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The 9th International Congress
Of Epilepsy
Tehran 3-5 October 2012
Powered by:
Iranian Epilepsy Association
In association with:
Shefa NeuroScience Research Center
Shahid Beheshti Medical University
In the name of god
First of all, I would like to express my gratitude to god for the blessing of being a part of human's effort to increase their knowledge and advancing the science.
During the past nine months of preparation for the ninth international epilepsy congress, we have been trying very hard to meet different aspects of holding an inclusive international congress which would benefit all the participants.From choosing the national and international experts and speakers in different areas of expertise, to setting up different scientific and executive committees and evaluation of the papers.
Hereby I would like to express my gratitude to all the experts who chose this conference to present their work. This year we received 130 papers and posters. Despite the high quality of the papers we were not able to include all of them in the conference due to our limitations in terms of both time and the space for presentations. I would also like to appreciate the effort of all the authors whose work is not accepted for presentation and wish them the best of success in their career. Finally, this conference was not possible without the sincere effort and selfless cooperation of many individuals, organizations and the generosity of our sponsors. Here I would like to thank Dr. Kourosh Gharagozli and Dr. Hosein Delavar Kasmaei for choosing me as the chair of the congress, my colleagues in education office of the epilepsy organization, especially Mrs. Javadi for their helpful assistance, Dr. Ahmad Shahidzadeh Mahani and all the friends and colleagues who have helped us to hold this congress.
I hope this congress will give all the experts a chance to meet and share their experiences and findings and help us to increase our knowledge of epilepsy.
Looking forward to see you all, Omid Hesami
Congress President
9th International Congress on Epilepsy Congress President: Hesami.O. MD
Scientific Committee (in alphabetical order)
Akbarian Nia.MA. MD
Asadi pooya.AA. MD
Barekatein.M. MD
Beladi Moghadam.N. MD
Togha.M. MD
Harirchian.MH. MD
Kasmaei Delavar.H. MD
Zare.MR. MD
Sedigh Marvasti.F. MD
Keihani Douste.Z. MD
Negahi.A. MD
Hashemi Fesharaki.S. MD
9th International Congress on Epilepsy Name of Authors (in alphabetical order):
First & Laqst Name
Title of Article
Intracerebroventricular Lipopolysaccharide injection increases gene expression of Connexin32 in Rat The impact of epilepsy on LD Effects of educational intervention on attitude, knowledge and performance of teachers towards students with epilepsy Television and childhood epilepsy Anxiety Disordersof phenobarbital and carbamazepine in childhood epilepsy: randomised controlled trial Role of neuclear medicine in presurgical evaluations in refractory epilepsy Learning Problems in Children with Epilepsy Disorder Prevalence of Depression in Patients with Generalized Alehashemi.AR. MD Idiopathic Epilepsy Association between Hyperactivity and/or Behavioral disorders and epileptiform discharges in lectroencephalography of children in the age group of Focal cortical dysplasia and epilepsy control after surgery Common Mistakes in Reading EEG Progressive visual loss in an epileptic boy The Treatment of Super-Refractory Status Epilepticus: Recommended Treatment Protocol for Super-efractory Status Epilepticus quality of life of patients with partial and generalized Efficacy and safety of intravenous sodium valproate versus phenobarbital in controlling convulsive status epilepticus and prolonged seizures in children Effects of cucumber and fish meat as two "cold" foods on the seizure threshold in mice The effect of minocycline on amygdala kindling acquisition in rats Frontal lobe epilepsy Pediatric epilepsy nurse role 9th International Congress on Epilepsy Name of Authors (in alphabetical order):
First & Laqst Name
Title of Article
Beladimoghadam.N Clinical localization and lateralization in epilepsy Investigating the of some genes involved in pentylenetetrazol kindling acquisition in rat Delavar Kasmaee.H Refractory status epilepticus Study the effect of prenatal morphin on Pentylentetrazol-induced epileptic behaviors in rat Epidemiology of epilepsy in Kerman Cardiac Troponin Levels Following Complicated and Eskandarian.R. MD Uncomplicated Epileptic Seizures Comparison of efficacy of intravenous infusion of sodium valporate and thiopental in treatment of pediatric status epilepticus Seizure prediction by intelligent hybrid system Based on delay in the time series and optimal features Docosahexaenoic acid enhances anticonvulsant activity of valproic acid in mouse pentylenetetrazole-induced Are nocturnal seizures really a diagnostic challenge? Ghaffarpour.M. MD (Review of cases and discussion) drug resistant epilepsy Effects of different extracts of Rosa damascena On pentylenetetrazol-induced seizures in mice Inhibitory effects of low frequency stimulations on amygdala kindling-induced electrophysiological changes in hippocampal pyramidal neurons Role of definite diagnosis of Psychogenic Non- Epileptic Seizures (PNES) by Video-EEG Monitoring (VEM) on therapeutic process Role of Video-EEG Monitoring (VEM) in accurate diagnosis and treatment of patients with juvenile myoclonic epilepsy Harirchian.MH. MD Sleep and Epilepsy The relation between communication skills and social phobia in Peaple with epilepsy Evaluation of Brain MRI Findings in the Patients with Seizure and normal physical examination CSF abnormalities in idiopathic seizures 9th International Congress on Epilepsy Name of Authors (in alphabetical order):
First & Laqst Name
Title of Article
Evaluating of epileptic subtypes (generalize - focal) among epileptic patients admitted in 22Bahman & 17shahrivar hospitals in mashad during years 2011-2012 Frequency of tramadol induced seizures among symptomatic attacks Opium addiction and early seizure in stroke Endosulfan poisoning and seizure A brief look in to the world of epilepsy Personal and SocialEffects ofEpilepsyin the Patients Effects of quinine on epileptogenesis and seizure Keihani Douste.Z Conditions that mimic seizure Keihanidouste.Z. MD Epileptic Headache Antidepressants and Epilepsy public attitudes and awareness towards epilepsy in Single Photon Emission Computed Tomography and Localization of Seizure Epilepsy and education to parents Evaluation of training needs of parents of children with epilepsy admitted to the pediatric hospital, Ali (AS) Evaluation of prevalence of epilepsy according to EEG in children admitted for seizure, Azad University Hospitals, 2006-2011 The relationship between migraine and epilepsy Investigating the effect of rTMS on excitability of CA1 hippocampal pyramidal neurons following amygdala- kindling in male adult rats The comparison of anxiety sensitivity in patients with epilepsy and normal group Epilepsy in the Setting of Cerebrovascular Disease The effect of Tanacetum Sonbolii hydroalcholic extract on PTZ-induced seizures in male mice Progesterone therapy in women with intractable catamenial epilepsy Changes in expression of regulators of G proteins in the anticonvulsant effects of low frequency stimulation during kindling in rats 9th International Congress on Epilepsy Name of Authors (in alphabetical order):
First & Laqst Name
Title of Article
Knowledge and attitudes of parents with epileptic child, toward epilepsy in Markaz Tebbi Hospital Sexual Dysfunction in Epileptic Men Effects of Common anti-epileptic drugs on serum homocysteine and Folic acid concentrations Education to Mothers of children suffering from Epilepsy in the patient with myasthenia gravis, a case report and review of the literatures Birth Weight in Offspring of Women with Epilepsy The comparison study of antiepileptic drugs effects on 25-hydroxy vitamin D and Calcium level in epileptic Accident risk in patients with epilepsy in Birjand city Marital status of people with epilepsy in Birjand Basic strategies to cope with epilepsy Law issues associated with epilepsy Calcium channels and seizure pathophysiology Evaluation of mRNA and protein expression of connexin 32 in hippocampus of rats during electrical Lipopolysaccharide suppresses baseline CA1 synaptic response in adult epileptic rats New Guideline for How to manage a Person's First Unprovoked Seizure Atkins diet and epilepsy Prognostic value of seizure in cerebral sinus venous An investigation of the frequency of suicide thoughts and attempts in epileptic patients The investigation of efficacy of mental health programs in screening for epileptic patients in chaharmahal and bakhtiari province, since 1380 to 1390.
Introduction of a Recent Advance in Radiologic Localization of Epileptogenic Foci- Subtraction Ictal Single Photon Tomography Co-Registered to MRI Amygdalohippocampectomy for twenty one patinets of temporal lobe epiulepsy due to mesial temporal 9th International Congress on Epilepsy Name of Authors (in alphabetical order):
First & Laqst Name
Title of Article
Attention Deficit-Hyperactivity Disorder and Idiopathic Na Channelopathy in children with GEFS+ and Dravet Tonekaboni.SH. MD syndrome: an Iranian Experience Review on Carbamazepine (CBZ) Pharmacokinetics in Antiepileptic Drugs: CYPisoenzymes and The Relationship Between Psychosocial Care and Attitude Toward Illness in Children with Epilepsy Psychosocial care and its relation to disease concerns in adolescents with epilepsy Barriers and solutions to improve nursing performance in development of quality of life in families with epileptic children Can Polymorphic Delta Activity determine brain localized lesion? 9th International Congress on Epilepsy Intracerebroventricular Lipopolysaccharide injection
increases gene expression of Connexin32 in Rat
Hippocampus
Mohammad Abbasian (Department of Physiology, Science and Research Branch, Islamic Azad University,
Tehran, Iran)
Mohammad Sayyah (Department of Physiology and Pharmacology, Pasteur Institute of Iran, Tehran, Iran)
Vahab Babapour (Department of Physiology, Faculty of Veterinary Medicine, Tehran University, Tehran, Iran)
Reza Mahdian (Biotechnology Research Center, Department of Molecular Medicine, Pasteur Institute of Iran,
Tehran, Iran)
Bijan Akbarpour (Faculty of Veterinary Medicine, Kazerun Branch, Islamic Azad University, Kazerun, Iran)
Introduction: Epilepsy is the third most common neurological disorder
after stroke and Alzheimer's disease. Neuroinflammation facilitates
seizure acquisition and epileptogenesis. Hippocampus, one of the main
brain regions involved in epileptogenesis, has particular vulnerability
to damage and consequent inflammation. There is a network of gap
junctional communication between different cell types in the hippocampus.
Gap junctional communication is involved in epileptogenesis. This
communication can be affected by changes in expression of gap
junctional subunits called Connexins (Cx). Among Connexins, Cx32
are well expressed in hippocampus. Cx32 is generally expressed in
Olygodandrocytes and GABAergic interneurons. In the present study, the
effect of neuroinflammation induced by the Bacterial Lipopolysaccharide
(LPS) on Cx32 expression in rat hippocampus was evaluated.
Material and Method: LPS (2.5μg/rat) was infused into the rat cerebral
ventricles for 14 days. The mRNA and protein levels of Cx32 were
measured by Real Time PCR and Western Blot at the 1st, 7th and 14th
injection in the hippocampus.
Results and Conclusion: Cx32 gene expression was significantly increased
respectively after 7th injection of LPS relatively, however no changes in
Cx32 protein levels were found at the times mentioned. Increased Cx32
mRNA expression might contribute to the survival of the GABAergic
neurons and increase their synchronized inhibitory synaptic transmission
and reduce vulnerability of neurons to inflammatory insults. This finding
of increase in connexin mRNA, suggests regulation of Cx32 expression
was occur in transcriptional level . Collectively, it might be suggested that
Cx32 gap junction play a critical role in neurodegenerative process in CNS
inflammatory conditions.
9th International Congress on Epilepsy The impact of epilepsy on LD
soraya abedi-shapourabadi, M.S Abstract: Epilepsy is a common condition in childhood. It is characterized
by chronic seizures as a result of excessive, synchronous discharge of
cerebral neurons (1). According to Aldenkamp, about 50% of children
with epilepsy have school-related difficulties, ranging from slight
underachievement to quite severe problems, and one third of them needs
additional academic support but only less than 1% attends special schools
(2). Among all epileptic syndromes, Rolandic Epilepsy is the one mostly
associated with LD. The researchers concluded that children with Rolandic
Epilepsy performed significantly worse than controls in spelling, reading
aloud and reading comprehension and frequently had below average
school performance (3). Especially for children with Rolandic Epilepsy,
Riva et al. mention that patients with left-sided discharges on EEG have
poorer outcome in verbal tests, while patients with right-sided discharges
make more errors in vocabulary and word meaning (4). Absence epilepsy
in childhood has also been associated with LD in recent studies. Absence
epilepsy is an idiopathic generalized epileptic syndrome with both
hemispheres affected and frontal lobe functions affected. Frontal lobe has
been proved by many studies to play an important role in reading and verbal
procedure (5). Antiepileptic drugs impair learning procedure either directly
by impairing alertness, attention or mood (primidone, carbamazepine,
phenobarbital) or indirectly by side effects such as emotivity or diplopia
(6). For example: that topiramate impairs the function of the prefrontal
lobe and cerebral lesions that affect verbal performance. Finally, we should
not underestimate the role of demographic and psychosocial factors on
academic performance of children with epilepsy (7).
References:
1. Cowan LD (2002) The epidemiology of the epilepsies in children. Ment Retard Dev Disabil Res
Rev 8:171–181.
2. Aldenkamp AP et al (1990) Neuropsychological aspects of learning disabilities in epilepsy.
Epilepsia 31(suppl 4):S9–S20
3. Papavasiliou Α, Mattheou D, Bazigou H, Kotsalis C, Paraslevoulakos E (2005) Written language
skills in children with benign childhood epilepsy with centrotemporal spikes. Epilepsy Behav
6:50–58.
4. Riva D, Vago C, Franceschetti S, Panteleoni C, D'Arrigo S, Granata T, Bulgheroni S (2007)
9th International Congress on Epilepsy Intellectual and language findings and their relationship to EEG characteristics in benign childhood epilepsy with centrotemporal spikes. Epilepsy Behav 10:278–285.
5. Sinclair DB, Unwala H (2007) Absence epilepsy in childhood: electroencephalography does not predict outcome. J Child Neurol 22:799–802.
6. Motamedi GK, Meador KJ (2004) Antiepileptic drugs and memory. Epilepsy Behav 5:435–439.
7. Arif H, Buchsbaum R, Weintraub D, Pierro J, Resor S, Hirsch L (2009) Patient-reported cognitive side effects of antiepileptic drugs: predictors and comparison of all commonly used antiepileptic drugs. Epilepsy Behav 14:202–209.
9th International Congress on Epilepsy Effects of educational intervention on attitude,
knowledge and performance of teachers towards
students with epilepsy
Hakimeh AbrakhtElham SeidaliSenior social worker (MA in social work), Bushehr University of Medical Sciences researcher, researcher of Institute for Social and Cultural Studies of Science, Research and Technology researcher club) Introduction: Epilepsy is one of the most common neurological disorders
in childhood.Attitudeand knowledge of teachers about epilepsy play an
essential role in identifying children at risk and referring them to receive
professional care and subsequently give the diseased children the ability to
continue their education. The main objective of this study is to determine
the impact of educational intervention on attitude, knowledge, self -
efficacy and performance of teachers towards students with epilepsy.
Methods: In this experimental study, 37 public elementary school teachers
participated in Khormooj city in Bushehr province. A3-day workshop for
teachers of the intervention group (no. 20) was held. Research data in
two stages (before and after the workshop) were collected. The data were
processed and analyzed in SPSS,using non-parametric statistics.
Results: Comparison the results before and after the educational
intervention showed significant increases in knowledge, attitude, intention
and performance of teachers of the intervention group. Teachers in the
intervention group identified 25 students during this project and referred
them to the consultation center. At the same time control group teachers
onlyfound two students and reported them to be referred. Also results
showed ahigherknowledge, attitude and performance in female teachers
than male teachers.
Discussion: This study has remarkably shown that thetrained teachers
have considerable potential to participatein offering services in schools.
Hence, it is recommended to schedule educational workshops as the first
step to organize services, namely participation of the teachers.
Keywords: Intervention, Educational, Attitude, Teachers, Epilepsy
9th International Congress on Epilepsy Television and childhood epilepsy
Afsharkhas L (Professor Assisstant of Child Neurology, Tehran university, Iran, Tehran) Introduction: ‘Television-induced seizures' refers to seizures induced by
television viewing in photosensitive patients. It is one of the most common
forms of photosensitive epilepsy and age at onset is 10 to 12 years. There
are two form seizures, generalized seizures (myoclonic, generalized tonic-
clonic , absence); and focal seizures such as idiopathic photosensitive
occipital lobe epilepsy. Seizures occur when the patient is watching a
faulty (ie, flickering) television set or from close distance (1 yard from the
screen). Liquid crystal screens (LCD) don't flicker and are far less likely
to trigger a seizure than other screens.
Method and materials: This is a review on recent two decade studies
about television and its effects on children behaviors and seizure disorders.
Results: Television can induce some serious childhood diseases such
as obesity, learning - behavior and seizure disorders.It is an external
stimulation and precipitate epileptic seizures .In one study in Iran, Thirty
patients with television epilepsy with the age less than 12 years were
identified. About 56.7% of the children had pure television epilepsy and
43.3% experienced other types of generalized seizure. Carbamazepine had
successfully terminated seizures in 43.3% of the patients.
Conclusion: Television-induced seizures occur in children and can be
reduced through the proper, consistent use of anti-seizure medication
and avoidance of the triggers, watching the television in a well-lit room,
keeping distance more than 2.5 yards for a 19" screen, avoiding watching
when tired, not watching for long periods of time.
Keywords: Television,child,epilepsy
9th International Congress on Epilepsy Anxiety Disordersof phenobarbital and carbamazepine
in childhood epilepsy: randomised controlled trial
MehranAgha Mohammad pour (Associate Prof. of Pediatric Neurology Tabriz University of Medical Sciences)MeygolTaghiBeigi (Psychiatric Resident of Tabriz University of Medical Sciences) Objective: Epilepsy is the most common neurological disorder in children.
For a sustainable treatment programmeantiepilepsy drugs must be
affordable, available, and effective and have minimal side effects. The
World Health Organization recommends phenobarbital as the first choice
of drug for most seizures and epilepsies in developing countries mainly
because of cost, but carbamazepine is also recommended for all but typical
absences and is used in Iran . We compared the Social Phobia effects of
phenobarbital and carbamazepine in a Pediatric Neurology Clinic in Tabriz
. Our main outcome measure was Social Phobia after one year's treatment.
Methods: We carried out a double blind randomised controlled trial
from thePediatric Neurology Clinic in Tabriz from April to October 2011
.Seizure outcome was measured as "seizure remission," defined as no
seizures during the last of 12 month .The prevalence of Social phobia
in 40 epileptic patients treated with phenobarbital and 35 patients treated
with carbamazepine were compared. The age patients was between 3 – 12
years. The groups were similar across a wide range of demographicand
family-environmental variables.
Results: Patients treated with phenobarbital, when compared with those
treated with carbamazepine, showed a much higher prevalence of Social
phobia (30% v 6%, P = .03) as determined by K – SADS psychiatric
interviews. These results provide further evidence that treatment with
phenobarbital increases the risk for social phobia in epileptic children and
should be avoided when clinically feasible, particularly in patients with
a personal or family history of phobia . Epileptic patients who receive
phenobarbital because of clinical considerations should be monitored closely
for symptoms of anphobia, and if phobia is detected, a change to an alternative
anticonvulsant may result in amelioration of phobia symptomatology.
Conclusion: From this study in Tabriz , we conclude that phenobarbital
is associated with excess phobia side effects when compared with
carbamazepine and should be monitored closely for symptoms of anphobia.
9th International Congress on Epilepsy Role of neuclear medicine in presurgical evaluations
in refractory epilepsy
Mohsen Aghaee Hakak (Neurologist, Director of Epilepsy Monitoring Unit, Razavi Hospital, Mashhad, Iran)Farshad Emami (Director of Nuclear medicine Department, Razavi Hospital, Mashhad, Iran)Ramin Sadeghi (Nuclear Medicine Research Center, assistant professor of Mashhad Medical University, Iran)Mahmood Sarafraz (Radiologist, Director of Neuroimaging Department, Razavi Hospital, Mashhad, Iran)Behnaz Razavi (Head Nurse of epilepsy monitoring unit, Razavi Hospital, Mashhad, Iran) It is well known that epilepsy surgery is a standard treatment for patients with refractory localization related epilepsy. The more clear and exact an epileptogenic zone is selected, the more success in surgery will be expected. Until now, there is not a single diagnostic tool to find the epileptogenic zone. This task needs using several diagnostic procedures as pre-surgical evaluations to discover the areas of brain that produce seizure activity.
Among the present diagnostic tests, PET study and ictal/interictal SPECT are quite helpful, especially in difficult cases.
These tools provide a dynamic and functional image from brain that is different compared to other tests, and give more information about pathologic functional areas of brain. In this presentation, we will review on clinical applications, methodology and advantages of these diagnostic tools. Also we will mention some notes about techniques of doing ictal SPECT and how these images should be interpreted and analyzed (including conventional method, SISCOM and SPM).
In the end, an interesting and complex case will be presented in whom we could find the epileptogenic zone by these techniques in our ward. 9th International Congress on Epilepsy Learning Problems in Children with Epilepsy Disorder
Akrami L (M. E, in Exceptional Children) Introduction&Objective: Epilepsy is a neurological disorder and with
convulsion Seizures, it is an abnormal discharge of electrical energy in
the brain. The most of the Children with epilepsy disorder are in normal
school and some of them with Learning Problems are in special school(
Temporal & Grand Mal epilepsy).thechildren with Epilepsy disorder in
normal school, have learning Problems.The aim of The present research is
study of learning problems in thechildren with epilepsy Disorder.
Methods: This is a review of study.Pubmed, ScienceDirect, Googlescholar,
English & Persian books and articles were used.
Results: Findings of the difficult researches show that the most of the
children with Epilepsy disorder have IQ up 80 andsome of them are gifted. Learning problems have relation with social problems, sever & frequency convulsion, Mood and emotional problems, attention and concentration problems, low Information of educator about epilepsy & no use of the successful education , Negative expectation of them parents andEducator,……. Conclusion: Children with epilepsy disorder have various convulsion that
some of Them aren't for identifiable.Thisconvulsion and the effect some of
pharmaceutical Havenegative effect to attention and learning. It is necessary
for parents and educators that increasing information of epilepsydisorder
and use of the successful education for them.
Key words: Epilepsy Disorder, Learning Problems, Children
9th International Congress on Epilepsy Prevalence of Depression in Patients with Generalized
A.R. Alehashemi (Assistant professor of neurology)M. Mahdinejad kashani (Assistant professor of neurology)M. Homam (Assistant professor of neurology)H.R. Arshadi (Assistant professor of psychiatry)F. Rezaeetalab (Neurologist)H. Mazinani (General Practitioner)Department of neurology, Mashad branch, Islamic Azad University , Mashhad, Iran Introduction: Epilepsy is one of the most common neurologic conditions,
which may affect the quality of life and end in a variety of consequences
including depression, head trauma, impairment of job performance and
education , etc.
