Secondary Epilepsy Research Articles

Risk factors for secondary epilepsy in children with complex febrile seizures and their effect on growth and development-a retrospective cohort study.

Complex febrile seizures are prolonged and can cause neurologic abnormalities, leading to secondary epilepsy and affecting growth and development. At present, the mechanism of secondary epilepsy in children with complex febrile seizures is not clear, and this study aimed to explore the risk factors for secondary epilepsy in children with complex febrile seizures and analyze its effects on the growth and development of children. The data of 168 children with complex febrile seizures admitted to the Ganzhou Women and Children's Health Care Hospital between January 2018 and December 2019 were collected retrospectively and divided into a secondary epilepsy group (n=58) and control group (n=110) according to whether the children had secondary epilepsy or not. The differences in clinical features between the 2 groups were compared, and logistic regression analysis was used to explore the risk factors for secondary epilepsy in children with complex febrile seizures. A nomogram prediction model for secondary epilepsy in children with complex febrile seizures was established and verified using the R 4.0.3 statistical software, and the effect of secondary epilepsy on the growth and development of children was analyzed. Multivariate logistic regression analysis showed that family history of epilepsy, generalized seizures, number of seizures, and duration of seizures were independent influencing factors of secondary epilepsy in children with complex febrile seizures (P<0.05). The dataset was randomly divided into a training set and a validation set, with a sample size of 84 in the training set and 84 in the validation set. The area under the receiver operating characteristic (ROC) curve of the training set was 0.845 (95% confidence interval: 0.756-0.934), and the area under the ROC curve of the validation set was 0.813 (95% confidence interval: 0.711-0.914). Compared with the control group, the Gesell Development Scale score in the secondary epilepsy group was significantly reduced (77.84±8.86 vs. 85.64±8.65, P<0.001). The nomogram prediction model could better identify complex febrile seizures children at high risk of secondary epilepsy. Strengthening intervention in such children may be beneficial for improving their growth and development.

Frontoparietal 18F-FDG-PET hypo-metabolism in Lennox-Gastaut syndrome: Further evidence highlighting the key network

IntroductionLennox Gastaut syndrome (LGS) can be conceptualised as a “secondary network epilepsy”, in which the shared electroclinical manifestations reflect epileptic recruitment of a common brain network, despite a range of underlying aetiologies. We aimed to identify the key networks recruited by the epileptic process of LGS using interictal 2-deoxy-2-(18F)fluoro-D-glucose positron emission tomography (18F-FDG-PET). MethodsGroup analysis of cerebral 18F-FDG-PET, comparing 21 patients with LGS (mean age = 15 years) and 18 pseudo-controls (mean age = 19 years), studied at Austin Health Melbourne, between 2004 and 2015. To minimise the influence of individual patient lesions in the LGS group, we only studied brain hemispheres without structural MRI abnormalities. The pseudo-control group consisted of age- and sex-matched patients with unilateral temporal lobe epilepsy, using only the hemispheres contralateral to the side of epilepsy. Voxel-wise permutation testing compared 18F-FDG-PET uptake between groups. Associations were explored between areas of altered metabolism and clinical variables (age of seizure onset, proportion of life with epilepsy, and verbal/nonverbal ability). Penetrance maps were calculated to explore spatial consistency of altered metabolic patterns across individual patients with LGS. ResultsAlthough not always readily apparent on visual inspection of individual patient scans, group analysis revealed hypometabolism in a network of regions including prefrontal and premotor cortex, anterior and posterior cingulate, inferior parietal lobule, and precuneus (p < 0.05, corrected for family-wise error). These brain regions tended to show a greater reduction in metabolism in non-verbal compared to verbal LGS patients, although this difference was not statistically significant. No areas of hypermetabolism were detected on group analysis, although ∼25 % of individual patients showed increased metabolism (relative to pseudo-controls) in the brainstem, putamen, thalamus, cerebellum, and pericentral cortex. DiscussionInterictal hypometabolism in frontoparietal cortex in LGS is compatible with our previous EEG-fMRI and SPECT studies showing that interictal bursts of generalised paroxysmal fast activity and tonic seizures recruit similar cortical regions. This study provides further evidence that these regions are central to the electroclinical expression of LGS.

