Neurological Disorders

ISSN: 2329-6895

Open Access

Current Issue

24th International Conference on Neurology & Neurophysiology (2020)

    Editorial Pages: 1 - 1

    Past Conference Editorial of Neurophysiology 2020

    Sheikh Abdul Saeed

    Conference  Series  LLC  Ltd  hosted  the  “Neurophysiology”, during March 16-17, 2020 at Berlin, Germany with the theme, “Contemporary Strategies for Prevention and Control of Neurological disorders”, which was a great success. Eminent keynote speakers from various reputed institutions and organizations addressed the gathering with their resplendent presence.

    We extend our grateful thanks to all the momentous speakers, conference attendees who contributed towards the successful run of the conference.

    Neurophysiology 2020 witnessed an amalgamation of peerless speakers who enlightened the crowd with their knowledge and confabulated on various latest and exciting innovations in all areas of Neuroscience.

    Neurophysiology Organizing Committee extends its gratitude and congratulates the Honorable Moderators of the conference.

    Conference Series LLC Ltd extends its warm gratitude to all the Honorable Guests and Keynote Speakers of “Neurophysiology”.

    • Sheikh Abdul Saeed, King Saud Bin Abdulaziz University of Health Sciences, Saudi Arabia

    Conference Series LLC Ltd is privileged to felicitate Neurophysiology 2020 Organizing Committee, Keynote Speakers, Chairs & Co-Chairs and also the Moderators of the conference whose support and efforts made the conference to move on the path of success. Conference Series LLC Ltd thanks every individual participant for the enormous exquisite response. This inspires us to continue organizing events and conferences for further research in the field of Neurophysiology.

    Conference Series LLC Ltd is glad to announce its “25th International Conference on Neurology & Neurophysiology, which will be held during March 15-16, 2021 at London, UK. We cordially welcome all the eminent researchers, Training Institutes, Young researchers, Data Management Companies, Hospital General Counsel, Legal Nurse Consultants, Manufacturing Medical Devices Companies, students and delegates to take part in this upcoming conference to witness invaluable scientific discussions and contribute to the future innovations in the field of Neurology & Neurophysiology with 20% abatement on the Early Bird Prices.

    Bookmark your dates for “Neurophysiology 2021, London” as the Nominations for Best Poster Awards and Young Researcher Awards are open across the world.

    Value Added Abstracts Pages: 2 - 2

    Changes in the GABAergic signalling in the prefrontal cortex of mice model of posttramautic stress disorder

    Arina Serbina

    It has  been  suggested  that  the  neurons  of  prefrontal  cortex, along with the hippocampus and amygdala, can undergo morphological and molecular remodeling during the development of stress-related disorders, such as PTSD. Pathological remodeling of the GABAergic inhibitory signalling during stress disorders might bring significant contribution to impairment of synaptic plasticity and cognition. In this work we have used an experimental model of PTSD in mice, based on a single prolonged stress protocol and studied alterations in the synaptic transmission and long-term synaptic plasticity in the pyramidal neurons of prefrontal cortex. The stress state in the animals was evaluated with the aid of open field and elevated cross-maze behavioral tests. We have found an increase in the quantal amplitude of GABAergic spontaneous inhibitory synaptic currents (mIPSCs) in the neurons of prefrontal cortex of stressed animals. There was also elevation in the frequency of mIPSCs in neurons of the stress- group vs control group. These results demonstrate that that exposure to stress can cause an up-regulation of the GABAergic inhibitory system in the prefrontal cortex. In the experiments on long-term potentiation (LTP) of field postsynaptic potentials (fEPSP), we have observed that the amplitude of LTP induced by the theta-burst stimulation in the prefrontal cortex synapses of stressed mice was much lower than in the control group. The data obtained suggest that stress-induced up-regulation of inhibitory signalling can affect long-term synaptic plasticity in the prefrontal cortex and thereby contribute to cognitive impairment.

