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Objective: The present study was aimed at investigating the effects of anti-seizure medications (ASMs), patient demographic characteristics, and the seizure type and frequency on the development of congenital malformations (CMs) in the infants of pregnant women with epilepsy (PWWE)., Methods: PWWE followed up at the neurology outpatient clinic of 21 centers between 2014 and 2019 were included in this prospective study. The follow-up of PWWE was conducted using structured, general pregnant follow-up forms prepared by the Pregnancy and Epilepsy Study Committee. The newborns were examined by a neonatologist after delivery and at 1 and 3 months postpartum., Results: Of the infants of 759 PWWE, 7.2% had CMs, with 5.6% having major CMs. Polytherapy, monotherapy, and no medications were received by 168 (22.1%), 548 (72.2 %), and 43 (5.7 %) patients, respectively. CMs were detected at an incidence of 2.3% in infants of PWWE who did not receive medication, 5.7% in infants of PWWE who received monotherapy, and 13.7% in infants of PWWE who received polytherapy. The risk of malformation was 2.31-fold (95% confidence interval (CI): 1.48-4.61, p < .001) higher in infants of PWWE who received polytherapy. Levetiracetam was the most frequently used seizure medication as monotherapy, with the highest incidence of CMs occurring with valproic acid (VPA) use (8.5%) and the lowest with lamotrigine use (2.1%). The incidence of CMs was 5% at a carbamazepine dose <700 mg, 10% at a carbamazepine dose ≥700 mg, 5.5% at a VPA dose <750 mg, and 14.8% at a VPA dose ≥750 mg. Thus the risk of malformation increased 2.33 times (p = .041) in infants of PWWE receiving high-dose ASMs., Significance: Birth outcomes of PWWE receiving and not receiving ASMs were evaluated. The risk of CMs occurrence was higher, particularly in infants of PWWE using VPA and receiving polytherapy. The incidence of CMs was found to be lower in infants of PWWE receiving lamotrigine., (© 2023 International League Against Epilepsy.)

Background: Psychogenic non-epileptic seizures (PNES) resemble epileptic seizures and are often misdiagnosed as epilepsy., Objective: To investigate the frequency of PNES and to calculate the economic burden of the patients who admitted to video-electroencephalographicmonitoring (VEM) to obtain a diagnosis of epilepsy in order to apply for disability retirement., Methods: The present retrospective study included 134 patients who required disability reports between 2013 and 2019 and had their definite diagnoses after VEM. Following VEM, the patients were divided into three groups: epilepsy, PNES, and epilepsy + PNES., Results: In total, 22.4% (n = 30) of the patients were diagnosed with PNES, 21.6% (n = 29) with PNES and epilepsy, and 56% (n = 75), with epilepsy. The frequency of PNES among all patients was of 44% (n = 59). In patients with PNES alone, the annual cost of using anti-seizure medication was of 160.67 ± 94.04 dollars; for psychostimulant drugs, it was of 148.3 ± 72.48 dollars a year; and the mean direct cost for diagnostic procedures was of 582.9 ± 330.0 (range: 103.52-1601.3) dollars., Conclusions: Although it is challenging to determine the qualitative and quantitative total cost in these patient groups, early diagnosis and sociopsychological support will reduce the additional financial burden on the health system and increase the quality of life of the patients., Competing Interests: The authors have no conflict of interests to declare., (Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Background: Restless Legs Syndrome (RLS) is a common disorder characterized by an irresistible urge to move the legs particularly during rest in the evenings often leading to insomnia and daytime impairment. No prior studies estimate the prevalence of RLS in a diverse sample of adults with epilepsy using standard diagnostic criteria., Material and Method: A total of 225 patients with epilepsy (61.8% female; mean age 33.3 ± 12.3 years) seen in the epilepsy clinic of Çukurova University Neurology Department were included. Restless Legs Syndrome diagnosis was based on structured interviews using internationally accepted criteria. Demographic and epilepsy-related variables were obtained through medical record review., Results: The prevalence of RLS was 5.8% (n=13). Mean score on the International RLS Study Group rating scale for these subjects was 9.3 ± 3.6 (6-18). Ten (76.9%) patients with RLS scored in the mild range and the remainder in the moderate range of severity. Patients with RLS were not significantly different from others in terms of demographics, epilepsy classification or duration, treatment regimen (polytherapy vs. monotherapy), patient-reported sleep assessment, or relevant laboratory data., Conclusion: The prevalence of RLS in adults with epilepsy was similar to that observed in the adult general Turkish population (3.18-5.2%), although we excluded subjects with conditions associated with RLS, rendering ours a conservative estimate. While preliminary, these findings support the need for future studies exploring RLS in epilepsy given the potential impact of untreated sleep disorders and sleep deprivation on seizures and quality of life in people with epilepsy., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The aim of this study is to evaluate the underlying etiologic factors of epilepsy patients and to predict the prognosis of these patients by using a Multi-Layer Perceptron Neural Network (MLPNN) according to risk factors. 758 patients with epilepsy diagnosis are included in this study. The MLPNNs were trained by the parameters of demographic properties of the patients and risk factors of the disease. The results show that the most crucial risk factor of the epilepsy patients was constituted by the febrile convulsion (21.9%), the kinship of parents (22.3%), the history of epileptic relatives (21.6%) and the history of head injury (18.6%). We had 91.1 % correct prediction rate for detection of the prognosis by using the MLPNN algorithm. The results indicate that the correct prediction rate of prognosis of the MLPNN model for epilepsy diseases is found satisfactory.

