- Email: [email protected]
No?
S134
Poster Abstracts
Monday, November 7, 2005
corneally-kindled N M R I mice (EDso -- 0.31 mg/kg i.p.) and hippocampal kindled rats (Minimal Active Dose -- 0.23 mg/kg p.o.), clonic convulsions in audiogenic seizure prone mice (EDs0 -- 0.17 mg/ kg i.p.) and spike-wave-discharges in the Genetic Absence Epilepsy Rats from Strasbourg (GAERS; EDso -- 0.15 mg/kg i.p.). Rotarod test TDs0 values of seletracetam in corneally-kindled mice and GAERS were 325 and 449 mg/kg i.p., respectively, resulting in safety margins of 1048 and 3075. In conclusion, seletracetam markedly reduces the epileptiform markers in in vitro slice models of epilepsy and potently suppresses seizures in vivo in epilepsy models mimicking both partial and generalized epilepsy in man. Tiffs suggests a promising therapeutic potential of seletracetam in epileptic patients. 0132 Analysis Of 42 Patients With Non-Convulsive Status Epilepticus From Rio De Janeixo, Brazil Arafljo, AQC 1"2'3, Afonso, CR 1'2, Amado, ML 1, Vaconcelos, CC 1, Matiello, M 1, Batista, E 1, Levy, S 1. 1Copa D'Or & Barra D'Or Hospitals, Rio de Janeiro, Brazil," 2The Federal University of Rio de Janeiro, Brazil," 3IPEC - FIOCRUZ, Rio de Janeiro, Brazil Background: Nonconvulsive status epilepticus (NCSE) is a cause of altered mental status and is frequently unrecognized. Its diagnosis depends on the correlation of clinical aspects and encephalographic demonstration. In the present study we aimed to analyze clinical, encephalographic (EEG) and MRI data from a group of patients with NCSE from two general hospitals. Methods: Forty two patients with NCSE were studied and separated according to MRI patterns, as follows: Group I signs of an acute disease; Group II signs of chronic disease; Group Ill unremarkable exam. The EEG results were analyzed and compared. Results: Only one patient had a previous history of epilepsy and presented a normal MRL On Group I there were 24 patients (57,1%), 8 with ischemic stroke, 7 with hemorrhagic stroke, 4 with brain tmnor, 4 with axonal diffuse lesion and one with cerebral edema. On Group II we had 7 patients (40,5%), 5 with old ischenffc signs, 1 with micro lacunae and 1 with craniotomy. On Group III there were 10 patients (23,8 %), signs of microangiopathy in three, brain atrophy in three and both in four. The seizure types found were: absence in 33 patients and partial complex in nine. The EEG from patients with acute neurological disease had a predominance o f focal disturbances (15 patients), while in the remaining groups the generalized pattern prevailed. Discussion: NCSE can be triggered by a great number of different diseases. In patients with sustained mental alterations, with or without an overt neurological disease, NCSE is a true diagnostic possibility. 0133 Ictal BradycartUa and Uncontrolled Blood Pressure as the Presenting Symptom of Symptomatic Seizure Aziz Mazarib, Radi shahien. Ziv Medical Center, Salad, Israel Objective: To describe the unusual presenting symptoms o f symptomatic seizure. Background: Symptomatic seizure is a seizure caused by a previously known or suspected disorder o f the CNS. Tiffs type of seizure is assodated with a prior CNS insult known to increase the risk of developing epilepsy. A n acute symptomatic seizure is one that occurs following a recent acute disorder such as a metabolic insult, toxic insult, CNS infection, stroke, brain tramna, cerebral hemorrhage, medication toxicity, alcohol withdrawal, or drug withdrawal. A n example of an acute symptomatic seizure is a seizure that occurs within 1 week of a stroke or head injury. Methods: Electromyography, Brain CT scan, MRI, Holter and cardiac echography were employed. Results: We studied a patient which presented to us with frequent bradycardia and uncontrolled blood pressure, and some times developed complex partial seizure with secondary generalization.
