Type Of Epilepsy Research Articles

Exacerbation of Mirror Movement Disorder: A Complex Case of Childhood-onset Mirror Movements Aggravated by Essential Tremors, and Parkinson's Disease

Background Mirror movement (MM), also known as bimanual synkinesis, is characterized by simultaneous involuntary movements of homologous muscles accompanying voluntary movements of contralateral body regions. MM can be observed in various neurological conditions, including cerebral palsy, corticobasal syndrome, Parkinson's disease, certain types of symptomatic epilepsies, Creutzfeldt-Jakob's disease, Huntington's disease, and others. Case Description A 52-year-old female with a history of epileptic seizures, essential tremors and mild MM was presented to a neurology clinic for seizure management. She had a long-standing history of seizures since childhood. Initial neurological examination revealed mild MM disorder. During the follow up visits, patient’s mirror movements were exacerbated months before she was diagnosed with Parkinson’s disease. Multiple antiepileptic drug regiments along with Carbidopa-levodopa were used and dose adjustments were done during follow up visits to help stabilize the patient’s symptoms. Conclusion In conclusion, this case highlights the progressive nature of mirror movement disorder (MMD) and its association with other neurological conditions, such as epilepsy, essential tremors, and Parkinson's disease. The primary aim of this study was to showcase that individuals with early childhood onset of MMD may experience a deterioration of their condition as they acquire additional neurological disorders, such as essential tremors or Parkinson's disease. Moreover, this study seeks to elucidate how the exacerbation of mirror movement symptoms in such cases can serve as an early indicator of the onset of Parkinson's disease. Medication adjustments played a crucial role in managing the patient's symptoms, emphasizing the importance of individualized treatment plans and close monitoring.

Behavioral and Cognitive Comorbidities in Genetic Rat Models of Absence Epilepsy (Focusing on GAERS and WAG/Rij Rats).

Absence epilepsy is a non-convulsive type of epilepsy characterized by the sudden loss of awareness. It is associated with thalamo-cortical impairment, which may cause neuropsychiatric and neurocognitive problems. Rats with spontaneous absence-like seizures are widely used as in vivo genetic models for absence epilepsy; they display behavioral and cognitive problems similar to epilepsy in humans, such as genetic absence epilepsy rats from Strasbourg (GAERS) and Wistar Albino rats from Rijswijk (WAG/Rij). Depression- and anxiety-like behaviors were apparent in GAERS, but no anxiety and depression-like symptoms were found in WAG/Rij rats. Deficits in executive functions and memory impairment in WAG/Rij rats, i.e., cognitive comorbidities, were linked to the severity of epilepsy. Wistar rats can develop spontaneous seizures in adulthood, so caution is advised when using them as a control epileptic strain. This review discusses challenges in the field, such as putative high emotionality in genetically prone rats, sex differences in the expression of cognitive comorbidities, and predictors of cognitive problems or biomarkers of cognitive comorbidities in absence epilepsy, as well as the concept of "the cognitive thalamus". The current knowledge of behavioral and cognitive comorbidities in drug-naive rats with spontaneous absence epilepsy is beneficial for understanding the pathophysiology of absence epilepsy, and for finding new treatment strategies.

Resting-state brain activity distinguishes patients with generalised epilepsy from others