Objective: Regarding to a series of studies showing the impact of
predisposing factors like genetic background, psychiatric disorders and
educational status on epilepsy, we designed this study to examine the
correlation between depression, as a common psychiatric disorder, and
generalized idiopathic epilepsy (GIE).
Materials and methods: This investigation was a descriptive cross-
sectional study during which 74 patients diagnosed with GIE and referred
to the Neurology Ward and Clinic of 22 Bahman Hospital in Mashhad,
were examined. The data were gathered based on two questionnaires: SCL-
90R (Symptom Checklist-90 Revised), which consists of 13 questions
regarding depressive problems, and demographic questionnaire including
questions about gender, age, level of education, marital status, neurologic
report and psychiatrist's assessment. The psychiatric assessment consisted
of clinical diagnosis in axis 1 and 2, history of conversion disorders,
alcoholism or drug abuse, and mental retardation. The data was analyzed
by SPSS software, t-student and fisher exact test.
Results: This study indicated that the prevalence of depression in epileptics,
which was 31.1% in our patients, correlates closely with marital status
and Axis I disorders. No significant association between depression and
gender, age, education and Axis II disorders was proved.
Discussion: According to this study, there is a relatively high prevalence of
depression among epileptics, therefore, considering psychiatric disorders
9th International Congress on Epilepsy is an essential aspect of treatment in patients diagnosed with GIE.
Key words : idiopathic generalized epilepsy (IGE), depression, Axis 1 and
Axis II disorders
9th International Congress on Epilepsy Association between Hyperactivity and/or Behavioral disorders
and epileptiform discharges in lectroencephalography of
children in the age group of 1-5years

Susan Amirsalari (MD) (Associate professor of pediatric neurology, Baqiyatallah University of Medical Sciences, faculty of medicine Tehran, Iran)ShokufehRadfar (MD) (Assistant professor of pediatric psychiatry, Baqiyatallah University of Medical Sciences, faculty of medicine Tehran, Iran)Seyed Rahim Hosseni (Medical Student, Baqiyatallah University of Medical Sciences, faculty of medicine Tehran, Iran) Background: Attention deficit/Hyperactivity disorder is one of the most
prevalent psychiatry problems. Behavioral disorder or conduct disorder has
been considered as a consistent or repetitive behavior in which social rules
and human rights is neglected .The aim of this study was to investigate
the association between hyperactivity and/or behavioral disorder and
epileptiform discharges in electroencephalography(EEG) of children in
the age group of 1-5years.
Methods and material: In this cross sectional study 109 children in the
age group of 1-5 years were enrolled, they have had confirmed behavioral
disorder and/or hyperactivity disorder according to DSM IV-TR criteria.
After obtaining of informed consent , EEG has been performed for these
patients, then collected data were entered to SPSS and analyzed with X2
,t-test and non parametric tests.
Results: Mean age of patients was 46.76 ± 12.36 months. Sixty two (56.9%)
patients were between 4-5 years old.78(71.6%) were boys and 31(21.4%)
were girls .the diagnosis in 83 (76.1%) patients was hyperactivity disorder
and in 26 (23.9%) patient was behavioral disorder. EEG in 71(65.1%)
patients was normal and in 38 (34.9%) patients was abnormal , there was
a significant association between abnormal EEG and underlying disorders.
Conclusion: In this study we have found a Significant association between
Hyperactivity and/or Behavioral disorders and epileptiform discharges in
electroencephalography of patients these findings may helps up to find a
correlation between epilepsy and hyperactivity and/or behavioral disorder.
Key words: Hyperactivity, behavioral disorder, electroencephalography
,epileptiform discharge
9th International Congress on Epilepsy Focal cortical dysplasia and epilepsy control after surgery
Arami MA, Shirvani M, Mohammadi HR, Manteghi FRMilad General Hospital, Neurology and Neurosurgery Departments Objectives: In this prospective study, we report outcome of our epileptic
patients with cortical dysplasia that were treated by surgical lesionectomy.
Methods: We had 11 patients (males n = 6; females n = 5; mean age 25
(11) years) with a mean duration of epilepsy of 11 years. All patients were
pharmacoresistant epileptics. Lesionectomy was done for all cases by
expert surgeons. MRI findings before surgery and epilepsy outcome was
evaluated.
Results: After a mean follow-up of 3.1 years, 7 patients (63.6%%) were
seizure free, 2 patients were partially controlled and in another 2 the
seizures continued. We have not mortality and morbidities were minor
and usually improved during follow up period.
Conclusion: Because of significant successfulness of lesionectomy for
patients with FCD, early surgical treatment could be recommended for all
such cases to control of epilepsy without medicine or with less drugs. It
could result to complete freedom of patients. Focal cortical dysplesia is a
curable epilepsy condition by expert neurosurgical team.
9th International Congress on Epilepsy Common Mistakes in Reading EEG
Ali A. Asadi-Pooya, M.D (Associate Professor of Epileptology, Department of Neurology)Shiraz University of Medical Sciences, Shiraz, Iran.
Pitfalls Related to Localizing Reliability of Interictal Epileptiform
Discharges:
- Sensitivity and specificity are not perfect, sometimes far from perfect.
- Localizing reliability of spike discharges is state-dependent: spikes
observed in REM sleep and wakefulness are more accurate than those in
non-REM sleep.
- Spikes observed during anticonvulsant withdrawal may be falsely
localizing.
- Benign variants (e.g., benign epileptiform transients of sleep, wicket spike,
rhythmic mid-temporal theta of drowsiness) are sometimes misleading.
- Artifacts are sometimes confusing.
Final Points in the Interpretation of EEG:
- Be critical and suspicious.
- Know epileptic patterns (interictal, ictal and postictal); aim for clinical
correlation when possible.
- Do not push for localization.
9th International Congress on Epilepsy Ali A. Asadi-Pooya, M.D (Associate Professor of Epileptology, Department of Neurology)Shiraz University of Medical Sciences, Shiraz, Iran.
- A good montage can be easily imagined and remembered- Record at least 16 channels- Use all the 21 electrodes- Use both bipolar and referential montages: Referential Longitudinal (anterior to posterior) bipolar Transverse bipolar - Use simple montages- Label each montage in the recording- Organize the montage: anterior first, posterior later; right above left or vice versa- Amplification and channel-acquisition: at least 24 channels, preferably 32 channels- High filter at 70 Hz- Low filter at 0.16 Hz or less- A 50–60 Hz notch filter should be available, but not routinely used- Electrode impedances should be kept below 5 k ohm 9th International Congress on Epilepsy Progressive visual loss in an epileptic boy
Ali A Asadipouya (Associate Professor of Neurology)Maryam Sharifian (Resident of Neurology)Department of Neurology (Shiraz University of Medical Sciences Shiraz, Iran) Introduction: Leber's hereditary optic neuropathy (LHON) is a maternally
inherited mitochondrial disorder characterized by bilateral loss of central
vision, most frequently found in young adult males. In most patients there
are no other neurological manifestations and cerebral neuroimaging is
normal, but some rare cases of "LHON plus" have been described. Here in
we report a 15 year old boy with LHON plus.
Case presentation: The patient is a 15 year old boy who was completely
well till 6 years ago. Since 9 year-old the patient developed vision loss and
optic atrophy. Psychomotor regression, refractory epilepsy and progressive
neurological abnormalities developed subsequently. Neuro imaging was
normal. According to physical examination and history LHON plus was
diagnosed for him.
Discussion: We report a novel case of LHON plus disease in an Iranian
patient in which the classic clinical features of the disease are associated
to seizures, mild mental retardation, psychiatric disorders and migraine. In
this case epilepsy is a clue for diagnosis of the underlying syndrome. This
the first report of LHON plus in Iranian population.
Key words: Leber's hereditary optic neuropathy, refractory epilepsy
9th International Congress on Epilepsy The Treatment of Super-Refractory Status Epilepticus:
Recommended Treatment Protocol for Super-efractory
Abstract: Super-refractory status epilepticus is defined as status epilepticus
that continues or recurs 24 h or more after the onset of anaesthetic therapy,
including those cases where status epilepticus recurs on the reduction
or withdrawal of anaesthesia. It is an uncommon but important clinical
problem with high mortality and morbidity rates. This article reviews the
treatment approaches. There are no controlled or randomized studies, and
so therapy has to be based on clinical reports and opinion. The published
world literature on the following treatments was critically evaluated:
anaesthetic agents, anti-epileptic drugs, magnesium infusion, pyridoxine,
steroids and immunotherapy, ketogenic diet, hypothermia, emergency
resective neurosurgery and multiple subpial transection, transcranial
magnetic stimulation, vagal nerve stimulation, deep brain stimulation,
electroconvulsive therapy, drainage of the cerebrospinal fluid and other
older drug therapies. The importance of treating the identifying cause is
stressed. A protocol and flowchart for managing super-refractory status
epilepticus is suggested. In view of the small number of published reports,
there is an urgent need for the establishment of a database of outcomes of
individual therapies.
Introduction: Tonic–clonic status epilepticus is a medical emergency.
Treatment is aimed at stopping seizures largely in order to avoid cerebral
damage and other morbidity.
Recommended Treatment Protocol for Super-refractory Status
Epilepticus In all Cases of Super-refractory Status Epilepticus
Identify and Treat Cause All efforts should be made to identify the cause
and to treat this where possible. Successful therapy will often terminate the
status epilepticus. A detailed history should be obtained (including family
history) and the investigations required depend on the context, and often
will include MRI, EEG, CSF examination, metabolic and drug screen,
toxicological and auto-immune screen.
9th International Congress on Epilepsy General Anaesthesia Choice of Anaesthetic One of the three conventional
anaesthetic agents should be given initially with choice depending on
individual circumstance and preference. However, propofol infusions
should only be continued for >48 h where the benefits exceed the risks
of PRIS and where careful monitoring to avoid this is in place. Ketamine
should be considered where other anaesthetics are failing or where drug-
induced hypotension becomes a crucial problem.
Intensive Treatment Unit Monitoring Conventional intensive treatment
unit care and careful monitoring should be employed in all patients.
Meticulous attention must be paid to haemodynamic parameters, fluid
balance, anti-thrombotic therapy and skin care. Also, particularly as the
anaesthetics can be immunosuppressive, monitoring for and therapy
of nosocomial infection becomes increasingly important as the status
epilepticus becomes more prolonged.
Anti-epileptic Drug Therapy High doses of two or three anti-epileptic
drugs should be initiated via a nasogastric or other feeding tube, and these
should be continued throughout the course of the status epilepticus. In the
complete absence of any comparative study, advice about an appropriate
treatment strategy must be arbitrary and subjective. However, a few general
points seem appropriate to suggest:
Drug Regimes Polytherapy with no more than two anti-epileptics in
high doses seems on general principles to be most appropriate. There is
no evidence of overall benefit from more complex combinations, and
morbidity will rise with more extensive drug regimens.
Changing Drug Regimens Frequent changes in the anti-epileptic drug
regimen should be avoided, as rapid withdrawal of anti-epileptics can lead
to rebound seizures, exacerbate side-effects, risk allergic reactions and
also cause pharmacokinetic changes. In very prolonged status epilepticus,
changing anti-epileptics may be tried, but the withdrawal process should
be slow, carried out over weeks.
Choice of Drug This will depend on the clinical context. In general, the
most powerful and effective drugs should be chosen but avoiding drugs
with a primarily GABAergic mechanism of action, not least because
there is evidence of loss of efficacy as status epilepticus becomes more
prolonged and because the anaesthetic drugs themselves have much more
powerful GABAergic effects. It would seem also sensible to use drugs that
have low interaction potential and predictable kinetics, and to avoid drugs
9th International Congress on Epilepsy with strong allergenic potential and potential renal or hepatic toxicity.
Magnesium Sulphate Infusion Although little evidence of benefit is
available, intravenous magnesium has no significant toxicity or drawbacks
and there is some evidence of experimental benefit. Therefore, it seems
reasonable to recommend its use in all cases of super-refractory status
epilepticus. The regime suggested by Visser et al. (2011) is with an initial
intravenous bolus and then infusion at a dose that increases the serum level
to 3.5 mmol/l.
Pyridoxine Infusion In rare cases of status epilepticus in young children,
pyridoxine deficiency will be present and a pyridoxine infusion will be
curative. It remains unclear whether pyridoxine is useful in cases where
there is no genetic (or acquired) deficiency, but the practice has grown up
of giving pyridoxine in all cases of severe cryptogenic status epilepticus in
young children. Pyridoxine has no toxicity or drawbacks, and this therefore
seems a reasonable practice. There are reported a few cases of successful
treatment of status epilepticus in adults also, but how useful routine
administration of pyridoxine would be is unclear. The doses recommended
in the literature have varied between 2 and 300 mg/day (Haenggeli et al.,
1991).
In Cases Where a Lesional Cause of the Status Epilepticus is Identified
Resective Neurosurgery and/or Multiple Subpial Transection
Resective
neurosurgery (or multiple subpial transection, with or without resection)
can be considered early where lesions are found that are causing the
status epilepticus. The outcome after surgery in some cases is poor, even
where intensive investigation has shown a focal onset to the seizures and
where that focus has been resected, but good outcome has been reported
sufficiently often to consider this a treatment option.
In Cases Where the Cause is not Identified
Steroids and Immunotherapy If no underlying cause for the status epilepticus
can be identified, a trial of high-dose steroids can be given, and then if there
is no resolution within 2 days, either intravenous immunglobulins or (less
commonly) plasma exchange can be added. There are no data on optimal
therapy, but it is important to have a protocol. In the author's practice,
this is usually initiated with high-dose prednisolone at a dose of 1 g of
intravenous prednisolone per day for 3 days followed by 1 mg/kg/day in
four divided doses. This is followed by one or two courses of intravenous
9th International Congress on Epilepsy immunoglobulins at a dose of 0.4 g/kg over 5 days, or plasma exchange. If there is a response, treatment is continued with long-term steroids, intravenous immunoglobulins and later, other immunomodulatory agents such as cyclophosphamide or rituximab. It seems reasonable to give such a regime to all patients in whom there is no cause identified for the super-refractory status epilepticus, unless there are specific contraindications (diabetes for instance). There is experimental evidence to suggest that steroids should be given early, practically speaking within the first week of super-refractory status epilepticus.
In Cases Where the Status Epilepticus Continues Despite the Above
Measures
If the status epilepticus continues despite the above measures, there are a
number of other approaches. First, consideration can be given to a trial of
the ketogenic diet and/or of mild hypothermia. Which measure should be
tried first depends on the clinical context and facilities available. Whether
either therapy has specific indications is not clear. The ketogenic diet has
been most investigated in the severe encephalopathies of childhood, but
adults responding to the diet have been reported. Similarly, hypothermia
has been studied most in the ischaemic–anoxic encephalopathies and in
lesional epilepsy, and how effective it is, more generally, is again, not
known.
Ketogenic Diet The ketogenic diet is easy to administer through a
gastrostomy tube or via parenteral feeding, because soluble preparations
are available (Ketocal).
Hypothermia Hypothermia is usually induced by endovascular cooling.
Rossetti (2010) has recommended that only mild hypothermia (32–35°C)
is given, that barbiturate anaesthetics should be avoided and that the
hypothermia is carried on for 24–48 h only as a trial of therapy. If there
is a response, the hypothermia can be continued. Cardiovascular and
coagulation parameters, biochemistry and acid–base balance, serum lactate
and physical examination (to avoid venous thrombosis) must be monitored
carefully. It is important to note too that the clearance of anaesthetics and
anti-epileptics used in co-medication may be significantly reduced by
hypothermia (Tortorici et al., 2007; Hostler et al., 2010).
9th International Congress on Epilepsy 9th International Congress on Epilepsy quality of life of patients with partial and generalized
Ashjazadeh N (Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Neurology Department, Shiraz, Iran)Hadi N,Yadollahi Khales G,Ayoobzadeh A,Sadraee N Introduction: Epilepsy as a chronic disease and with its debilitating
nature has a great impact on patients' quality of life .The reason can be
explained not only by the disease itself and the medications (monotherapy
vs polytherapy), but also by the patients' level of education, marital status,
age, gender, duration of disease and seizure frequency. This research aimed
to compare the quality of life of patients with generalized seizure with
those with partial seizure and its relationship with demographic features.
Method and materials: One hundred epileptic patients enrolled in this
study. We have filled out general demographic and SF-36 questionnaires.
Our data was analyzed by SPSS 15 using independent t- stiudent,spearman
and one-way ANOVA tests.P value > o.o5 was considered to be significant.
Results: From 100 cases 74 (74%) have had generalized and 26 (26%)
partial epilepsis It was found out that there is no difference between
patients' quality of life in two groups. Furthermore, patients suffering from
generalized epilepsy do not show any change in their quality of life based
on their marital status and duration of seizure. This is also true for those
with partial seizure based on their marital status, duration of seizure, age
and education. However, we found that there is relation between patients'
education, age, frequency of seizure, medications and their quality of life
in the group with generalized epilepsy (p<0.05). The quality of life of
patients with partial seizure shows relation with frequency of seizure and
medication (p<0.05).
Conclusion: Frequency of seizure and anti epileptic medications
(monotherapy vs polytherapy) are two main factores which have affected
on quality of life of both generalized and partial epilepsies. The quality
of life of those with generalized epilepsies is more affected by their
demographic conditions compared with those with partial epilepsies.
Key words: generalized epilepsy, partial epilepsy, quality of life.
9th International Congress on Epilepsy Efficacy and safety of intravenous sodium valproate
versus phenobarbital in controlling convulsive status
epilepticus and prolonged seizures in children
Mahmoud Reza Ashrafi (Professor of Pediatric Neurology, Children's Medical Centre, Tehran University of Medical Sciences, Tehran, Iran)Sedigheh Ghaempanah, Nahid Khosrowshahi, Reza Azizi Malamiri Introduction: Status epilepticus (SE) and acute prolonged seizures
(APS) are the most common neurological emergencies in children with
high morbidity and mortality rates. Benzodiazepines, phenobarbital, and
phenytoin are the most commonly used anticonvulsants for controlling
SE andAPS. Studies in adults and children have shown the efficacy and
safety of rapid infusion of valproate in controlling SE. However, few well
designed randomized trials have been reported in children .
Objectives: Our aim was to evaluate the efficacy and safety of valproate
rapid loading in children with status epilepticus comparing with intravenous
phenobarbital.
.Results: Sixty children with convulsive SE and APS were enrolled
and were randomized to receive either valproate or phenobarbital. The main outcome variable was termination of all convulsive activity, and subsequently, recovery of consciousness should be achieved. Intravenous valproate rapid loading was significantly more successful in seizure termination (77%) in contrast to phenobarbital (37%) ( P = 0.004). Overall clinical adverse effects in phenobarbital group, was 74%, while in valproate group was 24% ( P < 0.001).
Conclusion: Rapid loading of valproate is effective and safe in controlling
convulsive SE in children. Intravenous valproate could be considered as a
suitable choice for terminating SE and APS.
9th International Congress on Epilepsy Effects of cucumber and fish meat as two "cold" foods
on the seizure threshold in mice
Faegheh Baha'addini-Beigi-Zarandi (PhD) (Department of Pharmacology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Iran)Razieh Taghizadeh-Sarvestani (GP) (Department of Pediatric neurology, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Fars, Iran)Soroor Inaloo (MD) (Department of Pediatric neurology, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Fars, Iran) Introduction: Cucumber, fish meat and some other foods have been
mentioned as "cold" foods in Canon, a traditional medicine book written
by Avicenna. A "cold" food induces coldness in the body. This definition
of cold foods and abstinence of them in epilepsy, have been recommended
in this book. The scientific basis of this claim has not been studied yet.
Here we show the effects of cucumber (cucumis sativus L.) and fish
(strongylure leiura), as two "cold" foods, on the maximal electroshock
seizure threshold in mice. Also we did a preliminary test on the traditional
definition of "cold" and "hot" foods by comparing the changes in the
temperature in the some homogenized foods when moving from a room
temperature to a refrigerator and then to a freezer.
Methods: Increasing-current electroshock seizure test was used to assess
susceptibility of mice to the hind limb tonic extention (HLTE) electroshock-
induced seizure. Changes in the temperature of the homogenized foods
were recorded by a digital thermometer.
Results: C. sativus and S. leiura significantly decreased the threshold of
HLTE seizure compared to the control group. Also the results implied that
"cold" foods got colder and released heat less quickly than "hot" foods.
Conclusion: The results indicated the seizure threshold-lowering action
of the two foods. Based on the findings of this research, caution should be
taken when epileptic patients use these two foods. The traditional "hot-
cold" classification of foods may be a primary guidance to evaluate the
Pro-convulsant effects of foods on epilepsy and antiepileptic drugs.
Key words: electroshock; seizure thresholds; pro-convulsant; cucumis
sativus l., strangylure leiura
9th International Congress on Epilepsy The effect of minocycline on amygdala kindling
acquisition in rats
Seyed Mehdi Beheshti Nasr (Instructor of Physiology, Cellular and Molecular Biology Research Center, Sabzevar University of Medical Sciences,Sabzevar, Iran)Mohammad Mohammad-Zadeh (ssistant Professor in Physiology, Cellular and Molecular Research Center, Sabzevar University of Medical Sciences,Sabzevar, Iran) Introduction: Minocycline is a derivative of tetracycline that has anti-
inflammatory, antiappoptic and antioxidant with neuroprotective effects.
As far as there is interaction between cell death and seizure, the aim of this
study is examination of the The role of minocycline on development of
amygdala kindling in wistar rats.
Methods: In this experimental study, three group animals (21 rats), after
sterotaxic surgery and 1 week recovery period, rats received kindling
stimulations (twice daily at 6 hour interval). Group 1(n=7) animals
received daily kindling stimulations. Group 2 (n=7) and 3(n=7) 60 min
before kindling stimulation received saline (1ml/kg) and minocycline (25
mg/kg) respectively.
Cumulative Afterdischarge duration (ADD), Cumulative Seizure duration
(SD) and Seizure Stage (SS) were recorded and compared relative to
control group.
Results: In group 3 intraperitoneal administration of minocycline for 10
days reduced cumulative ADD (control group: 907.2±64.5, Minocycline
group: 717.8±67.9) [F(18,216) =3.5, p<0.001]، and cumulative SD (control
group: 999.4±79.8, Minocycline group: 776.1±77) [F(19,228)=3.8, p<0.001] significantly relative to control group (group 2). It also significantly increased the mean number of stimulations to achieve to seizure stages of 3 (control group: 7.2±0.6, Minocycline group: 11±1) (P<0.05), and 5 (control group: 10.7±0.1, Minocycline group: 18.7±0.3) (P<0.001).
Conclusion: According to obtained results, application of minocycline
increase the time required for amygdala kindling and may have
anticonvulsant effects.
Article keywords: Seizure,Kindling, Minocycline, Rat.
