Introduction: The purpose of this retrospective study was to provide whether there was a difference regarding pre-operative
inflammatory markers between typical and atypical hippocampal sclerosis (HS).
Methods: For this purpose, 44 patients who underwent epilepsy surgery due to drug-resistant temporal lobe epilepsy were
included. Pre-operative neutrophil, lymphocyte, monocyte, and platelet counts as well as neutrophil-lymphocyte ratio,
platelet-lymphocyte ratio, lymphocyte-monocyte ratio, and systemic immune-inflammation index) were noted from peripheral
blood tests.
Results: Although the majority of inflammatory markers showed higher levels in typical HS, no significant differences were
found. None of the markers studied showed a correlation with the degree of neuronal loss.
Discussion and Conclusion: Although no differences between typical and atypical HS were demonstrated, there was a
trend to increase in the levels of some inflammatory markers in typical HS which is severe form of neuronal loss compared to
atypical HS and further studies with larger cohort of retrospective and preferably prospective are needed.
|
Electroencephalography (EEG) is the gold standard for analyzing electrophysiological processes involved in epilepsy, as well as in several other dysfunctions of the central nervous system. Firstly, to properly interpret the EEG record, one must clearly have in mind the elements of a normal EEG. Secondly, to assist in producing useful information for clinical and research purposes, it is recommended to use standardized terminolo-gies and to follow an orderly EEG reporting approach. The EEG report gives a clinical interpretation in light of the diagnosis and must meet the expectations of the clinician. The EEG terminology should be understandable to other physicians who are not specialized in EEG. The review aims to provide a standardized format for reporting the results of adult routine scalp EEG.
|
Objectives: It has been found that pain response is higher in patients with depression and anxiety and also found higher in the patients with psychogenic non-epileptic seizures (PNES). However, these studies are limited in number and they are mainly focused on the chronic pain perception. We aimed to investigate anxiety and depression levels and the perception of acute pain along with childhood traumas among the patients with PNES. Methods: In our study, a total of 100 gender- and age-matched patients with PNES and 50 healthy controls were included in the study. The beck depression inventory (BDI), the beck anxiety inventory (BAI), and the childhood trauma questionnaire-28 were applied to all the participants. Pain perception was also evaluated by applying gradually increasing pressure with tension cuff while the participants were in a seated position. While the tension was about 180 mmHg, the participants were asked to evaluate their pain using the visual analog scale (VAS). Results: The major findings of our study are as follows: (i) The BDI and BAI scores were significantly higher in the PNES group than in the control group; (ii) VAS scores were significantly higher in the PNES group than in the control group; and (iii) among the PNES group, BAI scores were correlated with VAS scores. Conclusion: PNES is experienced by a heterogeneous patient group, and its underlying factors are still not well described. Depression and anxiety are common accompanying factors, and the pain response is higher in patients with PNES with high anxiety levels.
|
Objectives: We aimed to investigate the effects of coronavirus disease (COVID)-19 infection on seizure recurrence in patients with epilepsy and the factors which may possibly be related to a deterioration of the seizure control. Methods: We evaluated the patients with epilepsy consecutively for 6 months. Data were collected in a pre-defined questionnaire from the patients and/or their parents, and past medical records. Results: A total of 574 patients were investigated during the study period, and 104 patients (18.1%) with epilepsy had COVID-19 infection. The majority of the patients (59.6%) were males. Sixteen patients with epilepsy (15.4%) had an increase in seizure frequency during COVID-19 infection. The mean age of the patients and the age at disease onset were significantly lower in patients with seizure exacerbation. The seizure frequency and the frequency of having a seizure within 1 month before the COVID-19 infection were also higher in these patients. Myalgia was significantly more common in patients with an increase in seizure frequency. The duration of the loss of smell and/or taste has lasted much more longer in this group of patients (48.0+60.6 vs. 13.8+13.4 days; p=0.013). The need for hospitalization was also more common in patients with seizure exacerbation (25.0% vs. 6.8%, p=0.045). Conclusion: This is the first study showing that one out of every six or seven patients with epilepsy will have seizure exacerbation during COVID-19 infection. Young patients, patients with early-onset epilepsy, and those with high seizure frequency were at higher risk for the seizure exacerbation.
|
Objectives: Posterior cortex epilepsies (PCE) are characterized by seizures originating from the occipital, parietal, or occipital border of the
temporal lobe. It is very important to analyze the patient series and bring them to the literature in the evaluation of the clinical features of this
rare seizure type. In our study, the patients with PCE were retrospectively examined and the cognitive functions of the patients were evaluated
and the results were compared with those of temporal lobe epilepsy (TLE).
Methods: Patients who fulfilled the inclusion criteria among epilepsy patients treated in Cerrahpaşa Faculty of Medicine, Department of Neurology
were retrospectively screened and included in this study. As a result of the described findings, cases where localization could be made
to the posterior or temporal lobe were included in the study and two separate study groups were formed: Group-1; Posterior cortex patients,
Group-2; Temporal cortex patients. A control group without any neurological or psychiatric disease was also formed. Detailed neurocognitive
tests were applied to all 3 patient groups.
Results: There was no significant difference between the demographic data of the control and patient groups. In all the parameters studied,
the test results of Group-1 were found to be lower than the control group. The variables that best differentiated the control group from Group-1
and 2 were determined as ‘Rey–Osterrieth complex figure test (ROCF)’, ‘Trail Making Test (TMT) Form A’, ‘The Judgment of Line Orientation (JLO)
test and California Verbal Learning Test (CVLT) delayed recall’ scores.
Conclusion: Our findings suggest that both posterior epilepsies and TLE are associated with impairments in visual configuration, verbal skills,
and executive functions. From these results, deterioration in visual configuration is an expected result in PCE, whereas deterioration in verbal
skills and executive functions is considered an unexpected result in PCE cases since it is typically controlled by the fronto-temporal regions. It
was suggested that it would be useful to follow up the patients with a comprehensive cognitive assessment.
|
|
Objective: Focal cortical dysplasia (FCD) is the most common cause of focal epilepsy in children and adults. The long-term seizure outcome has been reported in children, but very limited data are available for adults. The aim of this retrospective study is to provide long-term seizure outcome in adults with isolated FCD.Methods: A total of 23 adult patients operated on type I and II FCD were included. Medical history, seizure semiology, and radiological features were reviewed from the patients’ charts. Long-term seizure outcome was obtained with telephone interviews and last follow-up data available in archive.Results: At the last follow-up, 16 patients (69.6%) were totally seizure free even without aura and 7 patients (30.4%) continued to have seizure. Both type I (75%) and type II FCD (63.7%) showed higher seizure-free rate, and no significant difference was found (p=0.6).Conclusion: Surgery is safe and results in high seizure-free rate in adult patients with isolated FCD, but it is not enough because we cannot still explain why some patients continue to have seizure after complete removal of the dysplastic area.
|
Postiktal sendrom (PIS), nöbetin sonlanmasının ardından gelişen klinik, biyolojik, elektroensefalografi ve manyetik rezonans görüntüleme bulgularını kapsar. Tüm bu bulgular epileptik nöbetin sonlanmasının hemen ardından başlar ve uzunca bir süre devam eder. Bu durum, klinisyenlerin bu tabloyu gözlemlemelerine olanak sağlar. PIS klinisyenlere epileptik ile nonepileptik nöbet ayırımında ve epileptik nöbet tipinin belirlenmesinde yardımcı olur.
|