seizures

This study aimed to investigate the potential impact of royal jelly (RJ) on hippocampal neurons in an ovariectomized (OVX) rat model with pentylenetetrazol (PTZ)-induced seizures by assessing luteinizing (LH) and follicle-stimulating (FSH) hormones.

Fifty-six female rats (n=7/group) were divided into groups receiving saline (CTL, OVX, RJ, and OVX-RJ) and those undergoing PTZ-induced seizures (PTZ, PTZ-OVX, PTZ-RJ, and PTZ-OVX-RJ). OVX rats underwent bilateral ovary removal, followed by a 15-day RJ treatment at 300 mg/kg. The seizure model commenced 24 hours after the final RJ dose. Serum LH and FSH levels were measured, and Golgi staining assessed hippocampal neuron morphology.

The RJ group exhibited elevated LH and FSH levels compared to CTL. However, the PTZ-RJ group showed no significant changes in these hormones relative to the PTZ and CTL groups. In OVX-RJ rats, LH and FSH levels decreased compared to the RJ group, while PTZ-OVX-RJ rats showed increased levels. Dendritic spines remained unchanged in both the RJ and PTZ-RJ groups compared to the CTL and PTZ groups, respectively. Notably, OVX-RJ exhibited reduced spines compared to the RJ group, while PTZ-OVX-RJ showed an increase.

RJ may protect against estrogen deficiency and seizure-related adverse effects on hippocampal neurons in OVX rats, highlighting its potential as a beneficial dietary supplement.

Recent research has revealed the central adverse effects of Botox after intramuscular injection. The aim of this study was to examine the role of brain oxidative stress factors and circulatory cytokines as indicators of the severity of seizures following acute intramuscular (IM) injection of Botox in mice.

Botox (1, 5 and 30 U, IM) was injected 60 minutes before inducing maximal electroshock (MES) seizures. Nitric oxide (NO), malondialdehyde (MDA) and glutathione (GSH) levels were measured in the brain. Tumor necrosis factor-alpha (TNF-α) levels were also determined in the serum. The motor coordination was assessed after Botox administration by using the chimney test.

Botox (5 and 10 U/kg, IM) significantly reduced the duration of hindlimb extension (HLE) and elevated levels of NO and MDA in the brain compared to the seizure group. Additionally, the administration of Botox (1 and 5 U, IM) increased the level of GSH in the brain, while 30 U decreased it. All Botox dosages demonstrated an enhancing effect on serum TNF-α levels compared to the seizure group. Botox at 5 and 30 U induced locomotor incoordination in mice.

Our results showed that IM injection of Botox can lead to the exacerbation of tonic-clonic seizures by stimulating oxidative stress in the brain and increasing circulating TNF-α levels in mice.

low-frequency electrical stimulation (LFS) has been considered as a new treatment method for epilepsy patients resistant to drug treatment, but its mechanism of action is not fully understood. Gi protein-coupled receptors such as dopamine D2-like receptors may play a role in mediating the effects of LFS. In this study, the role of dopamine D2-like receptors in the effects of LFS on seizure-induced spontaneous synaptic activity in the hippocampal CA1 region of fully kindled rats has been investigated. Animals were kindled by semi-rapid kindling method (6 stimulations per day) by electrical stimulation of the hippocampal CA1 region. In LFS-treated groups, animals received 4 LFS packets at 5 minutes, 6 hours, 24 hours, and 30 hours after the last LFS stimulation.Each LFS package consisted of 4 series with an interval of 5 minutes, and each series consisted of 200 pulses, and the pulse duration was 0.1 ms with a frequency of 1 Hz. Haloperidol (D2 receptor antagonist, mµ2) or bromocriptine (D2 receptor agonist, g/µlitµ2) was injected into the lateral ventricle immediately after the last kindling stimulation, before applying LFS. The obtained results showed that the application of LFS in kindled animals did not affect the spontaneous excitatory currents in the hippocampus, but it caused a decrease in the spontaneous inhibitory currents in the hippocampus. D2 receptor agonist did not mimic the effects of LFS. The use of haloperidol did not affect the effects of LFS. Therefore, spontaneous excitatory and inhibitory potentials are not a suitable quantity to investigate the effectiveness of LFS.