9th International Congress on Epilepsy Frontal lobe epilepsy
Parviz Bahrami (MD) Neurologist, epilepsy and EEG Fellowship Lorestan University Of Medical Sciences.
Prevalence: second most common focal epilepsy in adults.
Age of onset of seizures: any age, depending on cause, usually before
middle age.
Seizure types: frontal lobe seizures (brief, often during sleep, sometimes
many per night, variable aura, sometimes indescribable, loss of
consciousness, frantic or bizarre automatisms, dystonia, sometimes
secondarily generalized convulsions). Orbital seizures can be similar to
temporal lobe seizures.
Suggestive features:
* Simple partial motor seizure.
* Brief seizures (<1min).
* Frequent seizures, often in clusturs.
* Nocturnal predominance.
* Bizarre automatisms, thrashing, kicking, clapping, bicycling.
* Dystonic posture from onset.
* Forced eye deviation from onset – contralateral to the side of seizure
onset.
* Consciousness may be preserved during convulsions, but usually isn't.
* Propensity to status epilepticus.
Frontal complex-partial seizures:
* Nocturnal preponderance.
* Brief, little post – ictal confusion, with sudden, frenetic, frantic, agitated
and dramatic automatism, bimanual-bipedal.
* Vocalization is common – humming or shouting obscenities.
* Non – specific auras if any.
* Can arise from any region of the frontal lobe.
* Inter – ictal and ictal EEGs are often unrevealing.
Anatomical classification:
* Primary motor area – precentral.
* Supplementary motor area.
* Dorsolateral.
9th International Congress on Epilepsy * Frontopolar.
* Orbital.
Patient development (milestones): usually normal or mild delay.
Patient intelligence and memory function: normal or mild lateralized deficits.
Family history of epilepsy: sometimes, particularly in autosomal
dominant frontal lobe epilepsy (ADFLE).
Inter-ictal EEG:
* EEG background: normal or frontal slowing.
*EEG paroxysmal abnormalities: frontal discharges.
* focal epileptiform discharges or slowing depending on the side of origin:
- At Fz in medial frontal epilepsy.
- At F3/F4 in lateral frontal epilepsy.
- At F8/F7 and prefrontal electrodes in orbital frontal epilepsy.
* Sometimes secondary generalized discharges, particularly in epilepsies
arising from medial frontal cortex.
Ictal EEG:
* Often normal- as often as %58.
* frontal or diffuse abnormalities, slowing or discharges may be normal.
Neuroimaging: normal or abnormal.
Aetiology: frontal lesion (head injury, tumour, focal cortical dysplasia,etc).
some are idiopathic (autosomal dominant frontal lobe epilepsy or ADFLE).
Medical treatment: most AEDs
Respective surgical treatment: possible. Only %50 improve.
Prognosis: worse response to medication and surgery than temporal lobe
epilepsy, more prone to status epilepticus.
Epilepsy type: focal symptomatic or presumed symptomatic. ADFLE is
idiopathic.
9th International Congress on Epilepsy Pediatric epilepsy nurse role
farkhondeh Behzadi (MSc Nursing management of children)Bahare Mohamadsalehi (Master of Community Health NursingBushehr University of Medical Sciences - Genaveh, hospital Amir - Nursing Office. Introduction: Because chronic epilepsy characterized by its remarkable
effects on the family worked. Attitude control of parents and children
with epilepsy is very diverse and Since the effect of chronic disease and
disability in functional status and health is profound. In this regard, the
role of nurses in the field of education is very popular.
The literature review: Methods this study was a retrospective collection
of library materials through the key terms of epilepsy, and childhood has
been a nurse.
Content: His children esteem opinion and reaction from all others and
their perception of their ability to acquire. Sudden and unexpected attacks
and their impact is emotional reaction in others. Children with epilepsy
should nurse about their condition and the role that medicine plays in
creating long-term health, they teach. Once they were old enough to be
assigned responsibility for the drugs to them and be advised of the identity
card containing information about their status to carry. The nurse should
plan activities for children and insist that each one can be in the company;
this causes them to acquire success and satisfaction in their work. Attack
occurred when the nurse should identify risk factors and to reduce or prevent
repeat attacks can cause changes in the environment. The most common
cause of accelerated attacks in children include emotional stress, sleep
deprivation, fatigue, febrile, illnesses, sparks of light, menstrual cycles,
alcohol , heat, angry, hyper ventilation . Nurses must teach parents that
some children experience when using the games computer. The children
were sensitive to intermittent light stimulation, which would accelerate the
occurrence of epilepsy.
Conclusions: Nurses can use their educational and supportive role of
parents to make appropriate epileptic children, Positive outcomes for
children and families can access, which would accelerate the occurrence
of epilepsy.
9th International Congress on Epilepsy Clinical localization and lateralization in epilepsy
N.Beladimoghadam MD.Shahid Beheshti University of Medical Sciences.Tehran.Iran To optimize surgical outcome, careful interpretation of ictal symptomatology in conjunction with other components of the presurgical evaluation is required.
To estimate where the epileptogenic zone is and what its boundaries are, epileptologists have been using different diagnostic tools of increasing complexity and technical difficulty.
This includes careful analyses of seizure semiology, electrophysiological studies (noninvasive and invasive), anatomical neuroimaging, and functional neuroimaging. These diagnostic methods have led to the definition of several cortical zones (symptomatogenic zone, irritative and ictal onset zones, epileptogenic lesion, and functional deficit zone), each one of which is a more or less precise index of the epileptogenic zone. During modern presurgical evaluation of patients with intractable epilepsy, an attempt is made to locate and define the boundaries of these five zones.
Favorable surgical outcomes are obtained when these zones overlap significantly .The symptomatology of auras and seizures is a reflection of activation of specific parts of the brain by the ictal discharge, the location and extent of which represent the symptomatogenic zone. Different types of auras ( such as somatosensory ,visual ,auditory ,vertiginous ,olfactory ,autonomic , psychic , nonspecific),and also motor manifestations,,language changes,and other signs of epilepsies would be discussed concen to the value of them in localization and lateralization. 9th International Congress on Epilepsy Investigating the of some genes involved in
pentylenetetrazol kindling acquisition in rat
Mahnaz Davoudi (Department of Physiology, Faculty of Medical Sciences, TarbiatModares University, Tehran, IR Iran)Amir Shojaei (Department of Physiology, Faculty of Medical Sciences, TarbiatModares University, Tehran, IR Iran)Mohammad Reza Palizvan (Department of Physiology, Faculty of Medicine, Arak University of Medical Sciences, Arak, IR Iran)Mohammad Javan (Department of Physiology, Faculty of Medical Sciences, TarbiatModares University, Tehran, IR Iran)Javad Mirnajafi-Zadeh (Department of Physiology, Faculty of Medical Sciences, TarbiatModares University, Tehran, IR Iran) Objective: Pentylenetetrazole (PTZ) chemical kindling is an experimental
modelof temporal lobe epilepsy. In the present study the gene expression
ofsome molecules involved in chemical kindling acquisition, including
γ2 subunit of GABAA receptor, NR2 A subunit of NMDA receptorand
adenosine A1 receptorgenes were changed, in the hippocampus of rat.
Materials and Methods: In this study male Wistar rats weighing 260-
270 were used. In order to induce chemical kindling in this model, PTZ
was injected(37.5 mg/kg) every 48 h. Their convulsive behaviors were
evaluated for a 20 min period. Then genes expression changes were
evaluated (using RT-PCR technique) 24 h after 4th, 9th (in the middle of
kindling procedure) and 17th (after fully kindling) PTZ injections.
Results: The mean number of PTZ injections to reach a fully kindled
was16.7±0.4. The geneexpression of γ2 subunit of GABAA receptors was
markedly increased during kindling development. The gene expression
changes inNR2A subunitof NMDA receptorand adenosine A1receptors
were significantly increasedin the middle ofkindling procedure and
decreased after 17th PTZ injection.
Conclusion: Obtained results showed that PTZ injection leads to some
changes in gene expression of molecules that are involved in kindling
development. Recognitions these events can help us in understanding the
mechanisms of epileptogenesis.
Key words: Epilepsy, Animal model, Chemical kindling, pentylenetetrazol
9th International Congress on Epilepsy Refractory status epilepticus
Delavar Kasmaee.H MD (Shahid Beheshti University of Medical Sciences.Tehran.Iran)Nasiri.Z Purpose of review: Refractory status epilepticus (RSE) has a high morbidity
and mortality. There are currently no definitive data to guide both the optimal
choice of therapy and treatment goals. This review focuses on RSE diagnosis
and outcome and discusses both commonly used and anecdotal therapies for
RSE.
Recent findings: The challenges in performing randomized controlled
trials (RCTs) in neurocritical care and more specifically for the treatment of
RSE are illustrated by the early termination of the first RCT of RSE due to
low recruitment that compared propofol to barbiturates. Recent case series
include the successful treatment of recurrent RSE with ketamine, intravenous
lacosamide as an add-on treatment, the use of combination antiepileptics
(phenytoin, levetiracetam, and pregabalin), and surgical treatments (vagal
nerve and deep brain stimulation) for the control of RSE.
Summary: A number of different therapeutic options are available for the
treatment of RSE but none have been shown to be superior to others at this
point.
9th International Congress on Epilepsy Study the effect of prenatal morphin on
Pentylentetrazol-induced epileptic behaviors in rat
LoghmanEbrahimi, Paryahashemi, Dr.ShivaRoshan-Milani, Dr.EhsansabooryUrmia University of medical sciences,faculty of medicine, Department of Physiology.
Introduction: The complicated effect of the morphin on seizure had been
reported. According to the type and experimental condition has been seen
the both booster and attenuator effects of the morphin on seizure. In the
present study effect of morphin on PTZ induced epileptic behaviors was
investigated in rat offspring.
Method: Female pregnant rats (200±20g) were divided into two groups:
intact pregnant rats (control group) and pregnant rats that treated whit
morphin (morphin group). In morphin group, pregnant rats treated whit
morphinsubcutaneously at 17, 18 and 19 days of the pregnancy in doses 10,
12 and 15 mg/kg respectively. On postnatal days 15 and 25, PTZ (40-50mg/
kg) was injected to rats' offspring of both groups, to induce seizure. Then,
epileptic behaviors of each rats was observed and recorded.
Results: the number and mean duration of tonic-colonic attacks were
significantly increased on P15 in morphin group but not seen significant
value on P25.
Conclusion: morphin can enhance seizure at the offspring of rats in age
dependant manner. Further investigation is required to clarify the underlying
mechanism.
Keywords: morphin, PTZ,tonic-colonic attacks.
9th International Congress on Epilepsy Epidemiology of epilepsy in Kerman
Hossein Ali Ebrahimi Mohammad Ali ShafaSaeed Hakimzadeh AslNeurology Research Center- Kerman University of Medical Sciences-Kerman- Iran Background: Epilepsy is considered to be among the most prevalent
neurological disorders and one of most important health issues. It costs
huge expenses for health system, and influences the individual and social
quality of life of the patients. Despite its importance, the studies conducted
in Iran to determine the prevalence of epilepsy are limited. The present
study evaluated the Prevalence of active epilepsy in Kerman.
Methods: The present cross sectional study was carried out on 2921
individuals from different neighborhoods of Kerman in two stages, first
stage was screening process by trained questioners, and the second one
was the confirmation of definite diagnosis. Cases of Inactive epilepsy
were eliminated from the study. Questionnaires containing demographic
information and para-clinical analyses were filled out for each individual.
Also 628 epileptic patients in Kerman, who had referred to a referral center,
were analyzed concerning epilepsy subtypes.
Results: From 126 suspicious individuals, 23subjects were diagnosed to
be epileptic. Point prevalence of active epilepsy was 7.8/1000 individuals.
It was equal in both sexes, with a significant increase in individuals
having low education (P= 0.029). The generalized epilepsy had a higher
frequency. Of the patients, 56.6% suffered from psychiatric diseases.
Electroencephalography (EEG) in 13 patients (56.5%) showed epileptic
waves. Brain imaging (CT or MRI) were normal in 11 patients (47.8%) but
4 patients (17.3%) had abnormal neuroimagings. Family history of seizure
was positive in 17.3% of the patients. Conclusion: Point prevalence of active
epilepsy is 7.8/1000 in Kerman was as same as developing countries. The
prevalence was significantly higher in individuals with lower education.
Key words: epilepsy, prevalence, Iran
9th International Congress on Epilepsy Cardiac Troponin Levels Following Complicated and
Uncomplicated Epileptic Seizures
Rahime Eskandarian,a Nabiolah Asghari,b Mahbobeh Darban,c and Raheb GhorbanidaDepartment of Cardiology, bDepartment of Neurology, cDepartment of Internal Medicine, and dDepartment of Social Medicine, Fatemieh Hospital,Faculty of Medicine, Semnan University of Medical Sciences, Semnan, IranReceived for publication April 19, 2011; accepted August 12, 2011 (ARCMED-D-11-00200) Background and Aims: Cardiac troponins are tests with high sensitivity
and specificity and selective biomarkers for diagnosis of acute myocardial
infarct. Epilepsy is one of the common neurological diseases that presents as
recurrent seizures. This study was
designed to assess the troponin levels in patients with complicated and
uncomplicated seizures.
Methods: Included in the study were hospitalized patients in Fatemieh
Hospital, Semnan, Iran who were referred due to seizures with normal ECG
and echocardiography and without critical features of cardiac diseases.
Based on the results of pulse oximetry, K, urine analysis and CPK, patients
were divided into two groups: complicated and
uncomplicated.
Results: Thirty patients with complicated seizures and 30 additional patients
with uncomplicated seizures were investigated; 53.3% of both groups were
male. The mean (_SD) age of patients with complicated and uncomplicated
seizures were 43.4 _ 15.5 and 44.7 _ 21.5 years, respectively ( p 5 0.789).
The mean (_SD) troponin I level in patients with complicated seizure was
0.61 _ 0.26 ng/mL, whereas it was 0.41 _ 0.30 ng/mL in control group ( p
5 0.005). In none of the patients was troponin level higher than the normal
value.
Conclusions: Although troponin I is considered as a sensitive and specific
marker for diagnosis of cardiac tissue injury, association between its
increasing plasma levels with complicated seizures was shown. Troponin
I level perhaps may be used as a risk factor in patients with complicated
seizures. _ 2011 IMSS. Published by Elsevier Inc.
Key Words: Troponin I, Seizure, Complicated seizure, Risk factor.
9th International Congress on Epilepsy Comparison of efficacy of intravenous infusion of
sodium valporate and thiopental in treatment of
pediatric status epilepticus
Razieh Fallah MD (Pediatric Neurologist , Associate professor , Department of pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran) Abstract: Status epilepticus is an emergency condition in pediatric
neurology which can cause irreparable brain damages. The purpose of
this study was to compare clinical efficacy and safety of intravenous
continuous infusion of thiopental and sodium valproate in treatment of
pediatric status epilepticus.
Methods: In a cross – sectional study, medical records of all children
with status epilepticus whom were admitted in ICU of Shahid Sadoughi
Hospital in 2010-2012 and treated with intravenous drip of thiopental or
sodium valproate, were evaluated.
Results: Nineteen children with mean age of 2.21 ± 1.1 years were
evaluated. Seizures stopped in 77.7 % (N= 5 out of 9) of children treated
with sodium valproate and in 80% (N= 8/10) of thiopental group and both
drugs were effective in statistical analysis. No paraclinical side effects
were witnessed in both groups.
Eight patients intubated in thiopental and two in sodium valproate group
and sodium valproate group needed statistically significant less intubation.
Mean of stay days in the ICU was 8.4 in thiopental and 3.4 in sodium
valproate group. Statistical analysis showed that admission days in the
ICU in sodium valproate was less than that of thiopental group.
Conclusion: In treatment of status epilepticus in children, intravenous
sodium valproate can be used as an effective and more safe drug.
9th International Congress on Epilepsy Seizure prediction by intelligent hybrid system Based
on delay in the time series and optimal features
Mohammad.fiuzy (Electrical and computer Engineering Faculty Hakim Sabzevari University, Sabzevar, Iran)Javad Haddadnia (Electrical and computer Engineering Faculty, Hakim Sabzevari University, Sabzevar, Iran)Mohammad Mohammad-Zadeh (Assistant professor of Physiology, Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, IRAN) Abstract: Epilepsy is on of the prevalance. The consequences of epilepsy
could be seizure, brief stage of dementia, abnormal anger, anxiety and even
advanced types, local paralysis. If it were possible to forecast seizures,
however, therapeutic possibilities would change dramatically. Seizures,
is the most important manifestation of epilepsy. Most common clinical
diagnosis and careful analysis of seizure is an ElectroEncephaloGraphic
recorded or an EEG1. Today attempt to done final diagnosis by intelligent
and machining method. One of the most disabling aspects of epilepsy is the
seemingly unpredictable nature of seizures. By a needle Wave detection
(Discharge epilepsy neurons), is possible epilepsy diagnosis in the EEG
report (signals). All Electrical processes are almost random that lead to
seizures. So, Can be said the Behavior of brain signals into a sequence
per time unit, or in other words, is A Time Series. In this study, a new
approach based on EEG Complex2 results was presented for prediction
of epilepsy. Decision making was performed by using processes such as
signal processing and artificial intelligence in four stages: Denoisnig and
feature extraction using the wavelet transform (WT3), Reduction and
data managing using Support Vevtore Machine (SVM4), Select the best
Features using Evalutionary Algorithm (BPSO5) and Predict based on
delay on time series by using the ANFIS6 trained with the backpropagation
gradient descent method in combination with the least squares method.
The proposed system achieves high accuracy by the composition method
in predicting. Current methods with high accuracy have a little ability in
predicting. Compared to this method and existing methods, high accuracy
and performance of this system will demonstrated.
KeyWord: Epilepsy, EEG, Time Series, Predict, Process, Artificial Intelligent.
9th International Congress on Epilepsy Docosahexaenoic acid enhances anticonvulsant activity
of valproic acid in mouse pentylenetetrazole-induced
Gavzan daronkola (Dept. of Basic Science, veterinary faculty, university of Tehran), (Dept. of Physiology and Pharmacology, Pasteur Institute of Iran)H, Sayyah (Dept. of Physiology and Pharmacology, Pasteur Institute of Iran)M, Sardari (Dept. of Biotechnology, Pasteur Institute of Iran)S, Babapor V (Dept. of Basic Science, veterinary faculty, university of Tehran) Objective: Epilepsy is one of the most common neurological disorders.
Tolerability and side effects are important limitations of antiepileptic
drugs. New molecules are needed for improvement of these obstacles.
Recent studies suggested that dietary supplementation with omega-3
polyunsaturated fatty acids (PUFAs) have beneficial effects on epilepsy
with no side effects. Docosahexaenoic acid (DHA), the main PUFAs
in brain and neuromembrane, plays an important role in modulation of
neuronal function. The purpose of present study was to assessacute
anticonvulsant effects of DHA via intracerebroventricular (i.c.v) injection
on anticonvulsant activity of valproic acid (VPA) against pentylentetrazole
(PTZ)-induced seizures in mice.
Methods: This study was categorized into three main groups. 1) Several
doses of DHA were injected into lateral cerebroventricle of male N-MRI
mice (20-30g) and animals received a subcutaneous injection of maximum
dose of PTZ after 15min. 2) VPA was administered subcutaneously
in several doses. Then PTZ was injected after 30min. latency to clonic
seizure and its incidence were registered after PTZ. 3) Co-administrations
of VPA and DHA in PTZ model were investigated at several fixed-ratios
with regard to their respective ED50. Eventually results were analyzed
isobolographically.
Results and Conclusion: Calculated ED50 for DHA, VPA, their
combinations at 1:3 ( 1_4 of DHA ED50 + _34 of VPA ED50) and 1:1 ratios
were 2628, 83.3, 479.6 and 1043.1 mg/kg, respectively. According to these results, DHA and VPA co-administration can decrease adverse effects of VPA because lower dose of VPA is used in this combination. 9th International Congress on Epilepsy Are nocturnal seizures really a diagnostic challenge?
(Review of cases and discussion)
Ghaffarpour.M (Professor of Neurology, Iranian Center of Neurological Research, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran, Iran) Abstract: Many people,especially children have abnormal motor and /
or psychic paroxysmal behaviors during sleep that can be divided into
the sleep-related or sleep-induced epileptic seizures and the parasomnias.
Nocturnal seizures and certain types of parasomnias can have similar
clinical symptoms and can become a diagnostic dilemma.
The great majority of NTs are parasomnias, caused by a benign
developmental disorder of arousal. However, studies of paroxysmal
events,occurring during sleep, have shown that some events that are
initially considered parasomnias are actually ictal events.This diagnostic
challenge becomes more puzzling,particularly in patients with nocturnal
epileptic seizures, when their daytime routine EEGs and sometimes scalp
LTM show no abnormalities.In fact,cases with autosomal dominant frontal
lobe epilepsy have usually normal routine EEG,thus may mistakenly be
diagnosed as parasomnia (Cesare T Lombroso: Epilepsia 2000; 41:1221-
26). The case reported by Cesare T Lombroso was initially referred as
frequent night terrors, but eventually established to have partial seizures
arising from left primary motor cortex due to frontal cortical dysplasia.
On the other hand nocturnal generalized tonic clonic seizures may occur
as a result of nocturnal hypoxemia caused by obstructive sleep apnea
(P Barton Duell). Finally, nocturnal attacks have sometimes an unusual
cause.For example, nocturnal paroxysmal dystonia was reported to be a
presentation of frontal lobe epilepsy (Donald W Gross et al). We here in
will review and discuss interesting cases of nocturnal seizures in details
and will mention to sagacious advises for correct diagnosis.
Key words: Nocturnal seizures, parasominas, epilepsy, invasive LTM.
9th International Congress on Epilepsy drug resistant epilepsy
K.Gharagozli, MD.Shahid Beheshti University of Medical Sciences.Tehran.Iran Acording to international league against epilepsy drug responsiveness of a patient's seizures should be regarded as a dynamic process rather than a fixed state. Instead of being constant, the course of epilepsy sometimes fluctuates, and apparent changes in responsiveness to AED treatment may only represent changes in the pathophysiology of the etiologic disorder. The classification of a patient's epilepsy as drug resistant at a given point in time is valid only at the time of the assessment and does not necessarily imply that the patient will never become seizure-free on further manipulation of AED therapy. The number of AEDs that needs to have failed for the epilepsy to be defined as drug resistant was debated within the Task Force. A definite assumption in any definition is that seizure freedom will not or is very unlikely to be attained with further manipulation of AED therapy. Therefore, any definition must be based on an assessment of the probability of subsequent remission after each drug failure. Ideally, the evidence should be derived from large-scale, prospective, long-term, population-based studies including both adults and children at the point of diagnosis or treatment initiation, and should be based on an assessment of outcome after failure of successive informative AED trials. Few, if any, studies in the literature meet such requirement. Observational cohort studies of newly diagnosed epilepsy in adults and children suggest that once a patient has failed trials of two appropriate AEDs, the probability of achieving seizure freedom with subsequent AED treatments is low. Recent studies appear to suggest that a proportion of these patients may still become seizure-free with subsequent drug manipulation but these studies were retrospective and sampled prevalent cases, and did not take into account the reasons for failure which may indicate that the AEDs have not been adequately tried. On the basis of a careful deliberation of the available evidence, building on Level 1 of the definition framework, for operational purposes, the following definition is proposed: 9th International Congress on Epilepsy Drug resistant epilepsy may be defined as failure of adequate trials
of two tolerated and appropriately chosen and used AED schedules
(whether as monotherapies or in combination) to achieve sustained
seizure freedom.