PurposeEpilepsy is a prevalent neurological disorder characterised by repetitive seizures. It is categorised into three types: generalised epilepsy (GE), focal epilepsy (FE), and combined generalised and focal epilepsy. Correctly subtyping the epilepsy is important to select appropriate treatments. The types are mainly determined (i.e., diagnosed) by their semiologies supported by clinical examinations, such as electroencephalography and magnetoencephalography (MEG). Although these examinations are traditionally based on visual inspections of interictal epileptic discharges (IEDs), which are not always visible, alternative analyses have been anticipated. We examined if resting-state brain activities can distinguish patients with GE, which would help us to diagnose the type of epilepsy. MethodsThe 5 min resting-state brain activities acquired using MEG were obtained retrospectively from 15 patients with GE. The cortical source of the activities was estimated at each frequency band from delta to high-frequency oscillation (HFO). These estimated activities were compared with reference datasets from 133 healthy individuals and control data from 29 patients with FE. ResultsPatients with GE showed larger theta in the occipital, alpha in the left temporal, HFO in the rostral deep regions, and smaller HFO in the caudal ventral regions. Their area under the curves of the receiver operating characteristic curves was around 0.8–0.9. The distinctive pattern was not found for data from FE. ConclusionPatients with GE show distinctive resting-state brain activity, which could be a potential biomarker and used complementarily to classical analysis based on the visual inspection of IEDs.

Diet-derived circulating antioxidants and risk of epilepsy: a Mendelian randomization study.

Previous studies suggest a link between diet-derived circulating antioxidants and epilepsy, but the causal relationship is unclear. This study aims to investigate the causal effect of these antioxidants on epilepsy. To assess the causal link between dietary antioxidants and epilepsy risk, we conducted a two-sample Mendelian randomization (MR) analysis. This involved examining antioxidants such as zinc, selenium, α- and γ-tocopherol, vitamin A (retinol), vitamin C (ascorbate), and vitamin E (α-tocopherol). We utilized instrumental variables (IVs) which were genetic variations highly associated with these commonly used antioxidants. Exposure data were sourced from a comprehensive genome-wide association study (GWAS). We aggregated data from the International League Against Epilepsy (ILAE) Consortium sample, which included various types of epilepsy, as an outcome variable. Finally, we applied the inverse variance weighting method and conducted sensitivity analyses for further validation. Based on the primary MR estimates and subsequent sensitivity analyses, the inverse variance weighting (IVW) method revealed that a genetically predicted increase in zinc per standard deviation was positively associated with three types of epilepsy. This includes all types of epilepsy (OR = 1.06, 95% CI: 1.02-1.11, p = 0.008), generalized epilepsy (OR = 1.13, 95% CI: 1.01-1.25, p = 0.030), and focal epilepsy (documented hippocampal sclerosis) (OR = 1.01, 95% CI: 1.00-1.02, p = 0.025). However, there is no evidence indicating that other antioxidants obtained from the diet affect the increase of epilepsy either positively or negatively. Our research indicates that the risk of developing epilepsy may be directly linked to the genetic prediction of zinc, whereas no such association was found for other antioxidants.

Choroid and Retinal Effects of Epilepsy and Epilepsy Subgroups.

The objective were to evaluate structural alterations in the retina and choroid tissue of epilepsy patients and subtypes using enhanced depth imaging optic coherence tomography (EDI-OCT). 46 epilepsy patients and 50 sex- and age-matched control patients were analyzed in the study. Patients' epilepsy types were recorded. The central macular thickness (CMT), retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and choroidal thickness (CT) were investigated through the Spectralis-OCT device (SD-OCT). Image-J program was used to calculate the total choroidal area (TCA), the luminal area (LA), stromal area (SA), and the choroidal vascularity index (CVI). CMT, TCA, LA, and SA outcomes were substantially reduced in epilepsy patients than in healthy controls. There was no significant difference between CT, RNFL, GCL, CVI results. There were no statistically significant differences between patients with partial and generalized epilepsy (p>0.05 for each). According to the results of our study, epilepsy disease has effects on the posterior segment of the eye. To the best of our knowledge, our study is the first to evaluate CVI in patients with epilepsy and the epilepsy subgroups.