Traumatic brain injury (TBI) is a significant medical concern, with post-traumatic epilepsy (PTE) being one of its consequences. Epilepsy, with a global prevalence of 1%, is the third most common neurological disorder after stroke and Alzheimer’s disease. Trauma accounts for 20% of symptomatic epilepsy cases. Understanding the prevalence of PTE and the factors influencing it can aid in diagnosis and treatment. This study aims to investigate the relationship between epilepsy prevalence, age, gender, and post-traumatic brain injuries.

This retrospective descriptive study analyzed data from 135 epilepsy patients hospitalized between 2018 and 2021. Statistical analysis involved reviewing relevant data and creating tables and graphs.

The findings indicate that epilepsy is more prevalent in men than in women, with the most affected age group being 20-29 years old. Post-traumatic epilepsy emerged as the most common factor among the patients. The prevalence of PTE in this study was 9.6%, closely aligning with the global rate of 7.8%.

The prevalence of post-traumatic epilepsy is significantly influenced by geographical conditions and living environments. In developing countries, the high volume of road traffic and increased accident rates contribute to a higher incidence of post-traumatic epilepsy.

For patients with epilepsy and their family caregivers, epilepsy risk awareness (ERA) can affect various aspects of health. They need effective education to improve their quality of life.

This study aims to compare the effect of self-care education on ERA in patients with epilepsy and their family caregivers using the face-to-face method and pamphlets.

In this quasi-experimental study, participants were patients with epilepsy referred to a neurological outpatient clinic in Tabriz, Iran and their family caregivers. They were randomly assigned to the intervention (60 patients and 60 caregivers) and control (60 patients and 60 caregivers) groups. The ERA scales for patients and family caregivers were completed before and one month after the education. The intervention group received ERA-based self-care education in a 60-minute session using the face-to-face method. The pamphlet group received the same education using pamphlets. Data were analyzed using descriptive statistics, paired t-test, independent t-test, Fisher’s exact test, chi-square test, and ANCOVA.

Most of the patients (70%) and caregivers (53.3%) in the intervention group were female, and their mean age was 28.07 and 40.75 years, respectively. In the pamphlet group, most of the patients (68.67%) and caregivers (63.3%) were female, with a mean age of 30.28 and 42.32 years, respectively. After education, mean ERA scores increased significantly in both intervention and pamphlet groups (P=0.001). Except for the two domains of physical and mental health, the mean scores of ERA domains were higher in the intervention group than in the pamphlet group (P=0.01). These results were confirmed by ANCOVA results (P<0.01).

Self-care education with the face-to-face method or pamphlets both can increase the ERA of patients with epilepsy and their family caregivers. Depending on the conditions and available facilities, nurses can use these methods to facilitate patient education and the learning process.

Seizure is a common sign in neonates hospitalized in the neonatal intensive care units (NICU) that may lead to morbidity and mortality. Most neonatal seizures are subclinical. Conventional EEG (cEEG) is the gold standard for detecting and monitoring seizures but is not widely available. Amplitude-integrated electroencephalography (aEEG) has been used for over a decade to evaluate infants with seizures. In this study, we tried to determine the efficacy of aEEG as
a widely available diagnostic tool in diagnosing seizures.

All cases with seizures or suspicious seizures were admitted to the NICU of the Children’s Medical Center for one year. cEEG and aEEG were performed for these infants. aEEG was recorded for at least six hours with a description of the tracing. Clinical information, outcomes, and questionnaires (patient information) were recorded in detail. The obtained data were analyzed with the SPSS version 24 software.

Eleven out of twenty-five aEEG recordings were abnormal; other patients showed normal aEEGs. The most common clinical and neurological manifestations were seizure (68%) and hypotonia (28%); the mortality rate was 12%. No significant correlation was observed between aEEG findings and gender, age, familial relation, outcome, ultrasound result, type of seizure, and underlying disease.

During Coronavirus disease-2019 (COVID-19) pandemic, patients with epilepsy (PWE) have faced with delayed outpatient visits, cancellation of their para-clinic tests, and problems in accessing to emergencies. Regarding to the previous studies, PWE are at increased risk of psychological disorders than healthy persons.

This study aimed to compare psychological distress between PWE and a healthy control group.

