Objective: To determine neurodevelopmental and seizure prognoses in our patients with West syndrome receiving adrenocorticotropic hormone (ACTH) therapy, and to identify the factors affecting these.Methods: We determined the demographic factors, previous seizure histories, ACTH use and drug response times, and etiological reasons of 34 patients diagnosed with West syndrome in our clinic at 3-24 months old and receiving ACTH therapy. We also investigated their neurological development and its effect on seizure prognosis.Results: We found a significant relationship between patients experiencing seizures before diagnosis and subsequent seizure prognosis. We also defined a later response to ACTH and poorer neurodevelopment and seizure prognoses in patients with symptomatic etiologies. Global developmental delay was identified in 76% of all cases, and seizures persisted despite antiepileptic drugs in 62%.Conclusions: Symptomatic etiological factors in West syndrome adversely affect the neurodevelopmental process and subsequent seizure prognosis.
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Aim: To determine serum iron, ferritin, folate, and vitamin B12 deficiency and associated hemoglobin (Hb),hematocrit (Hct), mean corpuscular volume (MCV), and red cell distribution width (RDW) values in childrenundergoing febrile seizure, and thus to reveal their potential etiological role.Method: The serum iron, folate, vitamin B12, and ferritin, and Hb, Hct, MCV, and RDW values of 98 patientsundergoing FS and presenting to the pediatric neurology department and of 64 control patients were retrievedretrospectively and compared. Patient group data were also compared within the group.Results: Serum iron, ferritin, and vitamin B12 values were significantly lower in the patient group than in thecontrol group. Intragroup comparison revealed higher RDW values in patients with more than three FS and inthose with complicated seizures.Conclusion: This is the first study to investigate the relationship between vitamin B12, folate, and irondeficiency and FS. It should be remembered that deficiencies in these micronutrients, which are not routinelyinvestigated in patients presenting with FS, may play a role in the etiology, and that the frequency can decreasewith treatment. It should also not be forgotten that FS patients with high RDW values may be at risk of frequentseizure recurrence.
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Objectives: The purpose of this study was to investigate the risk factors for epilepsy development following febrile seizure (FS).Methods: This study included 449 patients undergoing first FS between 2014 and 2017. The sociodemographic, clinical, and electroenceph-alography (EEG) characteristics of the patients were retrieved from hospital records. Patients followed-up for at least 3 years after FS were divided into two groups (epilepsy and FS group; FS only group).Results: Of the 449 patients followed-up due to FS (238 [53.2%] boys and 211 [46.8%] girls), 42 (9.4%) were diagnosed with epilepsy during follow-up. The mean age at the time of the first FS was 21.4±14.5 months. A positive family history of FS and epilepsy was observed in 217 (48.3%) and 66 (14.7%) patients, respectively. In terms of FS characteristics, the prevalence of complex FS was significantly higher in the sub-sequent epilepsy group. The presence of a history of perinatal asphyxia and epileptiform or background abnormality findings at first EEG was also significantly higher in the subsequent epilepsy group (p<0.001).Conclusion: The findings of this study show that a history of perinatal asphyxia, complex FS, and epileptiform discharges at initial EEG exhib-ited an increased association with epilepsy development.
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Aim: The purpose of this study was to examine the effects of antiepileptics on thyroid function tests and to compare these effects among different antiepileptics. Materials and Methods: Two hundred and twenty patients (102 female and 118 male) aged 1-17 years indicated for antiepileptic drug (AED) therapy for epilepsy were enrolled in this study which was performed in a child neurology clinic between January 2014 and January 2018. Those patients using a single AED and with complete seizure control were included. In this study period, according to the local protocol, we measured free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels at the beginning of treatment and at the 12th month of AED therapy. Results: The mean age of the patients was 10.2±4.4 years. TSH elevation was observed in only eight patients. These eight patients’ thyroid autoantibodies were negative and their thyroid ultrasonography were normal. Subclinical hypothyroidism (TSH: 5-10, fT4 normal) was present in three of these eight patients, and they were therefore not started on medication. The other five were started on L-thyroxine. Four of these were using valproic acid and one was using carbamazepine. We found no significant difference between TSH and fT4 levels measured before the start and at the 12th month of drug therapy, nor among the different AEDs used. Conclusion: AEDs have no marked effects on thyroid function, and may therefore be safely used from that perspective.