Telemedicine and Epilepsy. Experience of the Central Hospital "Dr. Ignacio Morones Prieto" During and Post-pandemic COVID-19

Background: Telemedicine is a real-time interactive communication that enables providers to join with patients and consultants across challenging geographic distances in a cost-effective, accessible manner. Telemedicine is helpful in the treatment of epilepsy and other neurological disorders. This work aims to share the use of telemedicine in the management of patients with epilepsy belonging to suburban communities during the COVID-19 pandemic and its post-pandemic follow-up. Material and Methods: A retrospective, descriptive, and analytical study was conducted. The Telemedicine database in our hospital underwent a retrospective analysis. The inclusion criteria encompassed patients who had an initial consultation during the confinement period (2020-2021) and had at least one videoconference in the post-confinement period (2022-2023). Various parameters, including the number of consultations received, city of origin, treatment, etiology, type of epilepsy, comorbidities, and treatment outcomes, were gathered to facilitate a comparison between the two periods. Statistical analyses were performed using IBM SPSS Statistics V.25 for Mac. Results: Ninety-eight patients with an initial consultation between 2020 and 221 were identified, discarding 41 due to loss of follow-up during post-confinement, resulting in N=57 cases for analysis. Conclusions: During the COVID-19 confinement period in our hospital, Telemedicine emerged as the sole feasible option for providing care to patients in remote communities. It demonstrated remarkable success in monitoring the short and midterm progression of epileptic patients. The decrease in seizure frequency was sustained during the midterm.

Spatiotemporal Microstate Dynamics of Spike-free Scalp EEG Offer a Potential Biomarker for Refractory Temporal Lobe Epilepsy.

Refractory temporal lobe epilepsy (TLE) is one of the most frequently observed subtypes of epilepsy and endangers more than 50 million people world-wide. Although electroencephalogram (EEG) had been widely recognized as a classic tool to screen and diagnose epilepsy, for many years it heavily relied on identifying epileptic discharges and epileptogenic zone localization, which however, limits the understanding of refractory epilepsy due to the network nature of this disease. This work hypothesizes that the microstate dynamics based on resting-state scalp EEG can offer an additional network depiction of the disease and provide potential complementary evaluation tool for the TLE even without detectable epileptic discharges on EEG. We propose a novel framework for EEG microstate spatial-temporal dynamics (EEG-MiSTD) analysis based on machine learning to comprehensively model millisecond-changing whole-brain network dynamics. With only 100 seconds of resting-state EEG even without epileptic discharges, this approach successfully distinguishes TLE patients from healthy controls and is related to the lateralization of epileptic focus. Besides, microstate temporal and spatial features are found to be widely related to clinical parameters, which further demonstrate that TLE is a network disease. A preliminary exploration suggests that the spatial topography is sensitive to the following surgical outcomes. From such a new perspective, our results suggest that spatiotemporal microstate dynamics is potentially a biomarker of the disease. The developed EEG-MiSTD framework can probably be considered as a general tool to examine dynamical brain network disruption in a user-friendly way for other types of epilepsy.

Epilepsy and inborn errors of metabolism

Epilepsy is a common manifestation in inborn errors of metabolism, with varying degrees of severity and response to treatment. To determine its incidence and characteristics in metabolic diseases. A retrospective review of neuropaediatric and metabolic databases was performed. Data on the type of epilepsy, age of onset and refractoriness were collected. Two cases out of three (66%) with molybdenum cofactor deficiency and neonatal epileptic encephalopathy; three with vitamin-sensitive epilepsies: pyridoxamine sulphate oxidase deficiency, antichitin and biotinidase deficiency, early onset and good seizure control with biotin; one with homocystinuria, with late onset and polytherapy; one with Menkes disease difficult to control; two with GLUT-1 deficiencies with absent and generalized discharges in the electroencephalogram; five (33%) peroxisomes in monotherapy, except for a suspected peroxisome biogenesis deficiency; 13 (34%) lysosomal deficiencies; a glycosylation disorder, with infantile and refractory spasms; seven (8.5%) organic aminoacidopathies and acidurias, one with infantile spasms (propionic acidemia), three with nonketotic hyperglycinemia with neonatal epileptic encephalopathy, one with monotherapy (leukinosis) and two (3.3%) with unscreened hyperphenylalaninemia; and five (20%) mitochondrial, most of which had oxidative phosphorylation deficiencies. The diagnosis of metabolic epilepsy requires a high level of suspicion in unscreened diseases. The semiology of the seizures and the electrocardiogram data are not characteristic, but some clinical data may provide guidance, such as early onset and refractoriness, neuroimaging and some biochemical markers. Although genetic studies are increasingly cost-effective in epilepsy, we must continue to search for earlier biomarkers and test targeted therapeutic trials.