    Value Added Abstracts Pages: 3 - 3

    Neurophysiology of sleep and sleep-wake disorders

    Dharitri Parmar

    Sleep     and     wakefulness     are     important     physiological manifestations of brain, even for clinicians. Review on Physiology of Sleep includes wakefulness as they are interchangeable, interdependent states. On discussion with introduction to sleep which includes sleep cycle; types of sleep; sleep waves neurotransmitters, pathways, circuits and receptors are summarised. Role of higher centres, parts of brain and other factors (steroid, biological rhythm, aging etc) are reviewed. Its implication in various sleep disorders and recent advances in neurophysiology related to sleep are described.

    Value Added Abstracts Pages: 4 - 4

    Influence on drug and substance abuse on the disease outcome in schizophrenic patients treated with antipsychotic drugs

    Felix-Martin Werner

    Many    schizophrenic    patients,    who    are    treated    with antipsychotic drug, do not adhere to the pharmacotherpy. Antipsychotic drugs constitute a palliative treatment, and their long-term administration is not secure. Instead of following the pharmacotherapy, some patients tend to consume alcohol and tobacco, and even amphetamines and cannabis. The reason of the patients to not adhere to the pharmacotherapy will be discussed, and the effect of alcohol, tobacco and drugs on the disease outcome will be addressed. Appropriate measures to make the patients to renounce of substances and drugs and to improve the patients’ adherence to the pharmcotherapy will be described. Alterations of classical neurotransmitters in the hippocampus, mesolimbic system and prefrontal cortex will be mentioned. The different compounds of cannabis, tetrahydrocannabidiol (a psychotomimetic) and cannabidiol (exerts antipsychotic actions). The effect of alcohol, tobacco and drugs to worsen the antipsychotic treatment will be pointed out. Appropriate measures to improve the antipsychotic pharmacotherapy and to reduce the consumption of substances and drugs are the administration of long-acting injectable antipsychotic drugs and psychoeducation and cognitive behavioral therapy Some new drugs, for example the cannabis compound cannabidiol that shows antipsychotic properties and ß-varenicline, a nicotinergic cholinergic agonist, might be administered when substance abuse (cannabis, nicotine) occurs.

    Value Added Abstracts Pages: 5 - 5

    Therapeutic effect of novel antidepressant drugs interfering with receptors of neurotransmitters and neuropeptides

    Felix-Martin Werner

    Major depression is a frequent psychiatric disease, which is mainly treated by different antidepressant drugs. However, one third of the depressive patients remain treatment-resistant. In major depression, in the brainstem, hippocampus and prefrontal cortex, alterations of neurotransmitters and neuropeptides and the belonging neural networks are updated. Starting from these findings, novel antidepressant drugs and combination of different antidepressant drugs are suggested. In the prefrontal cortex, glutamatergic neurons, which receive a postsynaptic excitatory potential from D2 dopaminergic neurons, exert a presynaptic inhibition upon M1 muscarinic cholinergic neurons via NMDA receptors. Medium spiny GABAergic/somatostatin neurons, which receive projections from M1 muscarinic cholinergic neurons, presynaptically inhibit D2 dopaminergic neurons via GABAA/somatostatin1 receptors. The combination of an NMDA receptor antagonist, for example ketamine with an M1 muscarinic cholinergic receptor antagonist, for example scopolamine, exert a rapid, long-lasting antidepressant effect. In preclinical studies, the antidepressant effect of orvepitant, an NK1 receptor antagonist, has been demonstrated: this antagonist reaches a complete antagonism of NK1 receptors. In clinical studies, the combination of an NMDA receptor antagonist with an M1 muscarinic cholinergic receptor antagonist should be investigated indepth as well as the therapeutic effect of orvepitant. In clinical studies, the antidepressant effect of a triple reuptake inhibitor should be examined and compared to current antidepressant drugs. The superior therapeutic effect of antidepressant drugs like venlafaxine, a selective noradrenaline and serotonin reuptake inhibitor and bupropion, a selective dopamine and nordrenaline reuptake inhibitor and their adverse effects will be pointed out. Non-pharmacological measures to enhance the antidepressant effect will also be discussed.

