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0074 Types of epilepsy and possible etiological factors among patients attending the neurology clinic in mulago hospital Kampala Uganda
Poster Abstracts Background: Available data indicates that young people with epilepsy experience higher levels of amniety and depression and lower levels of health related quality of life than the normal population. The aim of our study was to assess the predictors of anxiety, depression and quality of life (QOL) for young people with epilepsy. Method: Young people (N - 112) with a mean age of 17.90 years (SD -- 3.92), of which 36% were male, completed a paper (62%) or Internet survey (38%) that included demographic., clinical and psychosocial questions. This included: the Family Assessment Device (FAD-GF), Adolescent Coping Scale (ACS-18), Orientation of Life Scale (SOC-13), Hospital and Atudety Scale (HADS) and Quality of Life in Epilepsy for Adolescents Scale (QOLIE-AD-48). Results: Using Latent Class Cluster Analysis, two well-being groups (high/low) were found utilizing anxiety, depression and quality of life scores. Logistic Regression revealed that low seizure severity (B 2.84, p < 0.01, OR -- 0.06), lfigher fanfily functioning (B - 0.14, p < 0.05, O R - 1.15), less use of non-productive coping strategies (B -- -0.08, p < 0.01, OR -- 0.92), and a stronger sense of coherence (B -0.08, p < 0.01, O R - 1.09) significantly increased the chance of being classified as being in the high rather than low well-being group. Discussion: In addition to seizure management, clinicians can promote better outcomes for young patients by encouraging them to: decrease non-productive coping strategies; increase their level of communication within their family; and explore their view of epilepsy. 0071 Quality of Life of Children with Benign Rolandic Epilepsy ConnoUy, A.M 1, Northcott, E L2, Cairns, D R 2, McIntyre, j3, Christie, j3, Berroya, A L4, Lawson, JA a's, Bleasel, A F 4, Bye, A M E a'5.
1School of Wornen'sand Children's Health, University of NSW, Sydney, Australia; 2Department of Psychology, Macquarie University, Sydney, Australia; 3Department of Speech Pathology, Sydney Children's Hospital, Sydney, Australia; 4Department of Neurophysiology, The Children's Hospital at Westmead, Sydney, Australia; 5Department of Neurology, Sydney Children's Hospital, Sydney, Australia
Monday, November 7, 2005
S119
Crawford, p1, Chappell, Be. 1Dept of Neuroseiences, York Hospital
York UK," "~Neuroeducation, York Hospital York UK Background: The aim was to ascertain outcomes for people who had taken or who were still taking three "new generation" broad spectrum antiepileptic drugs (AEDs); namely lamotrigine, levetiracetam and topiramate. Method: Hospital patient notes were searched on three separate occasions for people who were taking or who had taken one of the three audit AEDs approximately two years post the United Kingdom licensing of each audit AED. The same search criteria were used on each occasion. Results: Ninety three exposures (20%) were in people who had primary generalised epilepsy, 57 (12%) had symptomatic generalised epilepsy and 317 (168%) had localisation related epilepsy. Ninety six exposures (20%) were in people who had learning disabilities. When audited 245 (52%) had taken lamotrigine (LTG), 94 (20%) topiramate (TPM) and 129 (28%) levetiracetam (LEV). Thirteen percent of people became seizure free and approximately one third had a reduction of greater than 50% in their seizures. Two thirds o f people were still taking their audit AED. In addition, approximately one third of people with a learning disability derived substantial benefit, although the rate of seizure freedom was lower. All three AEDs were most successful at treating primary generalised epilepsy and least successful with symptomatic generalised epilepsy. Conclusion: With some reservations the data suggests that levefiracetam and topiramate are the most efficacious AEDs, but topiramate is the least well tolerated. These results mean consideration of a "general prescribing policy" is important when using and choosing these AEDs. 0073 Fznotional and Spatial Memory in Patients with Temporal Lobe Epilepsy Daulaseeno, A, Alessio, A, Damasceno, BP, Min LL, Cendes F.
