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Epilepsy among elderly Sudanese patients
Abstracts / Journal of the Neurological Sciences 405S (2019) 116542
Background The effect of antiepileptic drugs (AEDs) on cognitive functions (CF) should be assessed in idiopathic generalized epilepsy (IGE) as it influences CF minimally. In 2018 the authors worked out Russianlanguage battery based on Luria's principles of neuropsychological assessment to study CF in children treated by AEDs. Purpose To evaluate the functions of energetic block of brain (EBB) in children with IGE treated by Valproic acid. Methods 42 children (5–16 years old) were examined, 17 (with IGE) formed the study group (SG), 18 (without neurological diseases) – control group (CG), 7 were excluded (cognitive deficit in anamnesis). EBB (indices of Rate, Fatigue, Sluggishness, Hyperactivity, Impulsivity) in SG was evaluated before treatment, after 3, 6, 9, 12 months (Valproic acid), during the same periods in CG (without treatment). Risk ratios (RR) and 95% confidence intervals for unfavorable outcome (UO) were calculated with RevMan 5.3 package. UO between SG and CG was compared (results were considered significant when p b .05). Results Significant difference was in indices: Rate after 9 (RR = 12.71), 12 (RR = 7.94) months of treatment; Fatigue: 9 (RR = 9.53), 12 (RR = 8.47); Sluggishness: 9 (RR = 4.76), 12 (RR = 7.41); Hyperactivity: 3 (RR = 4.76), 6 (RR = 3.88), 9 (RR = 6.88), 12 (RR = 4.94); Impulsivity: 9 (RR = 4.76), 12 (RR = 3.88). Conclusion Valproic acid influences negatively the functions of EBB in children with IGE; reduce of rate, growth of fatigue, sluggishness, impulsivity is registered after 6 months from the start of pharmacotherapy; growth of hyperactivity – after 3 months. The reported study was funded by Russian Foundation for Basic Research (RFBR) according to the research project №17-2909096. doi:10.1016/j.jns.2019.10.893
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Objective The aim of the study was to evaluate the satisfaction with life and job among doctors working in the Silesian Province, Poland. Material and methods The study group consisted of 401 doctors (mean age 45.1 ± 12.6) working in the hospitals and outpatient clinics in Silesia, Poland. The following tests were used: Satisfaction with Life Scale, Physicians' Career Satisfaction Questionnaire, Hospital Anxiety and Depression Scale. An Institutional Review Board has waived the requirement for the formal approval of the study. Results Based on the analysis of the collected data, job satisfaction of doctors was rather high in various aspects. The relationship with other doctors and nurses, as well as doctor-patient relationship were highly evaluated. On the other hand, the economic aspect of the profession and the lack of possibility to separate job duties from personal life were low rated. The level of physicians' satisfaction with life seems quite low. A lot of doctors had anxiety and/or depression symptoms which affected the results of tests assessing life and job satisfaction. Factors such as: concomitant cardiovascular diseases and/or diabetes, bed economic status, and having credit obligations affected significantly level of satisfaction with life and job. Conclusion Polish doctors are rather satisfied with their own professional development, but they could not separate personal life and develop other areas of life. Their general satisfaction with life is rather low. doi:10.1016/j.jns.2019.10.894
WCN19-0820 Journal of the Neurological Sciences 405S (2019) 104557 Poster Session 2 Epilepsy among elderly Sudanese patients
WCN19-0817 Journal of the Neurological Sciences 405S (2019) 104556 Poster Session 2 Life satisfaction and job satisfaction among doctors in the Silesian Province, Poland P. Pawlowskia, B. Labuz-Roszaka, E. Niewiadomskab a Faculty of Public Health in Bytom- Medical University of Silesia in Katowice, Department of Basic Medical Sciences, Bytom, Poland b Faculty of Public Health in Bytom- Medical University of Silesia in Katowice, Department of Biostatistics, Bytom, Poland Background The job satisfaction is one of the most important factors determining the life satisfaction.