    Value Added Abstracts Pages: 6 - 6

    Deformed non-local neural network for retinal vessel segmentation

    Junping Zhao

    Vessel  segmentation  is  a  challenging  problem  in  medical image segmentation, as it requires knowing the location of each tiny blood vessel and understanding the global semantic information. Previous method has demonstrated that long-range dependencies information plays an important role in understanding global segmentation information. To capture long-range dependencies information, researchers often use non-local structure. However, it requires too much computing power and a large amount of GPU memory. In this paper, we present a deformed non-local (DNL) neural network structure for retinal vessel segmentation. DNL inherits the structure of the Non-local module, but it changes the operation rules of non- local weight matrix multiplication, which can greatly reduce the problem of excessive computation and memory usage. Meanwhile, we introduce the atrous spatial pyramid pooling module to increase the receptive field of the networks, which showed that it is effective to resample features at different scales for accurately and efficiently classifying regions of an arbitrary scale. The proposed method was evaluated on retinal vessel datasets and experimental results show that it outperforms state-of-the-art methods. For a 128 × 128 input, DNL is around 2.5 times faster than a non-local block on GPU.

    Value Added Abstracts Pages: 7 - 7

    Effect of Lactobacilli on spatial memory and hippocampal APP gene expression in the rat model of Alzheimer's disease

    Maryam Noorbakhshnia

    Background     and     Aim:     Alzheimer's     disease     is     a neurodegenerative disorder that is associated with progressive degeneration of hippocampal and cortical neurons that leads to memory loss. Overexpression and production of amyloid-beta (Aβ) is the most significant factor in the pathogenesis of Alzheimer's disease. Recent studies have found a role for the gut microbiota in the gut-brain axis, which can affect cognitive and memory abilities. The purpose of this study was to investigate the effect of lactobacilli on the spatial memory and expression of APP gene in the hippocampus of Aluminum chloride (AlCl3) induced animal model of Alzheimer's disease.

    Methods: Adult male wistar rats weighing (240–250 g) were used. Animals received either saline, Alcl3 (100 mg/kg), lactobacilli, or lactobacilli plus ALCL3 by oral gavage for 42 days. Lactobacilli contained L.plantarum, L.rhamnosus, and L.reuteri. Morris water maze test was used for evaluating spatial memory. After completion of the behavioral test, animals were sacrificed and hippocampi dissected, and stored at

    -80°C. Finally, the level of APP gene expression was evaluated by Real-Time PCR.

    Results: Our results indicated that ALCL3 significantly impaired spatial memory and intensified hippocampal APP gene expression. Pre-treatment with lactobacilli improved memory in control rats and prevented memory and APP deterioration in ALCL3 treated rats.

    Discussion: lactobacilli used in this study can prevent destructive effect of AlCl3 on memory and can introduce as a way to prevent Alzheimer's disease, possibly via decreasing APP gene expression. However, more investigations are necessary to know related cellular and molecular mechanisms.

    Value Added Abstracts Pages: 8 - 8

    Progress of neuroendocrine modulators in the field of pediatric neurorehabilitation

    Ni Hong

    Many endocrine   regulators   are   widely   expressed   and secreted in the brain, and play important neuromodulatory roles in physiological and pathological processes such as brain development, brain function protection, and brain injury repair. In addition, many endocrine regulators undergo significant changes in the serum and cerebrospinal fluid of neurological diseases and can be used as biological markers for early diagnosis, prognosis and treatment of diseases. In recent years, significant progress has been made in understanding the effects of endocrine modulators on pediatric neurological diseases, especially epilepsy, dravet syndrome, autism spectrum disorder, cerebral palsy and ADHD. These advances stem from a series of research advances on specific endocrine regulators such as melatonin, leptin and ghrelin, as well as ketogenic diet (KD) . KD is a nutritional therapy that has been found to be beneficial against refractory epilepsy, and has also been proposed to treat many other neurological disorders. Recently, we opened a column in the magazine “Frontiers in Endocrinology” in collaboration with scholars from Italy and India: "Endocrine Modulators of Neurological Processes: Potential Treatment Targets of Pediatric Neurological Diseases". Here, we summarize the new progress of the articles published in the column, hoping to provide useful clues for future research.

