How Much is SUDEP Known by Patients by Epilepsy?

Objective:Sudden unexpected death in epilepsy (SUDEP) is the most common cause of death in patients with epilepsy. The issue of informing every epilepsy patient and/or their relatives about SUDEP remains controversial. We evaluated the level of knowledge about SUDEP in patients with epilepsy.Methods:Patients were asked whether they knew about seizure risks and wanted to be informed about seizure risks, whether they had heard of SUDEP before and if they did, from whom or where they had heard about it, and seizure triggers. In addition, the patient’s relatives were asked about what to do or not to do during the seizure.Results:We included 80 patients with epilepsy in the study, of which 45 were female (56.2%) and 35 were male (44.8%). Twenty-five (31.2%) patients stated that they had not received any information about epilepsy. Only nine (11.2%) patients stated that they heard about SUDEP, six of them learned from the internet, three from a doctor, two of them said it happened to their relatives, and 69 (86.2%) patients thought that epilepsy patients should definitely be informed about this issue.Conclusion:Our findings indicate that the level of knowledge about SUDEP among epilepsy patients is quite low. Even though learning SUDEP caused uneasiness in patients, it was observed that patients wanted to learn this information. More efforts should be made to inform patients with epilepsy about epilepsy and its risks and SUDEP

Restless Legs Syndrome in Patients with Epilepsy Under Levetiracetam Monotherapy

Objective: Restless Legs syndrome (RLS) is a frequent neurological disease. Levetiracetam (LEV) is an effective and broad-spectrum anticonvulsant drug. The aim of this study is to investigate the frequency of RLS in patients diagnosed with epilepsy who took LEV monotherapy. Materials and Methods: Two neurologists were reviewed the files of 1680 patients, who were followed in epilepsy outpatient clinic. One hundred seven patients under LEV monotherapy for at least six months and 120 healthy controls were included in the study. The criteria for the International Restless Legs Syndrome Study Group were taken into consideration for the assessment of RLS. Results: The mean age of patient group was 38.26±17.39 years, while the mean age of healthy controls was 39.17±16.12 years. There were no statistically significant differences in terms of age and sex between each two groups. The mean duration of LEV usage was 28.34 months. The LEV usage dose was between 500-3000 mg/day. RLS was seen in 7 (5.83%) healthy controls, whereas 4 patients (3.73%) had RLS in patient group before LEV treatment. The symptom of RLS in two patients disappeared after LEV treatment started and this rate decreased to 1.87%. The biochemical parameters were normal in all patient groups, after LEV treatment, peripheral neuropathy was detected in one patient whose symptoms were not relieved. Conclusion: LEV may have therapeutic effect on RLS. It may be preferred especially in comorbid situations where epilepsy and RLS are seen together. Longitudinal and prospective studies are needed to manifest better the therapeutic effects of LEV on RLS

COVID-19 Vaccine Take-up Rate, Safety and Tolerability in Patients with Epilepsy

Objective:Although vaccines are considered safe for most people, patients with some chronic diseases have been very hesitant to get vaccinated, especially at the initial stages of vaccination. We conducted a survey among patients with epilepsy (PWE) who are currently experiencing hesitations, aiming to investigate the vaccination rates against Coronavirus disease-2019 (COVID-19) and the side effects emerged in vaccinated patients.Methods:Two hundred nineteen PWE were questioned during a routine outpatient follow-up through previously prepared questionnaires that contained questions about patients’ demographic features, information about the vaccination status, and its adverse effects.Results:We included 219 PWE in the study of which 112 (51.1%) were female and 107 (48.8%) were male. One hundred eighty patients (82.1%) had been vaccinated at least once, 75% of the patients preferred two doses of BNT162b2 mRNA COVID-19 vaccine, 9.4% of the patients preferred two doses of Sinovac’s inactivated vaccine, 6.1% of the patients preferred three doses of Sinovac, and 9.4% of the patients preferred Sinovac and BNT162b2 vaccines. Seventy-seven (42.7%) patients reported that they experienced side effects after vaccination whereas ten patients (5.5%) reported worsening of their seizures after vaccination; one person stated that she/he was hospitalized in the intensive care unit due to status epilepticus.Conclusion:Generally, the tolerance of COVID-19 vaccines has progressed with mild side effects in most cases, which is consistent with previous studies in the general population, similarly no serious and previously unreported side effects were found in our study. Our study showed that COVID-19 vaccines are well-tolerated and safe for seizures in PWE

A retrospective analysis of restless legs syndrome in epileptic patients.

