non-epileptic children with an Odds Ratio of 2.90 with 95% specificity and a confidence interval of 1.87 to 4.43. Among the cases, 52.94% of the children had their first seizure before the age of 2 years with a predominance of generalized tonic-clonic seizures at 57.65%, the majority of which were of the idiopathic type (67.06%). The majority of children with epilepsy had a lack of concentration in 43.53% of cases and memory impairment in 31.76%, while memory impairment (38%), lack of concentration in 20% and repetition in 20% of non-epileptic children. &#x0D; Conclusion: Epilepsy is a serious illness for the child that can lead to a learning disability. &#x0D; Therefore, prevention of seizures and early detection are essential.

An association between the rs1799853 and rs1057910 polymorphisms of CYP2C9, the rs4244285 polymorphism of CYP2C19 and the prevalence rates of drug-resistant epilepsy in children

Objective Epilepsy is a neurologically based disease. Literature data indicate a certain association between the polymorphism of these genes, which participate in the metabolism of drugs (CYP), and drug-resistant epilepsy. Aim The reports describe studies in which an association was evaluated between the rs1799853 (430C > T) and rs1057910 (1075A > C) polymorphisms of CYP2C9 gene and the rs4244285 (c.681G > A) polymorphism of CYP2C19 gene on one hand and the incidence of drug-resistant epilepsy in children on the other. Material and methods The above-mentioned polymorphisms were assessed by the PCR-RFLP technique in a group of patients with drug-resistant (n = 106) and drug-responsive (n = 80) epilepsy, as well as in non-epileptic children (n = 97), all of them hospitalised at the Department of Neurology of the Institute-Polish Mother’s Memorial Hospital in Lodz. Results It was demonstrated that CT genotype of the rs1799853 polymorphism of CYP2C9 gene and GA genotype of the rs4244285 polymorphism of CYP2C19 gene caused an enhanced risk of epilepsy. It was also shown that the occurrence of C-G-A haplotype, when referred to the rs1799853 polymorphism of CYP2C9 gene and the rs4244285 polymorphism of CYP2C19 gene, could be associated with a decreased risk of epilepsy occurrence. In case of the rs1799853 polymorphism in CYP2C9 gene, the occurrence of T allele four times increases the risk of drug-resistance in patients with diagnosed epilepsy. Conclusion The obtained results indicated that the rs1799853 and rs1057910 polymorphisms of CYP2C9 gene and the rs4244285 polymorphism of CYP2C19 gene could be associated with the occurrence of drug-resistant epilepsy in children.

Association of folic acid, vitamin B12, and intelligence scores in epileptic children

Epilepsy is a serious childhood disease associated with cognitive impairment. Our aim was to investigate the possible association of serum folic acid, vitamin B12, and intelligence scores in epileptic children. A group of 30 children with established diagnosis of idiopathic epilepsy for at least one year as well as another group of 30 nonepileptic healthy children as the control group were recruited for analysis. Cognitive performance was assessed by a battery of psychological tests that covers verbal and nonverbal intelligence. Serum B12 level was significantly lower in patients than the control group (264.17 ± 58.07, 450.55 ± 134.9, respectively). No significant difference was detected between patients and the control group regarding serum folic acid level. Verbal, performance, and total IQ were significantly lower in patients than the control group (83.2 ± 3.08 vs. 95.8 ± 6.22, 78.4 ± 10.68 vs. 91.3 ± 2.45, and 180.6 ± 6.58 vs. 93.5 ± 3.02, respectively). However, no significant correlation was detected in folic acid, vitamin B 12, and cognitive scores. Epileptic children were five times more at risk of having low IQ (verbal, performance, and total) < 85 than the control group (OR = 4.754, 95% CI 13.047–1031.316, p = .000). In conclusion, children with epilepsy might be at higher risk for cognitive dysfunction than normal children. No significant association was detected between cognitive performance and either folic acid or vitamin B12 in epileptic children receiving sodium valproate. Supplementation of those vitamins should be restricted to those with documented deficiency.