Cardiac investigation within normal limits, Brain imaging described a fight perisyMan infiltrative lesion without enhancement. Inter-ictal EEG described a RT temporal epileptic discharges. We started Carbamazepine with effective benefits, seizures free more than several months. Condasions: We report that bradycardia and uncontrolled blood pressure could be the presenting symptom of symptomatic, seizures. Perisylvian infiltrative lesion can cause ictal bradycardia and uncontrolled blood pressure, complex partial seizures with secondary generalizations. Effective therapy like carbamazepine improve the patient symptoms very well. 0134 Adverse effects of Antiepileptic Drugs and their impact on quality of life in children with Epilepsy Mazurldewicz-Bddzinska, M x, Matheisel, A 1. ZDepartrnent of Developmental Neurology" Medical University of Gdansk, Poland Background: Epilepsy is a major cause of childhood disability. Additionally A E D through their potential to evoke side effects can potentiate this disability. Both efficacy and safety of treatment are important parameters in assessing quality of life as an outcome measure. In order to assess the impact of side effects of antiepileptic drugs (AED) on quality of life in children with epilepsy following study was performed. 250 children with epilepsy (aged 3-13 years) and their caregivers participated in the study. The quality of life questionnaire specially developed in our department for parents of epileptic, children was applied. Additionally the 5 questions especially designed to describe side effects were asked. Comparison between parents and medical staff opinions were made. Results: The most frequent side effects observed in 70% of patients were: tiredness, poor concentration, nervousness, headache, vertigo, weight loss or gain, rush and other skin problems, abdominal pain and others. Occurrence and nmnber of side effects as well as the efficacy of treatment significantly correlated with quality of life. It also correlated with the caregivers' opinion about the disease and theirs fear about its influence on the children. Interestingly parents reported their worries about the effects of drugs on cognition much stronger than effects of epilepsy itself. Conclusion: Not only epilepsy by itself but also the side effects of AED have the important impact on quality of life in children with epilepsy. 0135 Initial Monotherapy with Levetiraeetam (LEV) Meeneke, H J ~, Dehnicke, C ~, Merschhenlke, M a, Meinken-J~iggi, D ~. 1Epilepsie- Zentrum Berlin-Brandenburg, Berlin, Germany Background: Levetiracetam (LEV) is an effective antiepileptic drug in add on therapy of pharmakoresistent focal epilepsies. In Europe it is not licensed for monotherapy and generalised idiopathic, epilepsies. Nevertheless we have good experience in responder cases when we switched from add on to LEV monotherapy. In tiffs study we want to present datas from initial LEV-monotherapy. MeillOd: Tiffs is a retrospective observational study in drug resistant cases with focal and generalised epilepsies. In our outpatient department we analysed retrospectively the patient charts and the patients diary in respect to seizure frequency (SZF) and tolerability. Results: From 855 patients under LEV add-on-therapy we had 48% responder with 25% seizure free patients, 142 patients were switched to monotherapy, 18 patients had an initial monotherapy (18 male, 10 female). The average duration of epilepsy was 7,47 years (10,06-25,13). The average follow up was 72,48 (12,71-178,86) weeks. From 18 cases, 12 (165%) were seizure free. From 8 focal epilepsies 5 and from 10 generalised epilepsies 7. Conclusion: LEV promises to be a good antiepileptic drug even in initial monotherapy. The number of cases is too small to give a
Poster Abstracts statement about a preference of efficacy either in focal or in generalised epilepsies. 0136 Phamlaeological Prevention of Postlraumatic Epilepsy atter Open Head Injury Yes/No?
