Progressive multifocal leukoencephalopathy with a benign prognosis in an immunocompetent patient : A case report

John Cunningham virus (JCV) is most com- monly acquired in childhood and is often asymptomatic throughout life. However, in the case of primary or secondary immuno- suppression, it is known to cause progres- sive multifocal leukoencephalopathy (PML) in the central nervous system. Hereby, we describe a rare case of PML in a patient with- out known factors of immunosuppression or use of immunomodulation. A 53-year-old female patient was presented with progres- sive left-side weakness and tremors in the left hand over a period of two months. The patient was diagnosed with PML based on history, examination, cerebrospinal fluid markers, histopathology, and brain magnetic resonance imaging at presentation. Despite detailed examination, nothing was found in the patient to cause an immunosuppressed state. Therapy was started with mirtazapine with significant neurological improvement.To our knowledge, PML in immunocompetent patient with bening prognosis is a very rare condition. There is also no effective treat- ment. Our case is a complicated example of this condition

The Impact of The Coronavirus Disease 2019 Outbreak on The Quality of Life of Patients with Epilepsy

Objectives:We aimed to investigate the effects of the coronavirus disease 2019 (COVID-19) outbreak on the quality of life (QOL) of patients with epilepsy.Methods:A total of 104 epilepsy patients admitted to our hospital during October and November of 2019 were evaluated for their QOL using the QOL in Epilepsy-31 questionnaire. These assessments were repeated in July 2020 and August 2020 to evaluate the impact of the epidemic on the QOL of epilepsy patients in the same group. The data of the patients were analyzed in SPSS.Results:During the pandemic period, overall score values decreased significantly compared to the pre-pandemic period (p=0.049). Although most of the subscores worsened with the pandemic, the most significant deterioration was observed in emotional well-being (p=0.021). There were six patients (5.8%) whose seizure frequency increased during the pandemic period. In the multivariate analysis, the only parameter that predicted an increase in seizure frequency during COVID-19 was the overall score. Overall score had a positive correlation with educational level. Disease duration, age, marital status, and number of drugs used were found to be negatively correlated with the overall score of the patients.Conclusion:The COVID-19 epidemic causes a significant deterioration in QOL in patients with epilepsy. During epidemics such as COVID-19, clinicians should consider psychosocial factors. In patients with epilepsy, measures should be taken not only to control seizures but also to prevent deterioration in mental health and QOL