Evaluation and assessment of clinical and demographic profile, aetiology and outcome of status epilepticus in paediatric patients

Background: Status epilepticus (SE) is one of the most frequent neurological emergencies that require prompt diagnosis and treatment. If not managed promptly, it may result in significant neurological morbidity and mortality. Methods: It is prospective observational study. Study for clinical and demographic profile, aetiology, outcome in patient of status epilepticus. Results: Occurrence of SE is in indoor paediatric patients was 2.05%. Male and female M: F ratio is 1.3:1. Fever was common associated symptoms in SE. The commonest type of seizure was generalised tonic-clonic seizure (GTCS). Infective etiology was most common amongst patients with SE. secondary epilepsy with CP was second most common cause followed by complex febrile seizure and primary epilepsy. In infants, metabolic etiology was the most common cause for SE. Majority of seizures were controlled only by benzodiazepines. Requirement of midazolam infusion was only in few patients and requirement of anesthetic agent was rare. Mechanical ventilation was frequently required in patients with refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE). Mortality was almost same in all age groups with SE. Mortality was directly proportional to duration of the SE and was highest in patient having &gt;30 minutes of duration of seizure. Conclusions: SE was more commonly associated with male gender and age &lt;5 years. By improving hygiene, nutritional and vaccination status, overcrowding and education, we can reduce occurrence of SE, by reducing infections. Mortality can be reduced by immediate control of seizure and improving intensive care facilities.

Diagnostic Overshadowing of Post-ictal Psychosis in the ED– A Case Series

IntroductionDiagnostic overshadowing is established as a mechanism by which physical symptoms are misattributed to mental disorder, hence under-diagnosing and under-treating medical pathology. We report a case series of adult males with established neurological disorders who presented to the ED with visual hallucinations in the postictal period. The phenomena of postictal psychosis is long established in neuropsychiatric literature, with reported rates of postictal psychosis in epilepsy of 2%. Patients vsual hallucinations resolve with anticonvulsant stabilisation and rarely require antipsychotic augmentation.ObjectivesTo illustrate diagnostic overshadowing in a case series of postictal psychosisMethodsRetrospective case seriesResultsCase 1:A 36year old man self-presented to the ED 24hrs post tonic-clonic seizure of 15minutes duration. Medical history was significant for hydrocephalus as an infant with 29 surgical revisions of in-situ ventriculoperitoneal shunt since initial placement. Secondary epilepsy was reported to be poorly controlled with an estimated 50 ED attendances in the past year for management of seizure activity. On assessment new symptomatology of non-threatening visual hallucinations with associated low mood was elicited. A diagnosis of postictal psychosis was advised following psychiatric assessment and medical admission with anticonvulsant titration recommended. Despite this characteristic presentation there were repeated requests to admit this patient to the psychiatric unit and a perceived lack of understanding of his acute medical needs.Case 2:A 45year old man self-presented to the ED &lt;24hours post discharge following medical admission for management of seizure. Medical history was significant for a right parieto-temporal infarct one year prior, with acceptable return to functioning following rehabilitation. The man had recently been diagnosed with secondary epilepsy and titration of sodium valproate commenced. The patient presented as distressed in the context of new onset visual hallucinations and palinopsia. Medical admission with urgent neurology input and anticonvulsant titration was advised following psychiatric assessment. ED physician repeatedly stated this patients presentation was stress related and requested psychiatric admission. Following medical admission the patient was managed by neurology. Sodium valproate was augmented with clobazam and the patients psychopathology resolved in full.ConclusionsDiagnostic overshadowing is prevalent in the ED. Despite established medical diagnoses there may be a reluctance for medical teams to acknowledge or treat organic psychopathology. Psychiatrists must keep abreast of medical comorbidities and physical treatment guidelines of neuropsychiatric disorders in order to advocate appropriately for due medical input. Postictal psychosis is effectively managed by neurological input for effective seizure control with collaborative neuropsychiatry input.Disclosure of InterestNone Declared

Proton beam therapy in pediatric patients with central nervous system tumors: method features, clinical data analysis