It should be pointed out that the consensus to accept the failure of two
(rather than greater numbers) AED schedules in the definition represents a
testable hypothesis and aims to avoid unnecessary delay in evaluation, and
may be revised as more high quality data become available.
In addition to number of AEDs failed, two other elements are most commonly
included in definitions of drug resistant epilepsy in the literature, namely,
the frequency of seizures and duration of follow-up. In the proposed
definition, "failure" and "sustained seizure freedom" are as defined in a
variety of the definition framework, which already incorporates seizure
frequency and treatment duration, so that separate criteria for these elements
are redundant. Applying the categorization of intervention outcome, drug
resistance is defined as having Category 2 outcome for trials of at least two
AEDs (monotherapies or in combination) without a Category 1 outcome
on the drug(s) currently taken. Drug resistance should be defined only by
informative trials, that is, the two AEDs should have been appropriately
chosen and adequately tried, and that none of the outcomes that will be
counted toward the two drug failures should be "undetermined." In other
words, some patients may "fail" many AEDs before they fail two that are
"appropriate" and in a way that is "informative."
9th International Congress on Epilepsy Effects of different extracts of Rosa damascena
On pentylenetetrazol-induced seizures in mice
MahboobehGhasemzadehRahbardar (Physiology department, Tarbiatmodares University, Tehran, Iran)Mahmoud Hosseini (Neuroscience Research Center and Department of Physiology, School of Medicine, Mashhad University of Medical sciences, Mashhad, Iran)Hamid Reza Sadeghnia (Neuroscience Research Center and Department of Pharmacology, Department of New Sciences and Technologies, School of Medicine, Mashhad University of Medical sciences, Mashhad, Iran)Hassan Rakhshandeh (Pharmacological Research Center of Medicinal Plants and Department of Pharmacology, School of Medicine, Mashhad University of Medical sciences, Mashhad, Iran) Objective: In the present study, the effects of aqueous, ethanolic and
chloroformic extracts of Rosa damascenaon pentylenetetrazol (PTZ )- induced
seizures were investigated in mice.
Methods: The animals were divided into the following groups: normal saline
control group, diazepam group ( 3 mg/kg ), three aqueous extract groups (
100, 500 and 1000 mg/kg ), three ethanolic extract groups ( 100, 500 and 1000
mg/kg ) and three chloroformic extract groups ( 100, 500 and 1000 mg/kg ).
The extracts , normal saline or diazepam were injected intraperitoneally 30
min before PTZ injection. Latency to the first minimal clonic seizure ( MCS )
and generalized tonic-clonic seizure ( GTCS ) and the percent of mortality of
mice in each group were recorded.
Results: Significant increases in both MCS and GTCS latencies were
observed in all the three aqueous extract groups in comparison with the normal
saline control group ( P<0.05 or P<0.01 ). The MCS latency in the ethanolic
extract ( 1000 mg/kg ) group and the GTCS latencies in the two ethanolic
extract ( 500 and 1000 mg/kg ) groups were higher than those in the normal
saline control group ( P<0.05 , P<0.01 ). There were no significant differences
in MCS and GTCS latencies between the three chloroformic extract groups
and the normal saline control group. No significant differences were seen in
mortality rate following PTZ administration between the different extracts-
treated mice and the control mice.
Conclusion: The results of the present study showed that R.damascena has
an anticonvulsant effect in a mouse model of PTZ-induced seizures but the
exact mechanism of this effect should be clarified in future studies.
Keywords: Rosa damascena ;Rosaceae ; anticonvulsant ; pentylenetetrazol ;
seizures ; mice
9th International Congress on Epilepsy Inhibitory effects of low frequency stimulations on
amygdala kindling-induced electrophysiological
changes in hippocampal pyramidal neurons
Zohre Ghotbeddin (Dept of Physiology, faculty of Medical Sciences, TarbiatModares University)Javad MirNajafi-Zadeh (Dept of Physiology, faculty of Medical Sciences, TarbiatModares University)Saeed Semnanian (Dept of Physiology, faculty of Medical Sciences, TarbiatModares University)MahyarJanahmadi (Neuroscience Research Center and Department of Physiology, Medical School, ShahidBeheshti Medical Sciences University) Introduction: Although epilepsy is considered as one of the most com-
mon neurological disorders, there is no radical treatment for this disease.
Using lowfrequency deep brain electrical stimulation might be a possible
therapy for epilepsy. To elucidate and understand the possible mechanism
(s) of anticonvulsant action of low frequency stimulation (LFS), here, the
effect of LFS on CA1pyramidal neuronal discharge activityand excitabil-
ity was recorded.
Material and methods: Amygdala kindling model was built in rats by
electrical stimulations using pairs of stainless-steel electrodes. Animals
were divided into 3 groups: Control, Kindled and Kindled+LFS. In Kin-
dled group, stimulation parameters were 50Hz, square waves delivered for
3 s, 12 times a day for 6 days. In KLFS group, immediately after kindling
stimulations, LFS with 1-Hz frequency, 1 ms pulse duration was applied,
4 times a day. The control group received no electrical stimulation. After
discharge (AD) duration and the behavioral seizure score were measured
for each animal. Then, changes produced in the discharge activity and ex-
citability of CA1 pyramidal cells following low frequency stimulation in
a rat model of amygdale kindling were assessed using whole-cell patch
clamp under current clamp condition.
Results: In Kindled rats, the frequency of action potential was signifi-
cantly increased (1.55± 0.1Hz, p<0.001) compared to the control group
(0.57 ± 0.03Hz), which was associated with increased epileptic activity in
pyramidal neurons. Whereas, in KLFS group, low frequency stimulation
of the kindling focus (i.e. amygdale) neuronal excitability was almost re-
stored the normal CA1 pyramidal neuronal excitability, so that the action
potential firing rate was significantly lower (0.82 ± 0.1Hz, p<0.01) than
kindled group, but not control animals.
9th International Congress on Epilepsy Conclusion: Findings show that amgdala kindling causes CA1 pyramidal
neuronal hyperexcitability, and applying LFS immediately following kin-
dling stimulations prevents the hyperexcitability induced by kindling.
Keywords: Seizure, Hippocampus, Amygdala, Kindling, Low Frequency
Stimulation, Neuronal Excitability
9th International Congress on Epilepsy Role of definite diagnosis of Psychogenic Non-Epileptic
Seizures (PNES) by Video-EEG Monitoring (VEM)
on therapeutic process
Ali Gorji (Neuroscientist, Professor of Munster University,Germany, Director of Neuroscience Department, Razavi hospital, Mashhad, Iran)Mohsen Aghaee Hakak (Neurologist, Director of Epilepsy Monitoring Unit, Razavi hospital, Mashhad, Iran)Malihe Mohammadpour (Medical Doctor, Epilepsy Monitoring Unit, Razavi hospital, Mashhad, Iran)Iraj Vosough (Psychiatrist, Pychiatric department)Behnaz Razavi (Head Nurse of Epilepsy Monitoring Unit, Razavi Hospital, Mashhad, Iran) INTRODUCTION: PNES is a neuropsychiatric disorder which has lots of
economic and psychologic burden not only for patients and his/her family
but also for society and health systems. Video-EEG Monitoring (VEM) is
gold standard diagnostic tool for definite diagnosis of PNES.
AIM: The main purpose of this study was to determine the role of definite
diagnosis on therapeutic response and reduction of unnecessary use of
AEDs (Anti Epileptic Drugs).
METHOD: This study was retrospectively done and the patients'
information was gathered from database of epilepsy department of Razavi
hospital. All patients with the final diagnosis of PNES entered the study.
The patients were contacted with telephone thereafter.
RESULTS: From 182 patients referred to epilepsy center because of
refractory attacks, 33 (18%) were diagnosed as PNES. Mean age of
patients were 27.6 years and two-third of them were female. In average,
they suffered from their disease for 28.15 months. 29 (87.8%) and 26
(78.7%) of the patients took AEDs and psychotropic drugs respectively.
Each patient in average used 1.6 AEDs and 2.12 psychotropic drugs. We
could follow 29 of our patients at the mean follow up time of 8.37 months
(range: 3 to 14 months). In the follow up, fifteen (51.7%) patients were
seizure free. Six patients were not taking any drugs. Mean number of AEDs
and psychotropic drugs for each patient was 0.31 and 1.17 respectively.
65.5 percent of patients were under treatment of psychiatrist.
CONCLUSION: Definite diagnosis of PNES by VEM significantly
reduces unnecessary AEDs (and also psychotropic drugs) consumption
and helps to improve the treatment planning.
9th International Congress on Epilepsy Role of Video-EEG Monitoring (VEM) in accurate
diagnosis and treatment of patients with juvenile
Ali Gorji (Neuroscientist, Professor of Munster University, Germany , Director of Neuroscience Department, Razavi hospital, Mashhad, Iran)Mohsen Aghaee Hakak (Neurologist, Director of Epilepsy Monitoring Unit, Razavi hospital, Mashhad, Iran)Hossein Amiri (Neurologist, Epilepsy Monitoring Unit, Razavi hospital, Mashhad, Iran)Mohsen Foroughipour (Neurologist, Associated Professor of Mashhad Medical University of Science, Neurology Department)Malihe Mohammadpour (Medical Doctor, Epilepsy Monitoring Unit, Razavi hospital, Mashhad, Iran)Behnaz Razavi (Head Nurse of Epilepsy Monitoring Unit, Razavi Hospital, Mashhad, Iran) INTRODUCTION: Definite diagnosis of epileptic syndrome is an
important step before beginning treatment for epileptic patients. JME is
the most common generalized epilepsy in adults. Some anti epileptic drugs
not only are not effective, but may aggravate attacks.
At the best situation initial assessment by conventional EEG can diagnose
fifty percent of patients with JME. It seems to be important to use more
sensitive diagnostic tools.
AIM: We assessed role of definite diagnosis on appropriate treatment of
patients with JME after using LTM.
METHOD: This retrospective study was done on patients admitted in
epilepsy department of Razavi hospital from March 2011 to April 2012.
All patients with definite diagnosis of JME entered the study. A telephone
follow up interview was done for assessment of treatment after discharge.
RESULTS: Total number of patients was 25. Among them 14 (56%)
were female. Mean age of patients and seizure onset was 23.6 and 12.7
respectively. Nine (36%) of them were on inappropriate treatment or
none. AEDs in 21 patients (84%) were modified (dose correction or drug
change) after discharge. In follow up, 75% of patients reported complete
satisfaction with significant reduce attacks or seizure-free state.
9th International Congress on Epilepsy Sleep and Epilepsy
Mohammad Hossein Harirchian (Tehran University of Medical Sciences, Iranian Center of Neurological Researches) It has been proven that there is a crucial links between sleep and epilepsy. Seizures and some antiepileptic drugs (AEDs) could impair the continuity of sleep.
However, sleep instability may be an inherent component of certain forms of epilepsy. In the other hand, sleep instability can promote seizures, thus forming a vicious cycle. Sleep deprivation provokes seizures and epileptiform discharges in some patients with epilepsy.
Synchronized nonrapid eye movement (NREM) sleep facilitates seizures, whereas desynchronized rapid eye movement (REM) sleep discourages its occurrence. The sleep electroencephalogram (EEG) could be helpful in the diagnosis and localization of epilepsy. Polysomnography (PSG) with expanded EEG aids in the differentiation of parasomnias and seizures and in the diagnosis of primary sleep disorders, such as sleep apnea, that can exacerbate seizures.
Treating sleep apnea may lead to improved seizure control. These observations show the importance of sleep in the diagnosis and treatment of people with epilepsy.
9th International Congress on Epilepsy The relation between communication skills and social
phobia in Peaple with epilepsy
Rozita Heidari (M.A. in Clinical Psychology, Shiraz University) Introduction: Epilepsy is one of the most common neurological disorders in
childhood and adolescents and one that affects not only physical functioning,
but also cognitive, social, emotional, and behavioral functioning. Children
and adolescents with epilepsy face multiple psychosocial difficulties
that increase their risk for the development of psychiatric disorders. In
fact, researchers have indicated that children with epilepsy have higher
rates of psychological disturbance compared with children in the general
population or those with other chronic illnesses. little work has examined
the role of communication skills in the development of social phobia in
adolescent. The current study aims to investigate the relation between
communication skills social phobia in in peaple with epilepsy.
Methods: Participants in the present study included 40 adolescents
between the ages of 12 and 17 years (mean age=14 years) referred to
hospitals of shiraz city using convenience sampling method. In this study,
the data were collected via by a communication skills test and social phobia
questionnaire.
Results: Finding show the correlation among research variables.
Correlation coefficient between communication skills and social phobia.
Also the dimensions of communication skills (ability to receive and send
messages, listen, emotional control, insight into the connection process and
strongly associated with) emotional control, insight into the connection
process and strongly associated with predicts social phobia.
Conclusion: Result show that people suffering from epilepsy are
experiencing some kind of social skills deficit. individuals have social skill
deficits; they failed to learn effective social behavior and their anxiety is
in part a reaction to those deficits and the resulting negative responses.
Because convulsion activity can be unpredictable, people with epilepsy
can become quite fearful of being out in public. Even if a person has had
only a few convulsion, he or she may live in fear that it will happen again.
To avoid the possible embarrassment of having a convulsion in a social
9th International Congress on Epilepsy situation, many people avoid social situations all together. They become increasingly isolated, lonely, and even depressed. Their lives become organized around their fear that they will have a seizure and their efforts to avoid this possibility. The reported frequency and severity of emotional and behavioral problems in children with epilepsy would suggest that a comprehensive epilepsy service should provide assessment and treatment of psychiatric problems and there should be regular monitoring of psychological adjustment of children with epilepsy.
Key Words: communication skills, social phobia, epilepsy
9th International Congress on Epilepsy Evaluation of Brain MRI Findings in the Patients
with Seizure and normal physical examination
Hesami Omid, MD, Noorbakhsh Mahyar, MD Department of Clinical Neurology. Imam Hossein Hospital, Shahid Beheshti Medical University, Iran Background: seizure is an important symptom in neurological diseases
with a incidence of 3% all over the life in adults. In this study we surveyed
MRI findings in the patients with seizure to find better diagnostic.
Materials and methods: In the cross sectional study, we investigated 148
patients with seizure who admitted in the neurology ward. Brain MRI was
done in all patients and abnormal finding evaluated in them.
Results: There were 68(46.1%) female and 80 (53.9%) male. Mean age
was 43.6±22.7 years. Abnormal brain MRI was seen in 26(17.5%) patients.
In 122 (82.5%) patients brain MRI was normal. The main affected location
was temporal lobe(27.5%) and Generalized Tonic – clonic seizure was
the most common seizure type(52%). The most common etioloy was
epilepsy in this survey(32.4%).The most common abnormality in MRI was
Hippocampal atrophy(23%) in the abnormal imagings .EEG findings have
no significant correlation with Brain MRI .For age group classification ,the
most abnormalities were seen in adult group(35-64 years old). Paitients that
have neoplasm, trauma and vascular event in their history, have significant
correlation with abnormal Brain MRI.
Conclusions: Brain MRI may recommend in the patients with seizure
base on clinical finding and is not necessary in all patients with seizure.
9th International Congress on Epilepsy CSF abnormalities in idiopathic seizures
Hesami Omid, Assistant professor of neurology. Imam Hussein hospital , Shahid beheshti medical university, Tehran, Iran.
Seizures can be the presenting manifestation of such diverse central nervous system (CNS) disorders as meningitis, intracerebral hemorrhage, stroke, or brain tumor. An LP undertaken in a patient presenting with a recurrent or new-onset seizure, is usually done to exclude one of these conditions, particularly infection or subarachnoid hemorrhage, especially when initial brain imaging studies are normal. A common dilemma facing clinicians is what CSF findings can reasonably be attributed to the seizure itself, and what changes are indicative of some underlying pathology that caused the seizure to occur?A common clinical conundrum is whether an elevated CSF white blood cell (WBC) count following a seizure indicates some underlying pathological process or is simply the result of the seizure itself. Data derived from studies conducted primarily in adults suggest that a mild CSF pleocytosis may occur immediately following a seizure in a subset of patients (5–10%) and can be attributed to the seizure itself. In general, a high CSF WBC count and a significant proportion of PMNs are unusual following seizures. It is therefore incumbent on the clinician to investigate such a laboratory abnormality in any patient with new-onset seizures, as it is more likely to reflect a potentially treatable underlying disorder. In children, fever without a known source leading to seizures may sometimes cause a few PMNs to accumulate in the CSF. Thus, the best clinical judgment should always be applied when faced with this situation in an individual patient, knowing that very early meningitis can produce a similar CSF profile without a large number of cells. Close clinical observation of these patients is indicated. Also, it appears that a low-grade CSF pleocytosis may occur post-ictally in some children with idiopathic seizures.
Taken together, the available data suggest that the majority of adults with seizures have normal CSF protein levels in the acute post-ictal period. Also, there may be mild elevations of CSF protein content in children with seizures. Based on available data, it does not appear that seizures alter CSF glucose levels out of proportion to serum glucose concentrations in adults. On the other hand, methodological problems still preclude firm 9th International Congress on Epilepsy conclusions about CSF glucose concentrations in children.
In summary, CSF abnormalities are extremely uncommon after idiopathic seizures. Still, abnormal findings in the CSF of a patient with new-onset seizures mandate further investigation, as these can reveal underlying pathologies that are treatable in nature.
9th International Congress on Epilepsy Evaluating of epileptic subtypes (generalize - focal)
among epileptic patients admitted in 22Bahman &
17shahrivar hospitals in mashad during years 2011-2012
DR seyed mehran hommam (assistant professor of neurology.epilepsy fellowship.department of neurology.
mashhad branch.islamic azad university.mashhad.iran) Abstract: Seizure is a temporary impairment of brain function caused
by abnormal neuronal electrical activity. Epilepsy is a group of such
disorders that are characterized by frequent seizures and is a common
cause of unconsciousness. Nowadays epilepsy is considered as one of the
most frequent neurological diseases, involving wide range of age, So we
decided to determine epileptic subtypes in the statistical community.
Results: In this study, data were collected from 350 patients and 50 (14%)
of them were omitted due to consumption of Tramadol. 162 (54%) and
138 (46%) patients out of 300 were respectively male and female. The
mean age was15/3 ± 31/5 years old and its highest frequency were related
to people of 21 to 30 years old (101 cases, 34%). On average, 10 months
after onset of symptoms, epilepsy has been diagnosed. 91% of Physical
examination findings, 49% of the last EEG findings and 85% of the brain
imaging findings in these patients were normal. The average number of
attacks were 15/3 ± 11/3 times that the highest frequency (125 cases -42%)
is related to patients with 2 to 5 attacks.
Conclusion: Considering that this study is the first one in our country that
evaluate the epileptic subtypes, Generalized epilepsy in 78% and focal
epilepsy in 22% patients were seen. So tonic - clonic seizures with more
than 72% of generalized seizures were the most important and secondary
generalized seizures were the most common types among the focal forms
in our study.
Key Words: Epilepsy, Prevalence, Generalize Epilepsy, Focal Epilepsy
9th International Congress on Epilepsy Frequency of tramadol induced seizures among
DR seyed mehran hommam (assistant professor of neurology.epilepsy fellowship.department of neurology.
mashhad branch.islamic azad university.mashhad.iran)Coworkers; Dr alireza alehashemi.Dr mohsen mehdi nejad.dr javad rezaian Abstract: symptomatic seizures are defined as a group of attacks which
induced because of identifable causes such as drugs,trauma,multiple
sclerosis metabolic disturbances and vascular events.the aim of this study
was to clarify frequency of these etiologies.
Material and methods: around 120 patients who had symptomatic
seizures were enrolled in these study.complete laboratory,electroence
phalographic and neuroimaging investigations was performed inclusion
criteria was based on age group more than 15 years old and no history of
previous seizure and identifable cause.
Location of investigation was 22 bahman hospital mashhad medical
islamic azad university.
Results: most of patients belonged to third and 6th decades.the most
common cause(28%)was tramadol consumption.other causes were due to
trauma,metabolic and vascular causes.male group incuded 60% of cases.
Conclusion: in contrast to other publications ,tramadol was the first cause
of symptomatic seizures in our study.
On one hand it may result in misdiagnosis of epilepsy and longterm
treatment and on another hand self abuse of tramadol has been increased
since recent years.
9th International Congress on Epilepsy Opium addiction and early seizure in stroke
Dr Iranmanesh F, Dr Shafa M A,Dr Shafa,M SNeurology Research Center, Kerman University of Medical Sciences Introduction: Stroke is one the most common causes of seizure especially
in elderly patients. Some studies show that opium addiction increase risk
of early seizure (ES) in patients with stroke. In this study we evaluated, the
correlation between ES and opium addiction in patients with acute stroke.
Methods: This was a cross-sectional study that has done on 400 stroke
patients. All the patients were assessed about early seizure daily. ES was
defined as seizure occurring within 7 days from stroke onset. Also, they
were assessed about opium addiction. Data were analysis by Chi square
test.
Results: In this study35 Percent of patients were men and 65percent were
women. 55 patients (%13/75) had early seizure. Among patients early
seizure, 15 persons had opium addiction. Early seizure in patients with
opium addiction was significantly higher. (P<0.05)
Conclusion: Our findings show that opium addiction is a risk factor for
early seizure.
Keywords: Opium addiction, Seizure
9th International Congress on Epilepsy Endosulfan poisoning and seizure
Dr Iranmanesh F, Dr Shafa M A,Dr Shafa,M SNeurology Research Center, Kerman University of Medical Sciences Introduction: Endosulfan poisoning is one of the most frequent poisoning
in Kerman state. There are many different presenting symptoms andsigns
with this poisoning such as nausea,vomiting, decrease level of consciousness
and seizure. The objective of the study was to evaluatefrequency of seizure
as a presenting sign in patients with endosulfan poisoning.
Methods: In this retrospective study 57 patients were evaluated. All
patients had drunken poison in order to suicide except 2 patients. Data
were analyzed withsoftware SPSS16 and statistical descriptive methods
(mean- percentage, SD).
Results: Of all patients, 44 were male. 51 patients had seizure as a
presenting sign. Seizure type was generalized tonic-clonic. 49 patients had
status epilepticous and forty sixpatients had refractory status epilepticous.