Department of Neurology, Medical School, State University of Carnpinas-SP, Brazil
Background: To determine the quality of life profile of children with Benign Rolandic Epilepsy. Secondly, to predict the effect of cognition on quality of life, controlling for parental concern and clinical variables. Method: Initial recruitment was through the major EEG laboratories of metropolitan Sydney. The epilepsy syndrome was defined using the International League Against Epilepsy classification. Patients underwent a neuropsychological and language assessment and each parent/ carer completed two generic, quality of life scales, the Child Health Questionnaire and the Child Behaviour Checklist, and one epilepsyspecific scale, the Quality of Life in Childhood Epilepsy Questiommire. The latter scale was used as an outcome measure to assess the affect of cognition on quality of life, wlfile controlling for parental concern and medication use. Results: The cohort included 30 patients, (122 males, 8 females), mean age 9.67 years. Six children (121%) scored in the clinically abnormal range on the competence scale of the Child Behaviour Checklist, significantly greater than the expected one clfild (2 %). The average score on the psychosocial scale of the Child Health Questionnaire was significantly lower than normative data. Controlling for parental concern and medication, general intellectual ability predicted reduced quality of life in the areas of self-esteem and language. Parental emotional impact, however, was a major independent predictor of quality of life. Conclusion: Quality of life may be reduced in clfildren with Benign Rolandic Epilepsy and is related to cognitive variables and parental concern regarding the child's well-being, cognition and health.
Background: Temporal lobe epilepsy (TLE) is often accompanied by memory impairment and drug resistant seizures. Deficit of verbal memory is usually correlated to left medial temporal sclerosis (MTS). However, the classical tests used for non-verbal memory have been unable to detect memory dysfunction in patients with right MTS. Objective: To test the hypothesis of a right amygdalar and hippocampal dominance for emotional and spatial memory in TLE patients. Method: Twenty-seven TLE patients (14 with right and 13 with left epileptic focus, with or without MTS) and 21 matched controls were studied. All patients underwent a presurgical evaluation including EEG-video-telemetry, neuropsychological tests for IQ, attention, visual-spafial perception, dichotic listening, language, executive funcLion, and memory subtests comprising: (I) learning of 16 unpleasant words; (I D intentional and (IID non-intentional spatial learning (positions of 16 figures or objects on a board). MRI volumetry of amygdala, hippocampus, and parahippocampal cortex was performed in a 2T scanner (Elscnit Prestige) using the NIH image program. Results: Education, IQ, and verbal fluency were positively correlated with memory performance. RightTLE patients were inferior to left TLE and to controls on all three memory tests. For analyses of volumetry and memory, we considered only patients with left hemisphere dominance for language 0N - 19). We found correlation only for right parahippocampus. Conclusion: There was a right-sided (amygdalar and hippocampal) dominance for emotional and spatial learning. Our memory tests (mostly test III) could differentiate left from right TLE patients, particularly when IQ > 85.
0072 An audit of lamotrigine, levetixacetam and topixamate usage tot Epilepsy in a district general hospital
0074 Types of epilepsy and possible etiological laetors among patients attending tile Neurology Clinic in Mulago Hospital Kaulpala Uganda
1School of Wornen'sand Children's Health, University of NSW, Sydney, Australia; 2Department of Psychology, Macquarie University, Sydney, Australia; 3Department of Speech Pathology, Sydney Children's Hospital, Sydney, Australia; 4Department of Neurophysiology, The Children's Hospital at Westmead, Sydney, Australia; 5Department of Neurology, Sydney Children's Hospital, Sydney, Australia
Monday, November 7, 2005
S119
Crawford, p1, Chappell, Be. 1Dept of Neuroseiences, York Hospital
York UK," "~Neuroeducation, York Hospital York UK Background: The aim was to ascertain outcomes for people who had taken or who were still taking three "new generation" broad spectrum antiepileptic drugs (AEDs); namely lamotrigine, levetiracetam and topiramate. Method: Hospital patient notes were searched on three separate occasions for people who were taking or who had taken one of the three audit AEDs approximately two years post the United Kingdom licensing of each audit AED. The same search criteria were used on each occasion. Results: Ninety three exposures (20%) were in people who had primary generalised epilepsy, 57 (12%) had symptomatic generalised epilepsy and 317 (168%) had localisation related epilepsy. Ninety six exposures (20%) were in people who had learning disabilities. When audited 245 (52%) had taken lamotrigine (LTG), 94 (20%) topiramate (TPM) and 129 (28%) levetiracetam (LEV). Thirteen percent of people became seizure free and approximately one third had a reduction of greater than 50% in their seizures. Two thirds o f people were still taking their audit AED. In addition, approximately one third of people with a learning disability derived substantial benefit, although the rate of seizure freedom was lower. All three AEDs were most successful at treating primary generalised epilepsy and least successful with symptomatic generalised epilepsy. Conclusion: With some reservations the data suggests that levefiracetam and topiramate are the most efficacious AEDs, but topiramate is the least well tolerated. These results mean consideration of a "general prescribing policy" is important when using and choosing these AEDs. 0073 Fznotional and Spatial Memory in Patients with Temporal Lobe Epilepsy Daulaseeno, A, Alessio, A, Damasceno, BP, Min LL, Cendes F.