A. Hussein, O. Eladil, A. Sidig, K.H. Hajnoor, M.M. Aldar, K. Mohamed Ahmed Abbasher, H. Abbashar, M. Abbasher Daoud Research Group, Neurology, Khartoum, Sudan
Background Seizure disorders become increasingly common after the age of 60 years and can have a significant impact on the functional status of the patient. Objective The aim of this study was to evaluate the clinical presentation and characteristics of elderly Sudanese patients with epilepsy. Methodology This is a prospective study (from Feb. 2017 to Jun 2018). The study population included 240 elderly epileptic patients (age 60 years or above). Results Cerebrovascular accident was found to be the most common cause of secondary epilepsy (31%).Generalize epilepsy was seen in
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Abstracts / Journal of the Neurological Sciences 405S (2019) 116542
120 (50%) of patients. Abnormal neurological findings were more common (49%) among patients with partial epilepsy. Fifty percent of our patients showed abnormal EEG. Abnormal CT brain findings were common among patients with partial epilepsy. Conclusion The pattern of clinical presentation of epilepsy among elderly Sudanese epileptic patients is similar to what was mentioned in the literature except that the percentage of epilepsy following infections was more among our studied group (6%).
doi:10.1016/j.jns.2019.10.895
WCN19-0822 Journal of the Neurological Sciences 405S (2019) 104558 Poster Session 2 Symptoms of Lewy-body dementia induced by herpes zoster encephalitis R. Verity, A. Kirk, G. Hunter University of Saskatchewan, Neurology, Saskatoon, Canada Varicella-Zoster virus (VZV) reactivation syndromes have been shown to have a multitude of neurologic sequelae, including vasculopathy and encephalitis. Complications of Herpes Zoster Encephalitis (HZE) have not been adequately studied, due to the rare and variable presentation of the condition. However, case reports have shown outcomes ranging from favorable to fatal. We present the case of a 65year-old male who presented with Herpes Zoster Meningoencephalitis, who developed symptoms suggestive of Lewy-Body Dementia (LBD) during the acute phase of his illness, which continued to progress. While no virus has been conclusively implicated in a neurodegenerative disease process, there is some evidence to suggest neurotropic viruses play a role in neurodegeneration. The temporal relationship between this patient’s acute viral infection and the onset of hallucinations, cognitive changes, REM behavior disorder and parkinsonism point to a possible causative relationship. Whether the HZE unmasked an early LBD or initiated a degenerative process with similarities to LBD remains unclear. In this report we discuss details of this unique case and review the available literature surrounding the impact of VZV in the central nervous system.
Background Pregabalin has been reported to induce myoclonic jerks, exacerbate myoclonic epilepsy and generalized tonic clonic seizures in overdose. Adult onset absence status epilepticus is unusual and is rarely medication induced. Objective We report a non-epileptic patient who presented with absence status epilepticus induced by pregabalin. Case report A 65 years old man with a past medical history of diabetes mellitus, hypertension, and chronic kidney disease on regular hemodialysis presented to the emergency department with 24 h of confusion. He was started on pregabalin 75 mg daily for diabetic polyneuropathy a few days prior to presentation. The patient presented confused, unresponsive to verbal command, spacing out and had automatism of mouth. No other abnormal movements were observed. An urgent EEG was performed and showed continuous 3HZ spike and waves consistent with absence status. The patient was given lorazepam 2 mg intravenously, after which he improved clinically and his EEG normalized. His brain CT was unremarkable. The patient's pregabalin was discontinued and he was placed on a maintenance dose of valproate for one week. He was then discharged home on no antiseizure medication. On follow up, he had a normal neurologic exam and a normal EEG. Conclusion Pregabalin may induce denovo absence status epilepticus. To our knowledge this is the first report of absence status epilepticus caused by pregabalin.
doi:10.1016/j.jns.2019.10.897
WCN19-0824 Journal of the Neurological Sciences 405S (2019) 104560 Poster Session 2 Ictal lid movements - Blinks and lid saccades N. Pyatkaa, G. Fernandez-BacaVacaa, S. Lhatoob, A. Shaikha a University Hospitals Cleveland Medical Center, Neurology, Cleveland, USA b University of Texas, Neurology, TX, USA
doi:10.1016/j.jns.2019.10.896
WCN19-0823 Journal of the Neurological Sciences 405S (2019) 104559 Poster Session 2 Pregabalin induced absence status epilepticus K. Hussain, B. Nabil, K. Sonia, A.S. Souda Prince Sultan Military Medical City, Neurology, Riyadh, Saudi Arabia
Two types of lid movements, lid saccades and blinks, have discrete kinematic properties and physiology. These differences are reflected in distinct phenomenology of disorders affecting their neural substrate. Proof of this principle was seen in two cases, one with parietal eyefield epileptiform discharges and the other with temporal lobe seizures. The lid movements in the patient with epileptiform discharges in the eyefield were rhythmic, yoked, and had rapid upward component that instantaneously followed slow downward drift. These cyclic movements strikingly resembled nystagmus, but unlike typical eye nystagmus, the rapid upward component was pathological and seemed to involve saccadic mechanism. We suggest terms “ictal lid saccade” or “ictal lid nystagmus” to describe such phenomenology. In contrast, the patient with temporal lobe seizures had ipsilateral lid movements