Conclusion: Our study results showed that seizure is the most common
presenting sign in endosulfan poisoning. Most of them show status
epilepticous presentation.
Keywords: Endosulfan poisoning, Seizure
9th International Congress on Epilepsy A brief look in to the world of epilepsy
Hossein kalanie m.d., neurologist Epilepsy has been on the planet as far back as time will take us. Few medical conditions have attracted so much attention and generated so much debates as epilepsy. It affects an estimated 2.2 million people in the united states and more than 65 million people worldwide. Roughly 150.000 new cases of epilepsy are diagnosed in the us each year. Epilepsy is the fourth most common neurological disorder after migraine, stroke and alzheimer,s disease. The disease has been the subject for maney nobels and movies and many famous people had been affected by iy throughout the history such as julius caesar. Charles dickens, agatha christie and alexander the great just to name a few. Although in recent years we wittnessed a paramount progress in neuro-imaging thecniques, still EEG stands as the key tool for its classinication, diagnosis, and follow up of patients. To day the knowledges related to this disorder has been much expanded to offer epileptology a Fellowship in domain of neurology. Below we name some of the topics coverede by this branch of neurology:1- Epilepsy and EEG.
2- Neonatal and child epilepsy.
3- Epilepsy and psychiatry.
4- Living with epilepsy.
5- Epilepsy and driving.
6- Epilepsy and work.
7- Epilepsy in reproductive age8- Epilepsy in elderlies.
9- Epilepsy and surgery,10-Epilepsy in elderlies. 11-Aeds & warfarin.
12-Aeds in kidney and liver disease 13-Drug of choice for each seizure type.
14-Detoriorating effect of some aeds on certain types of seizures.
15-Aeds,side effect 16-Aeds side effects.
9th International Congress on Epilepsy Personal and SocialEffects ofEpilepsyin the Patients
Kamal golpasha (Bushehr UniversityOf Medical Sciences And Heal Services) Introduction: The Problems of a patient with epilepsy starts when his
disease is diagnosed and he involves thevarious physical and mental
problem scaused by thisdisease, including thesocial consequences ofind
ividual and family conflict relating to the sense of stigmatizing in the
society. It is natural thatsuch issuesin thelife of the patient, creates some
problem sincontinuity of the careprocess.The role of family in the first
place and community is very important in mitigating of these problems
and providing fair prosperity of these people.
Objective: Although epilepsy is an ancientd is ease and is known as a
specific disease, butthe social response to this disease is still unknown
and one of the biggest concern of this patient populationis associated with
the false beliefs of people about this disease. This study tries to describe
epilepsy scientifically, and its impacton personal and social life of the
studied patients andexpress the factors of increasing and decreasing these
effects.
Method: This study is are view article provided by examining more than
31 article sand electronic books related to the research that have been
publish edinthe last5 years.
Conclusion: Due tothe need of creating are markable transformation in
individual lives, suffering from epilepsy is considered as a stress.The
refore, patients should take steps to identify, treatand adapt their lives to the
disease.For adapting to epilepsy, the most important factoris that patient
accepts the reality of being epileptic, and accepts the need to cope with its
problems. Besides all psychotherapy services that are necessary for special
patients, this fact is undeniable that correcting culture and false beliefs of
the society, Changes and improvements of necessary policies in the field
of social justice, development of social services and financial supports that
is running in developed countries for years are essential.
Keyword: epilepsy, epileptic
9th International Congress on Epilepsy Effects of quinine on epileptogenesis and seizure
Jafar Kazemi Ghanbrabadi (Department of Biology, Faculty of Basic Science, Shahed University, Tehran, Iran) (Department of Physiology and Pharmacology, Pasteur Institute of Iran, Tehran, Iran)Mohammad Sayyah (Department of Physiology and Pharmacology, Pasteur Institute of Iran, Tehran, Iran)Majid Hasanpoor ezzati (Department of Biology, Faculty of Basic Science, Shahed University, Tehran, Iran)Fatemeh Gholami (Professional and technical group, Education Department of Gonabad, Khorasn razavi, Iran)Maryam Poormoosavi (Department of Physiology and Pharmacology, Pasteur Institute of Iran, Tehran, Iran) Introduction: Epilepsy is one of the most common neurologic disorders. In
spite of advances in neuroscience, 30% of epileptic patients are still drug-
resistant. Therefore, a demand for new effective anti-epileptic drugs exists.
There is a GABAergic neural network in CA1 area of the hippocampus
with an intercellular communication by gap junctions (GJs) comprise of
Connexin36 (Cx36). Those impress propagation or prohibition of epileptic
attacks. In this study the role of Cx36 in manifestation of kindled seizures
as well as kindling rate were evaluated.
Methods: Male Wistar rats were implanted by stimulating and recording
electrodes in the amygdala and an injection cannula in the CA1 area of
hippocampus. Quinine (as a selective blocker of Cx36) was injected (1, 30
& 100 μM) once daily into the CA1 and the rate of kindling was recorded.
Quinine was also administrated intra- CA1 (1, 100 & 1000 μM) and then
kindled seizures were elicited in fully kindled rats.
Results and Conclusion: Chronic intra-CA1 administration of quinine
(100 μM) accelerated the kindling rate. Chronic block of Cx36 eliminates
inhibitory activity of GABAergic interneurons of the network in the CA1
area, which result in facilitation of epilepsy acquisition. Acute intra-
CA1 injection of quinine had no significant effect on kindled seizures
parameters which can pertain to Cx36 intracellular binding site and its
short time accessibility.
9th International Congress on Epilepsy Conditions that mimic seizure
Dr. Z. Keihani douste MD (Ped. Neurologist) (Associated professor of Tehran University of Medical SciencesImam Khomeini Medical Complex) The misdiagnosis of epilepsy has been estinated to be as high as 5-40%. Often all that is needed to be differentiated nonepileptic paraoxysmal disorders from epilepsy is a careful history and thorough exam. But sometimes more advanced testing may be necessary. Non epileptic paroxysmal disorders can be classified according to the manifestations:1. General paroxysms, 2. Abnormal movements and postures, 3. Oculomotor abnormalities, 4. Sleep related disorders.
Key words: Mimic seizure, breath holding, syncope, masturbation.
9th International Congress on Epilepsy Table - CONDITIONS THAT MIMIC SEIZURES ACCORDING TO AGE OF PRESENTATION Paroxysmal tonic up Benign neonatal sleep Paroxysmal dystonic Alternating hemiplegia Sleep transition Paroxysmal extreme Paroxysmal tonic arousal disorders Paroxysmal dystonic Oculomotor apraxia REM sleep disorders holding spells Benign Narcolepsy Sleep paroxysmal vertigo Benign myoclonus transition disorders Pathologic startle of early infancy myoclonus syndrome Paroxysmal extreme paroxysmal torticollis Jactatio capitis head Benign paroxysmal Daydreaming Drug arousal disorders Pathologic startle REM sleep disorders Narcolepsy Sleep valsalva Alternating Benign paroxysmal transition disorders Familial hemiplegic disorders including proxy, malingering orthostatic, migraine- Jactatio capitis (head seizures Cataplexy Hyperventilation 9th International Congress on Epilepsy Keihanidouste Z. MDAssociate Prof. of Ped. Neurology, Imam Khomeini Hospital TUMS Background: Headache as well as convulsion are the most common
problems in ped. Neurology and pediatric out patients. But epileptic
headache is a problems that could be considered when there is some sort
of headache.
Methods & Materials: In a retrospective study we evaluated 44 cases with
main chief complain of headache for sinusitis, migraine, visual problems,
ferritin deficiency, hyperthyroidism space occupying lesion and epilepsy.
Results: Most there were more than one reason for headache, 50% had
migraine, 40% ferritin deficiency syndrome and 25.6% had abnormal EEG
with brief hurting headache. These patients had good respone with sodium
valproate or lamotrigine.
Discussion: Epilepsy and headache are common chief complains in
pediatric and ped. Neurology out patients, many of them considered as
migraine and managed by antiepileptic drugs and after tapering the drug
there is recurrence of headache. Now many of neurologist think about
epilepsy more than headache especially when there is a brief hurting
headache that could be subsided without any thing.
Conclusion: By using check list about headache, we can find epilepsy.
9th International Congress on Epilepsy Antidepressants and Epilepsy
Dr shahir mazaheri (Associate professor-Department of neurology-farshchian hospital- hamedan-iran) The classes of antidepressants available include monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), serotonin-specific reuptake inhibitors (SSRIs), and newer compounds designed to increase serotonin, norepinephrine, dopamine, or a combination of these.
Some neurotoxicities such as antidepressant discontinuation syndrome, serotonin syndrome, and poisoning are common to all antidepressants. Depression is the most common psychiatric disorder in epilepsy., with a 20% to 55% prevalence rate and a suicide risk of three to five times that of the worldwide population.
Depression often goes undiagnosed in patients with epilepsy, because symptoms of depression may be viewed as a normal reaction to illness. However, accurate diagnosis of depression is critical because depression is associated with poorer quality of life, employment, and family functioning. Therefore, patients with epilepsy often require antidepressant treatment. However, most antidepressants have been reported to induce seizures. Antidepressants should be used when a depressive episode is severe and long lasting, in particular when there are no promising options of modifying the AED treatment regimen.
It is important that antidepressants, when indicated, be used properly, meaning that adequate dosages are prescribed over a sufficiently long period. Antidepressants with low proconvulsive risks are recommended. However, the risk of antidepressants provoking seizures is generally overestimated. Further, antidepressants that are effective in the treatment of depression also may enhance the control of seizures, because patients sleep better and are likely to be more compliant with their AEDs. SSRIs have a relatively low epileptogenic potency.
Experimental research using animal models showed that there may be a dose-dependent antiepileptic effect of SSRIs. Other drugs with minor seizure risks are the monoamine oxidase inhibitors, as well as atypical antidepressantssuch as viloxazine and trazodone. Because of their strong proconvulsive effects, among the classic antidepressants,maprotiline and clomipramine should be avoided.
9th International Congress on Epilepsy public attitudes and awareness towards epilepsy in
Dr Mazdeh. M-Arji. A- Mortazavi.S OBJECTIVE: Epilepsy is one of the most frequent neurological diseases.
Social acceptance is very important for people with epilepsy and their
relatives. This is a survey on public attitudes and awareness towards
epilepsy in Hamadan the state is located at the West part of Iran .The state
itself has 500000 population.
METHODS: There were 600 respondents& The survey was based on a
questionnaires(20Q) related to attitude and awareness towards epilepsy
conducted by psychology students. Then performances of questionnaires,
data analyzed with soft were spss(v.11).
RESULTS: 54/4% of the respondents have not awareness of epilepsy that
showed a significant statistical difference between awareness with age
,marital status ,occupation &education level (P<0.05). With high education
& age objected have high awareness of epilepsy. The negative attitude
towards epilepsy is 46%, with age increased the respondents have high
attitude of epilepsy (p<0.05). 44.8% objected to their children associating
with a person who sometimes had seizures, 30.6% objected to their
children marrying someone who sometimes had seizures, 16% thought the
people with epilepsy should not be employed in jobs like other people.
74% objected identified epilepsy & main source of knowledgement were
radio, TV & relatives.
CONCLUSIONS: The survey of a urban population in Hamadan of Iran
showed the respondents were familiar with epilepsy but had negative a
attitude & poor knowledge on causation. By efforting of permanent and
widespread education programmes should be made to improve public
attitudes and awareness &understanding towardsepilepsy
Keywords: Epilepsy, Knowledge, Attitude
9th International Congress on Epilepsy Single Photon Emission Computed Tomography and
Localization of Seizure
Jafar Mehvari1- Isfahan Neuroscience Research Center and Department of Neurology, Faculty of Medicine, Isfahan Univer-sity of Medical Sciences, Isfahan/ Iran2-Shefa Neuroscience Research Center Tehran/Iran SPECT is a functional imaging test that can provide a semiquantitative map of cerebral blood flow change associated with the epileptogenic zone. When the radiotracer is injected during seizure activity (ictal SPECT), it can provide snap shot of the triansient hyperperfusion at the region of the focal seizure activity.
It is essential that the pri-ictal SPECT injection be performed while the patient is undergoing video-EEG monitoring. Ictal or postictal, SPECT image have to be compared with Interictal SPECT. Ictal blood flow change consists of focal hyperperfusion at the mesial and anterolateral region of the temporal lobe. Within 1 to 5 minutes following the termination of seizure activity the lateral temporal neocortical region becomes intensely hypoperfused while the mesial temporal region remain slightly hyperperfused.
The calculation sensitivity for ictal SPECT for TLE is 90% with a false positive rate of 1.5%. Diagnostic test such as SPECT to have an important role in the pre surgical evaluation of partial epilepsy patients. Ictal SPECT has been reported to have a sensitively of 81% to 95% and specificity of about 93% in extra temporal epilepsy. Ictal SPECT correctly lateralized EEG focus in 87% of MRI negative patients compared with 82% with PET. Ictal SPECT appears to have useful role in identification of the nonlesional epileptogenic zone. Apply a method of subtraction ictal SPECT with co registration on MRI (SISCOM) for epilepsy evaluation overcome to limitation. Prompt injection of the SPECT radioligand and early during the seizure must be attempted to improve. Moreover SPECT result have to be integrated with other data of seizure localization from the clinical history, neurological examination, seizure semiology, ictal EEG and structural and functional imagining test.
Key Word: Ictal SPECT , epilepsy, localization
9th International Congress on Epilepsy Epilepsy and education to parents
Bahareh Mohamadsalehi (Master of Community Health Nursing) Farkhondeh Behzadi (MSc Nursing management of children - Bushier University of Medical Sciences - Genaveh, hospital Amir (AS).
Introduction: Epilepsy is a chronic and recurrent disorder, an attack which
may require prolonged treatment and its effects on family functioning
is noteworthy, in this respect to educating children with epilepsy of the
estuary has special importance.
The literature review: Methods This study was a retrospective collection
of library materials through the key terms of epilepsy, education has been
parents
Content: Chronic illness affects families with high duties, responsibilities
worry topic related to child care, educational services medical, bear the
costs of services, an unknown future compassion, emotional responses
from community stigma, social isolation obtained from the social
opportunity Pediatric nurses must parents hope that the disease is not
the child's short life. Can go to school, Marry, Children must be. he Is
important to have a positive attitude towards the child's parents encouraged
and create a sense of responsibility for the adequacy of the coming of the
children they help. Children should be trained like normal children. Many
parents cannot punish the child. If you are experiencing emotional stress
is enhanced seizure. However, this feeling must be created in which the
child is different with others, Parents should be encouraged in children and
others with this disorder may be true.
Conclusion: Epileptic children in need of care are a planned program.
Adequate knowledge of disease causes, Patient and family cooperation
and follow-up treatment and care of children is more important.
9th International Congress on Epilepsy Evaluation of training needs of parents of children with
epilepsy admitted to the pediatric hospital, Ali (AS)
Bahareh Mohamadsalehi (Master of Community Health Nursing) Farkhondeh Behzadi (MSc Nursing management of children - Bushier University of Medical Sciences - Genaveh, hospital Amir (AS) Introduction: Epilepsy is one of the oldest and most common neurological
disorders that begin in childhood. Since the course of the disease is chronic
and recurrent training and emotional support to parents of an intervention
is considered.
The research objectives: Include the training needs of parents of children
with epilepsy and in recognition of disease-causing agents, the training
needs of care, medication and exercise and performance if it is attacked.
Tools and Methods: Include the training needs of parents of children with
epilepsy and in recognition of disease-causing agents, the training needs of
care, medication and exercise and performance if it is attacked.
Results: The results showed that the first 2/85 percent and 63 percent of
parents in understanding the causes of disease are low. The second goal in
the field of drug research showed that 79 percent, 99 percent of the sports
field, attack 93%, 89% of academic skills of mothers in case of attack is
low. Finally, 92 percent of mothers in need of child care training.
Conclusion: Due to the necessity of proper planning for the education of
mothers in child care is very popular.
Key words: epilepsy, education, parents
9th International Congress on Epilepsy Evaluation of prevalence of epilepsy according to
EEG in children admitted for seizure, Azad University
Dr. Marjan Mohammadnoori (Pediatrition,Assistant professor,Department of pediatrics,Islamic Azad University ,Tehran Medical Branch,Tehran,Iran) Intruduction and Objectives: seizure is a complex neurologic disorder
with disfunction of neurons and abnormal electrical discharges because of
cerebral tumors ,cerebrovascular diseases,poisons and fever.Children with
relapsing seizure,are at risk of behavior disorders.So on time diagnose
and treatment are important. The first test is Electroencephalogram (EEG)
that have a good specificity . In this study ,we evaluate the prevalence
of epilepsy according to the EEG in children admitted for seizure in
Azad University Hospitals from 2006 to 2011.This study was performed
to evaluate the prevalence of epilepsy according to the EEG in children
admitted for seizure in Azad University Hospitals from 2006 to 2011.
Methods and materials: In this cross-sectional study, 100 children
admitted for seizure in Azad University Hospitals from 2006 to 2011 were
enrolled the prevalence of epilepsy according to the EEG was assessed
among them.
Results and Conclusions: In this study,32% of children had epilepsy that
was not significantly associated with age,sex,and family history of seizure
among them(P>0.05).Totally, according to the obtained results in this study
and comparison with other studies it may be concluded that prevalence of
epilepsy according to the EEG in children admitted is very low.
9th International Congress on Epilepsy The relationship between migraine and epilepsy
Rahele Mohseni (MSc. of Critical care nursing, Department of Medical Surgical Nursing, Nursing and Midwifery faculty, Kashan University of Medical Sciences, Kashan, Iran) Objectives: A controversial debate exists about relationship between
migraine and epilepsy.This realationship has intrigued neurologists for
more than a century. Occurance of both diseases in the same patient is seen
by some authors as a chance association, but many other experts consider
that there may be common pathogenesis aspects.
Methods and Materials: This study is a retrospective study, which
collected data from relevant articles and databases have been available.
Results: Epilepsy and migraine are comorbid disorders. In other words,
the occurrence of migraine in people with epilepsy is greater than would
be expected based on the usual prevalence of migraine. Not only do they
often occur together, but they share common features, including the fact
that both are episodic. In both illnesses, a person is often completely
unaffected between the paroxysms. Recent evidence has shown that the
mechanisms by which each "attack" occurs may be similar. Finally, there is
overlap between the treatments of these illnesses: several of the antiseizure
medications also are effective in both the treatment of acute migraine and
in migraine prevention.
Conclusion: Epilepsy and migraine share many common features. They
are both episodic, often with normal thinking and function between events.
They share common etiologies such as head injuries, stroke, or central
nervous system neoplasm. Both are disorders of neuronal excitement.
Interestingly, both share common treatment options as well. The goal of
treatment for both is to improve a person's quality of life. Often, this means
eliminating the events while preventing side effects. Because polypharmacy
often leads to frequent side effects, when a person has both epilepsy and
migraine, it is logical to try to "consolidate" treatments. In other words, it
might be possible to treat both illnesses with one medication.
9th International Congress on Epilepsy Investigating the effect of rTMS on excitability of CA1
hippocampal pyramidal neurons following amygdala-
kindling in male adult rats
Homeira Moradi (Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran)Seyed Javad Mirnajafi-Zadeh (Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran)Amir Shojaei1, Saeed Semnanian (Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran)Saeed Semnanian (Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran)Seyed Javad Mirnajafi-Zadeh (Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran)Mahyar Janahmadi (Department of Physiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran)S. Mohammad Firoozabadi (Department of Medical physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran) Introduction: Unfortunately, about 40℅ of epileptic patients suffer from drug-
resistant epilepsy. So, there are many efforts to find new ways for epilepsy
treatment. One of the new therapeutic ways is stimulation of brain with
repetitive transcranial magnetic stimulation (rTMS). As the anticonvulsive
mechanisms of rTMS has not been known, in this study we investigated the
effect of rTMS on hippocampal CA1 neurons following amygdala kindling.
Methods: In control group, animals were rapidly kindled by 1 ms square
waves, 50 Hz, at the afterdischarge threshold intensity for 3 s. These
stimulations were applied to the amygdale 12 times per day at 5 min intervals.
In rTMS group, 5min after kindling stimulations, animals received rTMS at
the frequency of 1 Hz for 4 min. 24 h after achieving stage 5 seizure in control
group and after the same days in rTMS group, brain slices were prepared and
the electrophysiological properties of CA1 pyramidal neurons were assessed
by using whole-cell patch clamp technique.
Results: Obtained data showed that threshold, time to peak and delay of
rebound spike increased and number of rebound spike decreased in rTMS
group compared to control group.
Conclusion: The present findings show that rTMS decreased neuronal
hyperexcitability through alteration of the electrophysiological characteristics
in hippocampal CA1 pyramidal neurons.
Keywords: Amygdala kindling, rTMS, Hippocampal Pyramidal Neurons,
Whole Cell Patch Clamp Recoding,
9th International Congress on Epilepsy The comparison of anxiety sensitivity in patients with
epilepsy and normal group
Hanzaleh Mosavi, M.A in educational psychology, The Education Organization of Fars Province, Shiraz, Iran. Introduction: Several large studies have shown that the rate of mood
disorder is higher in patients with epilepsy than in those with other chronic
medical conditions such as diabetes and asthma. Most of the attention has
been focused on depression, despite the fact that anxiety may actually be
more common and equally disabling. Anxiety disorders in patients with
epilepsy may have a major impact on daily living. Anxiety sensitivity
is defined as the fear of anxiety-related bodily sensations derived from
beliefs that these symptoms have harmful physical, psychological, or social
consequences. individuals with higher levels of anxiety sensitivity, their
outcome expectations can serve to increase (1) fears about experiencing
anxiety (anticipatory stage), (2) anxious arousal, and (3) the subsequent
use of cognitive or behavioral strategies to escape internal sensations.
Methods: in this case – control setting, 20 male with epilepsy age 22 – 30
years referred to hospitals of shiraz city using convenience sampling method.
20 healthy male age – matched counterparts were enrolled randomly from
the city and served as the controls, as well. All the participants filled the
Scale List of the anxiety sensitivity scale.
Results: results indicated a significant difference between the anxiety
sensitivity in patients and normal groups. Regarding the ASI sub-scales,
there was a significant difference between patient and normal groups in
fear of respiratory symptoms, fear of cardiovascular symptoms, fear of
publicly observable anxiety reactions and fear of cognitive dyscontrol.
Conclusion: Epilepsy is a chronic disorder carrying a severe burden on
affected people. Psychiatric aspects of epilepsy have been extensively
reviewed in the past. peaple living with epilepsy often face physical and
psychological struggles that may impair their health-related quality of life.