Introduction. Central nervous system (CNS) tumors are the most common pediatric solid tumor, that need multimodality treatment approach including surgery, intensive chemotherapy (CT) and radiotherapy (RT). Due to toxicity, mostly late, RT has limited use in children, especially those under 3 years of age. The physical characteristics of proton beam therapy (PBT) minimize the risk and types of toxicity compared to photons, making it the preferred choice for pediatric use. Aim – to analyze the experience of PBT in patients under 18 years of age with various types of CNS malignancies, the assessment of risk factors for acute and late toxicity and its clinical manifestations. Materials and methods. A retrospective analysis of 63 courses of PBT performed in 58 patients with CNS malignancies for the period from 2018 to 2022 was carried out on Proton Center of the Sergey Beresin Medical Institute. The manifestations of local and systemic toxicity (predominantly acute) were analyzed, with an assessment of the influence of age, the volume of RT, the use of previous and concomitant CT on the severity of adverse events (AE). Results. In the study cohort, patients with embryonal CNS malignancies predominated (72.3 %). Median age was 5 years 2 months, median follow-up was 15 months. In 36 % of cases, a complete response was achieved by the start of PBT. Patients with craniospinal irradiation (CSI) prevailed (60 %). Among the manifestations of toxicity, AE grade I–II predominated. The most common AE were local reactions (dermatitis (84 %), focal alopecia (96 %)). Among systemic AE, hematological complications (84 %) were the most often occurred. A more pronounced toxicity profile was registered in the group with CSI, while concomitant CT, the patient’s age, previous CT did not significantly affect the severity of most of the assessed AE parameters (p &gt; 0.05). The analysis of late toxic effects was difficult due to the short follow-up period, the cumulative effect of other treatment modalities on the AE’s development. The reported complications included persistent focal alopecia (14 % of cases), endocrinopathies (7 %), neurological manifestations (6 %). One (2 %) child had a severe neurological deficit, secondary epilepsy with psychomotor regression, which can also be associated with the potentiating effect of previous CT and high-dose CT. Conclusion. The analysis of our data and literature review allows to conclude that PBT has relatively low toxicity profile, which is the determining factor for choosing this method of RT in pediatric patients. The main risk factor of AE’s was CSI. The acceptable acute toxicity of repeat PBT makes it possible to be used in pts with disease progression or relapse in case of absence of alternative therapeutic options.

Abstract TP229: Impact Of Genetic Polymorphisms On The Risk Of Epilepsy Amongst Patients With Acute Brain Injury: A Systematic Review

Introduction: Stroke and traumatic brain injury (TBI) accounts for 70% of secondary epilepsy in the adult population. The genetic architecture of epilepsy secondary to TBI or stroke is poorly understood. Objective: We undertook a systematic review to test the association of single nucleotide polymorphisms (SNPs) with the risk of posttraumatic epilepsy (PTE) and post-stroke epilepsy (PSE). Methods: We conducted a comprehensive literature search until 5 July 2022 in PubMed, Embase, PsycINFO, Web of Science, and Google Scholar. We preregistered the protocol of this systematic review on PROSPERO (CRD42022325617). We collated the association statistics from the articles to assess the association of SNPs with the risk of epilepsy amongst TBI or stroke patients. We assessed the study quality using the Quality of Genetic Association (Q-Genie) tool. We report Odds Ratio (OR) and Hazard Ratio (HR) with a 95% confidence interval (CI), including combined OR where a meta-analysis was possible. Results: The literature search yielded 420 articles, of which 16 were included in our systematic review. Q-Genie-based assessment of the literature found that 58% of the included studies were of poor quality. We examined published data on 127 SNPs from 32 genes identified in PTE and PSE patients. Twelve studies reported that 718 TBI patients (21%) suffered from PTE. Four studies reported PSE in 1192 stroke patients (50%). Eleven SNPs were associated with an increased risk of PTE. Three SNPs, TRMP6 rs2274924, ALDH2 rs671, CD40 -1C/T, were significantly associated with an increased risk of PSE, while two SNPs, AT1R rs12721273 and rs55707609, were significantly associated with reduced risk. Only two studies tested the association of APOE E4 with PTE; no other studies validated previously reported genetic association data. Hence, the limited data precluded meta-analysis of all but one SNP, i.e., the APOE E4 allele. The meta-analysis for the association of the APOE E4 allele with PTE was non-significant (OR 1.8, CI 0.6-5.6). Conclusions: The current evidence on the association of genetic polymorphisms in epilepsy secondary to TBI or stroke is of low quality and lacks validation. A collaborative effort to pool genetic data linked to epileptogenesis in stroke and TBI patients is warranted.