Suljie, E ~, Alajbegovic, A ~, Loncarevic, N ~, Kantardzic, Dz ~, Kucukalic, A. 1Neurology Clinic, Clinical Center, Sarajevo ; ~Psyciatric
Clinic, Clinical Center, Sarajevo Introduction: Posttraumatic epilepsies occur among 40"/0 o f patients with open craniocerebral injuries. Late posttraumatic epilepsy onset is seven days after the injury or later, and it is closely related to injury of dura matter, intracerebral hemorrhage and neurological deficit. Pharmacological prevention after the injury decreases incidence of posttraumatic epilepsy. Aim: To determine fiequency o f late posttraumatic epilepsies within population with open and closed cratffocerebral injuries of brain. To test relation among occurrence of late posttraumatic epilepsies and preventive administration of anticonvulsants, and to determine degree of disablement according to given criteria. Material anti tnethods: The research is retrospective, epidemiological, diagnostically-analytic and clinically applicable. Sample consisted of investigated and control groups 50 patients each, evaluated by the Commission for disability determination during one year. Results: 586 cases with cranial-cerebral injuries had been evaluated, and 193 cases had open cranial-cerebral injury. Late posttraumatic epilepsy occurred in 50 cases. Majority of cases had partial motoric seizures with secondary generalization (62%). The most fiequent localizations of injuries were temporal and frontal sides (t - 2,7, p < 0,01). In control group all cases, as a preventive measure, take antiepileptics drugs. Conclusion: Late posttraumatic epilepsies are significantly more frequent among open craniocerebral injuries and closely correlated with existence of neurological deficit, localization of injury and psychological changes. Preventive adnffnistration of anticonvulsants decreases percentage of late posttraumaric epilepsies.
0137 Patient perceived Cognitive side etl~cts of anti-epileptic drug treahnent: An international per~eetive Mounlield, H 1, Baker, G 2, Feichtinger, M 3, Ryvlin, p4. 1Epilepsy
Scotland; :Walton Center for Neurology and Neurosurgery, Liverpool UIQ 3Kar[-Franzens University, Graz, Austria; 4Neurology Hospital Lyon, France Background: To provide a patients' perspective on the cognitive side effects of anti-epileptic drug (AED) treatment and the consequences for quality of life. Method: A nine-item questionnaire comprising a combination of forced-choice and open-ended questions was distributed to 4,500 members of nine chapters of the International Bureau for Epilepsy (:Austria, Belgium, Dermmrk, France, Ireland, Israel, Norway and Scotland). Results: Data analysis was performed on 837 completed questionnaires. The average age of respondents was 40 years, 54?,'; were female and 95% were taking medication for their seizures (60% polytherapy vs 39°,5 monotherapy). Average length of time on treatment was 18.07 years (±18.07). Indicators of cognitive impairment considered to be affected 'very much' or 'moderately' included sleepiness/tiredness (57%), slowness of thought (142%) and difficulties lean-ring something new (141%). Two thirds stated that cognitive impairment was related to their condition or AED therapy, with 41% attributing impairment to their A E D therapy alone. More than half (59o';) stated that cognitive impairment had prevented them from achieving a goal and approximately 50% reported that their quality o f life had been affected including: work (48%), education (46%), relationships (48%)
Monday, November 7, 2005
S135
and leisure pursuits (1447,';). When asked what side effects they would most like to avoid, respondents reported indicators of cognitive impaimlent most frequently, including sleepiness/tiredness (35%), memory problems (19%), lethargy/sluggishness (9%) and difficulty paying attention (8%). Conclusions: Insights gained from this survey lffghlight the debilitating effect of cognifive impairment on individuals with epilepsy and the importance ascribed to minimising cognitive side effects of AEDs.