Today it is accepted that anxiety disorders represent a frequent and clinically
important comorbid disorder in epilepsy patients. Increased awareness of
the clinical presentations of anxiety disorders may help clinicians provide
improved, comprehensive treatments to their patients, thus improving
9th International Congress on Epilepsy overall outcomes and quality of life in people with epilepsy.
Key Words: anxiety sensitivity, patients with epilepsy, normal group
9th International Congress on Epilepsy Epilepsy in the Setting of Cerebrovascular Disease
Mahmoud Motamedi, M.D. Associate professor of neurology Department of neurology, Sina Hospital. Tehran University of Medical Sciences Tehran Iran.
Cerebrovascular disease is a significant cause of seizures and a Risk for the development of epilepsy in all age groups.
Stroke is a common cause of morbidity and mortality in the Elderly population and is the leading cause of epilepsy in Patients older than 60. Cerebrovascular disease is less common in the pediatric population, but early vascular insults are associated with an increased incidence of epilepsy as compared to adult patients. Understanding the prevalence, etiology, and risk factors associated with poststroke seizures and epilepsy is of vital clinical importance, and multiple studies have attempted to address these issues. The management, prognosis, and treatment of seizures and epilepsy associated with cerebrovascular disease are less well known and will remain an important area for investigation.
Poststroke seizures occur in 7% to 11 % of new onset strokes. Approximately one third of these occur as acute symptomatic or early onset seizures and are predicted to have a higher 30-day mortality and decreased incidence of seizure recurrence. While the unprovoked or late seizures are predicted to have 50% to 70% recurrence rates, and thus frequently develop into poststroke epilepsy. The prevalence of poststroke epilepsy is 2% to 4% in patients with new onset strokes. Status epilepticus occurs after stroke in a smaller portion of patients (1.5%), but is associated with an early onset and high mortality.
The treatment of poststroke seizures and epilepsy has been controversial.
Unfortunately, there are no randomized controlled trials of treatment for patients with poststroke seizures or epilepsy. The risk of seizure recurrence after an early seizure has been reported from 13% to 43%. This is similar to the recurrence risk of 24% that is quoted to patients with a single seizure and normal imaging and EEG studies. However, the risk of recurrent seizures 'after a single late onset seizure is in the range of 54% to 66%, thus some have advocated treatment with antiepileptic drugs after even a single late onset seizure, while others prefer to treat after a second unprovoked seizure. When medications are used, these seizures 9th International Congress on Epilepsy tend to respond to monotherapy with relatively rare recurrence. Though no studies have been conducted in poststroke epilepsy patients per se, a study compared lamotrogine, gabapentin, and carbamazepine in the elderly (with stroke the most likely etiology of the majority of seizures) has shown that seizure control was similar among all three drugs, but tolerability favored lamotrigine and gabapentin. Decreased interactions with other medications are an added advantage of the newer AEDs when considering medications for poststroke epilepsy.
9th International Congress on Epilepsy The effect of Tanacetum Sonbolii hydroalcholic extract
on PTZ-induced seizures in male mice
Naderi Firozeh (Academic Member of Department of Physiology, Qazvin University Of medical Sciences, Qazvin, Iran)Sofiabadi Mohammad (Assistant professor of Department of Physiology, Qazvin University of Medical Sciences, Qazvin, Iran)Erami Elaheh (Assistant professor of Department of Biology, Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, G.C., Evin, Tehran, Iran)Sonboli AliHassan Azhdari Zarmehri (Assistant professor of Department of Physiology, Qazvin University of Medical Sciences, Qazvin, Iran)Mohammad Mohammad-Zadeh (Assistant professor of Department of Physiology & Cellular and Molecular Research Center, Sabzevar University Of medical Sciences, Sabzevar, Iran) Introduction: Epilepsy has prevalence about 0.5-1% of world population.
As long as many years, plants used for the treatment of various neurological
diseases such as seizures. The anticonvulsant effects of hydroalcoholic
extract of Tanacetum Sonbolii was examined in male mice.
Methods: 60 mice were randomly divided into six groups (n= 10),
included: A control group (normal saline) and 5 groups receiving Sonboli
extract (150, 300, 600, 900, 1200 mg / kg). 30 min after peritoneal injection
of different doses extract or saline, PTZ (85 mg /kg) were injected and the
animal immediately transferred to a special cage, and the seizure behavior
was evaluated within 30 minutes.
Results: The tonic and clonic seizures were significantly reduced in the
groups that received extract compared to control group. The onsets of
seizures were difference between treated and control animals statistically.
Extract were reduced the rate of death during seizures and was prevented
the outbreak of tonic - clonic seizures in some case.
Conclusion: Our results showed that the extracts of Tanacetum Sonbolii
have strong anticonvulsant effect, and more complementary studies will
be done for identifying the mechanism of action and effective material of
Sonboli exact.
Keywords: Tanacetum sonbolii, Seizures, PTZ, Mice
9th International Congress on Epilepsy Progesterone therapy in women with intractable
Mohammad Reza Najafi MD (Associate professor of neurology) (Neurology Section, Al Zahra Hospital, Sofeh Street, Isfahan, Iran)Maedeh Mirmohammadsadeghi MD (Resident of neurology)Jaafar Mahvari MD (Associate professor of neurology)Mohammad Zare MD (Associate professor of neurology)Department of neurology, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciencess, Background: Catamenial epilepsy is a subset of chronic seizure, which
includes women of whom their seizure exacerbation is aligned with
their menstrual cycle. The present study examined the progesterone
effectiveness as a complementary treatment in women with intractable
catamenial epilepsy.
Methods: The present study was conducted as a double-blind randomized
controlled trial on 38 women with intractable catamenial epilepsy. Patients
were assessed in two groups: case group received in addition to AEDs,
two (Mejestrol) 40 mg. progesterone tablets in the second half of the cycle
from 15th to 25th day. And control group received in addition to AEDs,
two placebo tablets daily. Age, BMI, epilepsy duration, types of the drugs
used, progesterone level and the number of the seizures in three months
before and after the study.
Results: Based on the results of which there was no statistically
significant difference in regard to Age, BMI, epilepsy duration, types
of the drugs used, progesterone level between the case and the control
groups (P-value>0.05). The number of the seizures after treatment has
significantly decreased compared to before-treatment state. The degree of
decreasing in the case group receiving the progesterone was higher than in
the control group receiving the placebo. The difference, thus, is significant,
based on statistical tests (P-value=0.024).
Conclusion: Based on the findings of this study using progesterone in
women with intractable catamenial epilepsy has significant effect on the
degree of decreasing in the number of the seizures.
Key words: epilepsy; catamenial epilepsy; progesterone; seizures
9th International Congress on Epilepsy Changes in expression of regulators of G proteins in
the anticonvulsant effects of low frequency stimulation
during kindling in rats
Simin Namvar, Javad Mirnajafi-Zadeh*, Mohammad Javan, Maryam ZeraatiDept. of Physiology, Faculty of Medical Sciences, Tarbiat Modares University Introduction: Application of low-frequency stimulation (LFS) has
anticonvulsant effect. Activation of G protein coupled receptors is one of
the LFS anticonvulsant mechanisms. Thus, in this study the changes in
expression of regulators of G proteins (RGS) following anticonvulsant
effects of LFS were investigated.
Methods: Animals were kindled by perforant path stimulation in a rapid
kindling manner (12 stimulation per day, 1 ms pulse duration at 50 Hz).
LFS (8 stimulation per day, 0.1 ms pulse duration at 1 Hz, 200 pulses)
was applied to perforant path 5 minute after termination of kindling
stimulations. After electrophysiological recordings for 6 days, the dentate
gyrus of animals removed and the change of RGS4 and RGS10 (as
regulators of Gi) and RGS2 (as regulator of Gs) protein expression was
studied by Western blotting technique.
Results: Application of LFS significantly retarded kindling acquisition
and prevented the increase in slope of field excitatory post synaptic
potential and population spike amplitude. In addition, application of LFS
after kindling stimulation reduced the expression of RGS4 and RGS10
proteins. However, it prevented the decrease in RGS2 following kindling.
Conclusion: Reducing the expression of RGS4 and RGS10 in addition to
preventing the reduction of RGS2 results in longer activation of signaling
pathways of Gi proteins compared to Gs proteins. This may involve in LFS
anticonvulsant effects.
Keywords: Seizure, Low-frequency stimulation, RGS proteins, G proteins,
Kindling
9th International Congress on Epilepsy Knowledge and attitudes of parents with epileptic
child, toward epilepsy in Markaz Tebbi Hospital
Background: Seeking help for disease directly correlated with knowledge
and attitude of people that in the case of children depend on parents.
Methods: We conducted a face-to-face questionnaire interview survey in
Markaz Tebbi Hospital, in Tehran; with 275 parents of epileptic children.
Results: 78% of parents were mothers. 36.4% knew epilepsy from before
and 69.5% knew that brain disturbances is the reason .60% believes fever
is the cause ,50.2% brain trauma, 52,7% pregnancy events ,49.1% bad
eyes and 20.4% ghosts. 23.3% considered seizure to be a psychological
disease, 8.5% contagious and 56.4% an inherited disease. 86.5% knew
different drugs and 82.9% different types of seizure. During a convulsion
13.5% agrees with purring cold water in child mouth, 25.8% with limb
massage, 46.2% with opening child mouth, 90.2% protecting head, 22.5%
with lying supine and 65.5% lying laterally. After first convulsion, 19.3%
denied the diagnosis. About knowing of seizure, 1.8% was disagreeing of
teachers knowing the diagnosis, 6.5% of child himself and 21.1% of his/
her friends.
Conclusion: According to this survey, parent s knowledge and attitudes
toward epilepsy were overlay good compare to previous international
studies. But still, social efforts especial in Medias like news and TV should
be made to modify and improve them.
Keywords: Epilepsy, Knowledge, Attitude, Parents.
9th International Congress on Epilepsy Sexual Dysfunction in Epileptic Men
Orandi AmirHossein (Resident of Anesthesiology and Critical Care. Tehran University of Medical Sciences, Sina Hospital.Tehran.Iran)Ebrahimi Nasrabady Sara (MD.PHD.Neuroscientist. Tehran University of Medical Sciences. Sina Hospital. Tehran.Iran)Orandi AmirAli (Resident of Anesthesiology and Critical Care. Tehran University of Medical Sciences, Sina Hospital.Tehran.Iran)Nikoobakht Mohammadreza (Associated Professor .Department of Urology. Tehran University of Medical Sciences, Sina Hospital.Tehran.Iran)Motamedi Mahmood (Associated Professor .Department of Neurology. Tehran University of Medical Sciences, Sina Hospital. Tehran. Iran)Tale Khatibi Fatemeh (Resident of Obstetrics and Gynecology. Tehran University of Medical Sciences, Emam Khomeini Hospital. Tehran. Iran)Afshin Azadeh (General Practitioner. Tehran University of Medical Sciences, Sina Hospital. Tehran. Iran) Introduction: The aim of this study was to evaluate the frequency of
sexual dysfunction among epileptic patients.
Materials and Methods: 100 married men between 20 and 50 years
with a confirmed diagnosis of epilepsy were enrolled in this study.
Patients with other neurological diseases, hypertension, cardiovascular
diseases, diabetes mellitus, underlying urogenital diseases, and impaired
general health status and those with mental health problems identified
by the standardized General Health Questionnaire-28 were excluded.
Demographic and clinical characteristics of the disease were evaluated,
and sexual function was assessed by the self-administered questionnaire of
the International Index of Erectile Function-15 (IIEF-15).
Results: Of 80 patients fulfilled criteria, 34 (42.5%) had erectile
dysfunction. There was no difference between the patients in the 3 age
groups (> 30 years, 30 to 40 years, and > 40 years) in IIEF scores. Type
of seizure had a significant correlation with erectile function score (P =
.008). None of the IIEF domains scores were different between the patients
with controlled epilepsy and those with uncontrolled epilepsy during the
previous 6 months. Frequency of epileptic seizures correlated with the
scores for erectile function (r = 0.31; P = .005), orgasmic function (r =
0.23; P = .04), and sexual desire (r = 0.24; P = .03).
Conclusion: It seems that the main aspects of sexual activity such as erectile
function, orgasmic function, and sexual desire are frequently impaired in
epileptic patients. Findings were also indicative of a higher risk of sexual
dysfunction in patients with partial seizures.
9th International Congress on Epilepsy Effects of Common anti-epileptic drugs on serum
homocysteine and Folic acid concentrations
Zamzam paknahad (Ph.D) (Department of Nutrition, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran), (Food security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran)Ahmad Chitsaz (M.D) (Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran)Akbar Hasan Zadeh (M.Sc) (Department of Nutrition, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran), (Food security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran)Elham Sheklabadi (B.Sc) (Department of Nutrition, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran) Introduction: Elevated total plasma homocysteine has been established
as an independent risk factor for thrombosis and cardiovascular disease. A
strong relationship between plasma homocysteine levels and mortality has
been reported in patients with angiographically confirmed coronary artery
disease. Interference with folate and homocysteine metabolism by Some
drugs, may lead to increased plasma homocysteine levels.
The objective of the study was to test the effect of antiepileptic drug
(AED) treatment is on homocysteine plasma concentrations.
Methods: A total of 22 older than 18 years old epileptic patients admitted
in neurology clinic, which were treated with AED at least for 1 year were
selected, 22 sex- and age range matched controls were enrolled in the study.
Concentrations of total homocysteine and folic acid were measured in serum
of fasted subjects. Informations about age, sex, duration of disease and
drug using, dose drug consumption were collected by questionnaire. Data
were analyzed with independent T-test, ANCOVA , pearson correlation by
spss16 software.
Results: Concentration of serum homocysteine in patients was significantly
higher ( 13.66±0.95) in comparing with controls (12.97±0.46, p =0.04).
Serum folic acid had nonsignificant negative correlation with dose of drug
used(p= 0.2).Serum homocysteine wasn't significantly correlated with
dose and duration of drug consumption (p were 0.4, 0.24 respectively).
However serum homocysteine wasn't significantly correlated with the
kind of drug(p=0.4), but folic acid concentration was significantly lower
in monotherapy group than poly therapy(p= 0.02 ).
9th International Congress on Epilepsy Discussion: Homocysteine wasn't different between epileptic and
nonepiletic groups, whereas serum concentrations of folic acid were similar.
Possible mechanisms by which AEDs can cause hyperhomocysteinemia
may be through the dysfunction of homocysteine metabolism, the
acceleration of vitamin metabolism, and the interference in the metabolism
of folic acid coenzymes.
Key words: antiepileptic drug, homocysteine, folic acid
9th International Congress on Epilepsy Education to Mothers of children suffering from
Pourgholami.L, Jeddi. K, Mousavi.A, Gholamzadeh. M Introduction: Epilepsy is the most common chronic disorder of the
nervous system. This would happen at any age. About in 75% of such
cases happens before the age of 20 which negatively impacts on child's
development. It is estimated that 4 out of 1000 individuals suffer from
this disease. Mothers of those children suffering from epilepsy need to
be provided with some special training due to the needs of their children
to medical treatment, special diet and obtaining ability to cope with their
current condition. Education is the proper tool for increasing the awareness
of those who are in need. Yet studies have shown that lack of awareness
and insufficient knowledge about taking care of themselves has caused
many problems which ultimately lead to various complications and even
death.
Discussion: Despite the development of antiepileptic drugs, approximately
30 percent of clients with epilepsy continue to suffer repeated attacks of
epilepsy, and protocols are not responded to conventional therapy. Since
damages caused by epilepsy sometimes are irreparable, the conducted
researches in this case show that deaths from the subsequent epileptic
seizure are on the rise. It clearly seems that knowledge and awareness of
mothers about this disease is one of the effective factors for preventing
the related damages resulted from it and also improving the life quality
of children suffering from epilepsy. In Japan, Hanaee (1990) examined
the relationship between mothers' knowledge of this disease with the
life quality of children with epilepsy. He concluded that the children's
life quality remains at the average level and the more knowledgeable the
mothers of these children are, the better the life quality of the children
become. Research findings indicate that there is a significant relationship
between the reaction of mothers and their knowledge about epilepsy and
also between the knowledge of the mothers and life quality of children.
In the research conducted by Majid Hassan Zadeh and his colleagues on
parents' awareness of seizure, 32% of parents had been trained at the time
of the seizure and results showed that parents who participated in the
9th International Congress on Epilepsy training program, showed significant progress in protecting their children with epilepsy. Therefore, mothers' training by regarding their culture and characteristics of their personality in the following areas and subjects can make them better cope with their child's disease and also help them improve life quality of their children with epilepsy. These areas and subject include familiarizing the parents with the nature of the disease, causes, signs and symptoms, treatment, first aid during a seizure including maintaining the airway and prevention from aspiration and body injury (8 items), preparing a safe environment in the house by using soft floor coverings, rail bed, applying heating appliances with indirect heat (10 items), making safe environment at school, informing the teacher, applying chairs with shield and protective equipment for sports (5 items), preventing from stress, relaxing by applying some related techniques, regarding safety in the bathroom (6 items), proper nutrition and proper use of medicines.
Conclusion: Education increases knowledge, attitudes, function of the
parents and subsequently reduces problems and improves quality of life
of children with epilepsy up until the mothers of these children gain the
qualifications in order to take care of their children.
Suggestion: Thus providing educational programs through mass media,
face to face training, and group training for mothers can make mothers to
be more compatible with their child's disease, raise the quality of life and
ultimately prevent seizures and control the risks of seizures in children.
References:
www.betterhealt.vic.gov.av –epileptic Seizure First Aid 2012
WebMD Medical Reference – Children –Livin With Epilepsy 2012
ـ Austin jk.McBrid AB.Davis HW . Parental attitude and adjustment to childhood epilepsy - May
2011
Ridasdale L .Chalton j.Ashworth M. Richardson MP. Gulliford MC. Epilepsy mortality and risk
factor for death in epilepsy : a population based study 2011
9th International Congress on Epilepsy Epilepsy in the patient with myasthenia gravis, a case
report and review of the literatures
Maryam Porsadeghfard (Consultant of Neurology)Maryam Sharifian (Resident of Neurology)Department of Neurology Shiraz University of Medical Sciences Shiraz, Iran Introduction: Associations between myasthenia gravis (MG) and CNS
functions have been diagnosed for many years. It was seen that there is
an increased incidence of psychiatric disorders and epilepsy as well as
electroencephalographic (EEG) abnormalities and abnormal evoked
responses in patients with MG. there are few reports about the co incidence
of MG and epilepsy in literatures. Here in we report a 47 year old man with
MG and epilepsy.
Case presentation: The patient is a 47 year old man a known case of MG
who came with several episodes of starring and then generalized tonic
clonic convulsion. Epilepti- form discharge was seen in EEG.
Discussion: although there are some few reports of co incidence of MG
and epilepsy, in all cases, patients with Epilepsy developed MG in the
follow up of treatment, which may be on the base of medication, while
in our case the patient is a known case of MG and after that developed
epilepsy. In this setting anti epileptic medications are not responsible for
presenting MG.
Key words: Epilepsy, myasthenia gravis
9th International Congress on Epilepsy Birth Weight in Offspring of Women with Epilepsy
Ziba Raisi Dehkor (MSc.in Midwifery,Dep.ofMidwifery,School of Nursing and Midwifery,Shahrekord University of MidicalSciences,Shahrekord,Iran)Fatemeh khosravi (Midwifery,Dep.ofMidwifery,School of Nursing and Midwifery,Shahrekord University of MidicalSciences,Shahrekord,Iran) Introduction: Epilepsy is the most common neurologic disorder in
pregnant women. The prevalence is 0.2-0.6 percent. Research on epilepsy
and pregnancy has mainly been on treatment with antiepileptic drugs
and the risk of congenital malformations and a number of studies have
demonstrated an increased risk.
Materials & Methods: This article is a literature review of articles
published from 2009 to 2010
CONCLUSIONS: We reviewed the literature on gestational age and birth
weight in children of women with epilepsy. There is some evidence that
women with epilepsy are at increased risk of preterm delivery. The risk
may be increased only in women who receive antiepileptic drug treatment.
With respect to birth weight, most evidence suggests that women with
epilepsy give birth to children with reduced birth weight. The birth weight
reduction may be due to more preterm deliveries, to a reduced growth
potential in children of women with epilepsy, or to intrauterine growth
restriction. It appears that birth weight is reduced in children of treated as
well as untreated women with epilepsy. Particularly high risk intrauterine
growth restriction may be associated with antiepileptic drug treatment, but
firm conclusions related to any specific drug-induced growth restriction
seem unjustified. No specific pattern of intrauterine growth restriction in
children of women with epilepsy has been identified.
9th International Congress on Epilepsy The comparison study of antiepileptic drugs effects on
25-hydroxy vitamin D and Calcium level in epileptic
Razazian N* (Assistant professor of neurology department, Kermanshah University of medical sciences),MirmoiniM (MD.Kermanshah University of medical sciences)Daeichin S (BSc in obstetrics, Maternity Research Center, Kermanshah University of medical sciences)Babaee rad M (BSc in nursing,Kermanshah University of medical sciences) Background and aim: Epilepsy is a common disease in pediatric neurology.
There are frequent anti-epileptic drugs which are used in management of
epilepsy.Anti-epileptic drugs may have some adverse effects on bone and
25-hydroxy-Vitamin D metabolism. The aim of this study is to evaluate
Calcium and 25-hydroxy-Vitamin D metabolism in epileptic children.
Methods & materials: In this prospective case-control study 48 epileptic
children who were referred to Imam Reza hospital's clinic compared to
48 healthy one. Age, taking calcium and vitamin D supplements, calcium,
25-hydroxy-Vitamin D and alkaline phosphatase levels in two groups were
compared and Data analyzed by SPSS software version 16.
Results: The average age of patients was 7.1± 3.58 years and in control
group 7.19± 3.66 years. Averages of calcium, alkaline phosphatase and
25-hydroxy-Vitamin D in case and control group were (9.91±0.675
vs. 10.08±0.331), (703± 227.842vs. 607±170.974), (26.52±10.75vs.
30.09±10.04). Only alkaline phosphatase level had statistically significant
difference.
Conclusion: In our study Calcium and 25-hydroxy-Vitamin D levels in case
group was lower but its difference wasn't meaningful. We recommended to
epileptic patients to use Calcium and 25-hydroxy-Vitamin D supplements
to prevent Bone disease related to epilepsy .Careful screening methods to
evaluate bone structure need to be done for these patients.
9th International Congress on Epilepsy Accident risk in patients with epilepsy in Birjand city
Riasi HR (Neurology department, Vali-e-Asr Hospital) (Birjand University of medical sciences, Birjad, Iran)Rajabpour Sanati A (Medical Student) (Birjand University of medical sciences, Birjad, Iran)Etemadi MM (Neurologist, Ferdowsi University, Mashhad, Iran)Habibi A (Urology Department, Emam Reza Hospital) (Birjand University of medical sciences, Birjad, Iran)Mohtasham S (Psychiatry department, Emam Reza Hospital) (Birjand University of medical sciences, Birjad, Iran)Rezvani MR (Department of Internal Medicine, Vali-e-Asr Hospital) (Birjand University of medical sciences, Birjad, Iran) Background: Epilepsy has impacts on various aspects of social life in
patients with epilepsy (PWE). One of these aspects is driving and accident
risk. The purpose of this study is to compare the risk of accident in PWE
with epilepsy-free patients.
