APLICACIÓN DE ESCALA DE EVALUACIÓN PEDIÁTRICA DEL INVENTARIO DE DISCAPACIDAD-PRUEBA ADAPTATIVA POR COMPUTADORA (PEDI-CAT) EN PACIENTES CON EPILEPSIA.

Introducción: La epilepsia representa una de las principales causas de morbilidad en neuropediatría. El inicio temprano de las crisis epilépticas, se relaciona con menor desempeño intelectual a largo plazo, y alteraciones en las habilidades adaptativas. Objetivo: Aplicar escala de evaluación pediátrica del inventario de discapacidad-prueba adaptativa por computadora (PEDI-CAT) en pacientes pediátricos con epilepsia. Métodos: Se realizó un estudio de nivel descriptivo, tipo observacional, prospectivo, trasversal y analítico, realizado el Departamento de Neurología Pediátrica del Hospital Infantil de México Federico Gómez, en la Ciudad de México. El reclutamiento de los pacientes fue durante abril y diciembre de 2020. Resultados: los pacientes con epilepsia presentaron un percentil <5 en sus habilidades de movilidad 22 (35,4%), actividades diarias 19(30,6%), social-cognitivas 19(30,6%), lo que significa que están por debajo de rango normal comparado con niños de su edad. Conclusiones: los pacientes con epilepsia presentaron un percentil <5 en el dominio de actividades diarias, movilidad y social-cognitiva, lo que significa que están por debajo de rango normal comparado con niños de su edad. Por tanto, la epilepsia debe ser considerado un trastorno que afecta la capacidad adaptativa de los pacientes y no sólo una patología cuya manifestación son las crisis, su detección temprano con el uso de escalas como PEDI-CAT se traduce en la identificación y planificación de estrategias terapéuticas eficaces para mejorar calidad de vida de los pacientes Palabras Clave: Epilepsia, Conducta Adaptativa, Trastornos del Neurodesarrollo. ABSTRACT Introduction: Epilepsy represents one of the main causes of morbidity in pediatric neurology. The early onset of epileptic seizures is related to lower long-term intellectual performance, and alterations in adaptive skills. Objective: To apply the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) report in pediatric patients with epilepsy. Methods: A descriptive, observational, prospective, cross-sectional and analytical study was carried out in the Department of Pediatric Neurology at Hospital Infantil de México Federico Gómez, in Mexico City. Patient recruitment took place between April and December 2020. Results: patients with epilepsy presented a <5 percentile in their mobility skills 22 (35.4%), daily activities19 (30.6%), social-cognitive 19 (30.6%), which means that they are below of normal range compared to children his age. Conclusions: patients with epilepsy presented a <5 percentile in the domain of daily activities, mobility and social-cognitive, which means that they are below the normal range compared to children of their age. Therefore, epilepsy should be considered a disorder that affects the adaptive capacity of patients and not just a pathology whose manifestation is seizures, its early detection with the use of scales such as PEDI-CAT translates into the identification and planning of strategies effective therapeutics to improve the quality of life of patients Keywords: Epilepsy, Adaptation, Psychological, Neurodevelopmental Disorders.