Intelligence Quotient among Epileptic and Non-epileptic Children

Intelligence Quotient among Epileptic and Non-epileptic Children

Omega-6/omega-3 ratio and cognition in children with epilepsy

Cognitive impairment is a common consequence of epilepsy in children. This study aimed to assess the ratio of omega-6 to omega-3 fatty acid levels and its impact on cognitive function in children with idiopathic epilepsy. We performed a case-control study in 30 children with idiopathic epilepsy and 20 healthy children. We measured levels of alpha-linolenic acid (omega-3) and linoleic acid (omega-6) by means of gas-liquid chromatography. We assessed cognitive function with the Arabic version of the fourth edition of the Stanford-Binet test and the P300 component of event-related potentials. All children had an intelligent quotient greater than 70. Children with epilepsy had lower levels of omega-3 and higher levels of omega-6 fatty acids and an abnormal omega-6/omega-3 ratio compared to non-epileptic children. We found a significant positive correlation of serum omega-3 levels and a significant negative correlation of serum omega-6 levels with cognitive function scores and P300 latency in children with epilepsy. Children with epilepsy have abnormal ratios of omega-6 to omega-3 fatty acid serum levels, which is associated with impaired cognitive function in these children.

Omega-6/omega-3 ratio and cognition in children with epilepsy

IntroductionCognitive impairment is a common consequence of epilepsy in children. This study aimed to assess the ratio of omega-6 to omega-3 fatty acid levels and its impact on cognitive function in children with idiopathic epilepsy. Patients and methodsWe performed a case-control study in 30 children with idiopathic epilepsy and 20 healthy children. We measured levels of alpha-linolenic acid (omega-3) and linoleic acid (omega-6) by means of gas-liquid chromatography. We assessed cognitive function with the Arabic version of the fourth edition of the Stanford-Binet test and the P300 component of event-related potentials. All children had an intelligent quotient greater than 70. ResultsChildren with epilepsy had lower levels of omega-3 and higher levels of omega-6 fatty acids and an abnormal omega-6/omega-3 ratio compared to non-epileptic children. We found a significant positive correlation of serum omega-3 levels and a significant negative correlation of serum omega-6 levels with cognitive function scores and P300 latency in children with epilepsy. ConclusionChildren with epilepsy have abnormal ratios of omega-6 to omega-3 fatty acid serum levels, which is associated with impaired cognitive function in these children.

Epileptiform Activity in Electroencephalogram of Normal Children.

Objectives This prospective cohort study assessed the prevalence of epileptiform discharges (EDs) in a cohort of healthy Egyptian children aged 1 to 18 years. Methods Children with a history of unprovoked seizure disorders, family history of epilepsy, neurological or psychological disorder, or any other chronic illness were excluded. Digital electroencephalogram (EEG) was recorded under resting condition for a minimum of 20 minutes including activation methods. Results The study included 1,382 healthy Egyptian children with no history of unprovoked seizures. Twenty-nine normal children had EDs, which represents 2.1% of total number of studied children. Centrotemporal spikes were detected in 19 children. The prevalence of EDs was significantly higher in children aged 6 to 12 years (3.59%) compared with children aged 13 to 18 years (1.2%) and children aged 1 to 5 years (0.45%). Conclusions EDs can be observed in nonepileptic normal children. Centrotemporal spikes are the most common epileptiform pattern in EEG of normal children. None of normal children with EDs developed seizures or other neurological disorders during follow-up.

Association between C3435T polymorphism of MDR1 gene and the incidence of drug-resistant epilepsy in the population of Polish children