Epilepsy is a disorder of cortical excitability and still an important medical problem. The correct diagnosis of a patient's epilepsy syndrome clarifies the choice of drug treatment and also allows an accurate assessment of prognosis in many cases. The aim of this study is to evaluate epileptic patients and classify epilepsy groups such as partial and primary generalized epilepsy by using Radial Basis Function Neural Network (RBFNN) and Multilayer Perceptron Neural Network (MLPNNs). Four hundred eighteen patients with epilepsy diagnoses according to International League against Epilepsy (ILAE 1981) were included in this study. The correct classification of this data was performed by two expert neurologists before they were executed by neural networks. The neural networks were trained by the parameters obtained from the EEG signals and clinic properties of the patients. Experimental results show that the predictions of both neural network models are very satisfying for learning data sets. According to test results, RBFNN (total classification accuracy = 95.2%) has classified more successfully when compared with MLPNN (total classification accuracy = 89.2%). These results indicate that RBFNN model may be used in clinical studies as a decision support tool to confirm the classification of epilepsy groups after the model is developed.

Background: Reflex epilepsy is characterized by seizures that are triggered in response to a specific stimulus and tooth-brushing epilepsy is an extremely rare form of reflex epilepsy in which the seizures are mainly induced by the act of tooth brushing. In this report, we describe an epilepsy patient whose seizures were exclusively triggered by the use of a powered toothbrush., Methods and Results: A 31-year old female had been treated for partial epilepsy of left temporal or frontal lobe for 20 years and she did not have seizures for the last 3 years. However, she experienced periods of auras, partial complex seizures, and nocturnal generalized seizures after she started using a powered toothbrush. The interictal electroencephalography revealed slow wave paroxysm over the left temporal or frontal lobe., Conclusions: This case report is, to our knowledge, the first report of reflex epilepsy in which the seizures were triggered by the use of a powered toothbrush. Possible mechanisms to explain the novel type of this rare disorder are discussed.

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Copyright of Turkish Journal of Neurology / Turk Noroloji Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: What is expected from anti-epileptic treatment is low side effects and drug-drug interactions as well as high efficacy. In this study, the efficacy of lacosamide in polytherapy and its effect on prognosis were evaluated. Methods: Seventy-seven patients with focal epilepsy who were followed up for at least 1 year and using lacosamide were included in the study. The antiepileptic drugs they use, the side effects of the drugs, neuroimaging and electrophysiological examinations were evaluated. Results: A total of 77 patients, including 35 women (44.9%) and 42 men (55.1%), were included in the study. The mean age was 33.9±10.6 (min: 19 max: 67). Average age of seizure onset was 12.6±10.7, and none of the patients were using Lacosamide (LKS) as monotherapy. Although only 3 patients were receiving dual therapy, the remaining 74 patients were receiving 3 or more antiepileptic treatments. While 33 of the patients (42.9%) had a decrease in the frequency of seizures after LKS treatment. Conclusion: Although the percentage of efficacy was obtained as low according to literature information, lacosamide is effective in resistant focal epilepsies with an efficiency of 42.9%. Especially in patients who use drugs other than antiepileptic drugs due to comorbid diseases, the absence of drug-drug interaction and the absence of serious side effects that require termination of treatment may be an indication that it can be used safely. [ABSTRACT FROM AUTHOR]