This survey was supported by an unrestricted educational grant from UCB Pharma 0139 The study of frequentT of seizure recurrence in the patients with I'tr~lt seizure after trealment and without treatment Najafi, M ~, Reissifar, M ], Najafi, F ]. 11sfahan University of Medical
Sciences, lsfahan, 1ran Background: Most of tire studies have shown that approximately one third of patients with single seizure will experience a second one. Data regarding recurrence vary widely. This study addresses the effect of anriconvulsant medication on recurrence of a single seizure. Method: Between 1996-2004, patients of single idiopathic generalized seizure were recruited from the neurology outpatient of Al-zahra hospital of Isfahn. Patients with a history of febrile seizures, symptomarie etiology, presence o f focal neurological deficit, abnormal EEG and positive family history were also excluded. Detailed data was collected in 105 patients. All the patients were subjected to EEG and CI" scan. They were randomized into two groups: one treated and the other untreated, after obtaining a written consent. All patients were followed up for recurrence for a period ranging from 12-36 (mean 19.1 ± 5.00) months. Results: Total patients were 105 (52 m and 53 f) between 7 to 78 years old aged (mean 28.83) and average age of relapse 29.58 ± 15.24. Total number of patients receiving medication and relapse were 45 and 62 respectively. Among those going on treatment after first attack 18 (:29"/0) experience relapse up to 3 years after first seizure. 44 (71%) out of 62 patients with relapse got no medications. There was no significant correlation between sex and relapse with or without medication Conclusion: We found strong correlation between relapse and treatment started after first attack (P < 0.001). The patients receive treatment in their first attack may be at lower risk for relapse. 0140 Immunity Against Epilepsy? Narayana, R. Assistant prof. Neurology', Andhra Medical College Background: A Tribal Primary Health Center wlffch is in South East India Endemic for malaria children and adults with hypersplenism and found to have few cases of epilepsy. Methods: Between January 2000 and December 2000 Children and Adults who presented to PHC and village wise health camp as part of government mass health camps for PHCs, careful questionnaire does reveal low prevalence for epilepsy. The staff involved one full time medical officer qualified in neurology, public heath nurse and multipurpose health assistants. Retrospective data from hospital records of the previous two years also suggest the same. Apart from epilepsy Questionnaire also include dietary habits, child rearing and social living. Results: Worldwide prevalence for active epilepsy is between 4 and 10 per thousand population. With 28000 population who live in that P H C area with 8 sub-centers and 160 small villages. We expect the people with epilepsy should around 100 to 1000 to our surprise we came across 10 cases only. Retrospective analysis of hospital data also showed 3 and 6 cases of diagnosed epilepsy in the previous two years. Tiffs P H C area endenffc for malaria. Most of these tribals eat rice and all types cooked vegetables and meat. They are not accessible for dairy milk and backed food products, soft-cola drinks.
Poster Abstracts
Monday, November 7, 2005
corneally-kindled N M R I mice (EDso -- 0.31 mg/kg i.p.) and hippocampal kindled rats (Minimal Active Dose -- 0.23 mg/kg p.o.), clonic convulsions in audiogenic seizure prone mice (EDs0 -- 0.17 mg/ kg i.p.) and spike-wave-discharges in the Genetic Absence Epilepsy Rats from Strasbourg (GAERS; EDso -- 0.15 mg/kg i.p.). Rotarod test TDs0 values of seletracetam in corneally-kindled mice and GAERS were 325 and 449 mg/kg i.p., respectively, resulting in safety margins of 1048 and 3075. In conclusion, seletracetam markedly reduces the epileptiform markers in in vitro slice models of epilepsy and potently suppresses seizures in vivo in epilepsy models mimicking both partial and generalized epilepsy in man. Tiffs suggests a promising therapeutic potential of seletracetam in epileptic patients. 0132 Analysis Of 42 Patients With Non-Convulsive Status Epilepticus From Rio De Janeixo, Brazil Arafljo, AQC 1"2'3, Afonso, CR 1'2, Amado, ML 1, Vaconcelos, CC 1, Matiello, M 1, Batista, E 1, Levy, S 1. 