A brief analysis of traditional Chinese and Western Medicine on the pathomechanism of spastic cerebral palsy in children

Pediatric spastic cerebral paralysis is a common type of pediatric cerebral palsy, and its clinical manifestations contain movement disorders, behavioral cognitive disorders, secondary musculoskeletal problems, secondary epilepsy and so on. Western Medicine believes that this is a brain disease with nerve abnormalities, while traditional Chinese medicine (TCM) considers that the disease is linked to abnormalities in the brain, but the radical pathogenesis is the deficiency of the liver, spleen and kidney, which can help the liver wind with blood rush to the brain. Although TCM and Western Medicine have different pathological understanding in pediatric spastic cerebral paralysis, but since the Huitong School of TCM and Western Medicine in the late Qing Dynasty, TCM and Western Medicine has been combined with Western Medicine knowledge, and we can better understand the connection among the liver, kidney, spleen and brain. Based on this background, this paper discussed the difference and connection between the perspective of Western Medicine pathology and TCM pathogenesis to analyze the mechanism of pediatric spastic cerebral paralysis.

A case report of epileptic seizures caused by Rosai Dorfman disease followed by a literature review

Rosai Dorfman disease is a rare benign histiocytoproliferative disorder that occurs in the intracranial area, which occurrs typically in lymph nodes. Extrapnodal Rosai Dorfman disease rarely develops in the central nervous system and is often a focal lesion based on the dura. Based on imaging and clinical symptoms, RDD may be misdiagnosed as meningioma, and some lesions can also occur in the brain parenchyma. In the case of benign disease, the final diagnosis is made by pathological tissue diagnosis. For chronic diseases, progression may be chronic or remitting and relapsing. A 54-years-old man was hospitalized after experiencing paroxic convulsions and being unconsciousness. A head magnetic resonance imaging demonstrates a strip of lesions in the right parietal lobe. No obvious abnormality is found in the laboratory data. We diagnosed meningioma of right parietal lobe and secondary epilepsy, and prescribed oral sodium valproate to treat him. The lesion is located in the right parietal lobe on neuroimaging prior to surgery, which was taken for immunohistochemical examination. If it is found that immunohistochemistry reveals histiocytes are positive for CD68, S-100, but negative for CD1a, it is identified as RDD. For patients who are seizure-free following surgery, symptomatic management is used. Following parietal lesion resection, patients are seizure-free during the follow-up period (44 months). Basing on studying and summarizing relevant literatures, RDD is described in the report in terms of its diagnosis, pathology, treatment, and clinical outcome, in order to improve the diagnosis and identification of intracranial RDD by physicians.

A cross-sectional study of early-onset epilepsy of intracerebral hemorrhage and construction of a risk prediction model

