Search

Background: Previous studies have found that patients with epilepsy are more likely to suffer impulsivity. However, the causal relationship between impulsivity and epilepsy is unknown. In this study, we conduct a bidirectional Mendelian randomization (MR) study to explore the causal relationship between impulsivity and epilepsy with recurrent seizure. Methods: Data of the genome-wide association studies (GWAS) on 14 impulsivity traits and epilepsy were obtained from the GWAS catalog and UK Biobank. Inverse-variance weighted (IVW) and weighted median (WM) methods were utilized for MR estimates. IVW, MR-Egger regression, and MR-pleiotropy residual sum and outlier (MR-PRESSO) methods were used to assess heterogeneity and pleiotropy. Results: Single-nucleotide polymorphisms (SNPs) related to the lack of perseverance were associated with a decreased risk of epilepsy with recurrent seizures according to the results of IVW (odd ratio [OR] = 0.93, 95% confident interval [CI] = 0.90–0.97, P = 0.001) and WM (OR = 0.93, 95%CI = 0.87–0.98, P = 0.007). Meanwhile, heterogeneity was not observed with a Cochran Q-derived P value of 0.819 for MR egger and a P value of 0.808 for IVW. Pleiotropy was not found according to the MR-PRESSO (P = 0.273). The other 13 impulsivity traits had no causal effect on epilepsy with recurrent seizures. Meanwhile, SNPs related with epilepsy with recurrent seizures had no causal effect on the 14 impulsivity traits. Conclusions: This MR study suggests that lack of perseverance may be a protective factor against epilepsy with recurrent seizures. However, epilepsy with recurrent seizures does not affect impulsivity. [ABSTRACT FROM AUTHOR]

(1) Background: The scientific literature highlights that children diagnosed with celiac disease (CD) are at a heightened risk of experiencing physical, psychological, and social challenges, impacting their overall healthy childhood development. However, there remains a lack of a clear understanding regarding the factors that contribute to this vulnerability. The purpose of this study is to analyze and map the evidence on the sociopsychosomatic vulnerability of these children and identify gaps in this topic. (2) Methods: Following Joanna Briggs Institute's guidelines for scoping reviews, we executed a detailed search of key electronic databases and explored the grey literature to capture a broad spectrum of studies. Our focus was on identifying research that looked into the multiple dimensions of vulnerability—physical, psychological, and social—in children with CD. We included a diverse range of study designs as well as systematic reviews, ensuring a comprehensive analysis. The selection process was stringent, utilizing clearly defined inclusion and exclusion criteria. (3) Results: We identified 61 studies that met our inclusion criteria. The review highlighted significant adverse health outcomes in children with CD and elucidated various individual and environmental determinants that influenced these vulnerabilities. It also underscored the lack of assessment tools to evaluate the risk of health problems in this population. (4) Conclusions: The findings underscore a critical need for further research to deepen our understanding of the vulnerabilities associated with CD in children. Developing targeted assessment tools will be crucial in stratifying health risks and enhancing care strategies for this vulnerable population. [ABSTRACT FROM AUTHOR]

Epilepsy is a prevalent neurological disorder, yet its underlying mechanisms remain incompletely understood. Accumulated studies have indicated that epilepsy is characterized by abnormal neural circuits. Understanding the circuit mechanisms is crucial for comprehending the pathogenesis of epilepsy. With advances in tracing and modulating tools for neural circuits, some epileptic circuits have been uncovered. This comprehensive review focuses on the circuit mechanisms underlying epilepsy in various neuronal subtypes, elucidating their distinct roles. Epileptic seizures are primarily characterized by the hyperactivity of glutamatergic neurons and inhibition of GABAergic neurons. However, specific activated GABAergic neurons and suppressed glutamatergic neurons exacerbate epilepsy through preferentially regulating the activity of GABAergic neurons within epileptic circuits. Distinct subtypes of GABAergic neurons contribute differently to epileptic activities, potentially due to their diverse connection patterns. Moreover, identical GABAergic neurons may assume distinct roles in different stages of epilepsy. Both GABAergic neurons and glutamatergic neurons with long-range projecting fibers innervate multiple nuclei; nevertheless, not all of these circuits contribute to epileptic activities. Epileptic circuits originating from the same nuclei may display diverse contributions to epileptic activities, and certain glutamatergic circuits from the same nuclei may even exert opposing effects on epilepsy. Neuromodulatory neurons, including cholinergic, serotonergic, dopaminergic, and noradrenergic neurons, are also implicated in epilepsy, although the underlying circuit mechanisms remain poorly understood. These studies suggest that epileptic nuclei establish intricate connections through cell-type-specific circuits and play pivotal roles in epilepsy. However, there are still limitations in knowledge and methods, and further understanding of epileptic circuits is crucial, particularly in the context of refractory epilepsy. [ABSTRACT FROM AUTHOR]

Childhood traumas have been considered risk factors for many psychiatric disorders. Recent studies demonstrated that childhood traumas can also be considered risk factors for neurological diseases. In this context, the objective of this study is to investigate the effects of childhood traumas on treatment resistance in patients with epilepsy. The study sample consisted of 85 epilepsy patients, 40 male and 45 female, who were diagnosed and followed up by a neurologist. Of these patients, 45 were being followed up with the diagnosis of refractory epilepsy, and 40 were being followed up with the diagnosis of treatment-responsive epilepsy. Cranial magnetic resonance imaging and electroencephalography were performed on all patients. In addition, all patients were administered childhood trauma questionnaire (CTQ) and Hamilton depression rating scale (HAM-D). Epilepsy patients included in the study were divided into refractory epilepsy and treatment-responsive epilepsy groups. There was no significant difference between the groups in sociodemographic characteristics. On the other hand, total CTQ and all CTQ subscale scores and HAM-D scores were significantly higher in the refractory epilepsy group than in the treatment-responsive epilepsy group. This study demonstrates that childhood traumas may contribute to treatment resistance in epilepsy patients. Therefore, it is recommended that a history of childhood traumas be routinely queried in the treatment of epilepsy patients. [ABSTRACT FROM AUTHOR]

Background: Epilepsy is a common, long-term neurological condition. Several previous case-control, cohort and cross-sectional studies have highlighted the role of prenatal, delivery and postnatal factors in the onset of epilepsy. In this systematic review, we evaluate the impact of these factors on the development of epilepsy in children and adolescents. Methods: We searched PubMed and Google Scholar for literature on the relationship between prenatal, delivery and postnatal factors and the occurrence of epilepsy. The research was performed according to the PRSIMA 2020 flowchart and checklist. Data were extracted and pooled according to the ReviewManager 5.3 software using a random-effects model. Sensitivity analysis and subgroup analysis were used to evaluate the source of heterogeneity. Results: We identified 25 reports, including 45,044 cases with confirmed epilepsy and 2,558,210 controls. Premature birth is significantly associated with the risk of epilepsy (pooled OR = 4.36 [95% CI: 1.26–15.09], P = 0.02). Smoking during pregnancy significantly increases this risk by 28% (pooled OR = 1.28 [95% CI:1.1–1.49], P = 0.002). Furthermore, maternal epilepsy confers a pooled OR of 2.06 [95% CI:1.26–3.36]. Eclampsia is linked to a 16.9-fold increased risk of epilepsy. In addition, both pregnancy metrorrhagia and maternal infection are significantly associated with the epilepsy risk (pooled OR = 2.24 [95% CI: 1.36–3.71] and 1.28 [95% CI: 1.17–1.41], respectively). For delivery conditions, cord prolapse (pooled OR = 2.58 [95% CI: 1.25–5.32]), prolonged labor (> 6 h) (OR = 6.74 [95% CI: 3.57–12.71]) and head trauma (pooled OR = 2.31 [95% CI: 1.54–3.48]) represent a meaningful risk of epilepsy occurrence. Moreover, birth complications (OR = 3.91 [95% CI: 2.43–6.29]), low birth weight (pooled OR = 1.83 [95% CI: 1.5–2.23]) and male birth (pooled OR = 1.18 [95% CI: 1.06–1.32]) are associated with an elevated risk of epilepsy in childhood and adolescence. Conclusions: Epilepsy in children and adolescents can be attributed to a multitude of intricate factors, notably those during pregnancy, delivery and the postnatal period. These findings highlight the crucial role of prenatal and postnatal care in reducing the impact of these factors on epilepsy occurrence. [ABSTRACT FROM AUTHOR]