Genetic epilepsy and role of mutation variants in 27 epileptic children: results from a "single tertiary centre" and literature review

<sec><title>Aim and scope</title><p>The wide use of next-generation sequencing has allowed professionals to reach relevant progress in the medical field including diagnoses, prognoses, and genetic counselling and to help in recognizing the pathogenic mechanisms which underlie several epileptic disorders. Genetic epilepsy refers to a disorder in which genetic mutations are recognized as the primary cause of epileptic seizures in the patients. Various types of epilepsy have been highlighted alongside a clear etiologic relationship with genetic mutations; however, for a select number of patients, some doubts remain on the role played by the variant mutations, as well as the adverse pathologic events which may interfere with the clinical manifestations. In this study, twenty-seven children affected by epileptic seizures are reported, with the aim to describe the clinical and neurological involvement presented by the children according to the genes and variant mutations, and to compare the neurological signs observed in these children with those reported in children with similar genetic mutations. Additionally, the roles played by single or associated variants on the clinical expression of the affected children are discussed.</p></sec><sec><title>Material and methods</title><p>A retrospective observational study was conducted on the gene mutations observed in 27 children affected by a clinical history and diagnosis of epilepsy, alongside an electroencephalographic analysis performed with the Pediatric Department of the University-Hospital S. Marco during the years ranging from January 2020 to January 2022. A genetic analysis was performed using an array comparative genomic hybridization (array CGH), a gene panel for epilepsy, Whole Exome Sequencing (WES), and a single nucleotide polymorphism (SNP) array.</p></sec><sec><title>Results</title><p>Nineteen children showed a single nucleotide variant, eight children carried two or more gene mutations in different genes, and one child was not reported. In this study, we identified a total of thirty-six gene mutations, where seventeen were de novo mutations, and twenty-two had either a maternal or paternal inheritance. The genes in which one or more allelic variants were found included <italic>GRIN2A</italic>, <italic>GABRA1</italic>, <italic>SCN2A1,</italic> <italic>KCNT1</italic>, <italic>PCDH19</italic>, <italic>SCN8A</italic>, <italic>KCNK4</italic>, <italic>SLC2A1</italic>, <italic>DNM1</italic>, <italic>ARID1B</italic>, <italic>WWOX</italic>, <italic>GABRG2,</italic> and others.</p></sec><sec><title>Conclusions</title><p>Genetic analyses are recognized to have a central role in the diagnostic process of children with epileptic seizures, alongside their family history, and clinical, neuroradiologic, and neurophysiologic examinations. The gene mutation anomalies reported in this study may be useful to be included in the wide field of factors related to epileptic seizures in children. The roles played by single or associated variant mutations in the clinical expression of the affected epileptic children remain difficult to be defined. Moreover, other factors such as pre-, peri-, and post-natal adverse events may negatively interfere with the severity of the clinical manifestations.</p></sec>

Cannabidiol and addiction.

Cannabidiol (CBD) has been investigated for several therapeutic applications, having reached the clinics for the treatment of certain types of epilepsies. This chapter reviews the potential of CBD for the treatment of substance use disorders (SUD). We will present a brief introduction on SUD and current treatments. In the second part, preclinical and clinical studies with CBD are discussed, focusing on its potential therapeutic application for SUD. Next, we will consider the potential molecular mechanism of action of CBD in SUD. Finally, we will summarize the main findings and perspectives in this field. There is a lack of studies on CBD and SUD in comparison to the extensive literature investigating the use of this phytocannabinoid for other neurological and psychiatric disorders, such as epilepsy. However, the few studies available do suggest a promising role of CBD in the pharmacotherapy of SUD, particularly related to cocaine and other psychostimulant drugs.