To study the early-onset epilepsy of intracerebral hemorrhage and build a prediction model to evaluate its prediction efficiency. A cross-sectional investigation was conducted to construct a specialized optimized prediction model. The prediction model was converted into a visual optimized scoring scale, so as to quantify the probability of secondary epilepsy after intracerebral hemorrhage. Based on the current prediction model of acute cerebral infraction and post-stroke seizure (AIS-PSS), the evaluation efficacy of optimized score for secondary epilepsy after hemorrhagic stroke was explored. (1) After sample size calculation and sufficient inclusion and exclusion, 159 patients with cerebral hemorrhage were continuously selected as the model group of this cross-sectional study. A total of 29 patients with early-onset epilepsy and 130 patients without secondary epilepsy were enrolled. The time span was from January 2021 to August 2021. In addition, 77 patients with acute cerebral hemorrhage from August 2021 to February 2022 were selected as the verification group, among which 12 patients had early-onset epilepsy and 65 patients had not any secondary epilepsy. (2) There were significant differences in demographic characteristics such as diabetes history, cerebral infarction history, smoking history, National Institutes of Health Stroke Scale (NIHSS) score, intracerebral hemorrhage hematoma volume, serum creatinine (SCr), neuron-specific enolase (NSE), S-100 protein and intracerebral hemorrhage site between the two model groups with different prognosis (all P < 0.05). (3) The above indexes were included in univariate and multivariate Poisson regression analysis, and the results showed that the duration of diabetes [relative risk (RR) = 1.229, 95% confidence interval (95%CI) was 1.065-1.896, P = 0.036], smoking history (RR = 1.419, 95%CI was 1.133-2.160, P = 0.030), history of cerebral infarction (RR = 1.634, 95%CI was 1.128-2.548, P = 0.041), hematoma volume of cerebral hemorrhage (RR = 1.222, 95%CI was 1.024-2.052, P = 0.041), NES content (RR = 1.146, 95%CI was 1.041-1.704, P = 0.032), were independent influencing factors to constitute the prediction model. The prediction model was converted into a visual optimized scoring scale in the form of a line diagram to obtain the prediction probability corresponding to the corresponding score. (4) Receiver operator characteristic curve (ROC curve) was used to test the evaluation efficiency of optimized score and AIS-PSS score for early-onset cerebral hemorrhage epilepsy. Relevant data of patients in the verification group were extracted according to the information of two scores, and the final score of each patient in the verification group was obtained. The score and prognosis were put into the ROC curve to evaluate the predictive ability of different prediction models. The results showed that the cut-off value of the optimized score and the AIS-PSS score were 144 points and 7 points, respectively, and the area under the ROC curve (AUC) and the Yoden index of the optimized score were slightly lower than the AIS-PSS score. However, compared with AIS-PSS score, there was no significant difference in the evaluation efficiency of optimized score for early-onset epilepsy (Z = 1.874, P > 0.05). This study constructed a specific early-onset epilepsy prediction model for patients with hemorrhagic stroke, and transformed it into an optimized score that is easy for clinical use, and its evaluation efficiency is reliable.

Characteristics of people with epilepsy and Neurocysticercosis in three eastern African countries-A pooled analysis.

Neurocysticercosis (NCC), a zoonotic disease caused by the pork tapeworm T. solium, represents one of the most common causes of secondary epilepsy but remains often undiagnosed due to lack of awareness and diagnostic facilities. We pooled data from four cross-sectional studies on epilepsy and NCC in eastern Africa. Study sites were in Uganda, Malawi and in Tanzania (Dar es Salaam and Haydom). The study in Uganda and Malawi were community-based, the two studies in Tanzania were hospital-based. The same questionnaire was used for assessment of clinical characteristics of patients with epilepsy. Computed tomography (CT) scans and serological testing were performed in order to diagnose NCC. Overall, 1,179 people with epilepsy were included in our analysis. Of those, 941 PWE underwent CT scanning and were pooled for NCC analysis. Seventy patients were diagnosed with NCC, but NCC prevalence differed considerably between sites ranging from 2.0% (95%CI 0.4% to 3.6%) in Dar es Salaam to 17.5% (95%CI 12.4% to 22.6%) in Haydom. NCC prevalence did not show any association with sex but increased with age and was higher in rural than urban settings. In addition, being a farmer, non-Muslim, eating pork and living with pigs close by was associated with a higher NCC prevalence. PWE with NCC experienced their first epileptic seizure around 3 years later in life compared to PWE without NCC and their epileptic seizures seemed to be better controlled (p&lt;0.001). There was no difference between focal onset seizures and focal signs on neurological examination in both groups (p = 0.49 and p = 0.92, respectively). The rT24H-EITB had a sensitivity for the detection of NCC of 70% (95% confidence interval [CI] 51 to 84%), the LLGP of 76% (95%CI 58 to 89%) and the antigen ELISA of 36% (95% CI 20 to 55%). NCC is prevalent among PWE in eastern Africa, although it may not be as common as previously stated. Demographic characteristics of PWE with NCC differed from those without NCC, but semiological characteristics and results on neurological examination did not differ compared to PWE without NCC. Interestingly, seizures seemed to be less frequent in PWE with NCC. Being aware of those differences and similarities may help triaging PWE for neuroimaging in order to establish a diagnosis of NCC.

