Optimal management of seizures associated with tuberous sclerosis complex: current and emerging options.

Seizures are clinically significant manifestations associated with 79%-90% of patients with tuberous sclerosis complex. Often occurring within the first year of life in the form of infantile spasms, seizures interfere with neuropsychiatric, social, and cognitive development and carry significant individual and societal consequences. Prompt identification and treatment of seizures is an important focus in the overall management of tuberous sclerosis complex patients. Medical management, either after seizure onset or prophylactically in infants with electroencephalographic abnormalities, is considered first-line therapy. Vigabatrin and adrenocorticotropic hormone have emerged over the past few decades as mainstay pharmacologic modalities. Furthermore, emerging research on mammalian target of rapamycin inhibitors demonstrated promise for the management of seizures and subependymal giant cell astrocytoma. For appropriate surgical candidates with an epileptogenic zone associated with one or more glioneuronal hamartomas, ideally in noneloquent cortex, resective surgery can be considered, which provides a cure in 56% of patients. For medically refractory patients who do not meet criteria for curative surgery, palliative surgical approaches focused on reducing seizure burden, in the form of corpus callosotomy and vagus nerve stimulation, are alternative management options. Lastly, the ketogenic diet, a reemerging therapy based on the anticonvulsant effects of ketone bodies, can be utilized independently or in conjunction with other treatment modalities for the management of difficult-to-treat seizures

Seroprevalence of toxocariasis in children aged 1-9 years in western Islamic Republic of Iran, 2003

We determined the seroprevalence of Toxocara canis infection in 544 children under 10 years randomly selected from urban and rural areas of Hamadan, An enzyme-linked immunosorbent assay was used for detection of antibodies to T. canis excretion - secretion antigens. Using a questionnaire, epidemiological factors associated with infection were examined, including age, sex, residence. Antibodies to T. canis were detected in 29 children (5.3%) and 19 children (3.5%) were categorized as borderline positive; thus together this gave a prevalence of toxocariasis of 8.8%. No significant differences were found in terms of sex, age and residence