Epilepsy's effect on cardiac rhythm and the autonomic nervous system.

Sudden unexpected death in epilepsy is the most common cause of death in young patients with epilepsy. The aim of this study was to evaluate changes in interictal electrocardiogram parameters and sympathetic skin responses as markers of autonomic dysfunction in patients with epilepsy and to determine their effects on the type and duration of epilepsy, frequency of seizures, and responses to treatment. A total of 97 patients with epilepsy and 94 healthy controls were recruited. We recorded their clinical and demographic characteristics and analyzed sympathetic skin response latency and amplitude, electrocardiogram recordings, and seven cardiac rhythm parameters: P-wave duration, PR segment, QRS duration, QT interval, QT interval distribution, Tpe duration, and Tpe/QT interval ratio. P-wave durations, T-wave durations, QT and QT interval durations, and Tpe and sympathetic skin response latency were significantly longer among patients with epilepsy than the controls, and their heart rate was significantly lower. However, sympathetic skin response latency and heart rate were negatively correlated, and T-wave duration, QT duration, QT interval duration, and Tpe were positively correlated. Our results from interictal electrocardiograms indicate clinically significant arrhythmias among patients with epilepsy and the correlation of such arrhythmias with sympathetic skin responses. Thus, noninvasive tests that evaluate the autonomic system should be used to predict the risk of sudden unexpected death in epilepsy among patients with epilepsy.

Extracellular vesicles in neurodegenerative, mental, and other neurological disorders: Perspectives into mechanisms, biomarker potential, and therapeutic implications.

Extracellular vesicles (EVs) are produced, secreted, and targeted by most human cells, including cells that compose nervous system tissues. EVs carry several types of biomolecules, such as lipids, proteins and microRNA, and can function as signaling agents in physiological and pathological processes. In this chapter, we will focus on EVs and their cargo secreted by brain cells, especially neurons and glia, and how these aspects are affected in pathological conditions. The chapter covers neurodegenerative disorders, including Alzheimer's disease, Parkinson's disease and amyotrophic lateral sclerosis, as well as several psychiatric disorders, namely schizophrenia, autism spectrum disorder and major depressive disorder. This chapter also addresses other types of neurological dysfunctions, epilepsy and traumatic brain injury. EVs can cross the blood brain barrier, and thus brain EVs may be detected in more accessible peripheral tissue, such as circulating blood. Alterations in EV composition and contents can therefore impart valuable clues into the molecular etiology of these disorders, and serve biomarkers regarding disease prevalence, progression and treatment. EVs can also be used to carry drugs and biomolecules into brain tissue, considered as a promising drug delivery agent for neurological diseases. Therefore, although this area of research is still in its early development, it offers great potential in further elucidating and in treating neurological disorders.

Hematological and biochemical parameters in various Clinical and Pharmacological types of Childhood Epilepsy

Hematological and biochemical parameters in various Clinical and Pharmacological types of Childhood Epilepsy

Classification of epileptic seizures in EEG data based on iterative gated graph convolution network.