PurposeEpilepsy is a disease of neurological character. Approximately one third of epileptic patients demonstrate a drug-resistant phenotype, which is associated with the development of drug-resistant epilepsy. The multidrug resistance protein 1 and glycoprotein P, encoded by MDR1, play a significant role in the transmembrane transport of anti-epileptic agents. Single nucleotide polymorphism C3435T (rs1045642) within MDR1 gene may be associated with an increased expression of P-gp which affects the levels of antiepileptic drugs in plasma. The presented studies analysed the association between C3435T polymorphism of MDR1 gene and the incidence of drug-resistant epilepsy in the population of Polish children.MethodsC3435T polymorphism of MDR1 gene was analysed by the high resolution melting technique in a group of patients with drug-resistant (n = 106) and drug-responsive epilepsy (n = 67), as well as in non-epileptic children (n = 98) hospitalised at the Department of Neurology, Polish Mother’s Memorial Hospital in Lodz. Genotype and allele distributions were evaluated and their compatibility with the Hardy–Weinberg distribution was assessed by means of the χ2 test. Genotype and allele evaluation, regarding their relationship with a given feature, was supported by an analysis of odds ratio and 95 % confidence interval, calculated according to the logistic regression model.ResultsAn association was observed between the incidence rate of DRE and the presence of C allele in C3435T polymorphism of MDR1 gene, which may enhance the risk of the disease. The T allele may then play a protective role. No differences were found in the studied groups, regarding either genotype or allele distribution in reference to patient’s gender or concomitant diseases.ConclusionFollowing the obtained results, C3435T polymorphism of MDR1 gene may be connected with the incidence of drug-resistant epilepsy in the population of Polish children.ISRCTN ISRCTN73824458. Registered 28th September 2014.

The subclinical epileptiform discharges among nonepileptic cerebral palsy patients

Background Subclinical epileptiform discharges (SEDs) are assumed to play a role in the development of cognitive dysfunction in cerebral palsy (CP) patients. Purpose The aim of this study was to estimate the prevalence of SEDs among nonepileptic CP patients and their cognitive correlates. Patients and methods Fifty-one nonepileptic CP patients were recruited. All patients were subjected to history taking, neurological examination, assessment using Gross Motor Function Classification System for CP, the Stanford–Binet scale (5th edition), encephalography, and MRI of the brain. They were divided into two groups: group 1, which included 19 CP patients without SEDs, and group 2, which included 32 CP patients with SEDs. A comparison between patients’ features studied in groups 1 and 2 was made using independent-samples t-test and the χ2-test. A correlation between SEDs and the studied features was made using Spearman’s rank correlation coefficient (ρ). Results The prevalence of SEDs among nonepileptic CP patients was 62.7%. The presence of MRI abnormality and moderate mental retardation showed a highly significant positive correlation with SEDs. Meanwhile, central nervous system malformation and severe mental retardation showed a significant positive correlation with SEDs. However, normal intelligence showed a highly significant negative correlation with SEDs. Kernicterus and dyskinetic CP showed a significant negative correlation with SEDs. Conclusion SEDs are a common finding among nonepileptic CP children. They are positively correlated to cognitive dysfunction. This finding supports the assumption that SEDs are therapeutic target in mentally subnormal children. Larger studies are needed to confirm our results and to evaluate the clinical benefit of treating SEDs.

Epileptiform abnormalities in non-epileptic children with ADHD: Correlation with clinical subtypes

There is high prevalence rate of attention deficit/hyperactive disorders (ADHD), and there is vague relation between it and epileptiform abnormalities. The objective of this study is to assess the relation between epileptiform abnormalities and ADHD. We studied 50 ADHD children and 25 sex and age matched controls. We used 20 channels electroencephalography under standard condition for assessing patients and control. ADHD rating scale was used for assessing patients. Epileptiform abnormalities were detected in 15 (30%) of ADHD children, in comparison with two (8%) of control group (P