Clinical and Social Findings of Childhood Epilepsy

Background: Seizures are defined as a transient occurrence of signs and symptoms due to the abnormal, excessive, or synchronous neuronal activity in the brain characterized by abrupt and involuntary skeletal muscle activity. Seizure is related to specific risk factors like positive family history, fever, infections, neurological comorbidity, premature birth, mother’s alcohol abuse, and smoking in pregnancy. Epilepsy is the most frequent chronic neurologic condition in children. Studies have suggested declining incidence rates of childhood epilepsy in high-income countries during the last decades. Objective: To describe the clinical features and social findings of epilepsy in children, and to evaluate some risk factors associated with control of epilepsy. Patients and Methods: This cross-sectional study was conducted in the pediatric department of Albatool teaching hospital in Diyala province, Iraq. A total of 100 children were included in the study from February 2020 to May 2020. All children diagnosed with epilepsy in this study. Results: One hundred children with epilepsy, their mean age was 5.96± 3.33 years (range 1-14 years). Of the 48(48%) children were male and 52(52%). Of the total patients, 79% were free from seizure on AED, 21% of them were refractory to treatment.Patients without developmental delay (88.7%, p=0.012) can be controlled by AED. Patients who had idiopathic seizures (87.5%, p=0.04) can be controlled by AED. Patients who had seizure attacks can be controlled by AED more than patients who had weekly or monthly seizure attacks (97.4%) (p<0.001). Patients who had been treated by monotherapy (94.7%, p=0.012) can be controlled more than patients who were treated by multidrug therapy. Affected social interaction and need more supervision were factors that detected more in patients with refractory epilepsy, p=0.04, 0.01 respectively. While there was no association between frightened other people and epilepsy control. Conclusion: Most of the patients are characterized by: treatment approach monotherapy, less affected by social interaction and need less supervision. Patients with refractory epilepsy had opposite factors. Keywords: Epilepsy, Albatool teaching hospital.

Evaluation of Family functioning among parents of epileptic patients

Epilepsy has aggregate of risk characteristic’s as, age of onset, triggering factors, genetics, natural history, prognosis, and it is not a condition based on single aspect or cause. Due to social problems, family functioning of epileptic patients suffers badly. The basic purpose of the study is to investigate the role of family functioning of the parents who has epileptic patients. Methods: Across-sectional study was conducted at Muzaffargarh Hospital Neurology OPD department. Total 36 parents were enrolled. All parents of children, who have 8 to18 years of age, which are diagnosis of epilepsy, were included in current study Data was collected on a predesign questionnaire and for family functioning the Family Assessment Device (FAD) was used. Statistical analysis was performed by using the Statistical Package for Social Sciences (spss) version 26. The frequencies, proportions were calculated for Qualitative variables and Mean + SD were calculated for quantitative variables. Results: The mean age of parents was 38.58+7.55 and children were 12.31+3.34. Out of 36 participants 12(33.3%) were males whereas 24(66.7%) were females. Majority of parents were holding secondary degree 13(36.1%), were unemployed 24(66.7%), 21(58.3%) were from rural area and dealing with generalized seizure type children 24(66.7%). The average seizures frequency per month was 2.64+1.15. The families of epileptic patients were more dysfunctional, especially in terms of problem solving (2.66+0.43), behavior control (2.68+0.49), affective involvement (2.62+0.64) and also family’s faces difficulties in finding their role (2.48+0.56). Conclusion: The families of epileptic patients have more dysfunctional, especially in terms of problem solving, behavior control, affective involvement and also families faces difficulties in finding their role. Therefore educational programme focusing on the importance of family functioning should be provided so that the aspect of treatments and social life of patients get improved. Keywords: Epilepsy, Family functioning, Social Support, Family support

Frequency of Fits in Pregnant Women with Previously Controlled Epilepsy

Background: Epilepsy drug therapy advancements have resulted in an increasing number of childbearing age well-controlled epileptic women. It is not surprising then, that the impact of pregnancy on the progression of epilepsy has sparked renewed interest. Aim: The aim of current study was to evaluate the frequency of fits or seizure in pregnant women with previously controlled epilepsy. Materials and Methods: This cross-sectional study was carried out on 98 pregnancies of 84 epileptic women during the period between August 2019 and August 2021in the department of neurology and gynaecology of Ayub Teaching Hospital, Abbottabad. All the pregnant women with less than three verified epileptic fits, pregnancy ended with abortion and incomplete seizure or fit frequency were excluded. All the patients were referred to Gynaecology and Neurology department for early pregnancy and planning by a neurologist and gynaecologist. Data analysis was done with SPSS version 23 with p<0.05 as statistical significance. Results: The association of fits frequency on pregnancy was studied and monitored in 84 epileptic women out of 98pregnancies. About 49 (50%) pregnancies were not affected by fits frequency. The fits frequency was increased in 36 (37%) pregnancies or puerperium while decreased in 13 (13%) pregnancies. Sleep deprivation or drug regimen on-compliances associated was increased in 30 (30.6%) pregnancies. Out of 19pregnancies, eight (42%) had improvement with sleep deprivation correction during none months pre-gestation. Antiepileptic drugs with low plasma concentration of uncontrolled epilepsy during pregnancy were found in 47%. Conclusion: Sleep deprivation, Non-compliance during pregnancy, and before and after pregnancy inadequate therapy all have a significant impact on the course of epilepsy during pregnancy. With proper medical care, pregnancy appears to have only a minor impact on the course of epilepsy. Keywords: Epilepsy, Frequency fits, Sleep Deprivation.