1Copa D'Or & Barra D'Or Hospitals, Rio de Janeiro, Brazil," 2The Federal University of Rio de Janeiro, Brazil," 3IPEC - FIOCRUZ, Rio de Janeiro, Brazil Background: Nonconvulsive status epilepticus (NCSE) is a cause of altered mental status and is frequently unrecognized. Its diagnosis depends on the correlation of clinical aspects and encephalographic demonstration. In the present study we aimed to analyze clinical, encephalographic (EEG) and MRI data from a group of patients with NCSE from two general hospitals. Methods: Forty two patients with NCSE were studied and separated according to MRI patterns, as follows: Group I signs of an acute disease; Group II signs of chronic disease; Group Ill unremarkable exam. The EEG results were analyzed and compared. Results: Only one patient had a previous history of epilepsy and presented a normal MRL On Group I there were 24 patients (57,1%), 8 with ischemic stroke, 7 with hemorrhagic stroke, 4 with brain tmnor, 4 with axonal diffuse lesion and one with cerebral edema. On Group II we had 7 patients (40,5%), 5 with old ischenffc signs, 1 with micro lacunae and 1 with craniotomy. On Group III there were 10 patients (23,8 %), signs of microangiopathy in three, brain atrophy in three and both in four. The seizure types found were: absence in 33 patients and partial complex in nine. The EEG from patients with acute neurological disease had a predominance o f focal disturbances (15 patients), while in the remaining groups the generalized pattern prevailed. Discussion: NCSE can be triggered by a great number of different diseases. In patients with sustained mental alterations, with or without an overt neurological disease, NCSE is a true diagnostic possibility. 0133 Ictal BradycartUa and Uncontrolled Blood Pressure as the Presenting Symptom of Symptomatic Seizure Aziz Mazarib, Radi shahien. Ziv Medical Center, Salad, Israel Objective: To describe the unusual presenting symptoms o f symptomatic seizure. Background: Symptomatic seizure is a seizure caused by a previously known or suspected disorder o f the CNS. Tiffs type of seizure is assodated with a prior CNS insult known to increase the risk of developing epilepsy. A n acute symptomatic seizure is one that occurs following a recent acute disorder such as a metabolic insult, toxic insult, CNS infection, stroke, brain tramna, cerebral hemorrhage, medication toxicity, alcohol withdrawal, or drug withdrawal. A n example of an acute symptomatic seizure is a seizure that occurs within 1 week of a stroke or head injury. Methods: Electromyography, Brain CT scan, MRI, Holter and cardiac echography were employed. Results: We studied a patient which presented to us with frequent bradycardia and uncontrolled blood pressure, and some times developed complex partial seizure with secondary generalization.
Cardiac investigation within normal limits, Brain imaging described a fight perisyMan infiltrative lesion without enhancement. Inter-ictal EEG described a RT temporal epileptic discharges. We started Carbamazepine with effective benefits, seizures free more than several months. Condasions: We report that bradycardia and uncontrolled blood pressure could be the presenting symptom of symptomatic, seizures. Perisylvian infiltrative lesion can cause ictal bradycardia and uncontrolled blood pressure, complex partial seizures with secondary generalizations. Effective therapy like carbamazepine improve the patient symptoms very well. 0134 Adverse effects of Antiepileptic Drugs and their impact on quality of life in children with Epilepsy Mazurldewicz-Bddzinska, M x, Matheisel, A 1. ZDepartrnent of Developmental Neurology" Medical University of Gdansk, Poland Background: Epilepsy is a major cause of childhood disability. Additionally A E D through their potential to evoke side effects can potentiate this disability. Both efficacy and safety of treatment are important parameters in assessing quality of life as an outcome measure. In order to assess the impact of side effects of antiepileptic drugs (AED) on quality of life in children with epilepsy following study was performed. 