Investigation of the Effects of Acute and Chronic PTZ Model Epilepsy in Rats Exposed to Neonatal Hyperoxia on Bdnf, Ngf, Cyt c, Bax, and Bcl-2 Gene Expression Levels in the Brain - Archives of Epilepsy

Objective:Despite its widespread use and safety data, the cardiac safety of lamotrigine was brought into question in October 2020 when the U.S. Food and Drug Administration issued a safety warning about its cardiac side effects. Here, we investigated whether there are differences in electrocardiogram (ECG) findings between epilepsy cases receiving lamotrigine monotherapy and those receiving duotherapy.Methods:Patients older than 16 years who were followed up with a diagnosis of epilepsy and receiving lamotrigine were retrospectively identified. Those receiving only lamotrigine and any second anti-seizure medication (ASM) in addition to lamotrigine were included in the study, and those receiving more than two ASMs were excluded. Eligible patients were asked to apply to any health institution and have an ECG performed. Heart rate, PR distance, QRS duration, QT duration, corrected QT value, and Tp-Tend value were calculated manually, and ST-T changes were evaluated. Comparisons were made between patients receiving monotherapy and dootherapy and those receiving low-dose and high-dose lamotrigine.Results:There were 19 patients receiving monotherapy and 11 receiving duotherapy. The ECG parameters of all other patients were within normal values. When ECG parameters were compared between patients receiving monotherapy and those receiving duotherapy, no significant differences were found in heart rate, PR distance, QRS duration, QT duration, QTc duration, Tp-Tend duration, and presence of ST-T changes. When the patients were divided into low-dose and high-dose lamotrigine groups, there were no significant differences in the ECG parameters between these two groups.Conclusion:The relationship between the use of lamotrigine and cardiac conduction problems in patients with epilepsy has attracted the attention of physicians since its introduction into clinical practice. Although our results did not indicate a significant relationship, there is still a need to determine the risk groups and clarify the pathophysiology of lamotrigine-related arrhythmia through genotype- and phenotype-related studies.

Status epilepticus may have long-term consequences, including neuronal injury. Some patients with status epilepticus have neuroimaging findings, including cytotoxic and vasogenic edema, abnormal signal intensity on T1-weighted, T2-weighted, and the T2 fluid-attenuated inversion recovery images, and perfusion abnormalities. The prognosis of these findings is unclear; they might be associated with de novo epilepsy and poor prognosis. In this report, we describe the clinical, elect roenc ephal ograp hic and the magnetic resonance, and the computerized tomographic perfusion findings in 4 patients with status epilepticus and emphasize the variable characteristic of the imaging findings, the correlation of the clinical and elect roenc ephal ograp hy findings with magnetic resonance image lesions, and the key features to differentiate these lesions from vascular lesions.

Objective:To evaluate the effect of short- and long-term treatment on laboratory parameters in patients diagnosed with epilepsy in childhood and receiving monotherapy (carbamazepine, valproic acid, phenobarbital, levetiracetam).Methods:This study included a total of 258 patients who were admitted to Adiyaman University pediatric neurology clinic between 1 October 2017 and 1 June 2019, diagnosed with epilepsy, and received monotherapy. Hematological, biochemical, and hormonal profiles were compared in the third and nine months following the initiation of monotherapy.Results:Of the patients, 115 (44.57%) were female and 143 (55.43%) were male. The mean age was 8.33 ± 3.51 (0-17) years. Examination of biochemical parameters showed that there was a statistically significant difference in creatinine levels in patients using levetiracetam and phenobarbital (p = 0.009, p = 0.031); calcium levels in patients using valproic acid (p = 0.002); and alanine aminotransferase levels in patients using carbamazepine (p = 0.045). Considering hematological parameters, a statistically significant difference was observed in white blood cell count levels in patients receiving valproic acid (p = 0.005); hemoglobin and hematocrit levels in those receiving carbamazepine (p = 0.010, p = 0.042); and platelet levels in patients receiving phenobarbital (p = 0.037). In all patients receiving monotherapy, there was no statistically significant difference between hormonal parameters (folate, 25-OH D3, vitamin B12, free t4, and TSH) measured in the third and ninth months.Conclusions:We recommend that AED therapy should be checked routinely to investigate the effects of treatment on hormonal, biochemical, and hematological parameters.

