Comparative evaluation of levetiracetam and valproic acid as monotherapy on cognitive impairment in patients of epilepsy

Background: Cognitive decline with AEDs (Anti-epileptic drugs) is associated with learning and memory deficits especially in the younger age group. The data regarding the impact of levetiracetam and valproic acid as monotherapy on cognition in epileptic patients is scarce. The present study was done for evaluation of cognitive decline associated with the use of AEDs.Methods: Present study was a prospective study on 60 patients on AEDs for a period of 12 weeks. Patients were enrolled from the Department of Neurology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India and divided into group A (levetiracetam) and group B (valproic acid) with 30 patients in each group. Permission from the institutional ethics committee and written informed consent was taken from all the patients. They were analyzed for cognitive impairment using MMSE and MoCA scales at baseline and 12 weeks.Results: The mean duration of disease was 2.13±1.1 years and 2.08±1.1 years and mean age of the patients was 14.67±1.9 years in group A and 16.20±1.6 years in group B. GTCS was present in 31 patients (52%) followed by partial seizures in 29 patients (48%). The mean change in the MMSE scores from baseline to 12 weeks was significant in group A 1.30±1.1 (p value <0.05) and change group B was -0.20±1.4 not statistically significant. The mean change was observed in MoCA scores from baseline to 12 weeks was significant in both groups A and B by 1.17±1.1 and -0.70±1.1 respectively (P value <0.05).Conclusions: Patients on levetiracetam showed cognitive improvement, whereas patients on valproic acid showed a decline in the MMSE and MoCA scores

Isoniazid-Induced Psychosis in a Patient with Pulmonary Tuberculosis: A Case Report

Isoniazid is one of the most important drugs in the management of pulmonary tuberculosis; of all the antituberculous drugs, it is one of the most commonly implicated drugs in drug-induced psychosis. We report a case of isoniazid-induced psychosis in a 31-year-old patient with pulmonary tuberculosis

Neuropsychiatric aspect of social isolation following a lockdown: A perspective

Coronavirus disease 2019 pandemic spreads through inhalation of aerosols or droplets. Therefore, the use of face masks, alcohol-based sanitizers, and most importantly practicing quarantine/ isolation and social distancing are the main modalities for its prevention and control. Although isolation is essential, various psychological effects have been implicated with its practice in most of the age groups. Longstanding isolation and negligible interpersonal interactions can have changes in psychological processes and neurological and morphological changes in the brain. Morphological changes as seen through the neuroimaging studies include reduced volume of the structures involved in the synthesis of various nerve growth factors leading to impaired neurogenesis and subsequently psychological changes which can manifest as mood alterations such as anxiety, depression, feeling demoralized, obsessive thinking, and altered sleep–wake cycles besides others especially, in the vulnerable age groups such as children and the elderly. Although quarantine remains the cornerstone to contain the spread of the pandemic, its psychological impact run simultaneously, which should be, understood, and addressed to ameliorate its long-term impact

Comparative evaluation of levetiracetam and valproic acid as monotherapy on cognitive impairment in patients of epilepsy

Background: Cognitive decline with AEDs (Anti-epileptic drugs) is associated with learning and memory deficits especially in the younger age group. The data regarding the impact of levetiracetam and valproic acid as monotherapy on cognition in epileptic patients is scarce. The present study was done for evaluation of cognitive decline associated with the use of AEDs.Methods: Present study was a prospective study on 60 patients on AEDs for a period of 12 weeks. Patients were enrolled from the Department of Neurology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India and divided into group A (levetiracetam) and group B (valproic acid) with 30 patients in each group. Permission from the institutional ethics committee and written informed consent was taken from all the patients. They were analyzed for cognitive impairment using MMSE and MoCA scales at baseline and 12 weeks.Results: The mean duration of disease was 2.13±1.1 years and 2.08±1.1 years and mean age of the patients was 14.67±1.9 years in group A and 16.20±1.6 years in group B. GTCS was present in 31 patients (52%) followed by partial seizures in 29 patients (48%). The mean change in the MMSE scores from baseline to 12 weeks was significant in group A 1.30±1.1 (p value &lt;0.05) and change group B was -0.20±1.4 not statistically significant. The mean change was observed in MoCA scores from baseline to 12 weeks was significant in both groups A and B by 1.17±1.1 and -0.70±1.1 respectively (P value &lt;0.05).Conclusions: Patients on levetiracetam showed cognitive improvement, whereas patients on valproic acid showed a decline in the MMSE and MoCA scores.</jats:p

Research on Sleep

Why publish a new book on sleep? The reasons are compelling. There is a growing recognition in clinical practice of our limited understanding of sleep, alongside a constant stream of discoveries and insights into this fundamental homeostatic process of our lives. Sleep is a universal experience; everyone has something to say about it, as it envelops us from the very start of our existence. Each night brings a transformation, making sleep a uniquely different experience, even for the same individual. From adolescence to old age, sleep evolves, shifting through the stages of menopause and becoming altered during various health conditions like cardiovascular diseases, OSAS, and particularly epilepsy. This new text aspires to offer the latest updates on key themes related to sleep, striving to inspire clinicians and researchers alike to explore new ideas and perspectives