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Aim: To evaluate the predictive roles of biochemical and complete blood count parameters in the diagnosis of febrile seizures by comparing these between patients with simple febrile seizures and febrile patients without seizures. Methods: One hundred fifty-two children (66 girls and 86 boys), aged 6-60 months presenting with fever symptoms presenting to our hospital’s pediatric emergency department between January 2015 and January 2020 were included in the study. Demographic data, complete blood count parameters and biochemical parameter levels were compared between the two groups. These were divided into a patient group with simple febrile seizures (n = 74) and a febrile control group without seizures (n = 78). Results: Comparison of biochemical parameters revealed significantly higher glucose, CRP, and ALT levels in the febrile seizure group, while Ca and Na were significantly lower. Comparison of complete blood count parameters revealed significantly higher white blood cell (WBC), neutrophil, red cell distribution width, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) values in the febrile seizure group, while hemoglobin, hematocrit, mean corpuscular volume, lymphocytes, and mean platelet volume were significantly lower. Conclusions: We think that in addition to markers such as WBC, leukocytes, and CRP for evaluating inflammation in patients with febrile seizures, simple, easily available, and inexpensive tests such as NLR and PLR can also be useful for assessing inflammation.
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Fatma HANCI , Mehmet CANPOLAT, Hüseyin PER, Hakan GÜMÜŞ, Sefer KUMANDAS
Fatma HANCI ,
Mehmet CANPOLAT, Hüseyin PER, Hakan GÜMÜŞ, Sefer KUMANDAS
Aim: This study investigated the effect of antiepileptic drug monotherapy on cognitive functions inpediatric epilepsy patients.Methods: 98 recently diagnosed epilepsy patients aged 6-16 years were included. All patientsunderwent routine laboratory tests, electroencephalography, brain magnetic resonance imaging, andintelligence testing. The patients were treated with valproic acid (VA), carbamazepine (CBZ),oxcarbazepine (OXC), or levetiracetam (LEV). The Wechsler Intelligence Scale for Children (WISCR) was applied three times, before, six months and 12 months after the start of antiepileptic therapy.Results: No significant difference was determined among the mean verbal, performance and totalintelligence scores of patients using a single antiepileptic drug at baseline, after six or 12 months.Conclusion: We conclude that the type of antiepileptic drug using has no adverse effects on cognitivefunctions.
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Nimet KABAKUŞ,
Fatma HANCI , Sevim TURAY, Mustafa DİLEK, Mervan BEKTAŞ
Nimet KABAKUŞ,
Fatma HANCI ,
Sevim TURAY, Mustafa DİLEK, Mervan BEKTAŞ
Aim: Migralepsy is a clinical entity that occasionally represents a diagnostic problem. An apparenthistory and clinical manifestation of migraine may mask the epileptic attack accompanyingmigralepsy. The aim of this study is to present our experience with clinical andelectroencephalography (EEG) findings and treatment of our patients diagnosed with childhoodmigralepsy disease.Methods: We documented six patients who were initially followed-up with a diagnosis of migraine,subsequently observed to have epileptic seizures, and then diagnosed with migralepsy.Result: Our patients became asymptomatic by giving good responses to antiepileptic therapy basedon clinical and electroencephalography (EEG) findings.Conclusions: This case series shows that EEG recording can be useful in all stages of migraine forlong-term, safe monitoring. Identifying patients with possible migralepsy will enable them to receiveantiepileptic treatment.
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