250 children with epilepsy (aged 3-13 years) and their caregivers participated in the study. The quality of life questionnaire specially developed in our department for parents of epileptic, children was applied. Additionally the 5 questions especially designed to describe side effects were asked. Comparison between parents and medical staff opinions were made. Results: The most frequent side effects observed in 70% of patients were: tiredness, poor concentration, nervousness, headache, vertigo, weight loss or gain, rush and other skin problems, abdominal pain and others. Occurrence and nmnber of side effects as well as the efficacy of treatment significantly correlated with quality of life. It also correlated with the caregivers' opinion about the disease and theirs fear about its influence on the children. Interestingly parents reported their worries about the effects of drugs on cognition much stronger than effects of epilepsy itself. Conclusion: Not only epilepsy by itself but also the side effects of AED have the important impact on quality of life in children with epilepsy. 0135 Initial Monotherapy with Levetiraeetam (LEV) Meeneke, H J ~, Dehnicke, C ~, Merschhenlke, M a, Meinken-J~iggi, D ~. 1Epilepsie- Zentrum Berlin-Brandenburg, Berlin, Germany Background: Levetiracetam (LEV) is an effective antiepileptic drug in add on therapy of pharmakoresistent focal epilepsies. In Europe it is not licensed for monotherapy and generalised idiopathic, epilepsies. Nevertheless we have good experience in responder cases when we switched from add on to LEV monotherapy. In tiffs study we want to present datas from initial LEV-monotherapy. MeillOd: Tiffs is a retrospective observational study in drug resistant cases with focal and generalised epilepsies. In our outpatient department we analysed retrospectively the patient charts and the patients diary in respect to seizure frequency (SZF) and tolerability. Results: From 855 patients under LEV add-on-therapy we had 48% responder with 25% seizure free patients, 142 patients were switched to monotherapy, 18 patients had an initial monotherapy (18 male, 10 female). The average duration of epilepsy was 7,47 years (10,06-25,13). The average follow up was 72,48 (12,71-178,86) weeks. From 18 cases, 12 (165%) were seizure free. From 8 focal epilepsies 5 and from 10 generalised epilepsies 7. Conclusion: LEV promises to be a good antiepileptic drug even in initial monotherapy. The number of cases is too small to give a
Poster Abstracts statement about a preference of efficacy either in focal or in generalised epilepsies. 0136 Phamlaeological Prevention of Postlraumatic Epilepsy atter Open Head Injury Yes/No?
Suljie, E ~, Alajbegovic, A ~, Loncarevic, N ~, Kantardzic, Dz ~, Kucukalic, A. 1Neurology Clinic, Clinical Center, Sarajevo ; ~Psyciatric
Clinic, Clinical Center, Sarajevo Introduction: Posttraumatic epilepsies occur among 40"/0 o f patients with open craniocerebral injuries. Late posttraumatic epilepsy onset is seven days after the injury or later, and it is closely related to injury of dura matter, intracerebral hemorrhage and neurological deficit. Pharmacological prevention after the injury decreases incidence of posttraumatic epilepsy. Aim: To determine fiequency o f late posttraumatic epilepsies within population with open and closed cratffocerebral injuries of brain. To test relation among occurrence of late posttraumatic epilepsies and preventive administration of anticonvulsants, and to determine degree of disablement according to given criteria. Material anti tnethods: The research is retrospective, epidemiological, diagnostically-analytic and clinically applicable. Sample consisted of investigated and control groups 50 patients each, evaluated by the Commission for disability determination during one year. Results: 586 cases with cranial-cerebral injuries had been evaluated, and 193 cases had open cranial-cerebral injury. Late posttraumatic epilepsy occurred in 50 cases. Majority of cases had partial motoric seizures with secondary generalization (62%). The most fiequent localizations of injuries were temporal and frontal sides (t - 2,7, p < 0,01). In control group all cases, as a preventive measure, take antiepileptics drugs. Conclusion: Late posttraumatic epilepsies are significantly more frequent among open craniocerebral injuries and closely correlated with existence of neurological deficit, localization of injury and psychological changes. Preventive adnffnistration of anticonvulsants decreases percentage of late posttraumaric epilepsies.
