Jafar Mehvari-Habibabadi; Mohammad Zare; Mohammad Reza Aghaye-Ghazvini; Maryam Rahnama
Volume 21, Issue 4 , October 2022, , Pages 224-229
Abstract
Background: Levetiracetam (LEV) is approved for treating epilepsy. The current evidence shows that LEV can cause behavioral problems such as depression. It is well-known that depression is associated with oxidative stress. Therefore, we conducted this study to assess the influence of LEV on depression ...
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Background: Levetiracetam (LEV) is approved for treating epilepsy. The current evidence shows that LEV can cause behavioral problems such as depression. It is well-known that depression is associated with oxidative stress. Therefore, we conducted this study to assess the influence of LEV on depression severity and anti-oxidant status.Methods: In this prospective longitudinal study, 50 patients with diagnosis of epilepsy on LEV were included. We used Beck Depression Inventory-II (BDI-II) to assess depression severity. The serum levels of zinc and glutathione were measured as anti-oxidant markers. These variables were evaluated at the baseline and 3 months after the commencement of LEV.Results: A total of 30 patients finished the follow-up. Among them, 21 patients were women. The mean age at baseline was 28.76 ± 11.37 (range: 16-68 years). The severity of depression at the last follow-up was significantly higher than the baseline. We observed a decrease in the serum levels of zinc and glutathione, though they were not statistically significant.Conclusion: Our results suggest that LEV can increase the risk of depression in patients with epilepsy. This study also suggests that zinc depletion can be induced through act of LEV. Further studies are needed to validate these findings
Ladan Afsharkhas; Shabnam Zamani; Azita Tavasoli; Babak Zamani; Atefeh Talebi
Abstract
Background: A wide range of adherence to the use of anti-seizure medications has been reported among children with the disease, and accordingly, various factors on the degree of adherence to the drug have been reported. But in our society, there is no clear picture of drug adherence and related factors ...
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Background: A wide range of adherence to the use of anti-seizure medications has been reported among children with the disease, and accordingly, various factors on the degree of adherence to the drug have been reported. But in our society, there is no clear picture of drug adherence and related factors among children with seizures. We evaluated the frequency of adherence to anti-seizure medication as well as related factors.Methods: This cross-sectional study was conducted on 120 children with epilepsy who referred to Ali Asghar Hospital in Tehran, Iran, during 2019 and 2020. Along with demographic characteristics, adherence to antiepileptic medications was assessed by the Modified Morisky Medication Adherence Scale [E1] (MMAS).Results: The overall frequency of adherence to anti-seizure medications among children was reported to be about 41.7%. Among all baseline characteristics, much higher adherence was revealed in patients with educated parents. The rate of drug adherence in children with a history of perinatal morbidities was much lower than in other patients. The type of seizure could also affect the rate of drug adherence as the highest and the lowest adherence was found concerning focal impaired awareness seizure (57.1%) and atonic seizures (11.1%) indicating a significant difference (P = 0.022). The most common causes of non-adherence to treatment were expressing inability to treat the patient (23.0%), parents’ forgetfulness to give medicine to the child (18.3%), and not taking medication when traveling or leaving home (16.7%).Conclusion: The lower level of education of the parents, type of seizure, as well as the presence of underlying perinatal morbidity in the child can predict non-compliance with anticonvulsant medication regimens among affected children.
Shahram Oveisgharan; Fariborz Ghaffarpasand; Peter Sörös; Mustafa Toma; Nizal Sarrafzadegan; Vladimir Hachinski
Abstract
During the past 30 years, rate of coronary artery disease, as the main cause of sudden death, has decreased more than rate of sudden death. Likewise, cause of sudden death remains elusive in not a trivial portion of its victims. One possible reason is attention to only one organ, the heart, as the cause ...
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During the past 30 years, rate of coronary artery disease, as the main cause of sudden death, has decreased more than rate of sudden death. Likewise, cause of sudden death remains elusive in not a trivial portion of its victims. One possible reason is attention to only one organ, the heart, as the cause of sudden death. In fact, sudden death literature focuses more on the heart, less on the brain, and seldom on both. A change is required. In this paper, we first review the pathological findings seen in heart autopsies of sudden death victims after psychological stressors such as physical assault victims without internal injuries. Then, we summarize new studies investigating brain areas, like the insula, whose malfunctions and injuries are related to sudden death. Then, we review prototypes of neurological diseases and psychological stressors associated with sudden death and look at heart failure related sudden death providing evidence for the brain-heart connection. Finally, we propose a new look at sudden death risk factors considering both brain and heart in their association with sudden death, and review strategies for prevention of sudden death from this perspective.
Ozlem Yayici Koken; Ayse Aksoy; Ozge Kucur; Mehpare Kafali
Abstract
Background: The aim of this study was to identify the demographic-clinical variables affecting idiopathic epilepsy (IE) [called genetic generalized epilepsy (GGE)] recurrence and determine cut-off values that can be used in pediatric neurology practice for children with IE/GGE. Methods: A total of 250 ...