Research Progress of Febrile Seizures in Children

Febrile seizures (FS) are common neurological diseases in childhood. It is age-dependent and often occurs in children from 6 months to 5 years old. The etiology of FS is diverse and the mechanism is complex, which is not completely clear, but most children have a good prognosis. Through timely identification, symptomatic treatment and health guidance to patients’ families, we can get a good prognosis. In the treatment of FS, we should pay attention to finding the cause, and do a good job in the health education and guidance for children's families. At present, the long-term use of antiepileptic drugs is not recommended to prevent the recurrence and secondary epilepsy of FS. In the future, through the development of traditional Chinese medicine, the combination of Chinese and Western medicine can be considered in order to improve the therapeutic effect of FS. This paper reviews the relevant literature about the research progress of FS in recent years in China and abroad, to provide new ideas for the diagnosis and treatment of FS in children.

Development and study of S100 calcium-binding protein B and Neuron-specific enolase-based predictive model for epilepsy secondary to cerebral infarction.

This study aimed to develop and validate a predictive model based on S100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE) as the core of epilepsy secondary to cerebral infarction. For this aim, 156 cases of cerebral infarction from June 2018 to December 2019 were selected. According to the ratio of 7:3, 109 cases were used for training and 47 cases were used for validation. The factors influencing cerebral infarction secondary to epilepsy were analyzed by a univariate analysis comparing the general data of the two groups and binary logistic regression, and the prediction model was established and validated. Results showed that there was no statistically significant comparison of general information between the training and validation groups (p>0.05). The comparison of NIHSS score, lesion location, lesion size, infarct staging, involved arterial system, large infarct, NSE, and S100B levels between the two groups was significant (P<0.05). The difference between the two groups will be secondary epilepsy= 1, non-epilepsy=0 as dependent variables and factors with significant differences in the univariate analysis as covariates for logistic regression analysis showed that NIHSS score > 15, cortical lesion, lesion size ≥ 5cm, carotid circulation involvement, large infarct, S100B, NSE were risk factors for secondary epilepsy in cerebral infarction. In conclusion, serum S100B and NSE levels were abnormally elevated in patients with epilepsy secondary to cerebral infarction, NIHSS score > 15, cortical lesions, lesion size ≥ 5 cm, carotid circulation involvement, large infarct, S100B and NSE are risk factors for epilepsy secondary to cerebral infarction, and the AUC area of S100B and NSE is large, based on S100B and NSE as The prediction model based on S100B and NSE has good predictive value.

Epileptic Seizures or not, that is the question: a case report

IntroductionPsychogenic nonepileptic seizures (PNES) consist of paroxysmal changes in responsiveness, movements, or behaviour that superficially resemble epileptic seizures.ObjectivesPresentation of a clinical case of a PNES in a patient with a diagnose of secondary epilepsy, illustrating the relevance of an adequate evaluation, differential diagnosis, and intervention.MethodsDescription of the clinical case, with brief literature review and discussion. A search was conducted on PubMed and other databases, using the MeSH terms “nonepileptic seizure”, and “epileptic seizure”.ResultsWe report the case of a 45-year-old female patient, brought to the emergency department because of tonic axial and limb nonsynchronous movements, closed eyes, long duration, with immediate awareness, no desaturation, tongue bite, facial flushing, dyspnoea or sphincter incontinency. She was medicated with clonazepam 1 mg and levetiracetam 1000 mg ev. TC-CE had no acute alteration. Bloodwork had no other major alteration except valproic acid below therapeutic levels (her usual medication, along with other antiepileptic drugs, antidepressant and antipsychotic). The antecedents of the patient: mild intellectual disability and an accidental traumatic brain injury in infancy, with secondary epilepsy. She was transferred to Psychiatry department. No electroencephalogram (EEG) was realized, because she had a recent one confirming PNES, and many other emergency observations with the diagnosis of PNES.ConclusionsThis clinical case showcases the diagnostic difficulties that clinicians face when there is an overlap in symptoms, emphasizing the need to combine patient history, witness reports, clinician observations, and ictal and interictal EEG to help distinguish these different clinical identities.DisclosureNo significant relationships.

Prediction Value of Epilepsy Secondary to Inferior Cavity Hemorrhage Based on Scalp EEG Wave Pattern in Deep Learning.