Aim: Restless legs syndrome is characterized by an abnormal sensation, a difficult-to-define type of dysesthesia in the extremities, especially in the legs. In our study, we aimed to determine the frequency of restless legs syndrome in patients with chronic epilepsy.Methods: A total of 86 epilepsy patients were included in the study. Epilepsy grading of the study patients was performed based on the International League Against Epilepsy 1981 classification. Demographic data of the patients were collected and Turkish version of the questionnaire consisting of 4 questions of diagnostic criteria issued in 2014 by International Restless Legs Syndrome Study Group (IRLSSG), in addition to the other forms, were completed through face-to-face interviews.Results: Restless leg syndrome prevalence among the patients included in the study was found to be 5.81% (5 patients out of 86). Mean score of IRLSSG evaluation scale was 17±6.5.Conclusion: The results of our study showed that the prevalence of restless legs syndrome is lower in patients with epilepsy, a common neurologic disorder, compared to the general population

Two Siblings Diagnosed as Lafora Disease

Lafora disease is a typical progressive myoclonic epilepsy that is characterized by autosomal recessive inheritance, myoclonic and occipital seizures, progressive dementia, ataxia, and dysarthria. Two siblings with myoclonic and generalized tonic clonic seizures, progressive dementia, ataxia and dysarthria, who were diagnosed as Lafora disease by sweat gland biopsy, are discusse

Two Siblings Diagnosed as Lafora Disease

Lafora disease is a typical progressive myoclonic epilepsy that is characterized by autosomal recessive inheritance, myoclonic and occipital seizures, progressive dementia, ataxia, and dysarthria. Two siblings with myoclonic and generalized tonic clonic seizures, progressive dementia, ataxia and dysarthria, who were diagnosed as Lafora disease by sweat gland biopsy, are discussed

Efficacy of Vagal Nerve Stimulation in Adult Patients: Experience of a Young Epilepsy Outpatient Clinic

Objectives:Antiepileptic drugs are the most commonly used treatments in epilepsy. However, in a group of about one-third of all epilepsy patients who have not been able to control seizures with antiepileptic drugs called drug-resistant epilepsy, epilepsy surgery, VNS (vagal nerve stimulation), neurostimulation, and the ketogenic diet are important treatment modalities. In this study, the patients who had refractory epilepsy and had VNS were reviewed retrospectively, and the results were evaluated.Methods:Patients who were followed-up with VNS in our clinic between July 2014 and January 2019 were evaluated in this study. Demographic and clinical features of the patients and seizure outcome after VNS were reviewed.Results:Seventeen patients who underwent vagal nerve stimulation were enrolled in this study. Three of these patients were VNS in the external centers and the patients we followed in our clinic. Eight (47.1%) of the patients were male, and nine (52.9%) were female; average age 32±8.40 years; (minimum 19 years, maximum 52 years). The mean age of VNS was 28.06±8.37 years, and the mean follow-up period after VNS was 38.82±14.67 months. The seizure of 52.9% of the patients degreased by more than 50%, 11.8% had no change in seizure frequency, 35.3% less than 50% improved. Cognitive improvement was observed in 47.1% of the patients.Conclusion:VNS is an important treatment modality in this group of patients to alleviate the frequency and the severity of the seizures, and to provide cognitive and behavioral improvement in drug-resistant epilepsy patients

Diagnostic Challenges of Psychogenic Nonepileptic Seizures

Objectives:Psychogenic nonepileptic seizures (PNES) resemble epileptic seizures. Accurate diagnosis of PNES can be challenging, and misdiagnosis and treatment confusion is common. This article is a review of patients with PNES who were initially diagnosed with epilepsy.Methods:Records of 1140 patients referred to the epilepsy center at Antalya Education and Research Hospital with diagnosis of epilepsy were retrospectively reviewed. Demographic characteristics, risk factors, and diagnostic methods were analyzed.Results:A total of 70 patients, 54 (77.1%) female and 16 (22.9%) male patients, were diagnosed with PNES. In 24 patients (34.3%), PNES alone was diagnosed, 46 patients (65.7%) had epilepsy and PNES. In the strictly PNES patients, there were abnormal electroencephalogram (EEG) findings in 10 (41.6%) patients, nonspecific changes in cranial magnetic resonance imaging (MRI) of 5 (20.8%), risk factors were found in 6 (25%), and 7 (29.2%) patients had family history of seizures.Conclusion:It is important to keep PNES in mind if epilepsy is suspected when evaluating patients with risk factors or EEG or MRI abnormalities in order to avoid misdiagnosis. History of seizures, semiological features and objective data should all be carefully evaluated to determine appropriate treatment plan

Rufinamide Use in Refractory Epilepsies

The drug rufinamide was approved in November 2008 by the US Food and Drug Administration for use in the adjunctive treatment of seizures associated with Lennox-Gastaut syndrome in patients older than 4 years. Lennox-Gastaut Syndrome is one of the most treatment-resistant epilepsies, and seizures require a diversity of polytherapy. In recent years, a remarkable number of reports have been published on the effectiveness of rufinamide in childhood epileptic encephalopathy and epileptic spasms, tonic seizures, myoclonic-astatic epilepsy, Dravet syndrome, and refractory partial seizures dependent on migration abnormalities. This article discusses the efficiency of rufinamide as used in the treatment of five refractor epileptic cases at the Epilepsy Clinic established in Antalya Education and Research Hospital in August 2011