Objective: It is known that the stress experienced during this period increases the risk of seizures. This study, it was investigated the effect of limited social isolation (SI) stress experienced in early life on penicillin-induced epileptiform activity. Methods: Wistar Albino male rats (n=21) 28 days postpartum (PND21) were randomly divided into 3 groups (n=7); control group (C), SI group for 28 day (SI28), SI group for 14 days (SI14). SI stress was established by keeping rats in cages alone for 6 hours per day. Following the experimental protocol, rats were anesthetized with urethane (1.25 g/kg). The epileptiform activity was induced with Penicillin-G (500 IU, i.c.) and ECoG was recorded for 3 hours. Results: SI stress was no effect on the spike frequency and amplitude of penicillin-induced epileptiform activity. There was no difference in penicillin-induced epileptiform activity whether the SI was 14 or 28 days. Conclusion: SI stress per day for 6 hours was no effect on penicillin-induced epileptiform activity early in life. After the rats were exposed to SI stress for 6 hours a day, housing in a standard cage may have reduced or eliminated the effects of isolation providing social interaction. In order to better interpret this finding, we suggest that possible changes with different durations of SI should be investigated with further studies. [ABSTRACT FROM AUTHOR]

The article assesses the optimal first-line treatment for young women with generalized epilepsy, finding that levetiracetam (LEV) shows greater efficacy over lamotrigine (LTG) in specific epilepsy subtypes, underscoring the necessity for improved treatment strategies in this demographic.

This systematic review aimed to identify factors significantly associated with the occurrence of epilepsy in autistic individuals and to consider the impact of study quality on findings. Electronic databases were systematically searched on October 2nd, 2020 and records retrieved were limited to those published from 2000 onwards. Study quality was categorised as 'good', 'moderate' or 'weak'. Fifty-three studies were included and in studies where the prevalence of epilepsy was reported (n = 257,892), 18,254 (7%) had co-occurring epilepsy. Intellectual disability/cognitive impairment was the most commonly reported risk factor associated with occurrence of epilepsy in autistic individuals. The evidence supporting other, potentially relevant factors was weak and inconsistent and requires further evaluation. Only 9/53 studies were considered 'good' quality. [ABSTRACT FROM AUTHOR]

Background: Epilepsy is a prevalent comorbidity in patients with brain metastases (BM) and could result in sudden and accidental damage, as well as increased disease burden due to its rapid onset. Foreseeing the potential for the development of epilepsy may permit timely and efficient measures. This study aimed to analyze the influencing factors of epilepsy in advanced lung cancer (ALC) patients with BM and construct a nomogram model to predict the likelihood of developing epilepsy. Methods: Socio-demographic and clinical data of ALC patients with BM were retrospectively collected from the First Affiliated Hospital of Zhejiang University School of Medicine between September 2019 and June 2021. Univariate and multivariate logistic regression analyses were applied to determine the influencing factors for epilepsy in ALC patients with BM. Based on the results of the logistic regression analysis, a nomogram was built to represent the contribution of each influencing factor in predicting the probability of epilepsy development in ALC patients with BM. The Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve were utilized to evaluate the goodness of fit and prediction performance of the model. Results: The incidence of epilepsy among 138 ALC patients with BM was 29.7%. On the multivariate analysis, having a higher number of supratentorial lesions (odds ratio [OR] = 1.727; p = 0.022), hemorrhagic foci (OR = 4.922; p =.021), and a high-grade of peritumoral edema (OR = 2.524; p <.001) were independent risk factors for developing epilepsy, while undergoing gamma knife radiosurgery (OR =.327; p =.019) was an independent protective factor. The p -value of the Hosmer-Lemeshow test was.535 and the area under the ROC curve (AUC) was.852 (95% CI:.807–.897), suggesting the model had a good fit and exhibited strong predictive accuracy. Conclusion: The nomogram was constructed that can predict the probability of epilepsy development for ALC patients with BM, which is helpful for healthcare professionals to identify high-risk groups early and allows for individualized interventions. [ABSTRACT FROM AUTHOR]

Objective: Withdrawal of anti-seizure medicine (ASM) may be considered in epilepsy patients when seizure control is achieved. Predicting the risk of recurrence after discontinuing ASM. We compared routine electroencephalography (EEG) and long-term EEG (LTEEG) findings in seizure-free epilepsy patients with planned drug discontinuation. Hence, we aimed to emphasize the relationship between interictal electrophysiological findings and clinical features to assess the superiority of LTEEG over routine EEG in medication termination. Methods: Fifty-eight patients diagnosed with epilepsy and under the follow-up epilepsy outpatient clinics of our tertiary center with normal EEG and at least a two-year seizure-free period were included. LTEEG was performed in all these patients. Age, sex, seizure onset age, type and frequency, risk factors for epilepsy, anti-seizure medications, neurological examination, and electrophysiological and magnetic resonance imaging (MRI) findings were retrospectively recorded. Results: The study group consisted of 36 females (62.1%) and 22 males (37.9%). Their mean age was 38.67 (21-70) years. The mean duration of seizure freedom was 4.8 years. Neurological examination was abnormal in 9 patients, and MRI detected an anomaly in 22 patients (37.9%). Epileptiform anomalies on LTEEG were observed in 27 (46.6%) of 58 patients. LTEEG anomalies and seizure frequency were correlated with a statistically significant relationship. Conclusion: LTEEG may reveal interictal epileptiform anomalies even in patients with long-term seizure-free epilepsy with a normal routine EEG. On the basis of our results, we would like to emphasize the value of LTEEG to reevaluate a better treatment strategy in seizure-free patients. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi 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.)

Background: Individuals with Down syndrome are at a higher risk of cardiac, renal, and other health issues due to a complex disease physiology. However, few data exist on long-term disease risks to guide prevention and care. We aimed to determine the 10-year incidence of cardiac, renal, and urinary tract complications in Down syndrome versus matched controls. Methods: This retrospective cohort study utilized a large collaborative database. We identified 32,444 patients with Down syndrome and matched controls, excluding those with pre-follow-up target events. Covariates included demographics, lifestyle factors, and comorbidities. Outcomes were ischemic heart disease, hypertension, hypothyroidism, epilepsy, urinary tract infections and chronic kidney disease. We calculated unadjusted and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox regression and plotted Kaplan–Meier survival curves. Findings: Over 10 years, Down syndrome patients showed a 3.7-fold higher ischemic heart disease risk (95% CI: 3.0–4.6) and a 1.6-fold higher hypertension risk (95% CI: 1.4–1.8) versus controls. Hypothyroidism (HR = 2.0; 95% CI: 1.7–2.4), epilepsy (HR = 4.5; 95% CI: 3.5–5.8), and urinary tract infection (HR = 3.9; 95% CI: 3.4–4.6) risks were also higher. Chronic kidney disease risk was 2.7-fold greater (95% CI: 2.1–3.5). Survival analysis confirmed a significantly higher incidence of all outcomes in Down syndrome (p < 0.0001). Interpretation: This large study found major health challenges in Down syndrome, with risks 3- to 5-fold higher for chronic conditions versus matched controls over 10 years. Though survival remains high with proper care, focusing resources on the prevention and management of complications in this high-risk group can optimize well-being across the lifespan. Future research accounting for limitations here would provide definitive estimates of disease risk in Down syndrome to guide targeted health strategies. [ABSTRACT FROM AUTHOR]

