A Prospective COHORT study of One Hundred Cases of First Unprovoked Seizure.

Seizures have been recognized since ancient days. One of the earliest descriptions of generalized tonic-clonic seizure was recorded over 3000 years ago in Mesopotamia and it was attributed to the God of the Moon. Epileptic seizures were also described in ancient cultures of India, China and Egypt. The word seizure is derived from Latin word "sacire", meaning, "to take possession of" indicating that the person having a seizure is possessed or at least out of control. A seizure is a paroxysmal self limited event caused by an excessive electrical discharge of central nervous system. Epilepsy is a disorder characterized by recurrent seizures. A First Unprovoked Seizure (FUS) is a first seizure episode occurring in an individual without an identified proximate precipitant and it excludes seizures occurring after an acute insult to the central nervous system or with generalised systemic metabolic disturbance of the body. Unprovoked seizures can be further classified into: Remote symptomatic seizure (associated with stroke, head injury, tumour, infection etc) and idiopathic seizures (without history of neurological insult or a neurological deficit presumed to be present from birth). A first seizure is a frightening event for families and friends. But the patients may have a certain degree of confusion and reluctance to seek attention. The consequences of a diagnosis of “epilepsy” are serious both for the patients and their families. In the management of epilepsy, it is important to humanely guide and counsel the anxious patients. The consequences of a diagnosis and treatment must outweigh the risks of seizures recurrence. CONCLUSIONS : 1. Following an attack of first unprovoked seizure, lower educated male laborers preferred AED therapy for the fear of injury, loss of job or their life itself. 2. Recurrence rate in the treated and untreated group after a one year follow up stood at 14% and 20% respectively. 3. Most of the recurrence in the preferred group occurred between the third to sixth months and in the deferred within 3 months, inferring that the AED therapy did not have any role in preventing seizure recurrence beyond three months. 4. Effective counseling resulted in better compliance rate (85%)

An interesting case of metastatic brain abscess

Klebsiella pneumoniae is a Gram-negative, non-motile, lactose fermenting, aerobic rod-shaped bacterium with three different subspecies, K. pneumoniae, Klebsiella ozaenae, and Klebsiella rhinoscleromatis. Here, we report the case of a 32-year-old male, chronic alcoholic presented with fever, hemoptysis, and headache of 20 days duration. Over a period of 4 days, the patient worsened with the development of altered sensorium and respiratory distress, connected to a mechanical ventilator. Computed tomography and chest X-ray showed consolidation involving the left lower lobe with an air-fluid level. Magnetic resonance imaging brain showed multiple metastatic brain abscess involving cerebrum and cerebellum and culture reports of sputum and blood showed K. pneumoniae. The patient was started on antibiotics along with anti-tubercular drugs. In spite of effective management, the patient developed recurrent episodes of hemoptysis and died of respiratory failure. For the concomitant involvement of both cerebrum and cerebellum for the first time

Vanishing headache in a young female: An interesting case report

Headache is one of the most common neurological symptom occurring worldwide. Here, we present a unique case of secondary headache in a young female which got reversed with appropriate treatment. A young female who presented with a severe subacute unilateral left-sided intractable headache with papilledema and obstructive hydrocephalus was found to have 4th ventricular neurocysticercosis causing obstruction of the foramen of Magendi and Luschka, relieved on timely surgical excision and with medical management. This case is reported to highlight the rare causes of secondary headache and various presentations of neurocysticercosis, in endemic areas like India as it causes neurological morbidity which can be alleviated on appropriate treatment, thereby preventing economic hardship and improving the quality of life

Elderly Patients With Squamous Cell Carcinoma of the Head and Neck and the Benefit of Multimodality Therapy

Limited data are available regarding outcomes in elderly head and neck cancer patients. This retrospective study was designed to characterize head and neck cancer in geriatric patients

Flavin as a photo-active acceptor for efficient energy and charge transfer in a model donor-acceptor system

A donor–acceptor dyad model system using a flavin moiety as a photo-active acceptor has been synthesized for an energy and photo-induced electron transfer study. The photophysical investigations of the dyad revealed a multi-path energy and electron transfer process with a very high transfer efficiency. The photo-activity of flavin was believed to play an important role in the process, implying the potential application of flavin as a novel acceptor molecule for photovoltaics