Department of Neurology, Medical School, State University of Carnpinas-SP, Brazil
Background: To determine the quality of life profile of children with Benign Rolandic Epilepsy. Secondly, to predict the effect of cognition on quality of life, controlling for parental concern and clinical variables. Method: Initial recruitment was through the major EEG laboratories of metropolitan Sydney. The epilepsy syndrome was defined using the International League Against Epilepsy classification. Patients underwent a neuropsychological and language assessment and each parent/ carer completed two generic, quality of life scales, the Child Health Questionnaire and the Child Behaviour Checklist, and one epilepsyspecific scale, the Quality of Life in Childhood Epilepsy Questiommire. The latter scale was used as an outcome measure to assess the affect of cognition on quality of life, wlfile controlling for parental concern and medication use. Results: The cohort included 30 patients, (122 males, 8 females), mean age 9.67 years. Six children (121%) scored in the clinically abnormal range on the competence scale of the Child Behaviour Checklist, significantly greater than the expected one clfild (2 %). The average score on the psychosocial scale of the Child Health Questionnaire was significantly lower than normative data. Controlling for parental concern and medication, general intellectual ability predicted reduced quality of life in the areas of self-esteem and language. Parental emotional impact, however, was a major independent predictor of quality of life. Conclusion: Quality of life may be reduced in clfildren with Benign Rolandic Epilepsy and is related to cognitive variables and parental concern regarding the child's well-being, cognition and health.
Background: Temporal lobe epilepsy (TLE) is often accompanied by memory impairment and drug resistant seizures. Deficit of verbal memory is usually correlated to left medial temporal sclerosis (MTS). However, the classical tests used for non-verbal memory have been unable to detect memory dysfunction in patients with right MTS. Objective: To test the hypothesis of a right amygdalar and hippocampal dominance for emotional and spatial memory in TLE patients. Method: Twenty-seven TLE patients (14 with right and 13 with left epileptic focus, with or without MTS) and 21 matched controls were studied. All patients underwent a presurgical evaluation including EEG-video-telemetry, neuropsychological tests for IQ, attention, visual-spafial perception, dichotic listening, language, executive funcLion, and memory subtests comprising: (I) learning of 16 unpleasant words; (I D intentional and (IID non-intentional spatial learning (positions of 16 figures or objects on a board). MRI volumetry of amygdala, hippocampus, and parahippocampal cortex was performed in a 2T scanner (Elscnit Prestige) using the NIH image program. Results: Education, IQ, and verbal fluency were positively correlated with memory performance. RightTLE patients were inferior to left TLE and to controls on all three memory tests. For analyses of volumetry and memory, we considered only patients with left hemisphere dominance for language 0N - 19). We found correlation only for right parahippocampus. Conclusion: There was a right-sided (amygdalar and hippocampal) dominance for emotional and spatial learning. Our memory tests (mostly test III) could differentiate left from right TLE patients, particularly when IQ > 85.
0072 An audit of lamotrigine, levetixacetam and topixamate usage tot Epilepsy in a district general hospital
0074 Types of epilepsy and possible etiological laetors among patients attending tile Neurology Clinic in Mulago Hospital Kaulpala Uganda