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AOEC: Anxiety and depression common in adolescents with epilepsy
as presented at the 10th Asian & Oceanian Epilepsy Congress
A high prevalence of affective disorders was demonstrated in adolescents with epilepsy in a study presented at AOEC, held in August in Singapore.
Researchers at Tuen Mun Hospital in Hong Kong used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression in patients (N=141) aged 10 to 18 years with a diagnosis of epilepsy attending mainstream schools.
Forty-six (32.8%) children had anxiety and 31 (22.1%) had depression. Fifteen (10.7%) children suffered from both anxiety and depression, which are highly associated. Common risk factors for these two affective disorders are frequent seizures at onset and duration of epilepsy. Factors associated with anxiety were: older age (odds ratio [OR] 1.16; 95% confidence interval [CI], 1.02 to 1.33, P = 0.028) and polytherapy (OR 2.15; CI, 1.26 to 3.69, P=0.005). Seizure free >12 months was a favorable factor (OR 0.86; CI, 0.3 to 2.42, P=0.012). Factors associated with depression were medical co-morbidities (OR 4.57; CI, 1.81 to 11.53, P=0.001), female gender (OR 8.86; CI, 1.22 to 64.06, P=0.024), and younger age of seizure onset (OR 0.88, CI, 0.79 to 0.98, P=0.016).
AOEC: Sudanese researchers assess anticonvulsant activity and mechanism of action of ginger
as presented at the 10th Asian & Oceanian Epilepsy Congress
According to a study at AOEC, held in August in Singapore, ginger is a potential source of anticonvulsant agents.
Researchers from the University of Gezira Faculty of Pharmacy, Wad Medani, Sudan, and Ahfad University for Women School of Pharmacy, Khartoum, Sudan, investigated the potential anticonvulsant activity of ginger extract as well as involvement of gamma aminobutaric acid (GABA) and vanilloid receptors in ginger mechanism of action as an anticonvulsant.
The researchers used experimental animal models for maximum electroshock (MES)- and pentylenetetrazole (PTZ)-induced seizures to determine the anticonvulsant activity of ginger. Picrotoxin (noncompetitive GABA antagonist) and capsazepine (vanilloid receptor antagonist) were used to determine the possible mediation of GABA and vanilloid receptors respectively in the mechanism of action of ginger as anticonvulsant.
According to the researchers, ginger (Zingiber officinale Roscoe) extract (400mg/kg) produced 100% seizure protection in MES- and PTZ-induced seizure animal models. The ED100 of ginger in the previous two models produced 20% seizure protection in picrotoxin-induced seizure animal model indicating possible partial involvement of GABA receptors. Further, the investigators recorded, capsazepine produced 80% and 60% block of the anticonvulsant activity of ginger on the MES and PTZ seizure animal models respectively, indicating possible involvement of vanilloid receptors.
AOEC: Some ICU patients have inapparent seizures contributing to decreased consciousness
as presented at the 10th Asian & Oceanian Epilepsy Congress
According to a study presented at AOEC, held in August in Singapore, a small minority of ICU patients -- all with recent clinically definite seizures -- have inapparent seizures contributing to decreased consciousness.
Malaysian and Australian researchers designed a study to determine the likelihood of epileptic seizures or nonconvulsive status contributing to impaired consciousness and/or abnormal movements in an adult general intensive care unit (ICU). They retrospectively analyzed the diagnostic EEGs of 337 consecutive patients treated in an adult general ICU. The indication for EEG was suspected seizure, 26% with recent definite clinical seizures and 23% after hypoxic brain injury.
The data showed that 14 patients (4.2%) had seizures recorded on EEG, three in non-convulsive status epilepticus. Nine patients (5.5%) had seizures without clinical accompaniment, eight already with recent clinically definite seizures (three in status) and on parenteral AEDs (seven polytherapy). The single exception had hypoglycemic encephalopathy; EEG showed stimulus-induced rhythmic, periodic, or ictal discharges, the treatment and prognostic implications of which were unknown.
The researchers noted that in five patients the seizures had clinical accompaniment. But all of those patients already had clinically definite seizures and had received parenteral AEDs. Abnormal movements un- related to seizures occurred in a further 80 patients. Their EEGs showed generalized/focal slowing (41), PLEDs (10), triphasic waves (9), GPEDs (13), or suppression burst (5) related to post-anoxic encephalopathy, psychogenic events (3), and interictal generalized spike and wave.
The investigators concluded that in the ICU “a small minority of patients with abnormal movements suspected of being seizure are having seizures.” However, “for most ICU patients, EEG mainly excludes the diagnosis of seizures, and can prevent inappropriate overtreatment.”
AOEC: Tashkent researchers assess epilepsy in patients with stroke
as presented at the 10th Asian & Oceanian Epilepsy Congress
In a poster presented at AOEC, held in August in Singapore, researchers at Tashkent Medical Academy, Tashkent, Uzbekistan, examined the presence of nitric oxide (NO) in the cerebrospinal fluid of patients with stroke.
They observed 306 patients with acute ischemic stroke; 22 (7.2%) of them (16 males and 6 females) had convulsions (mean age 62.5). In the cerebrospinal fluid of stroke patients with and without early seizures differences were seen in the metabolites of NO.
According to the researchers, in patients with acute ischemic stroke there is marked accumulation of cerebrospinal fluid nitrite during the first day. This phenomenon has been observed neither in patients with early seizures after stroke nor in hemorrhagic stroke. A defect in endothelial nitric oxide synthesis is a feature of stroke patients with epileptic seizures, they noted. This may be one of the mechanisms of epileptic seizures in stroke.
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