Objective:The aim of this study was to investigate the diagnostic utility of routine electroencephalogram and video electroencephalogram monitoring.Methods:We performed a retrospective analysis on patients admitted to our video electroencephalogram monitoring unit. The yield of routiene electroencephalogram and video electroencephalogram monitoring was compared and assessed with the detection of epileptiform discharges.Results:Out of 191 patients, the epileptiform discharges found in routiene electroencephalogram and video electroencephalogram monitoring were 39 (21%) and 99 (52%), respectively. The yield of epileptiform discharges differed significantly between video electroencephalogram monitoring and routiene electroencephalogram (P < .001). While the epileptiform discharges detection rate (95% CI) was 0.29 (0.25-0.46) for routiene electroencephalogram, it was 0.93 (0.86-0.97) for video electroencephalogram monitoring.Conclusion:Compared to routiene electroencephalogram, video electroencephalogram monitoring is superior in detecting epileptiform discharges.

Objective:The frequency of epileptic seizures is high in patients with brain tumors and its treatment is important. It is atypical mitotic proliferation that is effective in the proliferation of malignant tumor cells. It is known that antiepileptics have direct or indirect effects on mitotic proliferation. In our study, we aimed to maximize the use of both the antiepileptic effect and the cytoreductive effect by suppressing tumor growth while choosing the drug to stop the seizure.Methods:In our study, anti-tumoral activities of antiepileptic agents containing gabapentin, pregabalin, valproic acid, levetiracetam, zonisamide, phenytoin, carbamazepine in in vitro glioblastoma (c6) and neuroblastoma cell cultures (NA/An1) were evaluated with a real-time cell analysis system. Statistically, the difference between groups was investigated by analysis of variance, followed by post hoc Tukey’s test Statistical Package for the Social Sciences software 16.0 (IBM Inc, Chicago, IL, USA).Results:In our study, it was observed that all drugs except gabapentin had antimitotic effects in glioblastoma cell cultures, among which phenytoin, levetiracetam, and valproic acid had dose-dependent antimitotic effects, while carbamazepine had reduced antimitotic effects at concentrations above 25 μg/mL. In in vitro neuroblastoma cell cultures, it was found that only valproic acid and zonisamide had antimitotic effects, and other drugs studied did not have antimitotic effects.Conclusions:In our study, it was observed that the preference of antiepileptics with a high antimitotic effect on tumoral cells was important when arranging seizure treatment in patients with brain tumors.

Objectives:This study aimed to evaluate health-related quality of life in patients with epilepsy and to investigate the role of sociodemographic attributes and clinical features.Methods:Two hundred five patients diagnosed with epilepsy and under the follow-up of epilepsy outpatient clinics of our tertiary center were enrolled. Gender, age, age of epilepsy onset, disease duration, seizure type, epilepsy etiology, frequency of seizures, anti-seizure drugs, electroencephalography, and magnetic resonance imaging findings were noted. The Short Form-36, valid and reliable in our country, was used to assess health-related quality of life. The Short Form-36 physical and mental scores were calculated.Results:All Short Form-36 subscores of patients were low when compared to the normative data of our country. Some physical and mental health scores of women with epilepsy were lower than the scores of men with epilepsy. All Short Form-36 subscores of patients under polytherapy were lower than the ones under monotherapy. Some quality of life scores were negatively correlated with disease duration; yet the range of age, age of epilepsy onset, seizure type, etiology of epilepsy, cranial magnetic resonance imaging, and electroencephalography findings were not significantly correlated with Short Form-36 scores.This study revealed that health-related quality of life of patients with epilepsy was lower than that of healthy individuals. It should be noted that Conclusions:women with epilepsy, patients with longer disease duration, patients suffering from frequent seizures, and the ones under polytherapy could have a lower quality of life. Patients with epilepsy should be supported in means of quality of life and modifiable factors.

Objective:The aim of our study is to evaluate the knowledge, attitudes, and behaviors of the parents of children diagnosed with epilepsy, regarding the treatment and first aid during seizures.Methods:Parents of children who applied to Balıkesir University Medical Faculty Pediatric Neurology Outpatient clinic, who were diagnosed with epilepsy, and who had regular controls were included in this cross-sectional study.Results:In total, 117 patient parents participated in our study. The majority of the attendees were mothers (n = 74, 63.2%). The youngest of the participants was 20, the oldest was 70 years old, and their mean age was 37.2. It was found that the parents often learned the information they had about epilepsy only from the doctors (n = 69, 59%), and only antiepileptic drugs were used in the treatment of 111 (94.9%) patients and they did not try any other treatment methods. The number of participants who stated that epilepsy could be treated with drugs was 105 (89.7%). Most of the participants stated that they would lay their children down comfortably during the attack (n = 113, 96.6%) and that they would keep their mouth and airway open if possible so that they could breathe comfortably after positioning the child (n = 104, 88.9%).Conclusions:In our study, our patients were informed both verbally and in writing about epilepsy and emergent intervention at certain periods before and after treatment and the right approach in the first intervention constituted the majority.