Women diagnosed with epilepsy must be followed by a neurologist as well as an obstetrician in the pre-pregnancy, pregnancy, birth, and puerperal periods. There are no indications for cesarean section or induced birth in epileptic patients, with the exception of some special cases, but in daily practice, cesarean section is routinely performed and these cases are referred to tertiary epilepsy centers. Likewise, withdrawal or unnecessary dose adjustment of antiepileptic drugs in breastfeeding mothers can cause adverse effects in the infant and the mother. The aim of this article is to minimize misjudgments that affect the quality of life of patients by increasing awareness of the genuine needs of pregnant women diagnosed with epilepsy during the birth and postpartum periods. [ABSTRACT FROM AUTHOR]

Amaç: Epilepsi tanılı gebe hastaların yönetimi zordur. Yüksek oranda sağlıklı (%92-96) çocuk doğurmalarına rağmen, prematüre doğum, fetal ve neonatal ölüm riski, konjenital malformasyonlar ve gelişme geriliği oranları normal populasyona göre artış göstermektedir. Epilepsi tanılı kadın hastaların büyük kısmında gebelik döneminde nöbet sıklıkları değişmemektedir. Bu çalışmada amaç epilepsi tanılı gebelerin, gebelik dönemindeki nöbet sıklıkları ve bu nöbetlerin yenidoğan bebeğin gelişim parametrelerine etkisinin ve yenidoğan bebekte karşılaşılabilecek malformasyonların belirlenmesidir. Gereç ve Yöntem: On dört Şubat 2014-14 Şubat 2016 tarihleri arasında doğumu gerçekleşen 55 epilepsi tanılı gebe hasta çalışmaya alındı. Nöbet tipi, sıklıkları, kullandıkları anti epileptik ilaçlar, bebeklerin ölçüleri, bebeklerdeki malformasyonlar kaydedildi. Bulgular: Gebelik süresince; hastaların %56,4 (n=31)'ünün nöbet sıklığının değişmediği, %21.8'inin (n=12) nöbet sıklığının arttığı, %21.8'inin (n=12) nöbet sıklığının azaldığı belirlendi. Bebeklerden %3.6'sı intrauterin eksitus oldu. Bebeklerin %7.3'ünde malformasyon saptandı. Sonuç: Gebelerin sadece %21.8'inde nöbet sıklığının arttığı saptanmıştır. Jeneralize nöbeti olan hastaların bebeklerinde malformasyon ve mortalite oranı daha yüksek bulundu. Monoterapi kullanan hastaların, politerapi kullananlara göre daha yüksek oranda sağlıklı bebek doğurdukları gözlendi. Objectives: Management of pregnant patients with epilepsy is difficult. Despite the high healthy birth rate (92-96%); prematurity, fetal or neonatal death, congenital malformations and developmental failure rates are higher than the average population. The seizure rates of the majority of the patients with epilepsy do not change during pregnancy. The purpose of this study is to determine the frequency of epileptic seizures of the patients during pregnancy and rate of malformations that may be encountered in newborn babies. Methods: 55 pregnant patients with epilepsy who were born between February 2014 and February 2016 were included in the study. Types of seizures, frequency, anti-epileptic drugs used, measures of infants, malformations in infants were recorded. Results: During pregnancy; it was determined that the frequency of seizure was 56.4% (n=31), and 21.8% of patients (n=12) had increased seizure frequency whereas 21.8% (n=12) had lower seizure frequency. 3.6% of infants were lost in intrauterine. 7.3% of infants had a malformation. Conclusion: Only 21.8% of the pregnant women had an increase in seizure frequency. Malformation and mortality rates were higher in infants of patients with generalised seizures. It was observed that patients who used monotherapy gave birth to more healthy babies than those using polytherapy. [ABSTRACT FROM AUTHOR]