Background: The relationship between serum copper and epilepsy has been elucidated in observational studies. In this study, we aimed to explore the causal relationship between serum copper and epilepsy using Mendelian randomization (MR) analysis. Methods: Single nucleotide polymorphisms (SNPs) associated with serum copper were used as instrumental variables for MR analysis to evaluate their causal effects on epilepsy. The main MR results were obtained by using the inverse variance weighting (IVW) method, supplemented by weighted median and MR-Egger regression. In addition, sensitivity analyses such as Cochran's Q test and pleiotropy test were used to assess these SNPs on epilepsy in terms of horizontal pleiotropy and heterogeneity. Results: The IVW method revealed that the serum copper was associated with an increased risk of generalized epilepsy (OR= 1.07; 95% CI 1.01- 1.14; P = 0.032), and the sensitivity analysis further supports the robustness of the results. Conclusions: The current study reveals a possible causal role for serum copper in increasing the risk of generalized epilepsy, which provide guidance for identifying potential risk factors for epilepsy. [ABSTRACT FROM AUTHOR]

Purpose: Despite the high incidence of epilepsy during adolescence, little attention has been paid to the outcomes and prognosis of adolescent-onset epilepsy. The aim of this study was to investigate the long-term pharmacological and psychosocial outcomes of adolescent-onset epilepsy. Methods: From 1993 to 2019, the electronic medical records of adolescent-onset epilepsy patients were retrieved from Asan Medical Center Children's Hospital. Seizure outcomes were evaluated based on the seizure-free period at last contact. Possible predictors of remission, relapse, and intractability were investigated. Neuropsychiatric comorbidities, socioeconomic status, and transition outcomes were also assessed. Results: In total, 137 patients were enrolled in this study. The median age at diagnosis of epilepsy was 14 years and the mean duration of therapy was 13.0 years. During follow-up, 93 patients (67.9%) achieved terminal remission, of which 27 cases (19.7%) resolved. Relapse after withdrawal of medication occurred in 74 patients (54.0%), and the presence of electroencephalographic abnormalities (odds ratio [OR], 8.23; 95% confidence interval [CI], 1.39 to 48.87; P=0.020), poor adherence (OR, 4.84; 95% CI, 2.13 to 11.02; P=0.000), and history of febrile seizures (OR, 4.10; 95% CI, 1.21 to 13.93; P=0.024) were risk factors for relapse. Neurodevelopmental and psychological comorbidities were documented in 17 (12.4%) and 12 (8.8%) patients, respectively. Thirty-six (26.3%) patients transferred to adult clinics, at a mean age of 21.9 years. Conclusion: This study showed overall favorable seizure outcomes with a high rate of remission, but with frequent relapse after withdrawal. [ABSTRACT FROM AUTHOR]

The safety of shoulder arthroplasty for patients with a history of convulsive seizures is unknown. Concerns include the possibility of a postoperative seizure resulting in dislocation, cuff disruption, or implant failure. We sought to compare outcomes and complications following shoulder arthroplasty in patients with and without a history of convulsive seizures. Our institutional Total Joint Registry Database was queried to identify all patients with a history of convulsive seizures who had undergone a primary shoulder arthroplasty between 2000 and 2018. The query identified 56 shoulders (49 patients) with an average age of 61.8 years. 51.8% of patients were female. This cohort was matched 2:1 to a group of patients with similar surgical and demographic characteristics who did not have a seizure history. Kaplan–Meier estimates and univariate Cox regression models were utilized to compare implant survival and reoperation rates. Patient-reported outcomes, including the American Shoulder and Elbow Surgeons score were also extracted. At most recent follow-up, cumulative reoperation rates were equivalent between the groups (P =.9) with 3 reoperations out of 56 shoulders (5.4%) in the seizure group, and 7 reoperations out of 112 shoulders (6.3%) in the nonseizure group. Rates of implant revision were also similar. Five-year Kaplan–Meier survival estimates free of reoperation were 97.8% (95% confidence interval, 91.1-100.0) in the seizure group and 93.1% (95% confidence interval, 87.4-98.9) in the nonseizure group. Postoperatively, 23 of 56 patients in the seizure group had at least 1 known seizure after their index arthroplasty, at an average of 4.4 years after surgery. None of the patients with postoperative seizures sustained a dislocation. Altogether only 3 episodes of prosthetic dislocation were observed, all in the nonseizure group. The only complication attributable to a seizure was an early postoperative seizure resulting in subscapularis failure, although this patient never underwent reoperation. Patient-reported outcomes and range of motion were similar between groups, with average American Shoulder and Elbow Surgeons scores of 77.2 and 74.9 in the seizure and nonseizure groups, respectively (P =.6). Reoperation rates and implant survival following shoulder arthroplasty were similar when comparing patients with and without a history of convulsive seizures. Postarthroplasty seizures occurred in a notable number of patients but did not result in any major complications. While it remains prudent to ensure that patients' seizures are well controlled prior to arthroplasty, our data suggest that individuals with a convulsive seizure disorder can undergo shoulder arthroplasty safely. [ABSTRACT FROM AUTHOR]

Stroke is the leading cause of neurological diseases globally. Remarkably, epilepsy is a common complication of stroke, which greatly impairs the quality of life of patients and poses a significant clinical challenge. Therefore, a better understanding of the risk factors for poststroke epilepsy is crucial. A recent study published in JAMA Neurology studied the brain network associated with poststroke epilepsy in a group of 76 patients compared to a cohort of 625 control patients using lesion mapping techniques. The results showed that negative functional connectivity between lesion locations and regions in the basal ganglia and cerebellum confers a higher risk of developing epilepsy after stroke. The lesion network nodes associated with epilepsy were identical across different lesion types including hematomas, traumas, tumors, and tubers. Furthermore, the poststroke epilepsy brain network has potential therapeutic relevance to deep brain stimulation (DBS). In a cohort of 30 patients, the functional connectivity between anterior thalamic DBS sites and the lesion network nodes was found to correlate with seizure control after DBS. In summary, the finding provides a novel method for predicting the risk of poststroke epilepsy in patients and may guide brain stimulation treatments for epilepsy. [ABSTRACT FROM AUTHOR]

Background: SYNGAP1 is a significant genetic risk factor for global developmental delay, autism spectrum disorder, and epileptic encephalopathy. De novo loss-of-function variants in this gene cause a neurodevelopmental disorder, for example, early-onset and drug-refractory seizures. We report two children with global developmental delay and epileptic encephalopathy, which are caused by SYNGAP1 gene novel mutations, and drug treatment is effective. Case presentation: We report a boy and a girl presented with global developmental delay when they were young babies; as they grew up, cognitive impairment and social-communication disorder became more and more prominent; unfortunately, the patients developed into various seizure types, including eyelid myoclonia, myoclonic and absences when the boy was 1 year 8 mouths old and the girl was 3 years old. The two patients were found two previously unknown mutations by high throughput sequencing [c.3271_ c.3272insT; (p.L1091L fs*62), c.2515A > T (p.K839*)] in exon 15 of the SYNGAP in the proband. Sanger sequencing confirmed the heterozygous nature, and neither of their parents carried the same mutation. The girl treated with valproic acid and prednisone became seizure-free, and valproic acid and levetiracetam combined with clonazepam were influential in the other. Conclusions: The global developmental delay and epileptic encephalopathy of the children were probably due to the pathogenic mutation of the SYNGAP1 gene, and prednisone and clonazepam may be effective in achieving seizure-free. [ABSTRACT FROM AUTHOR]