Background The effect of antiepileptic drugs (AEDs) on cognitive functions (CF) should be assessed in idiopathic generalized epilepsy (IGE) as it influences CF minimally. In 2018 the authors worked out Russianlanguage battery based on Luria's principles of neuropsychological assessment to study CF in children treated by AEDs. Purpose To evaluate the functions of energetic block of brain (EBB) in children with IGE treated by Valproic acid. Methods 42 children (5–16 years old) were examined, 17 (with IGE) formed the study group (SG), 18 (without neurological diseases) – control group (CG), 7 were excluded (cognitive deficit in anamnesis). EBB (indices of Rate, Fatigue, Sluggishness, Hyperactivity, Impulsivity) in SG was evaluated before treatment, after 3, 6, 9, 12 months (Valproic acid), during the same periods in CG (without treatment). Risk ratios (RR) and 95% confidence intervals for unfavorable outcome (UO) were calculated with RevMan 5.3 package. UO between SG and CG was compared (results were considered significant when p b .05). Results Significant difference was in indices: Rate after 9 (RR = 12.71), 12 (RR = 7.94) months of treatment; Fatigue: 9 (RR = 9.53), 12 (RR = 8.47); Sluggishness: 9 (RR = 4.76), 12 (RR = 7.41); Hyperactivity: 3 (RR = 4.76), 6 (RR = 3.88), 9 (RR = 6.88), 12 (RR = 4.94); Impulsivity: 9 (RR = 4.76), 12 (RR = 3.88). Conclusion Valproic acid influences negatively the functions of EBB in children with IGE; reduce of rate, growth of fatigue, sluggishness, impulsivity is registered after 6 months from the start of pharmacotherapy; growth of hyperactivity – after 3 months. The reported study was funded by Russian Foundation for Basic Research (RFBR) according to the research project №17-2909096. doi:10.1016/j.jns.2019.10.893
67
Objective The aim of the study was to evaluate the satisfaction with life and job among doctors working in the Silesian Province, Poland. Material and methods The study group consisted of 401 doctors (mean age 45.1 ± 12.6) working in the hospitals and outpatient clinics in Silesia, Poland. The following tests were used: Satisfaction with Life Scale, Physicians' Career Satisfaction Questionnaire, Hospital Anxiety and Depression Scale. An Institutional Review Board has waived the requirement for the formal approval of the study. Results Based on the analysis of the collected data, job satisfaction of doctors was rather high in various aspects. The relationship with other doctors and nurses, as well as doctor-patient relationship were highly evaluated. On the other hand, the economic aspect of the profession and the lack of possibility to separate job duties from personal life were low rated. The level of physicians' satisfaction with life seems quite low. A lot of doctors had anxiety and/or depression symptoms which affected the results of tests assessing life and job satisfaction. Factors such as: concomitant cardiovascular diseases and/or diabetes, bed economic status, and having credit obligations affected significantly level of satisfaction with life and job. Conclusion Polish doctors are rather satisfied with their own professional development, but they could not separate personal life and develop other areas of life. Their general satisfaction with life is rather low. doi:10.1016/j.jns.2019.10.894
WCN19-0820 Journal of the Neurological Sciences 405S (2019) 104557 Poster Session 2 Epilepsy among elderly Sudanese patients
WCN19-0817 Journal of the Neurological Sciences 405S (2019) 104556 Poster Session 2 Life satisfaction and job satisfaction among doctors in the Silesian Province, Poland P. Pawlowskia, B. Labuz-Roszaka, E. Niewiadomskab a Faculty of Public Health in Bytom- Medical University of Silesia in Katowice, Department of Basic Medical Sciences, Bytom, Poland b Faculty of Public Health in Bytom- Medical University of Silesia in Katowice, Department of Biostatistics, Bytom, Poland Background The job satisfaction is one of the most important factors determining the life satisfaction.
A. Hussein, O. Eladil, A. Sidig, K.H. Hajnoor, M.M. Aldar, K. Mohamed Ahmed Abbasher, H. Abbashar, M. Abbasher Daoud Research Group, Neurology, Khartoum, Sudan
Background Seizure disorders become increasingly common after the age of 60 years and can have a significant impact on the functional status of the patient. Objective The aim of this study was to evaluate the clinical presentation and characteristics of elderly Sudanese patients with epilepsy. Methodology This is a prospective study (from Feb. 2017 to Jun 2018). The study population included 240 elderly epileptic patients (age 60 years or above). Results Cerebrovascular accident was found to be the most common cause of secondary epilepsy (31%).Generalize epilepsy was seen in
68
Abstracts / Journal of the Neurological Sciences 405S (2019) 116542
120 (50%) of patients. Abnormal neurological findings were more common (49%) among patients with partial epilepsy. Fifty percent of our patients showed abnormal EEG. Abnormal CT brain findings were common among patients with partial epilepsy. Conclusion The pattern of clinical presentation of epilepsy among elderly Sudanese epileptic patients is similar to what was mentioned in the literature except that the percentage of epilepsy following infections was more among our studied group (6%).