Objective To search the predictive value of epilepsy secondary to acute subarachnoid hemorrhage (aSAH) based on EEG wave pattern in deep learning. Methods A total of 156 cases of secondary epilepsy with lower cavity hemorrhage in our hospital were selected and divided into the late epilepsy group and the early epilepsy group according to seizure time, and the nonseizure group and the seizure group according to seizure condition. General data of patients were collected, the EEG types of each group were analyzed, and the disease recurrence rate, treatment effect, and symptom onset time were compared. Results Rapid and slow and rapid blood flow velocity were the main abnormal manifestations of epilepsy secondary to inferior cavity hemorrhage, accounting for 33.3% and 18.6%, respectively. Compared with the seizure group, the proportion of type ii and type iii in the nonseizure group was higher, and the proportion of type ii and type iii in the early epilepsy group was higher than in the late epilepsy group (P < 0.05). The diagnostic accuracy, missed diagnosis rate, misdiagnosis rate, specificity, and sensitivity of the EEG wave pattern were 94.9%, 3.2%, 1.9%, 91.7%, and 96.2%, respectively. Compared with the early epilepsy group, the recurrence rate of type iii and type iv in the late epilepsy group was higher (P < 0.05). The effective rates of the attack group and the nonattack group were 72.7% and 97.0%, respectively. Compared with the attack group, the effective rate of the nonattack group was higher (P < 0.05). The effective rates of the early epilepsy group and the late epilepsy group were 91.7% and 85.0%, respectively. Compared with the late epilepsy group, the effective rate of the early epilepsy group was higher (P < 0.05). Compared with the early epilepsy group, the late epilepsy group had longer tonic-clonic seizures, atonic seizures, and absent seizures, and the difference between the groups was statistically significant (P < 0.05). Conclusion In aSAH secondary epilepsy disease prediction, based on indepth study of the scalp EEG wave type prediction, they play an important role, including aSAH high-risk secondary epilepsy wave types for V, III, and IV types, as well as early and late epilepsy associated with disease stage. Through the diagnosis method to predict the severity of disease, this builds a good foundation for clinical treatment. It is beneficial to improve the effective rate of treatment.

Radio clinico histological presentation of intracranial dural chondroma

We report a challenging diagnosis and the successful management of a rare case of intracranial dural chondroma in a 19-year-old student. He was admitted for secondary epilepsy with behavioral and mood disorder without neurological deficit. His past medical history was unremarkable. The patient was initially taken, by his parents, to the psychiatry department, where medical treatment was prescribed. The cerebral MRI was done, and based on the extra-axial, left fronto-parietal lesion found. Plus, the nonspecific aspect of the clinical findings, the radiological investigations did not help for a straight forward diagnosis orientation. The patient underwent surgery and promptly recovered after the gross total resection of the tumor.

Effects of maternal intake of docosahexaenoic acid on febrile status epilepticus and increased susceptibility to seizures after growth

Febrile seizures are caused by an abrupt increase in body temperature. They are sometimes recurrent, and the more seizures are triggered, the higher the risk of epilepsy and psychiatric disorders increase after growing up. Prevention of febrile seizure is considered to be one of the effective countermeasures in protecting the future health of children. Docosahexaenoic acid (DHA) is an important nutrient especially during pregnancy and childhood and is reported to suppress several types of epilepsy. Therefore, we challenged maternal DHA intake to prevent febrile seizures and secondary epilepsy after growth in mice. We used a heat chamber for febrile seizure induction. Intake of DHA during pregnancy and infancy increased the amount of DHA in the brain of offspring. DHA prolonged the seizure latency and increased body temperature at which the first seizure occurred, indicating that maternal DHA intake decreases febrile seizure sensitivity. The mice with febrile status epilepticus showed increased susceptibility to seizures induced by pentylenetetrazol. DHA intake during infancy suppressed the appearance of excitatory electroencephalography and prolonged the seizure latency. Collectively, DHA intake during pregnancy and infancy is of significance in protecting infant from seizures as well as conserving health after growth.