Copyright of Epilepsi: Journal of the Turkish Epilepsi Society is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Epilepsi: Journal of the Turkish Epilepsi Society is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Epilepsi: Journal of the Turkish Epilepsi Society is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To assess the influence of carbamazepine (CMZ) and oxcarbazepine (OXZ) on quality of life (QOL) in nondepressed adult patients with epilepsy. In addition, assessment of the influence of different factors on QOL was also targeted.Ninety patients on monotherapy, 61 (33 female, 28 male) receiving CMZ and 29 (18 female, 11 male) receiving OXZ, were included in this study. We used the mini mental test (MMT), state-trait anxiety inventory (STAI-I and STAI-II), structured clinical interview for DSM-IV clinical version (SCID), Beck depression inventory (BDI), and Quality of life in Epilepsy Inventory-10 (QOLIE-10). We evaluated the relation with QOLIE-10 between demographic and clinical properties of the patients.MMT score was 28.41±1.36 (25 to 30) in CBZ group and 28.72±1.39 (26 to 30) in OXZ group (P, 0.31). In addition, the mean score of STAI-I was 34.5±10.9 (20 to 67), STAI-II was 40.9±9.2 (25 to 68), BDI was 9.8±6.8 (0 to 29), and QOLIE-10 was 21.2±4.9 (13 to 39). There was no statistical difference between the groups.In our study, we concluded that there was no considerable influence of any type of antiepileptic drug (CMZ, OXZ) and demographic properties of the patients on QOL, whereas state-trait anxiety and high score of BDI without depression had a negative role on OQL of the patients with epilepsy. [ABSTRACT FROM AUTHOR]

Epilepsy is a disorder of cortical excitability and still an important medical problem. The correct diagnosis of a patient's epilepsy syndrome clarifies the choice of drug treatment and also allows an accurate assessment of prognosis in many cases. The aim of this study is to evaluate epileptic patients and classify subgroups of partial epilepsy by Multilayer Perceptron Neural Networks (MLPNNs). This is the first study to classify the partial epilepsy groups using the neural network according to EEG signals. 418 patients with epilepsy diagnoses according to International League against Epilepsy (ILAE, 1981) were included in this study. The epilepsy outpatients at the Neurology Department Clinic of Cukurova University Medical School between the years of 2002–2005 were examined and included in the study. The MLPNNs were trained by the parameters obtained from the EEG signals and clinical findings of the patients. Test results show that the MLPNN model is able to classify partial epilepsy with an accuracy of 91.5%. Moreover, new MLPNNs were constructed for determining significant variables on classification. The loss of consciousness in the course of seizure time variable caused the largest decrease in the classification accuracy when it was left out. In conclusion, we think that the classification performance of MLPNN model for partial epilepsy is satisfactory and this model may be used in clinical studies as a decision support tool to determine the partial epilepsy classification of the patients. [ABSTRACT FROM AUTHOR]

Although it had long been observed that psychiatric disorders occur in patients with epilepsy, it was only in the 19th century that those were understood and classified. Having been demonstrated in the literature for the last 50 years, forced normalization (alternative psychosis, paradoxical normalization) is a phenomenon that emerges in patients diagnosed with epilepsy. Landolt described it as "a phenomenon characterized by the relative or complete normalization of EEG findings, compared to the previous ones after the occurrence of psychotic states." The psychiatric disorders reported are mostly psychoses; however, "prepsychotic dysphoria" (insomnia, irritability, anxiety), hysteria, and hypochondriasis as well as mood disorders (depression, mania) have also been reported. The pathogenic mechanisms and neurobiological processes that cause this phenomenon have not yet entirely understood. Moreover, there is lack of information on the incidence of this phenomenon. In this report, the potential pathogenic mechanisms, clinical features, and the diagnosis of forced normalization that is generally assessed by neurologists, yet is also attracting the attention of psychiatrists with the increasing number of cases reported recently, will be reviewed. [ABSTRACT FROM AUTHOR]