doi:10.1016/j.jns.2019.10.895
WCN19-0822 Journal of the Neurological Sciences 405S (2019) 104558 Poster Session 2 Symptoms of Lewy-body dementia induced by herpes zoster encephalitis R. Verity, A. Kirk, G. Hunter University of Saskatchewan, Neurology, Saskatoon, Canada Varicella-Zoster virus (VZV) reactivation syndromes have been shown to have a multitude of neurologic sequelae, including vasculopathy and encephalitis. Complications of Herpes Zoster Encephalitis (HZE) have not been adequately studied, due to the rare and variable presentation of the condition. However, case reports have shown outcomes ranging from favorable to fatal. We present the case of a 65year-old male who presented with Herpes Zoster Meningoencephalitis, who developed symptoms suggestive of Lewy-Body Dementia (LBD) during the acute phase of his illness, which continued to progress. While no virus has been conclusively implicated in a neurodegenerative disease process, there is some evidence to suggest neurotropic viruses play a role in neurodegeneration. The temporal relationship between this patient’s acute viral infection and the onset of hallucinations, cognitive changes, REM behavior disorder and parkinsonism point to a possible causative relationship. Whether the HZE unmasked an early LBD or initiated a degenerative process with similarities to LBD remains unclear. In this report we discuss details of this unique case and review the available literature surrounding the impact of VZV in the central nervous system.
Background Pregabalin has been reported to induce myoclonic jerks, exacerbate myoclonic epilepsy and generalized tonic clonic seizures in overdose. Adult onset absence status epilepticus is unusual and is rarely medication induced. Objective We report a non-epileptic patient who presented with absence status epilepticus induced by pregabalin. Case report A 65 years old man with a past medical history of diabetes mellitus, hypertension, and chronic kidney disease on regular hemodialysis presented to the emergency department with 24 h of confusion. He was started on pregabalin 75 mg daily for diabetic polyneuropathy a few days prior to presentation. The patient presented confused, unresponsive to verbal command, spacing out and had automatism of mouth. No other abnormal movements were observed. An urgent EEG was performed and showed continuous 3HZ spike and waves consistent with absence status. The patient was given lorazepam 2 mg intravenously, after which he improved clinically and his EEG normalized. His brain CT was unremarkable. The patient's pregabalin was discontinued and he was placed on a maintenance dose of valproate for one week. He was then discharged home on no antiseizure medication. On follow up, he had a normal neurologic exam and a normal EEG. Conclusion Pregabalin may induce denovo absence status epilepticus. To our knowledge this is the first report of absence status epilepticus caused by pregabalin.
doi:10.1016/j.jns.2019.10.897
WCN19-0824 Journal of the Neurological Sciences 405S (2019) 104560 Poster Session 2 Ictal lid movements - Blinks and lid saccades N. Pyatkaa, G. Fernandez-BacaVacaa, S. Lhatoob, A. Shaikha a University Hospitals Cleveland Medical Center, Neurology, Cleveland, USA b University of Texas, Neurology, TX, USA
doi:10.1016/j.jns.2019.10.896
WCN19-0823 Journal of the Neurological Sciences 405S (2019) 104559 Poster Session 2 Pregabalin induced absence status epilepticus K. Hussain, B. Nabil, K. Sonia, A.S. Souda Prince Sultan Military Medical City, Neurology, Riyadh, Saudi Arabia
Two types of lid movements, lid saccades and blinks, have discrete kinematic properties and physiology. These differences are reflected in distinct phenomenology of disorders affecting their neural substrate. Proof of this principle was seen in two cases, one with parietal eyefield epileptiform discharges and the other with temporal lobe seizures. The lid movements in the patient with epileptiform discharges in the eyefield were rhythmic, yoked, and had rapid upward component that instantaneously followed slow downward drift. These cyclic movements strikingly resembled nystagmus, but unlike typical eye nystagmus, the rapid upward component was pathological and seemed to involve saccadic mechanism. We suggest terms “ictal lid saccade” or “ictal lid nystagmus” to describe such phenomenology. In contrast, the patient with temporal lobe seizures had ipsilateral lid movements