The automatic and precise classification of epilepsy types using electroencephalogram (EEG) data promises significant advancements in diagnosing patients with epilepsy. However, the intricate interplay among multiple electrode signals in EEG data poses challenges. Recently, Graph Convolutional Neural Networks (GCN) have shown strength in analyzing EEG data due to their capability to describe complex relationships among different EEG regions. Nevertheless, several challenges remain: (1) GCN typically rely on predefined or prior graph topologies, which may not accurately reflect the complex correlations between brain regions. (2) GCN struggle to capture the long-temporal dependencies inherent in EEG signals, limiting their ability to effectively extract temporal features. To address these challenges, we propose an innovative epileptic seizure classification model based on an Iterative Gated Graph Convolutional Network (IGGCN). For the epileptic seizure classification task, the original EEG graph structure is iteratively optimized using a multi-head attention mechanism during training, rather than relying on a static, predefined prior graph. We introduce Gated Graph Neural Networks (GGNN) to enhance the model's capacity to capture long-term dependencies in EEG series between brain regions. Additionally, Focal Loss is employed to alleviate the imbalance caused by the scarcity of epileptic EEG data. Our model was evaluated on the Temple University Hospital EEG Seizure Corpus (TUSZ) for classifying four types of epileptic seizures. The results are outstanding, achieving an average F1 score of 91.5% and an average Recall of 91.8%, showing a substantial improvement over current state-of-the-art models. Ablation experiments verified the efficacy of iterative graph optimization and gated graph convolution. The optimized graph structure significantly differs from the predefined EEG topology. Gated graph convolutions demonstrate superior performance in capturing the long-term dependencies in EEG series. Additionally, Focal Loss outperforms other commonly used loss functions in the TUSZ classification task.

Combined epilepsy with generalized and focal seizures

<p>Combined epilepsy (with generalized and focal seizures) is a recently accepted and yet underreported epilepsy type. We intended to review the literature of combined epilepsy and to report the individual findings of the 31 combined epilepsy patients in our database. Thereafter, we investigated the characteristics of the patients at the group level.</p>. <p>The individual findings of the 31&nbsp;patients were tabulated. We characterized the group with special reference to epide&shy;miology, timing and the sequence of gene&shy;ralized and focal seizures, family history of seizures and severity of the electro-clinical phenotype. The variables were compared to those of the generalized epilepsy and the focal epilepsy groups of our database. We carried out statistical analyses by the two-sided Fishers&rsquo;s exact test and the Kruskal-Wallis and post-hoc Dunn tests.</p>. <p>The prevalence of combined epilepsy was 1.56% within the total sample of the classifiable epilepsy patients. Females were affected more often than males (67.7% and 32.3%, respectively). Statistically significant associations emerged firstly between the &ldquo;short interval&rdquo; subgroup (where the generalized and focal seizures occurred with short time difference) and the lack of other cerebral abnormality, and secondly between the &ldquo;long interval&rdquo; subgroup (where 4 to 37 years elapsed between the occurrence of the two seizure types) and the presence of other brain abnormality (p = 0.02). The proportion of patients with positive family history of seizures was greater in the combined epilepsy- than in the generalized epilepsy group (p = 0.03) and the focal epilepsy group (p &lt; 0.0001) of the database. The electro-clinical phenotype of the absence seizures showed more atypical findings (indicating poor prognosis) in combined epilepsy than in the generalized absence epilepsy patients of the database (p &lt; 0,0001).&nbsp;Despite dissimilar patient selection and study design, our main findings were in accord with those of prior studies. The dissection of the combined epilepsy group into the &ldquo;long interval&rdquo; and &ldquo;short interval&rdquo; subgroups was a novel approach that highlighted the dissimilar pathogenetic and clinical correlates of each.</p>. <p>The case reports might facilitate the spread of information about combined epilepsy in the medical community. Analyses of the patients at the group level resulted in clinically useful pieces of evidence.</p>.