Vitamin D levels in epileptic children on long-term anticonvulsant therapy

Background Long-term anticonvulsant therapy, especially with enzyme inducers, has been associated with low 25-hydroxyvitamin D [25(OH)D] levels and high prevalence of vitamin D deficiency. However, there have been inconsistent results in studies on the effect of long-term, non-enzyme inducer anticonvulsant use on vitamin D levels.Objective To compare 25(OH)D levels in epileptic children on long-term anticonvulsant therapy and non-epileptic children. We also assessed for factors potentially associated with vitamin D deficiency/insufficiency in epileptic children.Methods This cross-sectional study was conducted at two pediatric neurology outpatient clinics in Jakarta, from March to June 2013. Subjects in the case group were epileptic children, aged 6-11 years who had used valproic acid, carbamazepine, phenobarbital, phenytoin, or oxcarbazepine, as a single or combination therapy, for at least 1 year. Control subjects were non-epileptic, had not consumed anticonvulsants, and were matched for age and gender to the case group. All subjects’ 25(OH)D levels were measured by enzyme immunoassay.Results There were 31 epileptic children and 31 non-epileptic control children. Their mean age was 9.1 (SD 1.8) years. Most subjects in the case group were treated with valproic acid (25/31), administered as a monotherapy (21/31). The mean duration of anticonvulsant consumption was 41.9 (SD 20) months. The mean 25(OH)D level of the epileptic group was 41.1 (SD 16) ng/mL, lower than the control group with a mean difference of 9.7 (95%CI 1.6 to 17.9) ng/mL. No vitamin D deficiency was found in this study. The prevalence of vitamin D insufficiency in the epileptic group was higher than in the control group (12/31 vs. 4/31; P=0.020). No identified risk factors were associated with low 25(OH)D levels in epileptic children.Conclusion Vitamin D levels in epileptic children with long-term anticonvulsant therapy are lower than that of non-epileptic children, but none had vitamin D deficiency.

Vitamin D levels in epileptic children on long-term anticonvulsant therapy

Background Long-term anticonvulsant therapy, especially with enzyme inducers, has been associated with low 25-hydroxyvitamin D [25(OH)D] levels and high prevalence of vitamin D deficiency. However, there have been inconsistent results in studies on the effect of long-term, non-enzyme inducer anticonvulsant use on vitamin D levels.Objective To compare 25(OH)D levels in epileptic children on long-term anticonvulsant therapy and non-epileptic children. We also assessed for factors potentially associated with vitamin D deficiency/insufficiency in epileptic children.Methods This cross-sectional study was conducted at two pediatric neurology outpatient clinics in Jakarta, from March to June 2013. Subjects in the case group were epileptic children, aged 6-11 years who had used valproic acid, carbamazepine, phenobarbital, phenytoin, or oxcarbazepine, as a single or combination therapy, for at least 1 year. Control subjects were non-epileptic, had not consumed anticonvulsants, and were matched for age and gender to the case group. All subjects’ 25(OH)D levels were measured by enzyme immunoassay.Results There were 31 epileptic children and 31 non-epileptic control children. Their mean age was 9.1 (SD 1.8) years. Most subjects in the case group were treated with valproic acid (25/31), administered as a monotherapy (21/31). The mean duration of anticonvulsant consumption was 41.9 (SD 20) months. The mean 25(OH)D level of the epileptic group was 41.1 (SD 16) ng/mL, lower than the control group with a mean difference of 9.7 (95%CI 1.6 to 17.9) ng/mL. No vitamin D deficiency was found in this study. The prevalence of vitamin D insufficiency in the epileptic group was higher than in the control group (12/31 vs. 4/31; P=0.020). No identified risk factors were associated with low 25(OH)D levels in epileptic children.Conclusion Vitamin D levels in epileptic children with long-term anticonvulsant therapy are lower than that of non-epileptic children, but none had vitamin D deficiency.

PP07.11 – 2695: Epilepsy in autism spectrum disorders

Objective Approximately one third of children with pervasive developmental disorders or autistic spectrum disorders reports an early regression of unknown cause in their children's language. Seizures are associated with language regression in acquired epileptic aphasia (Landau-Kleffner syndrome) and some other pediatric epileptic syndromes. Children with ASD and epilepsy had significantly more autism symptoms and maladaptive behaviors than children without epilepsy. Methods Children of our study were 72 boys and 20 girls on the autistic spectrum disorders seen consecutively in consultation by one child neurologist and psychiatrist in Universitary Hospital Center Tirana. Data on autistic regression, seizures, and cognitive function were entered prospectively into a data base. Results 28 (30%) had a history of regression, and 20 children (22%) had a history of epilepsy. Regression had occurred equally among children without seizures and in those with epilepsy. Regression was associated with an epileptiform EEG in 15% of 76 nonepileptic children who had undergone a regression. Mean age at regression was 23 months. Half of the epileptiform discharges were centro-temporal. Children with lower cognitive function were more likely to have undergone regression than those with better cognitive skills (30% vs 20%). Conclusion Epilepsy occur in a significant minority of autistic children with a history of regression and in a smaller minority without regression. There is no evidence-based treatment recommendation for individuals with autism, regression, and subclinical epilepsy.