The Screening models for antiepileptic drugs: A Review

Considering the prevalence of epilepsy and the problems associated with currently available antiepileptic drugs like side effects, resistance, safety issue and high cost, herbal medicine with fewer complications could be very appropriate alternative. Therefore in the present study, we have examined the antiepileptic properties of ethanolic extract of leaves in mice using maximal electroshock seizers (MES)test, Pentylenetetrazole (PTZ), induced seizures, strychnine induced convulsion, Isoniazid-induced convulsions, Picrotoxin-induced convulsions, Kainic acid (KA) model etc.There is increased concern on agents for epilepsy disease modification and prevention. To solve these unmet needs, the research scientist must have a thorough knowledge of available animal models of epilepsy so that he can pick up the best model for his research. In this article, we are reviewing the diversity of animal models of epilepsy and their implications in antiepileptic drug discovery. Keywords: Epilepsy, animal model, seizures,

Features of affective disorders correction in patients with epilepsy (therapy, rehabilitation, prevention)

For many decades, epilepsy has remained a serious medical and social problem that requires constant attention not only from neurologists, psychiatrists, but also from medical psychologists and social workers. The priority in the treatment of epilepsy is not only to prevent seizures, but also to help the patient maintain social functioning and restore quality of life. Achieving drug remission of epileptic seizures is only part of the management of the disease, it is necessary to help restore the patient's psychosocial adaptation and form a correct understanding of their disease and related limitations in daily functioning. A comprehensive examination which involved 65 patients with epilepsy of both sexes aged 18–40 years was conducted in compliance with the principles of bioethics and medical deontology. The mean age of the subjects ranged from (34.0±1.6) years, duration of the disease in patients did not exceed 10 years. All subjects had disorders of the emotional sphere of non-psychotic level, which were recorded in the interictal period of the disease. Selected comprehensive system of correction of affective disorders in patients with epilepsy helped to achieve following results, especially: reduction of anxiety and depressive disorders (73.5 %), reducing the level of motor and ideational inhibition (65.2 %), reducing the intensity and duration of depressive affect (72.5 %), restoration of interest in activities that previously interested patients (69.5 %), improvement of psychosocial adaptation (81.3 %), managed to achieve the transition of maladaptive types of attitudes to the disease to adaptive (66.5 %) and improve quality of life (83.2 %). A study of affective disorders in patients with epilepsy allowed us to make following conclusions: epilepsy is often combined with affective disorders. Depressive disorders are more common among all affective disorders. Epilepsy and affective disorders interact with each other and complicate clinical prognosis. Keywords: epilepsy, affective disorders, rehabilitation, psychoeducation.

Ultrasound characteristics of the internal genital organs in adolescent girls with gynecological and extragenital pathologies born with low or high body weight

We studied the effect of birth weight on ultrasound parameters of the uterus and ovaries in adolescent girls with gynecological pathology. 65 adolescent girls aged from 10 to 18 years old, who were treated at the surgical department № 4 of the Regional Child Clinical Department, were examined. Study groups were formed according to data relating to gestational weight in terms of low or overweight. The differences in ultrasound scanning of the pelvic organs between the studied groups were revealed. So, with the syndrome of intrauterine growth retardation of the fetus, a lag in ultrasound indicators develops in the postnatal period, and with macrosomia, on the contrary, a tendency to an increase in the size of the uterus and ovaries is revealed. The revealed changes can serve as prognostic criteria in diagnosing the risk of developing disorders of puberty during ultrasound scanning of the internal genital organs of adolescent girls, depending on the body weight at birth. Keywords: epilepsy, affective disorders, rehabilitation, psychoeducation.