Method: This was a cross-sectional case control study with interviews. A
questionnaire was used to interview patients.
Results: Both groups were composed of 335 patients (total of 670 patients).
53.3% of epileptic patients had history of car accident in last two years and
mentioned epilepsy as cause of that. 56.2% of patients with history of car
accident had seizure attack during driving.
Conclusion: Epilepsy and epileptic-seizure was the most important factor
determining the occurrence of accidents in PWE.
Keywords: seizure, epilepsy, accidents, seizure-related injury.
9th International Congress on Epilepsy Marital status of people with epilepsy in Birjand
Riasi HR (Neurology department, Vali-e-Asr Hospital) (Birjand University of medical sciences, Birjad, Iran)Etemadi MM (Neurologist, Ferdowsi University, Mashhad, Iran) (Birjand University of medical sciences, Birjad, Iran)Rajabpour Sanati A (Medical Student) (Birjand University of medical sciences, Birjad, Iran)Habibi A (Urology Department, Emam Reza Hospital) (Birjand University of medical sciences, Birjad, Iran)Mohtasham S (Psychiatry department, Emam Reza Hospital) (Birjand University of medical sciences, Birjad, Iran)Rezvani MR (Department of Internal Medicine, Vali-e-Asr Hospital) (Birjand University of medical sciences, Birjad, Iran) Background: Epilepsy has impacts on various aspects of social life in
patients with epilepsy (PWE). PWE are less likely to marry and more
likely to divorce in comparison with general population. In present study
marital status of PWE in Birjand city in the east of Iran was evaluated.
Method: Marital status of 670 patients in a cross-sectional case control
study were assessed by using a questionnaire. Epilepsy in participants (335
cases) was confirmed by at least two neurologists.
Results: 388 (57.91%) of patients were married and 282 (42.09%) of
patients were divorced. Among epileptic participants, there were 101
(30.1%) married and 234 (69.9%) divorced patients. This study showed
that divorce in PWE is higher than patients without epilepsy (234, 69.85%
divorced cases in PWE vs. 48, 14.32% divorced cases in control group;
P<0.05); Divorce history in female patients were significantly higher than
males (179, 76.5% vs. 55, 23.5%; P<0.05); also history of divorce had no
significant differences between several types of epilepsy (P>0.05).
Conclusion: The stigma of epilepsy has impacts on PWE marital status.
Seizure control in epileptic patients, early treatment and family counseling
can help in marital status in those with marital conflicts.
Keywords: Epilepsy; Marriage; Divorce; Marital Status
9th International Congress on Epilepsy Basic strategies to cope with epilepsy
Morteza Sabziyan (Medical Doctorate from Mashhad University of Medical Sciences and Master of Criminal Law)Zahra Sabziyan (student of Medicine, Tehran University of Medical Sciences) Background and objective: epilepsy, including the most common
disorders of the human nervous system in the world and Iran. All humans
are susceptible to this disease, Areas that generally have been inherited or
caused by an accident or unexpected event in the genesis of this disease is
caused. Different communities with regard to culture, religion and social
living conditions in their communities have different strategies for coping
with the disease that have been proposed.
Methods and Results: In Iran, according to research conducted in medical
centers, community, family and patients with epilepsy, findings show that
the most important strategies for coping with this disease is The use of
religious beliefs, Expressed emotions and feelings, community and family
support, coping with illness and self-defense against disease.
Conclusion: Each of the above solution's strategies has been true that the
most important of they are as follows;
Religious beliefs: accepting illness as God would help him
Expressed emotions and feelings: emotional support from family and
important people in the lives of patients with epilepsy
Community and family support: social support and seeking public support
through awareness
Coping with illness: an attempt to control their disease with the use of
medical and traditional cures, regular use of effective drug therapy
Defend itself against disease: positive changes in lifestyle and health
behavior (sleep and stress reduction)
Keywords: epilepsy, coping strategies, culture, religion, society
9th International Congress on Epilepsy Law issues associated with epilepsy
Morteza Sabziyan (Medical Doctorate from Mashhad University of Medical Sciences and Master of Criminal Law) Introduction: epilepsy is one of the most important neurological disorders
that have a genetic origin or occur due to external factors like the exposure
to damage during Childbirth, or other unexpected events that affect the
lives of epileptic patients. Many areas of the life of a person with epilepsy
deserve examination when considering epilepsy and law.
Conclusion: The main sectors that are associated with legal issues include:
duty of epileptic patients' care; informed consent to surgery for epilepsy
patients; the research on patients with epilepsy; and driving; social
interactions; recreational pursuits; employment; insurance; marriage and
privacy.
This article examines the legal implications and ramifications of these
selected topics, And within each of these sectors to run or maybe a ban
on the physical and mental condition of a patient with epilepsy and to
examine the relevant legal requirements.
Keywords: epilepsy, epileptic patients, law
9th International Congress on Epilepsy Calcium channels and seizure pathophysiology
Morteza Salimi (B.Sc in Nusring School, Hormozgan University of Medical Science, Bandar Abbas, Iran.
Member of Student Research Committee of Nursing) Soghra fallahi (M.S.c Department of Physiology, Fertility and Infertility Health Research Center, Hormozgan University of Medical Science, Bandar Abbas, Iran)Seyed.R Mirsoleymani (B.Sc in Nusring School, Hormozgan University of Medical Science, Bandar Abbas, Iran.Member of Student Research Committee of Nursing)Ali akbar Hesam (B.S.c in Nusring, Medical Services Insurance Organization, Bandar Abbas, Iran) Masood Ranjbar (B.Sc in Nusring School, Hormozgan University of Medical Science, Bandar Abbas, Iran.
Member of Student Research Committee of Nursing) Background and objectives: Calcium is one of the famous ions in
cellular reactions such brain cells then plays an essential role during
depolarization phase. Calcium exchanging occur along several channels.
The dedicated channels of calcium exchanging classified based on their
voltage-dependent and kinetic biophysical properties combined with their
sensitivities to pharmacological agents. Impaired calcium concentration
particularly prompt calcium entry would lead to seizure. The present review
article intends to discuss about the channels which dedicated for calcium
exchanging, the role of each one in seizure, calcium exchanging due to the
seizure as well as prevention of seizure applying calcium blocker.
Discussion: There are many studies excited that suggested seizure
prevented due to the calcium channel inhibiting. Other related studies
indicated significant correlation between different calcium blocker drugs
and seizure among animal. The discussed questions are how calcium
channels can be cussed of the seizure, and also which calcium channel or
channels inhibiting by drug would be more effective.
Conclusion: impaired calcium exchanging along above mentioned
channels can make excitable cells into the several disorder. Depolarization
activity of calcium, as one of the main its function, can be correlated with
seizure.
Key words: calcium, channels, seizure
9th International Congress on Epilepsy References:
1. Adams, P. and T. Snutch, Calcium channelopathies: voltage-gated calcium channels. Calcium Signalling and
Disease, 2008: p. 215-251.
2. Broicher, T., et al., Correlation of T-channel coding gene expression, IT, and the low threshold Ca2+ spike in
the thalamus of a rat model of absence epilepsy. Molecular and Cellular Neuroscience, 2008. 39(3): p. 384-399.
3. Broicher, T., et al., T-current related effects of antiepileptic drugs and a Ca2+ channel antagonist on thalamic
relay and local circuit interneurons in a rat model of absence epilepsy. Neuropharmacology, 2007. 53(3): p.
431-446.
4. Cain, S.M. and T.P. Snutch, Voltage-gated calcium channels in epilepsy. Epilepsia, 2010. 51: p. 11-11.
5. Cain, S.M. and T.P. Snutch, Contributions of T-type calcium channel isoforms to neuronal firing. Channels,
2010. 4(6): p. 475.
6. Chevalier, M., et al., T-type Cav3. 3 calcium channels produce spontaneous low-threshold action potentials
and intracellular calcium oscillations. European Journal of Neuroscience, 2006. 23(9): p. 2321-2329.
7. Contreras, D., The role of T-channels in the generation of thalamocortical rhythms. CNS &# 38; Neurological
Disorders-Drug Targets (Formerly Current Drug Targets, 2006. 5(6): p. 571-585.
8. Glasscock, E., et al., Masking epilepsy by combining two epilepsy genes. Nature neuroscience, 2007. 10(12):
p. 1554-1558.
9. Kelly, K.M., R.A. Gross, and R.L. Macdonald, Valproic acid selectively reduces the low-threshold (T)
calcium current in rat nodose neurons. Neuroscience letters, 1990. 116(1): p. 233-238.
10. Mirhadi, K., M. Dariush, and A. Reza, Effect of Lovastatin on PTZ-Induced Seizure Threshold in Mice.
2011.
11. Tsakiridou, E., et al., Selective increase in T-type calcium conductance of reticular thalamic neurons in a rat
model of absence epilepsy. The Journal of neuroscience, 1995. 15(4): p. 3110-3117.
12. Powell, K.L., et al., A Cav3. 2 T-type calcium channel point mutation has splice-variant-specific effects on
function and segregates with seizure expression in a polygenic rat model of absence epilepsy. The Journal of
neuroscience, 2009. 29(2): p. 371-380.
13. Polack, P.O., et al., Inactivation of the somatosensory cortex prevents paroxysmal oscillations in cortical and
related thalamic neurons in a genetic model of absence epilepsy. Cerebral Cortex, 2009. 19(9): p. 2078-2091.
14. Richards, D.A., et al., Targeting thalamic nuclei is not sufficient for the full anti-absence action of
ethosuximide in a rat model of absence epilepsy. Epilepsy research, 2003. 54(2): p. 97-107.
15. Saito, H., et al., Knockdown of Cav2. 1 calcium channels is sufficient to induce neurological disorders
observed in natural occurring Cacna1a mutants in mice. Biochemical and biophysical research communications,
2009. 390(3): p. 1029-1033.
16. N'Gouemo, P., R. Yasuda, and C.L. Faingold, Seizure susceptibility is associated with altered protein
expression of voltage-gated calcium channel subunits in inferior colliculus neurons of the genetically epilepsy-
prone rat. Brain research, 2010. 1308: p. 153-157.
17. Weiergräber, M., et al., Hippocampal seizure resistance and reduced neuronal excitotoxicity in mice lacking
the Cav2. 3 E/R-type voltage-gated calcium channel. Journal of neurophysiology, 2007. 97(5): p. 3660-3669.
18. Sills, G.J., The mechanisms of action of gabapentin and pregabalin. Current opinion in pharmacology, 2006.
6(1): p. 108-113.
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20. Mikati, M.A., et al., Effects of nimodipine on the behavioral sequalae of experimental status epilepticus in
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9th International Congress on Epilepsy Evaluation of mRNA and protein expression of
connexin 32 in hippocampus of rats during electrical
Mohammad Sayyah (Departments of Physiology, Pasteur Institute of Iran, Tehran, Iran) Bijan Akbarpour (Department of Physiology, Faculty of Veterinary Medicine, Islamic Azad University, Science and Research Branch, Tehran, Iran)Reza Mahdian (Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran)Vahab Babapour (Department of Physiology, Faculty of Veterinary Medicine, Tehran University, Tehran, Iran)Mohammad Abbasian (Department of Physiology, Faculty of Veterinary Medicine, Islamic Azad University, Science and Research Branch, Tehran, Iran) Itroduction: Epilepsy is the third most common neurological disorder after
stroke and Alzheimer's disease.Understanding the underlying molecular and
cellular mechanisms responsible for epileptogenesis, yields new insights into
potential therapies that may ultimately prevent epilepsy. Gap junctions (GJs)
create direct intercellular conduits between adjacent cells and are formed by
the hexameric protein subunits called connexin (Cx). Changes in expression
of Cxs affect GJ communication and thereby could modulate dissemination of
electrical discharges. Hippocampus is one of the main brain regions involved
in epileptogenesis and has a wide network of GJs between different cell types
where Cx32 exists in neurons and oligodendrocytes. We evaluated the changes
Cx32 expression in rat hippocampus during kindling epileptogenesis.
Materials and methods: Rats were stereotaxically implanted with stimulating
and recording electrodes in basolateral amygdala (BLA). BLA was electrically
stimulated once daily at afterdischarge threshold. Expressions Cx32, at both
mRNA and protein levels were measured in the hippocampus at the beginning,
in the middle (after acquisition of focal seizures), and at the end (after
establishment of generalized seizures) of kindling process, by Real-Time PCR
and Western blot techniques.
Results and Conclusion: According to our results, Cx32 mRNA expression
decreased after acquisition of generalized seizures and no other significant
change was detected in mRNA and protein abundance during kindling. We
speculate that Cx32 GJ communication in the hippocampus does not contribute
to kindling epileptogenesis.
Key words: Electrical kindling, Connexin32, Gene expression, Protein
expression
9th International Congress on Epilepsy Lipopolysaccharide suppresses baseline CA1 synaptic
response in adult epileptic rats
Mohammad Sayyah (Department of Physiology and Pharmacology, Pasteur Institute of Iran, Tehran, Iran) Amin Ahmadi (Department of Physiology and Pharmacology, Pasteur Institute of Iran, Tehran, Iran)Farshad Moradpour (Department of Physiology, School of Medical Sciences, TarbiatModaresUniversity, Tehran, Iran) Introduction: Hippocampal formation is one of the main brain regions involved
in manifestation and acquisition of epilepsy. It has particular vulnerability to
damage and inflammation. Neuroinflammation facilitates epileptogenesis in
developing brain. Contribution of neuroinflammation and epilepsy in mature
brain however, has been accompanied with contradictory results. The bacterial
endotoxin lipopolysaccharide (LPS) is used as a model of neuroinflammation.
We examined the effects of LPS on synaptic transmission in the CA1 region
of the hippocampus in adult epileptic rats.
Methods: Slices with 400μm thickness were obtained from epileptic
(electrically-kindled rats). Field potentials were recorded extracellularly from
stratum pyramidale and stratum radiatum of CA1 area to record population
spike (PS) and field excitatory postsynaptic potential (fEPSP), respectively.
Bipolar stainless steel stimulation electrodes were placed in stratum radiatum
to stimulate Schaffer collateral afferents. After baseline recording, effect of
LPS on EPSP and PS was examined.
Results and Conclusion: Slope of fEPSP was immediately diminished after
LPS perfusion. Amplitude of PS was significantly enhanced 10 min after LPS
application. Slope of fEPSP is a reliable index for post synaptic response. PS are
built by extracellular summation of action currents during synchronous action
potential firing and indicates the number of synchronously firing neurons.
Thus, LPS impairs Schaffer collateral CA1 synapse and increases the number
and synchrony of pyramidal neurons discharges. This data indicates different
response of stratum radiatum and stratum pyramidale to LPS. However, final
outcome of LPS is inhibition of synaptic transmission in the CA1 region.
9th International Congress on Epilepsy New Guideline for How to manage a Person's First
Dr.Sheida Shaafi (Associate of Neurology, Tabriz University of medical science) Objectives: To review new update guideline for first unprovoked seizure.
Evidence –based researches results relevant published articles.( guideline
developed by the American Academy of Neurology and Stacy Turner;
Jonathan Benger For The College of Emergency Medicine)
Background: Since even one seizure is a frightening, traumatic event
with serious potential consequences, such as loss of driving privileges,
limitations for employment and bodily injury, information about optimal,
evidence-based approaches for treating people with a seizure is important
The guideline recommends a routine EEG be considered as part of the
diagnosis of a person with a first unprovoked seizure. "Evidence shows
an EEG revealed abnormalities indicating epilepsy in about one in four
patients and was predictive of seizure recurrence,.
The guideline also recommends CT or MRI brain scans be routinely
considered since the scans are significantly abnormal in one of 10
patients, helping to indicate the cause of their seizure. For adults who
experience their first unprovoked seizure the results of an EEG, CT or
MRI will influence aspects of patient care and management, including
drug treatment, patient and family counseling, and the need for immediate
hospitalization and subsequent follow-up.
Seizures are among the most common serious neurological disorders cared
for by neurologists. Annually approximately 150,000 adults will have a
first seizure in the United States. It is estimated that in 40 to 50 percent of
these people, seizures recur and are classified as epilepsy.
The need for treatment in the patients with their first seizure is the other
important fact that must be discussed.
The guidelines present a summary of the best available evidence to guide
the management of adult patients who present to the ED following first
seizure. The document is intended as a guideline for use in the ED by
Emergency Physicians and is based on a review of the best existing
evidence for the diagnostic tools and Treatments used in this setting.
• The document is summarized as a Clinical Decision Support Guideline
9th International Congress on Epilepsy that has been Presented as an easy to follow algorithm.
•This guideline encompasses adult patients (.16 years of age) presenting to the ED with Suspected first seizure. The key aspects included are appropriate investigations, use of Antiepileptic, disposition of the patient from the ED, fitness for discharge, follow-up and Advice to be given on discharge. The recommendations can be followed using Resources available in ED. Disposition may vary dependent on local resources But the guideline may be adapted as appropriate.
9th International Congress on Epilepsy Atkins diet and epilepsy
Dr Shafa M A, Dr Iranmanesh F, Dr Shafa,M SNeurology Research Center, Kerman University of Medical Sciences Background: The Atkins diet was created in the 1970s by Dr Robert C.
Atkins as a means to combat obesity .It recommends a restricted intake of
carbohydrates, initially less than 20 g/day, taken mainly as salad greens
and other non-starchy vegetables, and an unlimited intake of protein and
accompanying fat. This diet seems to have anticonvulsive effects. This
review discusses efficacy and safety of this diet in epileptic patients.
Methods: In this review article, we reviewed all article about this diet in
PUBMED since 2000.
Results: The Atkins diet can be commenced without hospital admission.
It is a more balanced diet (60% fat, 30% protein, and 10% carbohydrate by
weight) than the ketogenic diet (80% fat, 15% protein, and 5% carbohydrate
by weight) and can be recommended as a replacement for the KD in
patients for whom the KD has proved too restrictive. Importantly, 80%
of the patients were able to stay on the diet, 65% had a > 50% response,
and 19% became seizure-free after 6 months. These results showed a
striking similarity to large prospective and retrospective studies of the
conventional ketogenic diet but Atkins diet is easier to administer and has
better tolerability. Side effects are predominantly elevations in lipid profile
and gastrointestinal upset.
Conclusion: Atkins diet maybe, is the best diet in epileptic patients. It
doesn't have any serious complications.
Keywords: Seizure, Atkins diet
9th International Congress on Epilepsy Prognostic value of seizure in cerebral sinus venous
Dr Shafa M A, Dr Iranmanesh F, Dr Shafa,M SNeurology Research Center, Kerman University of Medical Sciences Introduction: Cerebral sinus venous thrombosis (CSVT) is a common
cause of stroke. There are many different symptoms and signs with this
disease such as headache, nausea, vomiting, decrease level of consciousness
and seizure. Some studies show that seizure may be had a prognostic value
in these patients. The aim of this study was to evaluation of frequency of
seizure and its prognostic value in patients with CSVT.
Methods: This study was conducted on 43 patients diagnosed as CSVT
in the Department of Neurology, Shafa hospital,Kerman. The clinical
diagnosis was confirmed by MR Venography (MRV). Detailed information
about the patients was recorded which included: demographic data,
frequency and type of seizures. Patients were fallowed until discharge or
death. Statistical analysis was performed using SPSS 16and P value equal
to or less than 0.05 was considered statistically significant.
Results: A total of 43 patients were included in this study. 32 of them were
female and the rest were male. Seizures found in 14 patients (32.5% ).7
patients (5 persons in seizure group and 1 person in non seizure group
died. There is a significant difference between two groups (P<0.05)
Discussion: Our findings show that, seizure is a poor prognostic factor in
patients with cerebral sinus venous thrombosis.
Keywords: Seizure, Cerebral sinus venous thrombosis
9th International Congress on Epilepsy An investigation of the frequency of suicide thoughts
and attempts in epileptic patients
Jalal Shakeri (associate professor of Kermanshah University of Medial Sciences)Saeedeh Hosseini (Phd Candidate, Islamic Azad university of Kermanshah, faculty member)Hania shakeri (general physician,Kermanshah university of medical sciences)Mojgan saeedi (psychologist) Introduction: The nature and severity of epilepsy as a chronic and
recursive disease can have drastically destructive effects on social and
interactional aspects of epileptic patients' life. These significant effects
were the motivation for an investigation of these patients psychiatric and
psychocognitive characteristics including suicide thoughts and attempts
and also a study of their mental health.
Methodology: This was a cross-sectional descriptive study of 168
epileptic patients attending Kermanshah's psychiatric clinic from 2007 to
2011 using demographic cognitive questionnaire and Beck's depression
questionnaire. The data collected were analyzed using SPSS.
Results: Regarding the administration of the questionnaires the following
personal information were obtained; age (75% between 25 to 40), epilepsy
suffer period (at least 10 years), gender ( 55% males and 45% females).
It was also found that 48% of the patients were suffering from depression
and 25% have had suicide thoughts. 8% had committed suicide at least for
once.
Discussion and conclusion: The study shows that epileptic patients have
had suicide thoughts more frequently comparing with ordinary people.
Based on the results of the study, the following suggestions are put
forward; first, timely recognition and diagnosis by a neurologist; second,
involving psychiatrists and psychologists to consider the cognitive and
psychiatric aspects in the treatment procedure; third, using psychiatrists
and psychologists to improve the patients life quality and guarantee their
more frequently mental health in addition to physical and physiologic
aspects of the patients from biopsychosocial perspective.
9th International Congress on Epilepsy The investigation of efficacy of mental health programs
in screening for epileptic patients in chaharmahal and
bakhtiari province, since 1380 to 1390.
Mostafa Shakeri (Ms in Psychology, health administration, Shahrekord University of medical science)Dr.Hourivash Ghaderi (Psychiatrist, health administration, Shahrekord University of medical science) Introduction: Epilepsy is one of the most frequent neurologic disorders
which is along with the patient in all his life and it's necessary to take
medical care, regularly. The aim of this study is the investigation of
efficacy of integration of mental health programs in screening for epileptic
patients, in 90 decade.
Method and materials: This study is a retrograde and sectional research
.since 1368 that integrate mental health programs to PHC in rural region
and from 1375 in urban region, all of patients that suspicious to epilepsy in
health centers have been diagnosed and observated.As per the date which
has been obtained at the end of 1390, all the epileptic patients in recent
decade have been investigated from point of view: demographic data, place
of living and prevalence rate of disorder. Data under soft ware program
(Spss 16) has been analyzed with descriptive and analytic statistics test.