Sports activities are of physiological, social, and psychological importance for people with epilepsy as well as for every other person. However, participation in sports activities is less common in people with epilepsy. Patients usually tend to refrain from participating in sports activities for several reasons such as the risk of injuries, the risk of physical exercise inducing seizures, stigmatization, prejudice, or lack of efficient medical advice. In this review, we specified the sports branches with their possible risks, precautions to be taken and their related advice for people with epilepsy. The sports branches are examined in the headings as martial arts, outdoor sports, collective ground sports, and gymnastics. The possible risk of injury, risk of the particular sports branch to precipitate a seizure, and the necessary precautions in each sports branch are discussed separately. A detailed clinical evaluation is required to make an appropriate decision on whether an individual with epilepsy can practice the mentioned sport. The type of sport, the type and frequency of seizures, presence of aura, seizure triggers, drug compliance, presence of efficient supervision, and presence of protective equipment should be evaluated. In this review, we have evaluated these topics for each sports branch separately. When appropriate precautions are taken in patients with epilepsy, sports will be accepted as a therapeutic entity rather than a ban. [ABSTRACT FROM AUTHOR]

The dental team should understand the nature of epilepsy and how the antiepileptic agents negatively affect oral and dental health. This helps to reduce the stigma developed by dentists to deal with epileptic patients and deliver safe dental treatment. It is also crucial for the dental team to help prevent the development of seizures by obtaining a thorough medical history and providing an easy and comfortable environment. Uncontrolled epileptic patients with acute dental pain and even controlled epileptic patients with either acute or chronic dental pain might develop attacks that require prompt management by the dental team. Accordingly, the dental team should anticipate seizures at any time during treatment. Implementing a clear pathway for the management of seizures in dental clinics by providing regular training courses to the dental team will help to build confidence in managing people with epilepsy. [ABSTRACT FROM AUTHOR]

Neurocysticercosis is one of the most common causes of acquired epilepsy worldwide. This diagnosis is rarely considered in patients presenting to the emergency department (ED) with recurrent seizures in the United States (U.S.). This is the case of a young adult male presenting with post-ictal confusion and recurrent seizures requiring intubation for agitation and airway protection. It illustrates the need to maintain a broad differential when considering etiology of seizures in a globalized patient population. Topics: Seizure, neurocysticercosis, epilepsy, parasitic infection. [ABSTRACT FROM AUTHOR]

Introduction: Previous reports described a pattern of hypoglycemiainduced damage predominantly affecting the parieto-occipital regions. The long-term neurological sequelae of severe neonatal hypoglycemic encephalopathy include developmental delay, poor head growth, learning or behavioral difficulties, visual impairment, and epilepsy. This study reports neurodevelopmental outcome of children with neonatal hypoglycemia-associated parieto-occipital brain injury who were evaluated in our pediatric neurology outpatient clinic for different neurological complaints. Methods: We retrospectively reviewed patients who were followed at Kocaeli University Hospital, Pediatric Neurology Department between 2007 and 2015. Patients (n=42) with predominately parieto-occipital lesions on magnetic resonance imaging (MRI) with the typical pattern of neonatal hypoglycemia were evaluated. Patients with documented hypoglycemia (n=21) were included in this study. Patients (n=9) with recurrent episodes of hypoglycemia longer than 12 hours were evaluated as prolonged hypoglycemia. Results: Eleven patients (52.4%) experienced seizures in the neonatal period. Eighteen patients (85.7%) developed epilepsy during the followup. Refractory seizures were observed in 8 patients (38.1%). Nine patients (42.9%) manifested microcephaly, seven patients (33.3%) manifested cerebral palsy. Parieto-occipital involvement and the spasticity rate were statistically high in patients with prolonged hypoglycemia (p<0.01). Two patients had autistic features and four patients (19%) had attention deficit hyperactivity disorder. VEP studies could be performed in 18 of 21 patients. All patients had abnormal VEP results. Conclusion: We are of the opinion that most patients of neonatal hypoglycemia are not always documented. Patients under risk and patients with symptoms of hypoglycemia should be vigorously screened and treated to prevent neurologic impairments including cerebral palsy, epilepsy and visual disturbance. [ABSTRACT FROM AUTHOR]

(1) Background: Cerebral palsy (CP) is associated with a higher incidence of epileptic seizures. This study uses a prediction model to identify the factors associated with epilepsy in children with CP. (2) Methods: This is a retrospective longitudinal study of the clinical characteristics of 102 children with CP. In the study, there were 58 males and 44 females, 65 inpatients and 37 outpatients, 72 had epilepsy, and 22 had intractable epilepsy. The mean age was 16.6 ± 1.2 years, and the age range for this study was 12–18 years. Data were collected on the CP etiology, diagnosis, type of epilepsy and spasticity, clinical history, communication abilities, behaviors, intellectual disability, motor function, and feeding abilities from 2005 to 2020. A prediction model, Epi-PredictMed, was implemented to forecast the factors associated with epilepsy. We used the guidelines of "Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis" (TRIPOD). (3) Results: CP etiology [(prenatal > perinatal > postnatal causes) p = 0.036], scoliosis (p = 0.048), communication (p = 0.018), feeding disorders (p = 0.002), poor motor function (p < 0.001), intellectual disabilities (p = 0.007), and the type of spasticity [(quadriplegia/triplegia > diplegia > hemiplegia), p = 0.002)] were associated with having epilepsy. The model scored an average of 82% for accuracy, sensitivity, and specificity. (4) Conclusion: Prenatal CP etiology, spasticity, scoliosis, severe intellectual disabilities, poor motor skills, and communication and feeding disorders were associated with epilepsy in children with CP. To implement preventive and/or management measures, caregivers and families of children with CP and epilepsy should be aware of the likelihood that these children will develop these conditions. [ABSTRACT FROM AUTHOR]

Both Alzheimer's disease (AD) and epilepsy are common chronic diseases in older people. Seizures and epileptiform discharges are very prevalent in AD and can occur since any stage of AD. Increasing evidence indicates that AD and epilepsy may be comorbid. Several factors may be related to the underlying mechanism of the comorbidity. Identifying seizures in patients with AD is a challenge because seizures are often clinically non-motor and may overlap with some AD symptoms. Not only seizures but also epileptiform discharges may exacerbate the cognitive decline in AD patients, highlighting the importance of early recognition and treatment. This review provides a comprehensive overview of seizures in AD from multiple aspects to provide more insight. [ABSTRACT FROM AUTHOR]

Seizure is one of the most common neurologic disorders in pediatric emergency department visits. Early detection of epilepsy development in children with afebrile seizures is important. We identified predictors of epilepsy development in children with their first afebrile seizure. In this retrospective multicenter study, we enrolled pediatric patients aged 1 month to 18 years who presented with afebrile seizures at the emergency department from January 2017 to December 2020. Multivariable logistic regression analysis was performed to identify factors associated with epilepsy development. A total of 417 pediatric patients were enrolled, 161 (38.6%) of whom developed epilepsy. From the multivariable logistic regression analysis, older age at onset (2–5 years, odds ratio [OR] 2.611, p = 0.010; 11–15 years, OR 3.138, p = 0.003; 16–18 years, OR 4.292, p = 0.002), longer seizure duration of more than 10 min (OR 4.869, p = 0.006), two or more seizures (OR 2.378, p = 0.004), lethargy (OR 2.341, p = 0.021), and a lactate level > 2.27 mg/dL (OR 4.205, p < 0.001) were significant predictors for the development of epilepsy in children experiencing their first afebrile seizure. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal of Tabriz University of Medical Sciences is the property of Tabriz University of Medical Sciences 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.)

