A case imitating Panayiotopoulos syndrome

Panayiotopoulos syndrome is one of the most common childhood-specific epileptic disorders. It is characterized by autonomic symptoms; the most common being emesis. However, the presence of emetic symptoms may cause misdiagnosis, for example with some organic disorders which have similar autonomic features. On the other hand, since this syndrome has been recently well documented, the tendency for early recognition may lead to overdiagnosis. Here, we present a case which could be mistaken for Panayiotopoulos syndrome based on anamnesis, however, with the aid of ictal video-EEG monitoring, the patient was shown to present with a non-epileptic psychogenic seizure. This report is an example of careful evaluation in order to avoid over- or underdiagnosis of this benign disorder. [Published with video sequences

Febrile Seizures in Idiopathic/Genetic Generalized and Self-Limited Focal Epilepsies

Objectives: Febrile seizure (FS) is the most common form of childhood seizures. Furthermore, idiopathic/generalized and focal/self-limited epilepsies present at the similar age-range. They usually have a favorable outcome. This study was conducted to investigate the prevalence and demographic profile of FS in patients with idiopathic/generalized and focal/self-limited epilepsies

End of the barbexaclone era: an experience of treatment withdrawal

Barbexaclone is a salt compound of phenobarbital and propylhexedrine (a drug with indirect sympathomimetic properties). Due to the presence of the psychostimulating agent, propylhexedrine, this drug has less of a sedative effect and is well tolerated, compared to phenobarbital. Barbexaclone was widely used in Turkey until 2009 when its production ended, however, it gave rise to an epidemic for which we were not prepared. Since then, no standardised management protocol has been developed and each patient has been evaluated individually, thereby creating tailor-made solutions based on the extent of each patient's supply of remaining drug (from a few tablets to a stock which might last for six months). The rate of seizure freedom was 37.7% under barbexaclone treatment and dropped to 32.2% in the follow-up period after discontinuation of the drug. In the majority of cases, a new antiepileptic drug was added and this was commonly levetiracetam, a more expensive drug. In this article, we share our experiences of a general problem: the withdrawal of an antiepileptic drug from the market. Although there was prior notification regarding barbexaclone withdrawal, it was not possible to contact all patients since such a database is not available in Turkey. Although no conclusions regarding the efficacy of the drug or comparison of efficacy with other antiepileptic drugs is provided, it is nonetheless noteworthy to share these experiences since some patients had lost seizure control for reasons that could not be explained

End of the barbexaclone era: an experience of treatment withdrawal

Barbexaclone is a salt compound of phenobarbital and propylhexedrine (a drug with indirect sympathomimetic properties). Due to the presence of the psychostimulating agent, propylhexedrine, this drug has less of a sedative effect and is well tolerated, compared to phenobarbital. Barbexaclone was widely used in Turkey until 2009 when its production ended, however, it gave rise to an epidemic for which we were not prepared. Since then, no standardised management protocol has been developed and each patient has been evaluated individually, thereby creating tailor-made solutions based on the extent of each patient's supply of remaining drug (from a few tablets to a stock which might last for six months). The rate of seizure freedom was 37.7% under barbexaclone treatment and dropped to 32.2% in the follow-up period after discontinuation of the drug. In the majority of cases, a new antiepileptic drug was added and this was commonly levetiracetam, a more expensive drug. In this article, we share our experiences of a general problem: the withdrawal of an antiepileptic drug from the market. Although there was prior notification regarding barbexaclone withdrawal, it was not possible to contact all patients since such a database is not available in Turkey. Although no conclusions regarding the efficacy of the drug or comparison of efficacy with other antiepileptic drugs is provided, it is nonetheless noteworthy to share these experiences since some patients had lost seizure control for reasons that could not be explained

Guillain-Barre Syndrome and Its Variants: Clinical Course and Prognostic Factors

Introduction: We aimed to analyze the frequency, clinical characteristics, medical treatment options and final functional status of Guillain-Barre syndrome (GBS) and its variants in a population from a tertiary hospital setting

Utility of Amplitudes of Positive Sharp Waves and Fibrillation Potentials

Objective: Fibrillation potentials and positive sharp waves are pathologic spontaneous potentials which originate disconnection anywhere betweenanterior hornof medulla spinalisto muscle fiber in the motor unit. In clinical practice, the presence and if present the intensity of the spontaneous denervation potentials has been evaluated. In this study, the relations between their amplitudes and parameters like lesion duration, lesion type, level of lesion, age of patient and size of recorded muscle were aimed to be examined beside the presence of spontaneous denervation potentials

Neutrophil-to-lymphocyte ratio as a marker of infl ammation in restless legs syndrome during pregnancy

PURPOSE: The pregnancy is accepted as an independent risk factor for restless legs syndrome/Willis– Ekbom disease (RLS/WED). The neutrophil-to-lymphocyte ratio (NLR) was recently reported in the pathophysiology of RLS/WED. In this report, we investigated the relationship between the presence of RLS/ WED and the levels of NLR in pregnancy. METHODS: We included 268 pregnant women attending routine prenatal visits; 148 women had RLS/WED, and 120 women without RLS/WED were the control group. A pre-formed questionnaire was administered to all participants regarding demographic characteristics, habitual behaviors, detailed medical history and questions about RLS/WED including disease duration, severity, and family history. Laboratory investigations were performed in all participants regarding the complete blood count, NLR, fasting blood glucose, blood urea nitrogen, creatinine, ferritin, and total iron binding capacity. RESULTS: NLR was signifi cantly higher in pregnant women with RLS/WED as compared to those without it (3.9±0.9 versus 3.5±1.1, p=0.039). Smoking was also signifi cantly more common in pregnant women with RLS/WED (p=0.022). NLR signifi cantly increased as the gestational period progressed, even after the adjustments for age, BMI, and smoking (p=0.035). Higher NLR in pregnant women with RLS/WED was especially prominent in the 3rd trimester, although the difference was not signifi cant. CONCLUSION: These results may suggest that an increased infl ammation demonstrated by the increased NLR, may, in part, play a role in higher prevalence of RLS/WED in pregnancy, especially in late gestational weeks (Tab. 2, Fig. 1, Ref. 34). Text in PDF www.elis.s

Effects Of Darbepoetin Alpha on Brain Tissue Oxidative Stress in Experimental Ethanol Administration

Objectives: The hyperglycosylated erythropoietin analogue darbepoetin alpha (alpha) has longer half-life and higher in vivo activity. There is no data about the effects of darbepoetin-alpha on ethanol-induced oxidative stress. In this study, we investigated the effects of darbepoetin-alpha on brain tissue oxidant/antioxidant status and nitric oxide levels in experimental ethanol administration

A prospective study of Willis-Ekbom disease/restless legs syndrome during and after pregnancy

Objectives: Willis-Ekbom disease/restless legs syndrome (WED/RLS) is the most common sleep-related movement disorder in pregnancy. We designed a prospective longitudinal study to investigate the correlates of WED/RLS during and after pregnancy