Evaluation of Homocysteine, Folic Acid and Vitamin B12 Levels among Egyptian Children with Idiopathic Epilepsy

Objective : To evaluate relationship between homocysteine (Hcy), folic acid and vitamin B12 with anti-epileptic drugs in epileptic patients and their role in epilepsy control. Patient and Methods: The study included 60 patients with idiopathic epilepsy and thirty non-epileptic children of the same age and sex served as controls. All cases were subjected to physical and neurological examination and electroencephalogram (EEG). Serum level of folic acid, homocysteine (Hcy) and vitamin B12 were done for both epileptic patients and controls. Non parametric test, one way ANOVA and Pearson’s correlation were used for analysis of data. Result: 44 patients (73.3%) had generalized epilepsy and the remaining patients had partial epilepsy (simple or complex). 37 patients (61.6%) were in grade I, 3 patients (5 %) were in grade II and the remaining 20 patients (33.3 %) were in grade III epilepsy. Vitamin B12 was significantly higher in epileptic patients. Duration of anti-epileptic drug treatment was correlated significantly to folic acid and Hcy level. Conclusion: antiepileptic drugs might upset the homeostatic balance of Hcy and its cofactors and cause abnormalities of their serum levels. The duration of anti-epileptic drug treatment was related to decrease of folic acid and increase in homocysteine levels.

Evaluation of Homocysteine, Folic Acid and Vitamin B12 Levels among Egyptian Children with Idiopathic Epilepsy

Objective: To evaluate relationship between homocysteine (Hcy), folic acid and vitamin B12 with anti-epileptic drugs in epileptic patients and their role in epilepsy control.Patient and Methods: The study included 60 patients with idiopathic epilepsy and thirty non-epileptic children of the same age and sex served as controls. All cases were subjected to physical and neurological examination and electroencephalogram (EEG). Serum level of folic acid, homocysteine (Hcy) and vitamin B12 were done for both epileptic patients and controls. Non parametric test, one way ANOVA and Pearson’s correlation were used for analysis of data.Result: 44 patients (73.3%) had generalized epilepsy and the remaining patients had partial epilepsy (simple or complex). 37 patients (61.6%) were in grade I, 3 patients (5 %) were in grade II and the remaining 20 patients (33.3 %) were in grade III epilepsy. Vitamin B12 was significantly higher in epileptic patients. Duration of anti-epileptic drug treatment was correlated significantly to folic acid and Hcy level.Conclusion: antiepileptic drugs might upset the homeostatic balance of Hcy and its cofactors and cause abnormalities of their serum levels. The duration of anti-epileptic drug treatment was related to decrease of folic acid and increase in homocysteine levels.

Pediatric Epilepsy and Parental Sleep Quality

To evaluate the effects of pediatric epilepsy on sleep in parents of epileptic children. Cohort design in which the sleep quality of parents of epileptic children (POEC) and parents of nonepileptic children (PONEC) in the month preceding recruitment were compared using the self-administered Pittsburgh Sleep Quality Index (PSQI). Mothers of epileptic children had a 7-fold occurrence of sleep disturbances when compared to mothers of non-epileptic children (OR = 6.66 CI 95% 1.10-70.08). The sleep characteristics that showed statistically significant differences were: sleep duration, sleep continuity, and self-evaluation of sleep quality (p < 0.05 for all parameters). No significant difference in sleep quality was found between fathers of epileptic children and fathers of nonepileptic children. Sleep disturbances are more common in mothers of epileptic children. The sleep quality of mothers to epileptic children should be considered in their comprehensive management, and if necessary, the sleep disturbance should be addressed.