This study was performed in the sixth wave of COVID-19 in Mashhad, Iran. We evaluated 132 PWE who consecutively referred to the Neurology Clinics of 22 Bahman Hospital. Also, 132 age and sex matched-healthy persons were included as the control group. Demographic and epilepsy related-data were collected through a questionnaire. The 6-item Kessler questionnaire was used to assess psychological distress.

The included PWE and the control groups were similar among all demographic variables, unless monthly income. We found that PWE had significantly higher psychological distress level (P=0.03) and spent significantly more time following the COVID-19-related news (P=0.000). By using ANCOVA test we found that PWE have significant higher levels of concerns about COVID-19 (P=0.03) and spend more time following COVID-19-related news (P=0.04). Logistic regression revealed that PWE 1.124 times more concern about COVID-19 outbreak and 0.294 time pay less attention to COVID-19 related news.

During public health emergencies, health care professionals should focus not only on seizure control but also on the mental health status of PWE, particularly those with higher number of seizures.

The study aimed to assess the awareness of mothers on the risk factors, prevention, and management of seizures in newborns.

This descriptive cross-sectional study was conducted on 359 mothers using simple random sampling. The data were collected using questionnaires that included general awareness, awareness of the causes, risk factors, prevention, and management. The data collected were analyzed using frequencies and percentages. Null hypotheses were tested using chi-square at 0.05 level of significance.

Two hundred seventy-four mothers (76.3%) had high awareness of seizures in newborns, thirty-four (9.5%) had average awareness, and fifty-one (14.2%) had low awareness. Two hundred and seventythree mothers (76%) had high awareness of the risk factors, and eighty-six (24%) had low awareness, meaning that although some respondents had misconceptions, awareness of the risk factors and causes was good. Two hundred twenty-three (62.1%) respondents had high awareness of preventing seizures in newborns, while 136 (37.9%) had low awareness. The awareness of respondents on managing seizures in newborns is positive, as 291 (81.1%) had high awareness of managing seizures in newborns, while sixty-eight (18.9%) had low awareness. There was a significant relationship between age (p =0.000), marital status (p=0.018), level of education (p =0.000), and awareness of risk factors of seizures in the newborn.

A high awareness of neonatal seizures was found among mothers because of their high educational level, although some still had some misconceptions. Improving maternal neonatal seizure awareness and appropriate educational interventions to correct misconceptions are needed.

Epilepsy is the second, most common and most dangerous neurological complication that can occur in a pregnant woman. Women with epilepsy (WWE) are at higher risk for miscarriage, prematurity, congenital anomalies and low birth weight (LBW).

The aim of this study was to investigate the outcome of pregnancy in women with epilepsy.

This descriptive study was conducted on 131 pregnant women with epilepsy who referred to Ardabil Alavi Hospital from September 2019 to September 2021. Necessary information such as BMI, type of seizure, congenital malformation, treatment drug and name of used drugs collected through patients file by a checklist and then analyzed by using statistical methods in SPSS version 25.

The frequency of neonate term birth was 83.21% and preterm birth was 16.79%. The frequency of babies with LBW was 22.85%. Most of women with 65.96% had cesarean delivery. More than 83% of seizures were generalized and 67.93% used mono-therapy. Only one fetus had malformation (0.76%). The most frequency among the patients receiving mono-therapy was related to the carbamazepine with 26.71% and among the women treated with multitherapy was related to Levetiracetam plus carbamazepine with 12.97%.

Pregnancies with epilepsy, even in cases with multidisciplinary care and no other risk factors, are still significantly associated with higher adverse outcomes.

 As the most prevalent noncontagious neurologic condition, epilepsy is an important cause of mortality and disability in children, and its etiology is an important issue.

 Epilepsy may be induced by different risk factors, some of which may be unclear; therefore, this study aimed to evaluate the risk factors of seizures in children.

 Children with seizures admitted to the Pediatric Clinic of Amir-Kabir Hospital were enrolled in this study. First, accurate biography of the parents was taken to rule out other differential diagnoses of seizures. After the diagnosis of seizures, based on the diagnosis of a pediatric neurologist, demographic information, detailed history of seizure, neurologic examination, and process of growth and development were recorded. Then, we take electroencephalogram (EEG), magnetic resonance imaging, and computed tomography scans from study cases.