    Value Added Abstracts Pages: 9 - 9

    Edit efficacy of constraint-induced movement therapy in cerebral palsy children with asymmetric hand impairment

    Rattana Rattanatharn

    Objective: To determine the efficacy of short-interval program of constraint-induced movement therapy on hand function training in asymmetric hand impairment cerebral palsy.

    Study design: Randomized single-blinded controlled trial study.

    Subjects: Asymmetric hand impairment cerebral palsy in Srisangwal School, Foundation for the Welfare of the Crippled System.

    Methods: Sixteen cerebral palsy spastic triplegia (8-14 years old) were assigned randomly to either CIMT or control group. Both groups participated in occupational therapy program for 1 hour per day, 5 days per week for 8 weeks. CIMT group wore slings on their less impaired arms during therapy session and the slings were removed at the end of each session. To assess the effect of hand function of participants by the Jebsen-Taylor Test of Hand Function, counting the number of the coins that patient was able to put in the box within 3 minutes and stereognosis before training and after training for 8 weeks.

    Results: Sixteen cerebral palsy spastic triplegia were divided equally into two groups. One participant in the control group was dropped out from the study because he had surgical intervention in his impaired arm. There was statistically significant (P< 0.05) improvement of hand function by Jebsen- Taylor Test of Hand Function and counting the amounts of the coins in the box within 3 minutes after training for 8 weeks in CIMT group but there was no significance in control group.

    Conclusion: CIMT is efficacious to improve fine motor function in asymmetric hand impairment cerebral palsy.

    Value Added Abstracts Pages: 10 - 10

    Effectiveness of meditation programs in empirically reducing stress and amplifying cognitive function and boosting individual health status: A review

    Reshu Gupta

    Meditation had long been believed to possess a multitude of putative beneficial effects which it could bestow upon it’s practitioner, but it was not until the 1960’s that scientific exploration into the process began. Rigorous increase in randomized controlled trials on mindful interventions has been observed in past two decades. It has been shown, with increasing evidence, to harbor a myriad of positive effects, a few including, but not limited to, stress reduction, cognition enhancement, an increase in memory, boosted intelligence, etc. Such profound positive influences have led to it being rather commonly deployed to promote general health and treat stress and stress related conditions. Meditative modalities are broadly classified as those stressing on mindfulness, concentration or automated self-transcendence. Certain popular modalities such as transcendental meditation follow the use of a mantra such that one transcends to a state where focused attention is absent. In contrast, others such as mindfulness-based stress reduction are based on present focused awareness or mindfulness. While it is not clear if these differences influence the result of  practice, all classes are broadly considered ‘meditation’ and studied as such. The session shall evaluate the increasing evidence of mindfulness intervention by reviewing and discussing the effects of indfulness interventions on boosting memory, recall, learning and reducing stress levels along with the psychological and neurobiological mechanisms of such interventions. This shall provide a robust understanding of the process involved in benefits of practicing mindfulness.

    Value Added Abstracts Pages: 11 - 11

    Teaching neurophysiology in an integrated problem base learning curriculum: A KSAU-HS experience

    Sheikh Abdul Saeed

    Problem  Based  Learning  (PBL)  in  Medical  Education  was introduced almost 50 years ago by McMaster University. In this teaching and learning strategy students work as a team to solve complex real-world clinical problems. This introduction had a ripple effect far beyond the confines of the Medical Education. Today hundreds of medical schools worldwide have adopted this strategy utilizing integrated system approach. King Saud Bin Abdulaziz University of Health Sciences opened its door for the first batch in 2004 in its Riyadh Campus and in 2010 at its Jeddah campus. University of Sydney PBL integrated curriculum was employed and over the years it has been gradually amended to suit local needs. It’s a six-year, three phase programme. In Phase I, emphasis is on English language and strengthening the Basic Sciences including Chemistry, Physics, Biology, Anatomy, Physiology, Pathology, Biochemistry, Microbiology, Immunology, Pharmacology, Ethics and introduction to contextual, integrated Problem Based Learning. In Phase II, students apply their Basic Medical Sciences knowledge (Anatomy, Biochemistry, Microbiology, Pharmacology, Physiology, and Pathology) in a system based, contextual process revolving around Clinical cases. Didactic lectures are used to reinforce learning from the PBL. Moreover, learning is strengthened by relevant Clinical Skills sessions. In the Phase III, students go through Clinical rotations in various clinical disciplines, learn clinical skills on real patients as well as on state-of-the-art mannequins and apply their Basic Medical Sciences knowledge to solve clinical cases. In this presentation we have concentrated on Neuropysiology teaching and learning in Phase II.