Epilepsy often causes more severe behavioral problems in children with autism spectrum disorder (ASD) and is strongly associated with poor cognitive functioning. Interestingly, individuals with ASD without a history of epilepsy can have abnormal electroencephalographic (EEG) activity. The aim of this study was to examine associations between EEG abnormalities and the ASD severity in children. The children with ASD who enrolled at the Rajanagarindra Institute of Child Development, Thailand were included in this study. The severity of ASD was measured by interviewing their parents with the Thai autism treatment evaluation checklist. The short sensory profile checklist was used for screening the abnormality of children in each domain. Ordinal logistic regression analysis was used to examine associations between factors potentially linked to EEG abnormalities. Most of the study participants were boys (87.5%) and the median age was 5 years. Among the 128 children, 69.5% showed EEG abnormalities (41.4% slow-wave and 28.1% epileptiform-discharge). The results show that a larger number of symptoms and increased severity of ASD were independently associated with a higher risk of EEG abnormalities. Our results emphasize the need for guidelines on the presence of EEG abnormalities in children with ASD for the early detection of epilepsy and improving treatment outcomes. [ABSTRACT FROM AUTHOR]

CONTEXT: Severe hyperbilirubinemia is associated with kernicterus. Informed guidance on hyperbilirubinemia management, including preventive treatment thresholds, is essential to safely minimize neurodevelopmental risk. OBJECTIVE: To update the evidence base necessary to develop the 2022 American Academy of Pediatrics clinical practice guideline for management of hyperbilirubinemia in the newborn infant ≥35weeks' gestation. DATA SOURCE: PubMed. STUDY SELECTION: English language randomized controlled trials and observational studies. Excluded: case reports or series, nonsystematic reviews, and investigations focused on <35-weeks' gestation infants. DATA EXTRACTION: Topics addressed in the previous clinical practice guideline (2004) and follow-up commentary (2009) were updated with new evidence published through March 2022. Evidence reviews were conducted for previously unaddressed topics (phototherapy-associated adverse effects and effectiveness of intravenous immune globulin [IVIG] to prevent exchange transfusion). RESULTS: New evidence indicates that neurotoxicity does not occur until bilirubin concentrations are well above the 2004 exchange transfusion thresholds. Systematic review of phototherapy-associated adverse effects found limited and/or inconsistent evidence of late adverse effects, including cancer and epilepsy. IVIG has unclear benefit for preventing exchange transfusion in infants with isoimmune hemolytic disease, with a possible risk of harm due to necrotizing enterocolitis. LIMITATIONS: The search was limited to 1 database and English language studies. CONCLUSIONS: Accumulated evidence justified narrowly raising phototherapy treatment thresholds in the updated clinical practice guideline. Limited evidence for effectiveness with some evidence of risk of harm support the revised recommendations to limit IVIG use. [ABSTRACT FROM AUTHOR]

Purpose: Children with epilepsy commonly have cognitive deficits; however, full-length neuropsychological testing is time- and resource-intensive. Therefore, we evaluated the feasibility of using the modified Mini-Mental Scale Examination (MMSE) and the Digit Letter Substitution Test (DLST) to screen children with epilepsy for cognitive deficits. Methods: This was a prospective case-control study comparing scores on the MMSE and the DLST in children with epilepsy with normal age-matched controls between 8 and 12 years of age. Results: In 35 cases and 36 controls, the cases had significantly lower (P<0.05) mean scores than the controls. The correlation coefficient between the MMSE and DLST scores was 0.902 (P<0.001). Children with developmental or speech delays and an epilepsy duration ≥5 years had lower scores than those without the corresponding risk factors. Conclusion: This study demonstrated significantly lower scores on the MMSE and DLST in children with epilepsy than in controls, as well as significantly lower scores in patients with developmental or speech delays and an epilepsy duration ≥5 years. [ABSTRACT FROM AUTHOR]

Background: Epilepsy is a paroxysmal disorder of the brain, caused by an imbalance of neuronal excitation and inhibition. Glutamate is the most important excitatory neurotransmitter in the brain and plays an important role in epileptogenesis. Mutations in genes at any step/component of the glutamate metabolic pathway may lead to the development of epilepsy or epileptic encephalopathy. Methods: Clinical history of 3 epilepsy patients with genetic variations of the glutamate metabolism pathway was collected. Electroencephalogram recording and magnetic resonance imaging were performed in each patient. We also reviewed recent literature for a variety of the genetic variations involved in epilepsy. Results: Case 1 was a SLC1A2 mutation-carrier diagnosed with developmental and epileptic encephalopathy (DEE) 41, whose seizures decreased after start of the ketogenic diet. Case 2 carried a GRIN2A gene mutation and was seizure-free for three years after taking levetiracetam and vitamin B6. Case 3 was a GRIN2B mutation-carrier diagnosed with DEE 27, who seizures diminished after taking oxcarbazepine. Conclusions: Preclinical and clinical evidence supports the therapeutic potential of glutamatergic signaling-targeting treatments for epilepsy. More studies are needed to discover novel DEE-related genetic mutations in the glutamate metabolic pathway. [ABSTRACT FROM AUTHOR]

Introduction: Epilepsy is the most common childhood neurological illness, which occurs in four to six per 1000 children. The maximum incidence of epilepsy occurs in children less than 3 years of age. The main objective of our study was to describe the etiological spectrum, EEG, and neuroimaging abnormalities and predictors of intractability in epilepsy. Methodology: A cross-sectional observational study was conducted over a 2-year duration at Dr DY Patil Medical College, Pune, Maharashtra, India. Hundred eligible children with epilepsy aged 3months to 2 years were included in the study. Appropriate statistical test such as Chi-square test and P value has been applied. SPSS software version 23 was used in our study. Results: Out of 100 children, 45% were in the age group of 19--24 months with M:F = 1.1:1. The mean age of onset of seizure was 11.6 ± 3.3 months. The majority of children belonged to lower-middle-class families (56%). Developmental delay was seen in 50%, and 43% had refractory epilepsy. The most common seizure type was focal onset (47%), followed by generalized onset seizures (37%). EEG findings were abnormal in 66%, multifocal IEDs being the most common abnormality (54.55%). MRI brain was normal in 27 cases, and out of 73 abnormal MRIs, the most common pattern seen was changes of perinatal and postnatal insults (75.3%). There was a statistically significant correlation between the type of seizures and MRI pattern with abnormal EEG (P <0.001). In 23% of children, no etiology was found, structural cause--62 (perinatal: 55; cortical malformation: 7), metabolic cause--nine, genetic etiology--six cases. The factors associated with refractory epilepsy in our cohort were the presence of developmental delay, abnormal neurological examination, abnormal EEG, and abnormal MRI (P < 0.001). Conclusion: Our study described the etiological spectrum of infantile-onset epilepsy, with the most common being acquired cause because of perinatal and postnatal insult to the developing brain. Earlyonset seizures have a high possibility of intractability, especially if it is associated with developmental delay, abnormal neurological examination, EEG, and neuroimaging. [ABSTRACT FROM AUTHOR]