 Of the 291 evaluated cases, 54.6% were male. Variables associated with seizure and epilepsy evaluation showed that generalized tonic-clonic seizure was the most prevalent seizure in 134 children (46%). The duration of seizures was lower than 15 minutes in 266 cases; in addition, 191 children (55.5%) had a fever before seizures. Regarding underlying diseases, 268 children (92.2%) had no disease. Cerebral palsy (CP) was the most common underlying disease in 10 cases (3.4%).

 Infectious diseases (such as gastroenteritis and pneumonia) were observed as the most important possible risk factors in this study.

Although much research on patients with epilepsy (PWE) has focused on psychiatric disorders such as depression, anxiety, and psychotic disorders, the relationship between epilepsy and personality disorders has not been frequently studied.

The study aimed to evaluate borderline personality traits in PWE.

In this case-control study, we evaluated 211 PWE who were consecutively referred to 22 Bahman Hospital, Mashhad, Iran, in 2021. We also compared the patients with an age-matched and gender-matched control group. The Borderline personality traits were assessed by the second subscale of the schizotypal questionnaire (STB) which is known as the borderline personality scale questionnaire. Data were coded and analyzed by SPSS software, version 20.

Epilepsy group had significantly higher borderline personality features in comparison with the control group (P=0.029). PWE had significantly higher scores in hopelessness (P=0.017) and impulsivity factors (P=0.046) on the STB questionnaire. Our results revealed that PWE who were married (P=0.011) and who had epilepsy for more than 10 years, had significantly higher borderline personality traits (P=0.04).

PWE are more likely to have borderline personality traits. Therefore, it is important to screen epileptic patients to detect it earlier to avoid further consequences and its possible effects on therapeutic responses.

Among the many types of central nervous system (CNS) disorders, seizures and epilepsy severely affect the quality of life and routine daily activity of the sufferers. We aimed to review research studies that investigated the effect of statins on the prevention and treatment of seizures and epilepsy. Both animal models and human studies were included in this review. This article starts with a brief introduction about seizure, its prevalence, treatment, and various animal models of seizures and epilepsy. Next, we discuss statin’s mechanism of action, side effects, and effects on neurological disorders with a specific focus on seizures. Finally, the effects of different types of statins on seizures are compared. The present review gives a better understanding of the therapeutic effects of statins on neurological disorders in animal models and human studies. This permits researchers to set up study designs to resolve current ambiguities and contradictions on the beneficial effects of statins on neurological disorders.

Meier-Gorlin syndrome (MGS) is a rare autosomal recessive disorder with homozygous or heterozygous mutations in one of the five following genes (ORC1, ORC4, ORC6, CDT1, and CDC6). This syndrome is characterized by the triad of short stature (pre/postnatal), microtia, and patella hypoplasia/aplasia. Special features included microcephaly, microstomia, full lips, micrognathia, narrow convex, and high nasal bridge nose. Also, it may be accompanied by feeding problems, skeletal disorders, urogenital or respiratory anomalies, and intelligence disorders. This case report describes the first Persian MGS accompanied by neonatal seizure, mental retardation, and attention deficit hyperactivity disorder.

Previous studies have shown that patients with epilepsy (PWE) perceived significant disruption in the quality and provision of care due to the coronavirus disease 2019 (COVID-19) pandemic. The present study aimed to investigate the effect of this pandemic on seizure control status and changes in seizure frequency in PWE.  A consecutive sample of adult PWE registered in the database of Shiraz Epilepsy Center (Shiraz, Iran) was included in the study. In July 2021, phone interviews were conducted with all selected patients. Information such as age, sex, last seizure, seizure type, and frequency during the 12 months before the study, and history of COVID-19 contraction was extracted. The seizure control status of the patients in 2019 (pre-pandemic) was compared with that during the COVID-19 pandemic. Data were analyzed using SPSS software with the Fisher’s exact test and Pearson’s Chi squared test. P<0.05 was considered statistically significant.  A total of 158 patients were included in the study, out of which 62 (39.2%) patients had a stable seizure control status, 47 (29.7%) had fewer seizures, and 50 (31.6%) had more seizures. Breakthrough seizures were reported by 32 (34.4%) patients. Seizure frequency increased in 18 (27.7%) and decreased in 46 (70.7%) patients. Overall, the COVID-19 pandemic has not been a major precipitating factor nor has it affected the seizure control status of PWE. In treated epilepsy, a fluctuating course with periods of seizure freedom followed by relapses is part of its natural history.