    Drugs for Stroke (2020)

      Case Report Pages: 1 - 3

      A Case Report on Miller Fisher Variant of Guillain Barre Syndrome in a Tertiary Care Hospital

      Aneena Annu Philipnand Praveen Kumar

      Miller fisher syndrome is considered to be an uncommon cranial nerve variant of Guillain Barre Syndrome. It is characterized by the clinical triad of opthalmoplegia, ataxia and are flexia that can result from nerve damage caused by an aberrant autoimmune response to a bacterial or viral infection. The following report describes the case of a 7 year old female patient who presented with complaints of blurring vision and right eye drooping. Later she developed weakness of all limbs with respiratory failure that required ventilatory support and was also treated with immunoglobins, corticosteroids, antibiotics and other supportive medications. The patient gradually improved and was discharged in the recovery phase.

      Research Article Pages: 1 - 7

      The Situation of Alzheimer's Disease in Bangladesh: Facilities, Expertise, and Awareness among General People

      Nipa Roy Al-Maruf Hassan, Rukaieya Alom, Md. Habibur Rahman Rajib and Khondaker Abdullah Al-Mamun

      The situation of Alzheimer’s disease (AD) in Bangladesh is investigated in this study, which depicted the overall condition in the country to treat AD affected individuals. Our team performed a brief online survey on the institutions and hospitals dealing with the mental health related issues to find expertise among the practitioners on AD. A survey was also done on the syllabus of trained caregivers such as nurses, or any other group of people receiving training on handling AD patients. There are nontrivial issues needed immediate attention from the government such as national policy for senior citizens that have facilities for AD affected people, specific training module to handle AD patients, and specific expertise to treat AD patients. This study also suggests taking initiatives to a broad level to make people aware of this disease, starting with acknowledging AD as a disease rather than being a generalized mental disorder

      Case Report Pages: 1 - 3

      A Case Report of Quadriparesis and Cranial Polyneuropathy: A Rare Presentation in Idiopathic Intracranial Hypertension

      Aravind G, Siddharth Maheshwari, Aldrin Anthony, Suman Kushwaha and Monali Chaturvedi

      Cerebral Venous Thrombosis (CVT) and Idiopathic Intracranial Hypertension (IIH) are always to be considered in patients with isolated intracranial hypertension. We report a patient with progressive visual loss, ophthalmoplegia and polyradiculopathy with are flexic quadriparesis, secondary to raised intracranial pressure (ICP). Quadriparesis due to raised ICP is a rarely reported presentation.

      Editorial Pages: 1 - 1

      Editorial Highlights of Journal of Neurological Disorders

      Athanasios K. Petridis

      I am delighted to introduce the a rapid peer reviewed journal which is a valuable source of information for scholars, researchers, professionals, and students, providing in-depth perspectives on intriguing contemporary topics with an ethos of openness, we are passionate about working with the global academic community to promote open scholarly research to the world. I am pleased to announce that, 7 issues of the Volume 8 were published online well within the time and the print issues were also brought out and dispatched within 30 days of publishing the issue online during the year of 2020.