Child and Adolescent Psychiatric Late Effects of Early Herpes Simplex Virus Type 1 Encephalitis

The most common late sequelae of herpes simplex virus type 1 encephalitis (HSVE) include secondary epilepsy, learning, language and memory disorders, and chronic headaches. The typical pattern of HSVE leads to necrosis in the temporal and frontal lobes, thus affecting areas of the brain specifically responsible for the coordination of memory and emotion. This case report describes the course of a patient who, in addition to the typical neurological long-term sequelae, also showed severe psychiatric abnormalities and subsequently addresses the question of why there have been hardly any reports of child and adolescent psychiatric late sequelae after HSVE to date. It can be assumed that the frequency of psychiatric late sequelae is underestimated in pediatrics and in child and adolescent psychiatry and that a targeted anamnestic diagnosis is therefore too often omitted later in child and adolescent psychiatry when psychiatric symptoms appear with a long latency. The second part of the article reviews the state of research to date, revealing that there are too few data on how often and to what extent early-experienced HSVE leads to psychiatric late effects. On the basis of the case report, the specific symptoms to which particular attention should be paid and the brain structures that are typically involved in relation to a psychiatric disorder are presented. From this, it can be deduced, according to the conclusion in the third part of the article, which medications might help. Because of the typical symptomatology of emotional instability some years after HSVE, it is suggested to consider the possibility of mood-stabilizing therapy. The results from the case report presented suggest this.

Development and use of an instrument (EKAT) for assessment of competence of medical trainees in providing epilepsy care at varying levels of their training

Epilepsy treatment gap in India and many other low and middle income countries can in large part be narrowed if competence to provide non-specialist (primary and secondary) epilepsy care is developed amongst medical trainees at the graduate, postgraduate and super-specialty levels. AIM To develop an instrument and use it for assessing the competence of medical trainees in providing epilepsy care at various levels of training.

Seroprevalence of Cysticercosis among Epileptic Patients Attending Neurological Units in the Urban Area of Abidjan

Cysticercosis is one of the main causes of secondary epilepsy in sub-Saharan Africa. To estimate the seroprevalence of cysticercosis among epileptic patients, we conducted a cross-sectional study of patients attending neurology consultation in Abidjan, Côte d’Ivoire. Methods: Patients’ socio-demographic and lifestyle data were collected as well as blood samples for serological testing using ELISA and Western blot based on IgG antibodies detection. For qualitative variables comparison, Chi2 or Fisher tests were used; a Student’s t-test was used to compare quantitative variables. A multivariate logistic regression model was fit to identify risks factors. Results: Among 403 epileptic patients included in the study, 55.3% were male; the median age was 16.9 years; 77% lived in Abidjan; 26.5% were workers. Most patients included in the study had tonic-clonic seizures (80%), and 11.2% had focal deficit signs. The seroprevalence of cysticercosis was 6.0%. The risk was higher in patients over 30 years old (aOR = 5.1 (1.3–20.0)) than in patients under 16. The risk was also considerably high in patients who reported epileptics in the family (aOR = 5 (1.7–14.6)). The risk was three-fold less in females than in males. Conclusions: This study highlighted the exposure of epileptic patients to Taenia solium larvae in an urban area. The risk of positive serology was increased with age, male gender, and family history of epilepsy.

Psychosocial Factors in the Experience of Epilepsy: A Qualitative Analysis of Narratives.

Introduction Epilepsy is a complex disease. The consequences of epilepsy are varied and manifested in all aspects of people with epilepsy's (PWE) lives. The purpose of this study was to define individual experiences of epilepsy, expressed in narratives, and to find the stem of each narrative—a core event in the PWE's experience of the disease around which they structure their overall narrative. Method A qualitative, phenomenological research method was used. We conducted semistructured interviews with 22 PWE and analysed the content using a combination of inductive and deductive methods, based on which we determined the stem narratives. Results The stem narrative of the epilepsy narrative is an important life experience of PWE. We divided the stem narratives into four groups: lifestyle changes, relationship changes, the consequences of the inciting incident, and the limitations of the disease. In our study, we found that the stem narrative was, in all but one case, a secondary (psychosocial) factor resulting from epilepsy, but not its symptom (epileptic seizure). The stem narrative, where aspects of life with epilepsy are exposed, points to a fundamental loss felt by PWE. Conclusion The narrative of the experience of epilepsy has proven to be an important source of information about the disease and life of PWE and also about the aspects at the forefront of life with epilepsy. The secondary epilepsy factors that we identified in the stem narratives were the greatest burden for PWE in all cases but one.