Abnormalities in the plasma amino acid and/or urinary organic acid profile have been reported in autism spectrum disorder (ASD). An imbalance between excitatory and inhibitory neuronal activity has been proposed as a mechanism to explain dysfunctional brain networks in ASD, as also suggested by the increased risk of epilepsy in this disorder. This study explored the possible association between presence of EEG paroxysmal abnormalities and the metabolic profile of plasma amino acids and urinary organic acids in children with ASD. In a sample of 55 children with ASD (81.8% male, mean age 53.67 months), EEGs were recorded, and 24 plasma amino acids and 56 urinary organic acids analyzed. EEG epileptiform discharges were found in 36 (65%) children. A LASSO regression, adjusted by age and sex, was applied to evaluate the association of plasma amino acids and urinary organic acids profiles with the presence of EEG epileptiform discharges. Plasma levels of threonine (THR) (coefficient = −0.02, p = 0.04) and urinary concentration of 3-Hydroxy-3-Methylglutaric acid (HMGA) (coefficient = 0.04, p = 0.02) were found to be associated with the presence of epileptiform discharges. These results suggest that altered redox mechanisms might be linked to epileptiform brain activity in ASD. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the incidence and risk factors associated with the unplanned removal of nasogastric (NG) tubes in neurocritical patients. Methods: Data were collected retrospectively from the medical records of 479 patients admitted to the tertiary hospital's neuro-intensive care units (NCU). Subjects were divided into two groups depending on whether there was unplanned NG tube removal. Multivariate logistic regression analysis was used to identify risk factors. Results: Unplanned removal of NG tubes occurred in 35.9% of patients. The incidence of unplanned NG tube removal was 47.2 per 1,000 patient days. Intubated time of the NG tube was 3.96 days in patients with unplanned removal. Risk factors associated with unplanned removal were men (Odds Ratio [OR]=2.19), epilepsy (OR=9.99), traumatic brain injury (OR=5.50), stroke (OR=4.42), improvement of Glasgow Coma Scale (GCS) (OR=1.08), delirium (OR=1.88), physical restraint (OR=2.44), and drainage or decompression purpose (OR=1.67). Conclusion: Unplanned removal of NG tubes occurred very frequently in neurocritical patients. Care should be taken for patients with neurological diseases who show improvement in their level of consciousness but are still confused due to brain lesions or delirium to reduce it. The application of physical restraints cannot guarantee the prevention of unplanned NG tube removal. Therefore, nurses need to assess the condition of patients and NG tubes frequently. In particular, more attention should be paid to using NG tubes for decompression or drainage purposes. It is also proposed to actively review the NG tube removal plan through periodic evaluation. [ABSTRACT FROM AUTHOR]

Objective: We investigated medical comorbidities in patients with functional seizures (FS) and those with epilepsy (idiopathic generalized epilepsies [IGEs] or temporal lobe epilepsy [TLE]). We hypothesized that the nature of medical comorbidities differs between these three groups. This might be helpful to postulate on the pathophysiology of FS. Materials and Methods: In a retrospective study, all adult patients with a diagnosis of IGE, TLE, or FS were recruited at the outpatient epilepsy clinic at Shiraz University of Medical Sciences, Iran, from 2008 until 2020. The three groups of patients were matched with regard to their age. Age, sex, and medical comorbidities were registered routinely for all patients at the time of the first visit. Results: Nine hundred and sixty-six patients were studied (254 patients with IGE, 467 persons with TLE, and 245 individuals with FS). The groups differed significantly with regard to having medical comorbidities. The most striking difference was comorbid thyroid disorders; this was more common among patients with FS. The diagnosis of FS was independently significantly associated with thyroid disorder comorbidity (odds ratio: 2.77, 95% confidence interval: 1.06-7.23; P = 0.038). Conclusion: Thyroid disorders are significantly associated with FS. We can make the following suggestions to advance the field: a. It is necessary to reproduce this observation in larger multicenter studies; b. We recommend to evaluate thyroid function in all patients with FS; c. It might be helpful to design clinical trials to investigate whether correction of any clinical or subclinical thyroid disorders changes the treatment outcome in patients with FS. [ABSTRACT FROM AUTHOR]

Objective To assess the bi-directional associations of epilepsy with dementia and Alzheimer's disease (AD). Methods We searched PubMed, Embase and the Cochrane Library for longitudinal studies assessing the associations of epilepsy with dementia and AD up to 4 August 2021. Two authors independently extracted study characteristics, exposures, outcomes and covariates. Summary hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled using a random effects model. Results From 8,545 articles identified in the initial research, 27 publications describing 20 longitudinal studies were included in the final analyses. There were 10 studies on epilepsy predicting risk of dementia, 5 studies on epilepsy predicting risk of AD, 11 studies on dementia predicting risk of epilepsy, and 6 studies on AD predicting risk of epilepsy. Baseline epilepsy was associated with higher risk of dementia (pooled HR 2.00; 95% CI 1.73–2.33) and AD (pooled HR 1.81; 95% CI 1.19–2.75). The pooled HRs for epilepsy associated with baseline dementia and AD were 2.91 (95% CI) 2.11–4.01) and 3.11 (95% CI 2.47–3.90), respectively. These positive associations persisted in sensitivity and subgroup analyses. Conclusions Our findings suggested positive and bi-directional associations of epilepsy with dementia and AD. However, these associations should be carefully interpreted due to the presence of substantial heterogeneity, and they need to be verified in additional high-quality studies. [ABSTRACT FROM AUTHOR]

The literature from inception to 2020 on the prevalence of epilepsy in autistic individuals was systematically reviewed and further explored by subgroup analyses and meta-regression models. This systematic review is registered with PROSPERO (CRD42020179725). A total of 66 studies from 53 articles were included. The updated pooled prevalence of epilepsy in autistic individuals was 10% (95% CI: 6–14). The respective prevalence estimate of epilepsy was 19% (95% CI: 6–35) in the clinical sample-based cross-sectional study, 7% (95% CI: 3–11) in the cohort study, and 9% (95% CI: 5–15) in the population-based cross-sectional study. The pooled prevalence of epilepsy was 7% (95% CI: 4–11) in autistic children and 19% (95% CI: 14–24) in autistic adults. Compared to the school-aged group, the adolescence group (OR: 1.15, 95% CI: 1.06–1.25) and the pre-school group (OR: 1.06, 95% CI: 0.94–1.19) were positively associated with the prevalence of epilepsy. The moderators of age, human development index of the country, gender, and intellectual function accounted for most of the heterogeneity. The prevalence estimates were associated with age, female gender, intellectual disability rate, and the human development index of countries. About 1/10 autistic individuals co-occurred with epilepsy, which was common in the clinical setting, adolescents, adults, females, or patients with intellectual disability, and less common in the country with high human development index. Autistic individuals experience higher co-occurring medical conditions than the general population, and yet the estimates of autistic individuals with epilepsy are not updated. Co-occurrence of epilepsy in autistic individuals often aggravated cognitive impairment and increased the risk of poor long-term prognosis. Thus, an updated systematic review and meta-analysis was conducted to study the relevant articles published from inception to 2020, evaluate the prevalence of epilepsy in autistic individuals, and further explore the putative factors influencing the prevalence. A total of 66 studies from 53 articles were included in this study. The results showed that epilepsy is more common in autistic individuals than in the general population. The prevalence of epilepsy in autistic individuals in the clinical sample-based studies was higher than that in the population-based based cross-sectional or cohort studies. The prevalence of epilepsy in autistic adults was higher than that in autistic children. A significantly increased prevalence of epilepsy was detected in the autistic adolescent group (11–17 years old), and a higher trend of prevalence of epilepsy was observed in the autistic pre-school group (⩽ 6 -years-old) than that of the autistic school-aged group (7–10 years-old). The prevalence of epilepsy increased with age, female rate, and low intellectual function rate of autistic individuals. However, the human development index of countries was negatively associated with the pooled prevalence, which could be attributed to the different levels of awareness, diagnostic technologies, and autism-service support worldwide. About 1/10 autistic individuals also had epilepsy, which was common in the clinical setting, adolescents, adults, females, or patients with intellectual disability and less common in the country with high human development index. Thus, these findings provided critical and innovative views on the prevalence of epilepsy in autistic individuals and contributed to the targeted clinical management and preventive measures. [ABSTRACT FROM AUTHOR]

Stroke is a common cause of acquired epilepsy, and nearly 50% of post-stroke epilepsy (PSE) patients are elderly. Hemorrhage has a higher incidence of post-stroke seizure (PSS) than ischemic stroke, and reports were 7% overall. PSS has different pathophysiology and is classified into early seizure, within seven days, or late seizure, which is beyond seven days after stroke. According to the latest definition, a single late PSS is qualified as structural epilepsy because of a 71.5% high risk of recurrence. Cortical involvement and early seizure are the most important risk factors for subsequent development of PSE, but no evidence supports the use of primary anti-epileptic drug (AED) prophylaxis. Statins used in the acute stage, within three days, can reduce incidence and prevent progression into chronic PSE. Comorbidity and drug-drug interactions should take into account for managing PSE, especially in the elderly population. A particular concern has raised on the increase in thrombotic events when using nonvitamin K antagonist oral anticoagulants and enzyme-inducing AEDs. Further studies on epilepsy connectome and genetic modification on synaptic plasticity, neuronal excitability should gain insight into disease-modifying treatment strategies. [ABSTRACT FROM AUTHOR]