Association of GABRG2 rs211037 Gene Polymorphism With Epilepsies and Pharmacoresistance to Anti-Epileptic Drugs; A Meta-Analysis

GABRG2 protein which is a crucial part of GABA receptor encoded by the gamma-aminobutyric acid A receptor, gamma 2 (GABRG2) gene. The exonic GABRG2 rs211037 gene polymorphism has been commonly explore with respect to variable association to different types of epilepsies (all types, IGE and FS) and AEDs response. The current meta-analysis study was designed to explore whether the GABARG2 C588 T (rs211037) genetic variant predicts susceptibility to different types epilepsy and pharmacoresistance to AEDs. Twenty studies were included, contained 3351 epileptic patients and 3649 controls in meta-analysis, for the association GABRG2 rs211037 polymorphism with susceptibility to different types of epilepsy. Similarly, five studies comprised of 632 responder patients and 401 non-responder patients in meta-analysis, were selected for the evaluation of the GABRG2 rs211037 polymorphism to pharmacoresistance to AEDs. Meta-analysis was performed separately for FS and IGE in Asian and Caucasian population for association to epilepsies and pharmacoresistance to AEDs but pharmacoresistance to AEDs in FS and IGE was not performed in Asian and Caucasian due to limited number of studies. Meta-analysis showed a significant link between GABRG2 rs211037 polymorphism and susceptibility to all types of epilepsies in total Population in (CC vs CT, OR 1.03, 95% CI 0.0–1.2, p = 0.0006 and CC vs TT, OR 0.03, 95% CI 0.8–1.2, p = 0.01) genetic models. Similarly, a significant association of this polymorphisms with all types of epilepsy was found with Asian population in genetic models of CC vs CT( OR 0.86 (0.7-1.0,p=0.11), CC vs TT (OR 0.67 (0.5-0.9, p=0.000), but CC vs CT+TT genetic model shows the association of all types of epilepsies in Asian as well Caucasian population ( OR 0.6 (0.5-0.7), p=0.001 and OR 1.05 (0.9-1.2), p=0.000). Similarly, CC vs CT, CC vs TT and CC vs CT+TT genetic models were also associated with IGE and FS epilepsies in total population, Asian and Caucasian population. The alleles also showed a significant association with epilepsy. Genetic models of CC vs CT, CC vs TT and CC vs CT+TT were also associated with pharmacoresistance to AEDs (P&lt;0.05) in total population, Asian and Caucasian population. The publication bias was not significant (P&lt;0.05) but the heterogenicity (I2%) was mostly more than 50%. FS, caused by two studies with small sample sizes, however the possibility of false positive results because of significant studies for FS cannot be excluded. This study showed a significant association of GABRG2 rs211037 polymorphism with susceptibility to different types of epilepsies and pharmacoresistance to AEDs in all population. Future studies with larger sample sizes from different population are suggested to verify the results.

Comparative effectiveness-safety of conventional versus newer antiepileptics in epileptic patients in a tertiary care hospital, India

&lt;b&gt;Background&lt;/b&gt;: As initial monotherapy, individuals with epilepsy are treated with both conventional and newer antiepileptic drugs (AEDs). The differences in their relative effectiveness and safety as a group, however, have not been thoroughly studied.&lt;br /&gt; &lt;b&gt;Objective:&lt;/b&gt; To evaluate and compare the effectiveness and safety of conventional and newer anti-epileptic drugs in epileptic patients.&lt;br /&gt; &lt;b&gt;Material and methods:&lt;/b&gt; A prospective comparative study was done in 126 epileptic patients. Patients divided into two groups Group A and B of 63 each received conventional and newer antiepileptic drugs respectively. Patients were allocated the AED based on type of epilepsy, patient characteristics and drug characteristics by the treating physician. Patients maintained a seizure diary which they filled weekly and this seizure diary was evaluated at 6 weeks and 12 weeks of follow up. Patients were assessed for adverse drug reactions (ADRs) at 0, 6 and 12 weeks of follow up and also for spontaneous reported ADRs at any time during the study.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; In both group A and group B, our study demonstrated that seizure freedom, seizure severity, and time before first seizure did not differ significantly (p&amp;gt;0.5). Except for cognitive dysfunction, impaired memory, and swollen gums, which were more frequent in the conventional anti-epileptics group, the ADR profiles of both group of medications were similar. Phenytoin was found to cause gum swelling and cognitive impairment. No subject experienced a serious adverse event.&lt;br /&gt; &lt;b&gt;Conclusion:&lt;/b&gt; Newer Antiepileptics as monotherapy are equally efficacious as conventional antiepileptics but may offer a better safety profile to epileptic patients.