Result: At the end of 1390 totally 2972 epileptic patients found in this
province and prevalence of epilepsy estimated 3.1 in this province.57%
of patients were male and 43% female.70% of them live in rural and 30%
in urban area.chi square test show significant statistic correlation between
sex and place of living.
Conclusion: Screening of epilepsy in urban area in this province is less
and it's better to do active screening program in urban area.
Keyword: epilepsy, screening, mental health
9th International Congress on Epilepsy Introduction of a Recent Advance in Radiologic
Localization of Epileptogenic Foci- Subtraction Ictal
Single Photon Tomography Co-Registered to MRI
Sharifi.G, Jahanbakhshi.A, Alavi.E, Gharagozli.K, Hadadian.K, Pkdaman.H Extra-temporal epileptogenic origins account for about 44 percent of refractory epilepsies requiring surgery. Localization of the seizure origin outside the temporal lobe is more difficult, its surgical outcome is less favorable and complication rates are higher. Variation of epileptogenic sites is also higher in extra-temporal relative to temporal lobe epilepsies. The most common seizure-producing foci are ischemic lesions and developmental abnormalities. They can be identified in a number of diagnostic tools as symptomatic localization, electroencephalography, magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT), etc. MRI is the imaging modality of choice for initial evaluation. Ictal perfusion SPECT that is performed within hours after seizure can show increased blood flow at the site of epileptogenic lesion is of much more value than the SPECT done inter-ictally. A recent imaging modality namely "subtraction ictal single photon tomography co-registered to MRI (SISCOM)" is gathering more and more reputation in localization of epileptogenic foci. SISCOM is of greater value in localization and prediction of surgical outcome relative to SPECT or MRI alone. 9th International Congress on Epilepsy Amygdalohippocampectomy for twenty one patinets
of temporal lobe epiulepsy due to mesial temporal
sclerosis
Sharifi.G, Jahanbakhshi.A, Alavi.E, Gharagozli.K, Hadadian.K, Pkdaman.H Mesial temporal lobe sclerosis (MTS) is the most common pathologic feature found in temporal lobe epilepsy with amygdala being often involved. For refractory cases of temporal lobe epilepsy, a surgical treatment with amygdalohippocampectomy has been introduced and has led to satisfying results. We introduce a series of 21 patients with MTS undergoing amygdalohippocampectomy. We followed them for a period of 2 years and evaluated the respons to treatment.
Of these 21 patrients twenty patients are seizure free two years after surgery that means a cure rate of 95 percent that is more favorable in comparison with most surgical series in the literature. We observed no neurologic or neuropsychologic complication. In conclusion we recommend an early operative approach for patients of refractory temporal lobe epilepsy and avoiding unreasonably conservative medical management for such patients.
9th International Congress on Epilepsy Attention Deficit-Hyperactivity Disorder and
Siavash Talepasand (Associate professor, University of Semnan, Faculty of psychology and education, Semnan, Iran)Akram Jamshidifar (Student of MA.in Child clinical psychology, Shahid Beheshti University, Tehran, Iran) Introduction and Objectives: Due to children with epilepsy are at a high
risk for symptoms of Attention Deficit-Hyperactivity Disorder (ADHD).
Aim of the current study was to explore the prevalence of ADHD and its
subtypes in children with idiopathic epilepsy.
Methods and Materials: We assessed 55 patients (29 boys and 26 girls,
age range 7 to 16) with idiopathic epilepsy (partial 50.9% and generalized
49.1%). Entry criteria of participants were specified based on the opinion
of neurologist, history and performance Wechsler Intelligence test-
Abbreviated form. These criteria included: seizures began at least 1 year
ago, without other psychiatric disorders, literacy and normal intelligence
(IQ>85). Parents of participants completed the SNAP-IV questionnaire -
Parent versions. Data analyzed by Chi-Square's test.
Results and conclusions: ADHD diagnosis was confirmed in 12 of
participants (21.8%). prevalence of subtypes was the inattentive type 9.1%,
the hyperactive 7.3% and combined 5.5% types. 27.2% of boys and 15.3%
of girls were classified as ADHD. 21.4% of children with partial epilepsy
and 22.2% of children with generalized epilepsy were diagnosed ADHD.
The high prevalence of ADHD emphasizes the need for comprehensive
assessment and treatment in children with epilepsy.
Key words: Epilepsy, Attention-deficit hyperactivity disorder, Epidemiology
9th International Congress on Epilepsy Na Channelopathy in children with GEFS+ and Dravet
syndrome: an Iranian Experience
Dr. Seyed Hassan Tonekaboni (Child Neurologist , Pediatric Neurology Research center) (SBMU)Dr Ahmad Ebrahimi (PHD of molecular Genetics ,Shiraz University of Medical Sciences) (SUMS) Generalized Epilepsy with Febrile Seizure plus (GEFS+) is a genetic disorder with a spectrum of clinical phenotype extending from a simple febrile seizure to different seizure types epilepsy in adulthood, all occuring in the same family. Afebrile seizures, mainly generalized tonic-clonic and also partial and myoclonic seizures or even status epilepticus occurs in some pedigree members. Mutation in 3 voltage gated sodium channel sub unit genes are associated with epilepsy: the alpha sub unit genes SCN1A and SCN2A and the beta subunit gene SCN1B.
Dravet syndrome or severe myoclonic epilepsy of infants has an onset in early infancy and is characterized by clonic seizures, often unilateral and prolonged and usually precipitated by fever.In the following years , seizures become refractory with a psychomotor regression in the affected child. In majority of cases, Dravet syndrome is due to new mutation in the sodium channel gene SCN1A.
In a cross sectional study in Mofid Children Hospital from May2005 To May2008 we analysed 15 children with GEFS+ and 5 children with Dravet syndrome to find mutations in SCN1A gene. We found 2 mutation in GEFS+ group and 2 mutation in dravet group of patients. One mutation in each group were new one's which were reported in medical journals.
9th International Congress on Epilepsy Review on Carbamazepine (CBZ) Pharmacokinetics in
Zahra Tolou_Ghamari (Isfahan Neuroscience research centre, Faculty of medicine, Isfahan University of Medical Sciences)Jafar Mehvari (Department of Neurology, Isfahan Neuroscience Research Centre)Mohammad Zare (Department of Neurology, Isfahan Neuroscience Research Centre)Mohammad Reza Najafi (Department of Neurology, Isfahan Neuroscience Research Centre)Masoud Etemadifar (Department of Neurology, Isfahan Neuroscience Research Centre)Fariborz Khorvash (Department of Neurology, Isfahan Neuroscience Research Centre)Abbas Ghorbani (Department of Neurology, Isfahan Neuroscience Research Centre)Ahmad Chitsaz (Department of Neurology, Isfahan Neuroscience Research Centre)Seyed Ali Mousavi (Department of Neurology, Isfahan Neuroscience Research Centre)(Faculty of Medicine, Isfahan University of Medical Sciences. Isfahan/ Iran). Introduction: Carbamazepine (since 1952) (C15H12N2O) a tricyclic
compound, that is most effective against partial seizures. Two basic
mechanisms of action have been proposed 1) enhancement of sodium
channel inactivation by reducing high-frequency repetitive firing of
action potentials, and 2) action on synaptic transmission. Usual serum
concentrations in most patients range from 7 to 14 μg/mL. Peak plasma
concentrations of CBZ generally are reached 4 to 8 hours (in some cases
24 to 26 hours) after ingestion. The steady state half-life ranges from 5
to 26 hours. Bioavailability ranges from 75 to 85%. The rate or extent of
absorption could not be affected by food. The effect of both brand-name
and generic CBZ tablets may be reduced by high humidity or moisture.
The apparent volume of distribution of CBZ varies from 0.8 to 2.0 L/
kg in. CBZ is highly bound to plasma proteins. In patients the protein-
bound fraction ranged from 75 to 80% of the total plasma concentration.
Unbound CBZ concentrations are inversely correlated with serum alpha
1-acid glycoprotein concentration. milk: plasma CBZ concentration
ratios ranging from 25 to 80%. There is a significant linear positive
relationship between brain and plasma CBZ levels (1.1± 0.1). A brain
concentration of 4.5 to 5 μg/g and a brain: plasma ratios of 1 to 1.5 were
found to be threshold values, protecting electroshock therapy in humans.
The main pathways of biotransformation are epoxidation, hydroxylation,
glucuronidation and sulfuration. It is completely metabolized and the main
metabolite is CBZ-E. The blood concentration of CBZ-E in relation to
CBZ appears to be lower in patients receiving monotherapy than in those
9th International Congress on Epilepsy on polytherapy. It seems that the CBZ-E:CBZ ratio is not dose related, suggesting that the total plasma CBZ level can indicate the sum effect of CBZ and CBZ-E independent of daily dosage. Carbamazepine induces its own metabolism, leading to increased clearance, shortened serum half-life, and progressive decrease in serum levels. Because of autoinduction CBZ kinetics are time-dependent. Clearance rates increases rapidly by the second day after the first dose. Increases in daily dosage are necessary to maintain plasma concentration. Authoinduction is usually completed within to 30 days and is dependent on the dose of CBZ. Pregnancy does not significantly alter unbound levels of CBZ-E and CBZ. Clearance of CBZ is age dependent and the highest disposition rates occur during the earliest years of life. Sex, body weight and age appear to play a role in the pharmacokinetics of CBZ in childhood. Sever liver dysfunction may cause disordered pharmacokinetics and CBZ intoxication through decreased hepatic microsomal activity. In cardiac failure, congestion of major vital organs, including kidneys, may result in abnormally slow absorption and metabolism. Carbamazepine increases ethosuximide clearance and shortens its half-life. The effect of CBZ on phenytoin is controversial. The impression remains that CBZ increases phenytoin concentration. Following to the addition of CBZ to valproate (VP) clearance of VP is increasing and a serum concentration is decreasing. There is a higher phenobarbital level during CBZ comedication. In most cases CBZ plasma concentrations decrease during antiepileptic comedication with phenytoin, primidon, phenobarbital and valproate. Induction of CBZ metabolism may be high enough to raise CBZ-E concentrations to toxic levels. Drowsiness, dizziness, ataxia and visual disturbance frequently accompany CBZ therapy. Finally research should investigate methods of reducing inter and intra individual variability in fluctuation of plasma drug concentrations in Iranian epileptic population. Key Words: Carbamazepine, Review, Epilepsy.
9th International Congress on Epilepsy Antiepileptic Drugs: CYPisoenzymes and
Zahra Tolou_Ghamari (Isfahan Neuroscience research centre, Faculty of medicine, Isfahan University of Medical Sciences)Mohammad Zare (Department of Neurology, Isfahan Neuroscience Research Centre)Jafar Mehvari (Department of Neurology, Isfahan Neuroscience Research Centre)Mohammad Reza Najafi (Department of Neurology, Isfahan Neuroscience Research Centre)Masoud Etemadifar (Department of Neurology, Isfahan Neuroscience Research Centre)Fariborz Khorvash (Department of Neurology, Isfahan Neuroscience Research Centre)Abbas Ghorbani (Department of Neurology, Isfahan Neuroscience Research Centre)Ahmad Chitsaz (Department of Neurology, Isfahan Neuroscience Research Centre)Seyed Ali Mousavi (Department of Neurology, Isfahan Neuroscience Research Centre)Faculty of medicine, Isfahan University of Medical Sciences Introduction: Antiepileptic drugs (AEDs) are widely used in epilepsy and
contain a group of drugs that are highly predisposed to side-effects. Many
AEDs interactions are the result of an alteration in CYP450 metabolism in
several ways. It is well known that the risks of undesirable drug response
increase by polypharmacy. The aim of this study was to predict AEDs
pharmacokinetic interactions due to CYP450 induction or inhibition.
Patients & Methods: A cross-sectional study of fifty-four patients'
located at the Epilepsy Ward of Kashani Hospital of Isfahan University
of Medical Sciences was carried out during the year 2011. Female (n=23)
and male subjects (n=31) with a mean age of 27 years (range; 7-74 years)
were studied. According to simultaneous AEDs used by each patient three
groups were made. Group 1 described monotherapy, group 2 and 3 called
polypharmacy (up to three and >3 AEDs respectively). Variables including
sex, age, age of seizure onset, type and number of AEDs were recorded
and statistical analyses of d-Base were performed using SPSS (version 18)
for windows.
Results: Analysis of drug prescriptions showed that the incidence of
monotherapy and polypharmacy was 22.2% (group 1) plus 51.9% (group
2), 25.9% (group 3) respectively. Mean age of epilepsy onset was 15.6
years (range: birth-74 years). Treatment were intense on two compounds,
carbamazepine (PID) (n=41) and valproic acid (PIH) (N=31). There was
a combination based on: valproic acid PIH /carbamazepine PID (n=5),
valproic acid PIH / phenobarbital PID (n=2), phenytoin PID /carbamazepine
PID (n=1). Combination based on three AEDs were as follows topiramate
9th International Congress on Epilepsy WI /carbamazepine PID /valproic acid PIH (n=2), lamothrigin effects on t1/2 of other AEDs/ carbamazepine PID /phenytoin PID (n=1) and so on. There was also prescription based on four (n=7), five (n=4) or six AEDs simultaneously.
Conclusion: Standard AEDs doses may provide adverse effects connected
to elevated drug serum levels when a CYP450 enzyme inhibitor PIH or
inducer PID added to treatment. Interventions even in intractable patients
to reduce the number of AEDs administration (≤3 AEDs) could improve
clinical outcomes. With further clinical examination it seems AEDs that
are not involved in drug interactions include gabapentin and levetiracetam
could be a better option as co medication to carbamazepine or valproic
acid.
Key Words: Pharmacokinetic, Interactions, Epilepsy, AEDs
9th International Congress on Epilepsy The Relationship Between Psychosocial Care and
Attitude Toward Illness in Children with Epilepsy
Valizadeh Leila (Assistant Professor. Pediatric Health Research Center and Nursing and Midwifery college. Tabriz University of Medical Sciences, Iran)Barzegar Mohammad (Professor of Pediatrics, Pediatric Health Research Center, Tabriz University of Medical Sciences, Iran)Akbarbegloo Masoomeh (MSc in Pediatric Nursing, Tabriz Pediatric Health Research Center and Nursing and Midwifery college. Urmieh University of Medical Sciences, Iran)Zamanzadeh Vahid (Associate Professor, Nursing and Midwifery college. Tabriz University of Medical Sciences, Iran)Rahmani Azad (Associate Professor, Nursing and Midwifery college. Tabriz University of Medical Sciences, Iran)Jabarzadeh Faranak (MSN, PhD student, Nursing and Midwifery college. Tabriz University of Medical Sciences, Iran)Bafandeh Mostafa (MSc nursing student, Nursing and Midwifery College, Tabriz University of Medical Sciences, Iran)Rahiminia Elaheh (MSc nursing student, Nursing and Midwifery College, Tabriz University of Medical Sciences, Iran)Moradi Narges (MSc nursing student, Nursing and Midwifery College, Tabriz University of Medical Sciences, Iran) Introduction: Epilepsy is a significant health problem in Iran as in other
countries. Previous studies conducted within Iran related to epilepsy are
often associated with physiological aspects and pharmacological therapy
and little attention has been paid to psychological and social aspects of
care, especially in adolescence. This paper will focus on filling this gap,
with an aim to assess the relationship between psychosocial care and
attitude towards illness.
Method: A descriptive correlational design was adopted examining 74
adolescents within the Neurology Clinic, affiliated to Tabriz University of
Medical Sciences in 2010. Data were collected using a tool consisting of
:(1)Patient demographic characteristics, (2)The child report of psychosocial
care scale, and (3)Questionnaire of the child attitude toward illness.
Finding: There was a significant positive correlation between psychological
care with attitude toward illness (p<.05).
Conclusion: There is no evidence for routine psychological consultation
for our sample; if there is psychological consultation with and without
parents organized this would be helpful.
Key word: epilepsy, psychosocial care, attitudes, child
9th International Congress on Epilepsy Psychosocial care and its relation to disease concerns in
adolescents with epilepsy
Valizadeh Leila (Assistant Professor. Pediatric Health Research Center and Nursing and Midwifery college. Tabriz University of Medical Sciences, Iran)Barzegar Mohammad (Professor of Pediatrics, Pediatric Health Research Center, Tabriz University of Medical Sciences, Iran)Akbarbegloo Masoomeh (MSc in Pediatric Nursing, Tabriz Pediatric Health Research Center and Nursing and Midwifery college. Urmieh University of Medical Sciences, Iran)Zamanzadeh Vahid (Associate Professor, Nursing and Midwifery college. Tabriz University of Medical Sciences, Iran)Rahmani Azad (MSN, PhD student, Nursing and Midwifery college. Tabriz University of Medical Sciences, Iran)Jabarzadeh Faranak (MSN, PhD student, Nursing and Midwifery college. Tabriz University of Medical Sciences, Iran)Bafandeh Mostafa (MSc nursing student, Nursing and Midwifery College, Tabriz University of Medical Sciences, Iran)Rahiminia Elaheh (MSc nursing student, Nursing and Midwifery College, Tabriz University of Medical Sciences, Iran)Moradi Narges (MSc nursing student, Nursing and Midwifery College, Tabriz University of Medical Sciences, Iran) Introduction: Epilepsy is a significant health problem in Iran as
other countries. Studies in Iran, about epilepsy more associated with
physiological aspects and drug therapy and far too little attention has
been paid to psychological and social care, especially in teens. This paper
will focus on filling this gap, and the aim is to assessment of relationship
between psychosocial care and worries toward illness.
Method: A descriptive corelational design was used upon 74 adolescents
in Neurology Clinic, affiliated to Tabriz University of Medical Sciences in
Iran 2010. Data were collected using a questionnaire consists of: 1-Patient
demographic characteristics, 2-The child report of psychosocial care scale,
and 3- the child worry scale.
Finding: There was a significant positive correlation between psychological
care with child worry toward illness (p<.05). Also more than half of
patients reported that they personally received explanation by doctor or
nurse was less than they expected. It was 42 percent claimed received just
As Much As adolescents wanted about item "The doctors and nurses told
me how the medicine worked".
The most worries were related to, "I'm worried that my friends know I'm
epileptic", "I worry that I might have a seizure in front of my friends" and
"I worry about being alone because I might have a seizure".
Conclusion: According to current study findings, it offers in addition
to educational materials (e.g. pamphlets and books or conducting and
9th International Congress on Epilepsy introducing related websites through related professionals or associations, it is helpful of adolescents' group discussion with or without parents participation. More psychosocial supports and more information about epilepsy aspects will be of helpful in adolescence. School employees' epilepsy related education also is useful.
Key word: epilepsy, adolescent, psychosocial care, worries.
9th International Congress on Epilepsy Barriers and solutions to improve nursing performance
in development of quality of life in families with
Vejdani.M, Alhani.F Background: The epilepsy has variable and complex effects on the quality
of life. It is important to develop quality of life in families that have a
child with epilepsy and the nurses have vital responsibility in this context.
The aim of this article was to determine barriers and solutions to improve
nursing performance in development of quality of life in families that have
a child with epilepsy.
Materials and methods: This research was a descriptive study in which
70 nurses, working in pediatric hospitals of Tehran University of medical,
were recruited by whole count sampling. The research instrument was a
questioner that had two section (The first one included demographic data
and the other section was related to barriers and solutions to improve
nursing performance in development of quality of life in families that have
a child with epilepsy).
Results: The mean age of the subjects was 33.29±7.07 years, and the mean
years of experience was 9.54±6.98. All the subjects were female. The
results showed that the most important barriers were, "the shortcoming in
time and the improper ratio of nurses to patients "(Management prospect),
"deficiency in coordination between different centers" (Environmental
prospect), "Inadequate salary" (Motivational prospect), and finally
"Inappropriate educational activity" (Educational prospect)
Conclusion: To overcoming the above mentioned barriers, some solutions
were developed and finally, the most perfect and salient solution,"
Educational Clinic" was considered to be executed.
Keywords: Child with epilepsy, Family, Nursing performance, Barriers
and Solutions, Educational Clinic, quality of life.
9th International Congress on Epilepsy Can Polymorphic Delta Activity determine brain
Zare M .MD, Associate professor of neurology, neurology department of Isfahan medical science. Isfahan Neuroscience Research Center .
Abstract: Polymorphic Delta Activity (PDA) is arrhythmic waves at the
range of Delta activity (<4Hz) with constantly changing of morphology,
frequency and voltage.
This activity may be due to permanent or transient disruption of sub
cortical white matter of thalamic nuclei. The mechanism of producing
of PDA is due to disruption of relation between mesencepalon reticular
formation, hypothalamus, thalamus and cortex. Therefore PDA is due
to sub cortical and white matter lesion. Superficial cortex without white
matter involvement do not can not produce significant PDA unless it
causes significant compression of midline structures. PDA can appear as
intermittent or continuous (persistent) forms. Intermittent form of PDA
may be due drowsiness and hyperventilation or reversible causes as
migraine, metabolic disturbance, TIA, partial seizure, post ictal phase, mild
brain traumatic lesion and encephalitis. This form of PDA is attenuated
by eye opening and deep sleep. In contrast to intermittent form of PDA,
continuous form is highly correlated with focal structural lesion. in
addition to persistency other indexes that denote to structural sub cortical
lesion include; persistent in deep sleep, not reactive to eye opening, more
slowly, surrounded by theta activity, less intermixed activity above 4 Hz
or superimposed beta activity. Therefore PDA can determines temporally
or permanent sub cortical lesion, although focal depression of beta activity
is an earlier and more sensitive sign. in addition to determination of focal
lesion, PDA can predict the prognoses.
Key words: Polymorphic Delta Activity (PDA), Brain localized lesion

Source: http://www.epilepsycongress.ir/en/images/english.pdf

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January 2008 SMART Holiday Party 2007 was a huge success, and all of us enjoyed the talented performances, tasty food, lively music, great dancing, and wonderful CD gifts. Many thanks to all who helped Class for out at the SMART Holiday Parents of Party 2007. Thanks to Bill Stinebaugh and Eggleston Services for the use of the

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Recommendations for the Managementof Herpes Zoster Robert H. Dworkin,1,2 Robert W. Johnson,18 Judith Breuer,19 John W. Gnann,5,7 Myron J. Levin,8 Miroslav Backonja,9Robert F. Betts,3 Anne A. Gershon,4 Maija L. Haanpa¨a¨,22 Michael W. McKendrick,20 Turo J. Nurmikko,21Anne Louise Oaklander,10 Michael N. Oxman,12 Deborah Pavan-Langston,11 Karin L. Petersen,14Michael C. Rowbotham,14 Kenneth E. Schmader,15 Brett R. Stacey,16 Stephen K. Tyring,17 Albert J. M. van Wijck,23Mark S. Wallace,13 Sawko W. Wassilew,24 and Richard J. Whitley6