Objectives: Pneumonia cases that first started in Wuhan were defined as Severe Acute Respiratory Syndrome Coronavirus-2 by The World Health Organization in January 2020. Neurological complications such as epileptic seizures may occur during COVID-19 infection. These seizures may occur for the first time or in the form of acute seizures that can be observed in epilepsy patients during the course of the disease. Methods: Demographic data of the patients, presence of the diagnosis of epilepsy disease, accompanying diseases, number of seizures during hospitalization, follow-up to the intensive care unit, COVID-19 clinical day during seizures, presence of disease that can be detected in the etiology of epilepsy, and discharge status were examined in this retrospectively planned study. Results: Seizure rate was determined to be 0.57% in these patients. 18 (58.1%) patients did not have a history of epilepsy, whereas 13 (41.9%) patients had a history of epilepsy. It was found that mortality was higher in the first seizures; there was no difference between age, gender, COVID-19 clinical day, presence of hospitalization in the intensive care unit, and Modified Charlson Comorbidity Index when the data of patients with and without epilepsy were compared. Conclusion: COVID-19 infection can increase the likelihood of seizures like other viral infections, but we do not have strong data that it can trigger seizures in different ways compared to other viral agents with all the data. [ABSTRACT FROM AUTHOR]

Seven point five per cent of births in Portugal in 2021 were premature live births (INE, 2023). According to the medical journal of the American Academy of Neurology, being born prematurely (23-31 weeks) may increase five times the risk of being hospitalised for epilepsy in adulthood when compared to those who were born full-term (Crump et al., 2011). The present analysis aimed to determine research hotspots and prospective directions of the relation between prematurity and epilepsy research. Research about epilepsy related to prematurity was done in Web of Science (WoS) and PubMed database, considering the data between the first of January 2013 and the twentieth of June 2023. The descriptors used were: "(epilepsy OR convulsion OR seizure OR epileptic) AND (prematurity) AND (childhood OR children OR child OR infancy OR pediatric OR kids)". The data extracted from Software R(V.4.3.0) in R format was analysed in the Bibliometrix program (http://www.bibliometrix.org (accessed 20/06/2023)), and the outcome was organised by sources, authors, affiliations, countries, keywords and the evolution of the research along time. One thousand and eighty-two articles were considered for analysis. Research growth since 2015, especially in 2022, was noticeable. USA, Israel and Australia are the countries with the largest number of publications, which was correlated with the affiliations with more research on the area (Tel Aviv University, Baylor College of Medicine and the University of Melbourne, from highest to lowest) and with the principal used keywords (humans, female, male and "infant, newborn"). The most relevant journal was Pediatric Neurology, and the most cited one was Pediatrics. Thomas Michael O'Shea (17 documents) and Francesco Pisani (16 documents) were the ones with the highest number of publications, and the most relevant affiliation was Columbia University Irving Medical Center (99 articles). The trend topics indicate microencephaly/genetics and "infant, newborn, diseases" as the most recently used. The country with the most citations was the USA (100 citations), and the one with the most collaborations. Portugal's collaborations mainly involved European countries but also with the USA, Egypt, Iran, and Israel. The USA is the country that publishes the most. Despite the large initial number, the most cited and relevant articles focus on a much smaller number. The most studied topics are currently microencephaly, genetics, infant, newborn and diseases. It would be important that future research focus on the relevance of these topics related to the incidence of cases in the population of the most influential countries. [ABSTRACT FROM AUTHOR]

To date, no guideline exists for the management of epilepsy in patients with prolonged Disorders of Consciousness (DoC). This review aimed to assess the occurrence of epilepsy and epileptic abnormalities (EA) in these patients, to determine their impact on recovery; and to review the effect of antiepileptic drugs (AED) and therapeutic interventions on seizure occurrence and consciousness recovery. A structured search for studies on prolonged DoC and epilepsy was undertaken following PRISMA guidelines. From an initial search resulting in 5,775 titles, twelve studies met inclusion criteria. The occurrence of epilepsy and EA in DoC was poorly and inconsistently reported across studies. The results estimated a seizure prevalence of 27% in DoC. No conclusive data were found for the effects of AED on recovery nor on the influence of any therapeutic interventions on seizure occurrence. Given the scarcity of data, it is premature to make evidence-based recommendations on epilepsy in prolonged DoC. Based on this review and current clinical practices the following are recommended: (1) repeated standard EEG for detecting seizures and EA; (2) treating epilepsy while avoiding AEDs with sedating or cognitive side-effects. Future research should use standardized classification systems for seizures and EA. [ABSTRACT FROM AUTHOR]

Aggression, aggressive behaviors, and violence are common phenomena in human beings including children, adolescents, and young adults. Aggression is a symptom of various disorders that can be medical, psychiatric, and combinations of these categories, such as substance use disorders. This discussion provides definitions of aggression and violence as well as consideration of etiologic concepts. Management of aggression depends on the underlying contribution disorders and includes behavioral approaches as well as potentially, pharmacologic interventions. Aggression in humans leads to severe consequences in the victims including turbulent trauma and even death. [ABSTRACT FROM AUTHOR]

Objectives We aimed to investigate the risk factors predicting the development of intractable epilepsy in children with cerebral palsy (CP), with an emphasis on perinatal characteristics, seizure semiology, imaging, and EEG findings. Materials & Methods Following a descriptive, retrospective, case-control design, 106 children with CP and epilepsy from 2015 to 2020 were studied (46 children with CP and intractable epilepsy and 60 with CP and controlled epilepsy). Data were retrieved from medical records of participants (i.e., demographics, clinical characteristics, perinatal history, etiology of seizure and CP, seizure semiology, intellectual functions, therapeutic options, brain imaging, and EEG findings). Results We established a model of the most important risk factors that can predict intractable epilepsy in children with CP. The model included the additive effect of a poor Apgar score at 5 minutes, the presence of neonatal seizures, focal epilepsy, and focal slowing on the EEG background (Area under the receiver operating characteristic of 0.810). Conclusion The findings can be used to identify intractable epilepsy in children who suffer from CP with further support by offering early therapeutic interventions intended to reduce the burden of refractory seizures. [ABSTRACT FROM AUTHOR]

Objective: Describes dental, occlusal, and craniofacial characteristics of 3 children aged 3 to 4 years with microcephaly due to congenital Zika infection in Cali Valle del Cauca, 2020. Design: Three children case report with congenital Zika virus microcephaly. Setting: Institutional Patients: Three children with maternal viral infection confirmed by polymerase chain reaction during first trimester of pregnancy were included and were born from 2016 to 2017. Interventions: Oral and mouth functional examination was performed including soft tissue examination; lingual and labial frenulum; evaluation of swallowing and chewing; craniofacial analysis; dimension of dental arch; intercanine and intermolar distance, palate form; relationship and growth of maxilla, mandible, and facial dental midline using plaster models; and complementary image analysis. Main Outcome Measures: Child and mother sociodemographic features, craniofacial measurements; dental and oral features; maxillary and mandibular measures; and speech, swallowing, and chewing disorders. Results: Small head circumference at birth and at the time of clinical evaluation was compared to normal children of approximately their age. Upper third of the face was short, and presence of hypertonic masticatory muscles with hypotonic swallowing muscles, dysphagia, dyslalia, bruxism, lip incompetence, tongue interposition, and hypersalivation and epilepsy were the main medical problem. They have complete primary dentition with normal dental morphology, tooth eruption altered, dental caries, and dental malocclusion was identified. Conclusion: There are no changes in the dental formula and dental morphology in the deciduous dentition. They present severe chewing and speaking limitation, facial disproportion, and occlusal problems that warrant dental and medical attention. [ABSTRACT FROM AUTHOR]