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Background: The aim of this study was to identify the demographic-clinical variables affecting idiopathic epilepsy (IE) [called genetic generalized epilepsy (GGE)] recurrence and determine cut-off values that can be used in pediatric neurology practice for children with IE/GGE. Methods: A total of 250 children and adolescents with IE/GGE were included and retrospectively evaluated. The patients’ hospital records were examined in order to identify possible electro-clinical features affecting epilepsy recurrence. Results: The overall rate of recurrence in the patients was 46%; the age at onset of seizures in recurrence group was lower (P = 0.040) and the age at last seizure was higher in the recurrence group (P < 0.001) than that in the non-recurrence group. Other factors found to be related to recurrence were the shorter duration of the seizure-free period (P = 0.030), shorter interval between the last seizure and antiepileptic drug (AED) withdrawal (P = 0.003), shorter duration of AED withdrawal (P = 0.005), and the existence of abnormalities on sleep electroencephalogram (EEG) during AED withdrawal (P = 0.010) and at the 6th month of withdrawal (P < 0.001). According to receiver operating characteristic (ROC) analysis, the risk of IE recurrence was higher in children who were younger than 3.6 years old (sensitivity: 65.6%, specificity: 62.7%), children with a seizure-free period that was shorter than 35.5 months (sensitivity: 89.6%, specificity: 32.8%), and children whose drug withdrawal period was shorter than 4.5 months (sensitivity: 56.3%, specificity: 71.6%). Conclusion: This study defined some electro-clinical factors that could guide clinicians when deciding to withdraw AEDs with regard to recurrence risk after evaluating a homogenous population of children with a diagnosis of IE/GGE.
Hamid Nemati; Maryam Jalalipour; Shadi Niliyeh; Behjat Maneshian
Abstract
Background: Epilepsy is the most common pediatric neurologic disease accompanying with psychosocial delays causing a child’s isolation from the society. Developmental language delays are among the most common complaints of children with epilepsy. In the current study, verbal skills and expressive ...
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Background: Epilepsy is the most common pediatric neurologic disease accompanying with psychosocial delays causing a child’s isolation from the society. Developmental language delays are among the most common complaints of children with epilepsy. In the current study, verbal skills and expressive and receptive language development have been assessed in patients with epilepsy and compared with age-matched normal group. Methods: This case-control study was conducted on 78 2-5-year-old children with epilepsy and 78 age-matched normal children referred to the outpatient clinic of Imam Reza affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, in 2017-2018. Demographic information of cases (age, age of onset, type of seizure, and number of consumed remedies) and controls was gathered. In order to assess study population’s verbal, receptive, and expressive language development, Newsha growth measurement test, a validated Persian version of verbal language development questionnaire, was utilized. Results: Comparison of children with epilepsy with normal controls showed a significant difference in spoken, expressive, and receptive language development between children with epilepsy and normal peers (P < 0.05). Spoken and receptive language developments were significantly in association with earlier age of onset, higher number of remedies received for seizure control, generalized type of seizures, and lacking of seizure control (P < 0.05). Expressive language development showed no association with type and control of seizures (P > 0.05) but had significant association with age of onset of epilepsy and number of remedies (P < 0.05). Conclusion: Assessment of verbal language development aspects among children with epilepsy showed a higher rate of delay among these children as compared with normal age-matched ones. Moreover, earlier age of onset, generalized type of seizures, higher number of consumed remedies, and poor seizure control were accompanied with higher and more severe speech and language delay.
Kaveh Shafiei; Mohammad Ali Shafa; Forugh Mohammadi; Ali Arabpour
Abstract
Background: Facial emotion recognition (FER) is a complex process, involving many brain circuits, including the basal ganglia that its motor involvement causes Parkinson's disease (PD). The previous studies used different tools for assessment of FER in PD. There is a discrepancy between the results of ...
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Background: Facial emotion recognition (FER) is a complex process, involving many brain circuits, including the basal ganglia that its motor involvement causes Parkinson's disease (PD). The previous studies used different tools for assessment of FER in PD. There is a discrepancy between the results of these studies due to different tools. In this study, we used a modified version of the Multimodal Emotion Recognition Test (MERT) to compare patients with PD to healthy controls (HCs). Methods: It was a cross-sectional study with primary objective of the mean percentage of the correct answers in MERT. Subjects had to name the emotions presented with different modalities. Results: 30 subjects were recruited and assessed in each group. The mean total MERT score was significantly lower in subjects with PD compared to HCs (35.0% vs. 44.5%). FER was significantly better when emotions were presented by video and worse when presented by still pictures. Both subjects with PD and HCs had lower MERT scores in recognizing negative emotions. There was no significant correlation between the duration and severity of PD and MERT score. Conclusion: Our study provided more pieces of evidence for impairment of FER in PD for recognizing emotions like sadness, disgust, and fear compared to happy expressions.