      Research Article Pages: 1 - 6

      Development of Assaying Plasma TDP-43 Utilizing Immunomagnetic Reduction

      Shieh-Yueh Yang, Heui-Chun Liu, Chin-Yi Lin, Ming-Jang Chiu, Ta-Fu Chen, Chin-Hsien Lin and Hsin-Hsien Chen

      TDP-43 is a promising biomarker for frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS). However, studies on TDP-43 in human biofluid are rare. In this work, the authors utilized an ultrasensitive technology, called immunomagnetic reduction (IMR), to develop the reagent for assaying TDP-43. The preclinical performance characteristics of the TDP-43 reagent, such as the standard curve, detection limits, assay linearity, dilution recovery range, assay reproducibility, spike recovery, reagent stability, and interference tests, were explored according to the CLSI guidelines. Plasma samples from normal controls (NC, n = 27) and from patients with frontotemporal dementia (FTD, n = 9), Alzheimer’s disease (AD, n = 34) and Parkinson’s disease (PD, n = 10) were collected for TDP-43 assays using the IMR TDP-43 reagent. The low-detection limit of assaying TDP-43 was 0.68 fg/ml, and the upper-detection limit was 100 pg/ml. There was no significant interference effect when assaying TDP-43 mixed with hemoglobin, bilirubin, intralipid, albumin, etc. The FTD patients had significantly higher levels of plasma TDP-43 (0.419±0.193 fg/ml) compared to the NC subjects (0.163±0.097 fg/ml), AD patients (0.165±0.082 fg/ml) and PD patients (0.069±0.068 fg/ml). Through analysis of the ROC curve, the cut-off value of plasma TDP-43 for discriminating FTD from the other patient groups was 0.237 fg/ml, which resulted a clinical sensitivity of 0.889 and a specificity of 0.831. These results demonstrate the feasibility of assaying plasma TDP-43 to specifically identify FTD.

      COVID-19 : Neurologic complications and Management of Neurologic Conditions (2020)

        Short Communication Pages: 1 - 2

        Influence of the COVID-19 Pandemic on the Quality of Life of Families with Children Suffering from Epilepsy in Ukraine

        Tantsura Y

        Statement of the Problem: Childhood epilepsy is one of the most common CNS diseases [1]. From the point of view of optimizing care for children with epilepsy and their families during and after the crisis caused by the COVID-19 pandemic, it is important not only the high frequency and severity of the pathology, but also its social consequences - stigmatization, some isolation of the child in many cases [2,3] and economic aspects [4,5].

        Short Communication Pages: 1 - 3

        Activation of K+- Cl-- Cotransporter KCC2 by Inhibiting the WNK-SPAK Kinase Signalling as a Novel Therapeutic Strategy for Epilepsy

        Jinwei Zhang

        The Cl--extruding transporter KCC2 (SLC12A5) critically modulates GABAA receptor signaling via its effect on neuronal Cl- homeostasis. Previous studies have shown that KCC2 was downregulated in both epileptic patients and various epileptic animal models. We discovered that the in vitro dual phosphorylation of Thr906 and Thr1007 in the intracellular carboxyl (C)-terminal domain of KCC2, mediated by the Cl--sensitive WNK-SPAK serine-threonine protein kinase complex, maintains the depolarizing action of GABA in immature neurons by antagonizing KCC2 Cl- extrusion capacity. GABAAR-mediated inhibition confines KCC2 to the plasma membrane, while antagonizing inhibition reduces KCC2 surface expression by increasing the lateral diffusion and endocytosis of the transporter. This mechanism utilizes Cl- as an intracellular secondary messenger and is dependent on phosphorylation of KCC2 at threonines 906 and 1007 by the Cl- -sensing kinase WNK1. We propose this mechanism contributes to the homeostasis of synaptic inhibition by rapidly adjusting neuronal [Cl-]i to GABAAR activity. We further demonstrate here that this signaling pathway is rapidly and massively activated in an acute epilepsy model. This indicates that dephosphorylation of KCC2 at Thr906 and Thr1007 is a potent activator of KCC2 activity, and small molecular targets WNK-SAPK kinase signaling may be a novel therapeutic strategy for epilepsy.