Objectives: (a) The objective of the study was to assess the control of seizure in glioblastoma patients receiving anti-epileptic drugs and chemotherapies after total resection and its association with O-methylguanine-DNA methyltransferase (MGMT) promoter methylation and the isocitrate dehydrogenase 1 (IDH1) mutation; (b) to determine which anti-epileptic drug exerts the best effective control on glioblastoma-associated epilepsy; and (c) to identify the relationship between seizure control and anti-epileptic drugs with recurrence interval. Methods: This was a retrospective cohort study of patients with postoperative glioblastoma-associated epilepsy. The correlation between IDH1 mutation and MGMT methylation with anti-epileptic drugs, chemotherapy type, seizure control, and recurrence interval was analyzed. Results: The study included 53 patients with glioblastoma-associated epilepsy. IDH1 mutation was present in 20 patients, and MGMT methylation was present in 13 patients. 37 cases received chemoradiotherapy while 16 cases received only radiotherapy. Levetiracetam was the most prescribed anti-epileptic drug (n=36, 60%), and 36 and 16 patients had controlled and uncontrolled seizures, respectively. IDH1 mutation and unmethylated MGMT were significantly present in cases with controlled epilepsy (p<0.05). Levetiracetam showed significantly better seizure control in cases with IDH1 mutation and unmethylated MGMT promotor (p<0.05). Conclusion: (a) Glioblastoma-associated epilepsy can be better controlled in patients with the IDH1 mutation and unmethylated MGMT, (b) levetiracetam was the first-line anti-epileptic drug for controlling seizure, (c) lack of seizure control in glioblastoma patients may not be related to tumor recurrence despite 1-year treatment, and (d) better understanding of the risk factors associated with glioma-associated epilepsy are needed to improve patient quality of life. [ABSTRACT FROM AUTHOR]

Background: We aimed to study the radiological and epilepsy outcomes of children with multiple neurocysticercosis (NCC) and the relationship with hippocampus volume. Study Design: Observational study. Materials and Methods: Children between 5 and 18 years of age with NCC lesions and completed more than 2-year follow-up were enrolled. Magnetic resonance imaging (MRI) brain with a predefined protocol was done as per clinical indication, and bilateral hippocampi volume was measured with a region of interest-based manual method. Proportion of children who had radiological resolution of lesions, proportion of children who were seizure-free for at least 3 months after antiepileptic drugs withdrawal, and mean hippocampi volume were calculated. Results: During the study period, 229 children followed up in pediatric NCC clinic were enrolled, the mean age was 10.5 ± 3 years, and 129 (56%) were boys. A total of 159 (65%) children had single-lesion NCC, and 79 (35%) had multiple lesion (> 2) NCC. Resolution of lesions was seen in 8% children with multiple NCC, significantly less as compared to the single NCC group (8% vs. 27%, P = 0.006). Multiple-lesion NCC group had a higher rate of calcification as compared to children with a single lesion (66% vs. 47%, P = 0.008). Twenty-nine (37%) children with multiple-lesion NCC were seizure free for at least 3 months after antiepileptic drug withdrawal. Mean combined hippocampal volume in children with single-lesion NCC was 2.96 (0.62) mL and multiple-lesion NCC was 2.88(0.43) mL. Conclusion: Children with multiple-lesion NCC have lower resolution, and higher calcification during follow-up in comparison to single-lesion NCC. Frequency of children who remained seizure-free 3-month post AED withdrawal was similar in single- and multiple-lesion groups. [ABSTRACT FROM AUTHOR]

The article focuses on epilepsy is a serious neurological condition which causes seizures can manifest as disturbances of consciousness, behaviour, cognition, emotion, motor function, or sensation. Topics include the focal seizures is originate in neural networks limited to one hemisphere, the focal seizures are divided into those with retained awareness or impaired awareness, and the generalised seizures is originate in bilaterally distributed neural networks.

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri 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.)

Stroke is the leading cause of seizures and epilepsy in older adults. Patients who have larger and more severe strokes involving the cortex, are younger, and have acute symptomatic seizures and intracerebral haemorrhage are at highest risk of developing post-stroke epilepsy. Prognostic models, including the SeLECT and CAVE scores, help gauge the risk of epileptogenesis. Early electroencephalogram and blood-based biomarkers can provide information additional to the clinical risk factors of post-stroke epilepsy. The management of acute versus remote symptomatic seizures after stroke is markedly different. The choice of an ideal antiseizure medication should not only rely on efficacy but also consider adverse effects, altered pharmacodynamics in older adults, and the influence on the underlying vascular co-morbidity. Drug–drug interactions, particularly those between antiseizure medications and anticoagulants or antiplatelets, also influence treatment decisions. In this review, we describe the epidemiology, risk factors, biomarkers, and management of seizures after an ischaemic or haemorrhagic stroke. We discuss the special considerations required for the treatment of post-stroke epilepsy due to the age, co-morbidities, co-medication, and vulnerability of stroke survivors. [ABSTRACT FROM AUTHOR]

Objective Febrile seizure is the most common worrisome neurologic disorder in children in terms of parental point of view. The purpose of this study was to answer distressing parents' questions about the prevalence and possibility of febrile seizure recurrence. Materials & Methods 140 patients who were admitted due to the first febrile seizure in the six months (March up to September) of the year 2015 were enrolled to this study. Exclusion criteria include central nervous system infection, non-confirmed febrile seizure and lack of parental acceptance for long-term inclusion in this study. All children were followed in terms of second febrile seizure during one year follow-up from the time of first febrile seizure. (3 sentences were deleted). Results Recurrence of febrile seizure was 25.7 % during one-year follow-up. Significant risk factors for recurrence include: age less than one year old, male gender, seizure with low level of fever, family history of epilepsy, family history of febrile seizure, complex febrile seizure (focal and repeated in 24 hours), seizure duration more than 15 minutes and parental indifference to the onset of fever in their children before seizure occurrence. Although duration of fever before seizure, failure to thrive, positive history of admission in neonatal period, dystocia at birth delivery and children with day care staying were associated with greater febrile seizure recurrence; but, they did not have significant relationship with recurrence rate. Prophylaxis with benzodiazepine reduced the recurrence rate. Conclusion Chance of febrile seizure recurrence in one-year follow-up increased in presence of risk factors expressed in finding part. parental indifference to the onset of fever in their children that is starting before seizure was a considerable risk factor in terms of recurrence prevalence. We recommended to emphasis on parental education about this new finding as a risk factor for febrile seizure in order to prevent its future recurrence. [ABSTRACT FROM AUTHOR]

Neurodevelopmental disorder caused by malformations of cortical development is a rare neurological disease. Heterozygous missense variants in the TUBG1 gene lead to malformations of human cortical development, which further result in intellectual disability, developmental retardation, and epilepsy. To the best of our knowledge, only thirteen patients and a total of nine pathogenic TUBG1 variants have been described in the published literature. This study reports the case details and genetic data analysis of a girl (aged 8 years, 9 months) with developmental delay, psychomotor regression, epilepsy, and left external ear deformity. A novel TUBG1 mutation was identified by whole-exome sequencing and Sanger sequencing, confirming that this mutation may be the cause of the neurodevelopmental disorders. This case report characterizes the phenotypic spectrum, molecular genetic findings, and functional consequences of novel pathogenic TUBG1 variants in neurodevelopmental disorders caused by cortical development malformations. [ABSTRACT FROM AUTHOR]