The Benefits of Physical Activity in Children and Adolescents with Epilepsy: A Systematic Review

The aim of this study was to review the literature about the effect of physical activity intervention in children and adolescents with epilepsy. Articles were searched in the central electronic databases of MEDLINE, Embase, PsycAriticles, and CINAHL for the following keywords: “epilepsy,” “seizure,” “physical activity,” “physical exercise,” “exercise therapy,” “sport,” using the Boolean operator “AND” and “OR.” The quality of the selected articles was evaluated by the Physiotherapy Evidence Database scale. Out of the 22 articles selected, 18 did not involve intervention or did not have pre- and postresults and therefore were excluded from the study. The remaining four were studies from Canada and Korea which comprised two long-period interventions and were included in the analysis. Both programs demonstrated a positive effect of physical activity on variables related to psychological well-being and cognitive function. All the four articles demonstrated a lower score of quality. In conclusion, reviewed studies suggest that physical exercise program induces some benefits in children and adolescents with epilepsy. However, the noncontrolled trials and the varied analyses (quantitative vs. qualitative) make it difficult to establish a consensus about benefits of physical activity in epilepsy.

Evaluation of M-Health Applications Use in Epilepsy: A Systematic Review

Background: Epilepsy is a neurological disorder characterized by seizures and recurrent attacks. Selfmanagement leads to seizure control and maximizes the quality of life in epileptic patients. The purpose of this study was to evaluate the quality of applications available in the epileptic google play store based on the rating features of MARS (Mobile Applications Rating Scale). Methods: The search was conducted systematically using the keywords "epilepsy", "seizure", "mobile health" at the Android google play store. Data were extracted and analyzed from Feb 2018 to Apr 2019. Results: Accordingly, 45 apps were identified potentially relevant of which 20 met inclusion criteria. Twentyfive apps were excluded because they were unrelated to epilepsy self-management, or not Development for people with epilepsy, not in English language or were not free and available. The total mean MARS score was 3.21 out of 5, and more than half of apps (17, 85%) had a minimum acceptability score of 3.0. The mean of apps’ items were 3.27 in Engagement, 3.96 in function, 3.30 in Aesthetics, 2.96 in Information and 2.73 in subjective quality items. Conclusion: Few apps meet prespecified criteria for quality, content, and functionality for epilepsy selfmanagement. Despite the rapid evolution of self-management apps, lack of validation studies is a significant concern that limits the clinical value of these apps. Moreover, having a guideline and benchmarking in the field of mobile application development, in epilepsy management, can help analyze the content of established applications.

Tele-neurology during the COVID-19 Pandemic as a Solution for Bridging the Healthcare Gap

Due to the COVID-19 outbreak in Thailand, patients were unable to be examined, to receive follow-up treatments, or to receive medication in the normal ways that they previously had. As a result, Srinagarind Hospital of the Faculty of Medicine at Khon Kaen University established a home delivery system for those patients, who needed to be continuously treated. Two types of services were made available: 1) Patients were able to make a request on the Facebook page of ‘Drug delivery’ or on the Line application: @Dr. Somsak, and 2) the physicians phoned the patients in order to assess symptoms and to provide treatment based on the symptoms and severity of the disease. Regarding neurological patients in Thailand, most patients; such as people with epilepsy (PWE) are most often treated by general practitioners in community hospitals or by internist or pediatricians in provincial hospitals. Only a small percentage of PWE are actually treated by neurologists or pediatric neurologists. The Epilepsy Clinic of Srinagarind Hospital has, therefore, developed a service system for the out-patient department in which the physicians call the patients in order to assess their symptoms and to provide continued treatment to those individuals with PWE so that status epilepticus, which arises from drug deficiency, can be prevented. Consequently, the Integrated Epilepsy Research Group has developed a tele-medicine system for PWE, who are treated in the Epilepsy Clinic. Moreover, the newly developed service system will continue to be used to treat patients with neurological diseases in order to resolve the problem of gaining access to neurological doctors. Keywords: Epilepsy clinic, Neurological disease, Tele-medicine