0137 Patient perceived Cognitive side etl~cts of anti-epileptic drug treahnent: An international per~eetive Mounlield, H 1, Baker, G 2, Feichtinger, M 3, Ryvlin, p4. 1Epilepsy
Scotland; :Walton Center for Neurology and Neurosurgery, Liverpool UIQ 3Kar[-Franzens University, Graz, Austria; 4Neurology Hospital Lyon, France Background: To provide a patients' perspective on the cognitive side effects of anti-epileptic drug (AED) treatment and the consequences for quality of life. Method: A nine-item questionnaire comprising a combination of forced-choice and open-ended questions was distributed to 4,500 members of nine chapters of the International Bureau for Epilepsy (:Austria, Belgium, Dermmrk, France, Ireland, Israel, Norway and Scotland). Results: Data analysis was performed on 837 completed questionnaires. The average age of respondents was 40 years, 54?,'; were female and 95% were taking medication for their seizures (60% polytherapy vs 39°,5 monotherapy). Average length of time on treatment was 18.07 years (±18.07). Indicators of cognitive impairment considered to be affected 'very much' or 'moderately' included sleepiness/tiredness (57%), slowness of thought (142%) and difficulties lean-ring something new (141%). Two thirds stated that cognitive impairment was related to their condition or AED therapy, with 41% attributing impairment to their A E D therapy alone. More than half (59o';) stated that cognitive impairment had prevented them from achieving a goal and approximately 50% reported that their quality o f life had been affected including: work (48%), education (46%), relationships (48%)
Monday, November 7, 2005
S135
and leisure pursuits (1447,';). When asked what side effects they would most like to avoid, respondents reported indicators of cognitive impaimlent most frequently, including sleepiness/tiredness (35%), memory problems (19%), lethargy/sluggishness (9%) and difficulty paying attention (8%). Conclusions: Insights gained from this survey lffghlight the debilitating effect of cognifive impairment on individuals with epilepsy and the importance ascribed to minimising cognitive side effects of AEDs.
This survey was supported by an unrestricted educational grant from UCB Pharma 0139 The study of frequentT of seizure recurrence in the patients with I'tr~lt seizure after trealment and without treatment Najafi, M ~, Reissifar, M ], Najafi, F ]. 11sfahan University of Medical
Sciences, lsfahan, 1ran Background: Most of tire studies have shown that approximately one third of patients with single seizure will experience a second one. Data regarding recurrence vary widely. This study addresses the effect of anriconvulsant medication on recurrence of a single seizure. Method: Between 1996-2004, patients of single idiopathic generalized seizure were recruited from the neurology outpatient of Al-zahra hospital of Isfahn. Patients with a history of febrile seizures, symptomarie etiology, presence o f focal neurological deficit, abnormal EEG and positive family history were also excluded. Detailed data was collected in 105 patients. All the patients were subjected to EEG and CI" scan. They were randomized into two groups: one treated and the other untreated, after obtaining a written consent. All patients were followed up for recurrence for a period ranging from 12-36 (mean 19.1 ± 5.00) months. Results: Total patients were 105 (52 m and 53 f) between 7 to 78 years old aged (mean 28.83) and average age of relapse 29.58 ± 15.24. Total number of patients receiving medication and relapse were 45 and 62 respectively. Among those going on treatment after first attack 18 (:29"/0) experience relapse up to 3 years after first seizure. 44 (71%) out of 62 patients with relapse got no medications. There was no significant correlation between sex and relapse with or without medication Conclusion: We found strong correlation between relapse and treatment started after first attack (P < 0.001). The patients receive treatment in their first attack may be at lower risk for relapse. 0140 Immunity Against Epilepsy? Narayana, R. Assistant prof. Neurology', Andhra Medical College Background: A Tribal Primary Health Center wlffch is in South East India Endemic for malaria children and adults with hypersplenism and found to have few cases of epilepsy. Methods: Between January 2000 and December 2000 Children and Adults who presented to PHC and village wise health camp as part of government mass health camps for PHCs, careful questionnaire does reveal low prevalence for epilepsy. The staff involved one full time medical officer qualified in neurology, public heath nurse and multipurpose health assistants. Retrospective data from hospital records of the previous two years also suggest the same. Apart from epilepsy Questionnaire also include dietary habits, child rearing and social living. Results: Worldwide prevalence for active epilepsy is between 4 and 10 per thousand population. With 28000 population who live in that P H C area with 8 sub-centers and 160 small villages. We expect the people with epilepsy should around 100 to 1000 to our surprise we came across 10 cases only. Retrospective analysis of hospital data also showed 3 and 6 cases of diagnosed epilepsy in the previous two years. Tiffs P H C area endenffc for malaria. Most of these tribals eat rice and all types cooked vegetables and meat. They are not accessible for dairy milk and backed food products, soft-cola drinks.