        Short Communication Pages: 1 - 2

        Coexistence of MSA and PSP; A Diagnostic Challenge

        Taha Assadnejad

        Progressive supranuclear palsy (PSP) is a neurodegenerative tauopathy characterized by Parkinsonism, vertical gaze palsy, and early falls. The neuropathology is characterized by neurofibrillary tangles, tufted astrocytes, and coiled bodies, but some brains show other pathologic processes. To investigate the frequency of a-synuclein pathology in PSP with immunohistochemistry and to report the clinical and pathological features of a case of PSP with concomitant Multiple system atrophy (MSA) (PSP/MSA), 290 cases of PSP were screened for a-synuclein pathology with immunohistochemistry. Double-labeling immunohistochemistry was performed on a case of PSP/MSA. Among the PSP cases screened for a-synuclein pathology, a single case of PSP/MSA was detected. The patient was an 86-year-old woman with clinical features consistent with PSP. She had no documented dysautonomia or cerebellar signs, and imaging studies were not diagnostic of MSA. Pathological examination showed s-immunoreactive neuronal and glial lesions consistent with PSP as well as a-synuclein immunoreactive glial cytoplasmic inclusions diagnostic of MSA. Double immunolabeling studies showed no co-localization of a-synuclein and s in most neuronal and glial lesions. Based upon the findings in this case, the neuropathologic changes of PSP and MSA are distinct and independent processes, but they can occasionally coexist.

        Short Communication Pages: 1 - 2

        The Clinical Spectrum of Autoimmune Epilepsy in Children: With Cases Illustrations

        Muhammad Akbar Malik

        There are many causes of seizures in autoimmune disorders of brain, and the first clinical Seizures are among the most common neurological manifestation. Occasionally seizures can be the presenting symptom, convert into epilepsy, may be detected up to 14% of epilepsy patient, which could herald a life-threatening progression of the underlying illness. However, existing criteria for autoimmune epilepsy are too reliant on antibody testing and response to immunotherapy, which might delay the diagnosis. Because autoantibody test results and response to therapy are not available at disease onset, the initial diagnostic approach should be on neurological assessment and conventional tests that are accessible to most clinicians. Through logical differential diagnosis, levels of evidence for autoimmune epilepsy (possible, probable, or definite) may be achieved, which can lead to prompt immunotherapy. Prompt recognition of these disorders is mandatory to offer the patient adopted therapeutic options. Neuronal surface antibody and intracellular antibody syndromes encompass a variety of disorders associated with severe epilepsy. These share clinical and neuroradiological features that pose challenges related to their recognition and treatment. On that basis, a target treatment can be started, anti-seizure drugs augmented with corticosteroids and intravenous immunoglobulin or plasma exchange as a first-line immunotherapy, followed by second-line drugs including rituximab, cyclophosphamide or mycophenolate mophetil, if the case. In children a prompt diagnosis and a targeted treatment may lead to a better clinical outcome.

        Short Communication Pages: 1 - 2

        Assessment of Knowledge, Attitude and Practice of Patients Taking Antiepileptic Drugs

        Hawraa Abou Khalil

        Epilepsy in one of the most common neurological diseases and may result in poor quality of life (QOL) in case of lack of knowledge, negative attitude, and reduced practice. The objective of this study is the assessment of knowledge, attitude, and practice (KAP) of patients taking anti-epileptic drugs (AEDs). An observational cross-sectional study was conducted on the Lebanese patients taking AEDs. The QOL score was assessed and calculated using the quality of life 10 instruments (QOLIE-10) questionnaire. Among the 150 patients included in the study, 60% took carbamazepine as AEDs and 62% were on a monotherapy. The mean of the QOLIE-10 score is 23.92 ± 7.17 which is indicates a good QOL. The mean of the knowledge sub-score is 5.14 ±1.68, the mean of the attitude sub-score is 6.72 ± 1.15, and the majority of patients (82%) always follow health care provider’s instructions about medication. The mean of the practice sub-score is 8.13 ± 1.78. The multiple linear regression carried out revealed that practice (p-value <0.001) is significantly associated with QOLIE-10 score. Being married (p-value < 0.001) and not being employed (p-value = 0.009) also affected the QOLIE-10 score. Treatment of epilepsy should include other health dimensions in addition to maintaining seizure free intervals. This study may be helpful to health care professionals in identifying the areas where the QOL of PWE can be improved; especially the impact of the practice that should be taken by them since it significantly affected the QOL as well as increasing their knowledge and favoring positive attitude towards epilepsy.

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