Neurophysiological and neuropsychological parameters in patients with temporal lobe epilepsy

Temporal lobe epilepsy (TLE) is the most common type of localization-related epilepsy (LRE) and has been extensively studied in the field of neuropsychology due to its significant association with cognitive impairments. Cognitive decline has long been recognized as a consequence of this form of epilepsy, with previous studies primarily focusing on neurophysiological measures. In this study, both neurophysiological and neuropsychological factors were analyzed in TLE patients compared to healthy control subjects. The Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE) tests were used to assess neuropsychological processes, while cognitive event-related potential (ERPs), particularly P300, were employed to analyze neurophysiological parameters. The study involved 21 TLE patients (mean age = 61.43) and 21 healthy control subjects. The results revealing that TLE patients scored significantly lower, indicating deficits in specific cognitive areas. The study also observed abnormalities in the ERPs, particularly in the assessment of P300 amplitude and latency, that may be indicative of underlying neural dysfunction related to attention and cognitive processing. In conclusion, the study provides compelling evidence of the association between TLE and a high incidence of cognitive deficits and decline. By considering both neurophysiological and neuropsychological factors, the study sheds light on the comprehensive impact of TLE on various cognitive domains and emphasizes the importance of early identification and management of cognitive impairments in TLE patients.

A Retrospective Study of Various Antiepileptic Drugs and Their Safety in Pregnancy

Antiepileptic drugs used in pregnant women have always been a topic under research, as it involves the safety of both mother and foetus. The aim of the study is tocollect various case report of pregnant women and analyse their prescription . The research involves the practical implementation of review of various antiepileptic drugs used in pregnancy. The study of individual cases and CBC fluctuation according to the type of epilepsy and nature of antiepileptic drugs prescribed. To investigate role of folic acid in epilepsy patient monitor the electrolytes fluctuation and change in antiepileptic drugs. To find out the most safest and successful antiepileptic drugs and its adjuvant for pregnant women.

Clinical, Sociodemographic, and Psychological Factors Associated with Transition Readiness in Patients with Epilepsy.

The transition to adult care for patients with epilepsy is a complicated clinical issue associated with adverse outcomes, including non-adherence to treatment, dropout of medical care, and worse prognosis. Moreover, youngsters with epilepsy are notably prone to emotional, psychological, and social difficulties during the transition to adulthood. Transition needs depend on the type of epilepsy and the epileptic syndrome, as well as on the presence of co-morbidities. Having a structured transition program in place is essential to reduce poor health consequences. A key strategy to optimize outcomes involves the use of transition readiness and associated factors assessment to implement the recognition of vulnerability and protective aspects, knowledge, and skills of these patients and their parents. Therefore, this study aims to provide a comprehensive framework of clinical and psychosocial aspects associated with the transition from pediatric to adult medical care of patients with epilepsy. Measures examining different aspects of transition readiness and associated clinical, socio-demographic, psychological, and emotional factors were administered to 13 patients with epilepsy (Mage = 22.92, SD = 6.56) with (n = 6) or without (n = 7) rare diseases, and a respective parent (Mage = 56.63, SD = 7.36). patients showed fewer problems in tracking health issues, appointment keeping, and pharmacological adherence as well as low mood symptoms and moderate resiliency. Moreover, they referred to a low quality of sleep. Notably, parents of patients with rare diseases reported a lower quality of sleep as compared to the other group of parents. Increasing awareness around transition readiness is essential to promote self-management skills of patients with epilepsy and their parents. Anticipating the period of transition could be beneficial, especially to prevent problematic sleep patterns and promote independence in health care management. Parents of patients with epilepsy and rare diseases should be monitored for their mental status which can affect patients' well-being.