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THE RELATIONSHIP OF INTERICTAL EPILEPTIC DISCHARGES WITH DURATION OF ILLNESS IN EPILEPTIC PATIENTS

Author: Shaymaa J. Mohammed شيماء جاسم محمد
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2014 Volume: 12 Issue: 1 Pages: 4-8
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Epileptic discharges generally initiated at specific locations and spread after time in preferred directions along specific pathways, this spread will simultaneously change the dynamics of system in which it spread and cause epileptic destabilization of neuronal circuits.Objectives:To study the relationship between single focal epileptic discharge or multiple focal epileptic discharges and the duration of their disease.Methods:Ninety six epileptic patients with partial epilepsy and mean age of 12.5±7.5 years were studied, no one of patients receive antiepileptic drugs or were on irregular treatment. They had been divided according to duration of illness into two groups; those with more than one year illness and those with less than one year illness. Electroencephalography recording were obtained via 10-20 system using bipolar and referential montage with a thirty minutes record for each patient, accordingly. Patients were divided into those with single focal epileptic discharge (unifocal) & those with multifocal (multiple focal) epileptic discharge.Results:A significant difference in mean duration of illness between patients with unifocal and multifocal epileptic discharge were found. Those with multifocal epileptic discharge show higher mean duration of illness (17.8±9.05) months as compared to those with unifocal epileptic discharge (9.1±6) months. Significant positive linear correlation was found (P = 0.01), and the duration of illness increased more in patients with multifocal epileptic discharge.Conclusion:We found that longer duration of exposure to epileptic discharge could lead to generation of new foci not exist previously and that may possibly be due to kindling phenomena and triggering more spread of epileptic discharge.Key words:Epileptic discharge, Kindling phenomena, electroencephalography.


Article
Treatment Of Subclinical Epileptic Discharges Affects Cognitive Functions In Epileptic Patients
تاثير معالجة افرازات الدماغ الصرعية اللاسريرية على مستوى ذهنية المرضى المصابين بالصرع

Author: zaid al madfaay زيد المدفعي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2012 Volume: 54 Issue: 1 Pages: 42-46
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: EEG recording showed a definite relationship between epileptiform EEG discharges and cognitive impairments (transient cognitive impairment “TCI”), since interictal spikes, which correspond to a large intracellular depolarization with evoked action potentials, in many ways mimic a “miniseizure.” Interictal spikes can result in transitory cognitive impairment with the type of deficit dependent on where in the cortex the spike arises. The interictal spikes, particularly if frequent and widespread, can impair cognitive abilities, through interference with waking learning and memory, and memory consolidation during sleep. Objectives: the aim of this study is to evaluate the effect of subclinical epileptic discharges on cognitive function in patients with epilepsy. Patients & Methods: This is a prospective study conducted in Basra teaching hospital in the period from December 2009 to February 2011 in order to evaluate the effect of epileptic discharge on cognitive function. EEG exam and cognitive function test (P300) was done for each patient four times at three months interval period, and one time for control group. Two hundred twenty four (224) patients included in this study with age range from (12-40) years. the EEG obtained after 30 mints of recording was categorized in to three groups frequent, infrequent and normal EEG record. Results: we found that patients with frequent IEDs have high mean P300 latency when compared to patients with infrequent and normal EEG exam, also the mean p300 latency significantly reduced (more improvement in cognitive function) after treatment with AEDs. Conclusion: Treatment of patients with frequent epileptic discharge improve cognitive function in patients with epilepsy, and reduction of IEDs greatly improve cognitive abilities in epileptics.

المقدمة : بين فحص تخطيط الدماغ أن هنالك علاقة مؤكدة بين إفرازات الدماغ الصرعية اللاسريرية ومستوى ذهنية المرضى المصابين بالصرع حيث أن هذه الإفرازات الصرعية تؤدي الى ما يسمى بحالة الشرود الذهني المؤقت والذي يشبه الى حد كبير نوبة صرعية مصغرة وهذه الإفرازات لاسيما اذا كانت متكررة ومنتشرة في عدة مناطق من الدماغ تؤثر وبشكل كبير على مستوى الذاكرة ,التعلم وذهنية وتركيز المرضى المصابين بالصرع.الهدف من الدراسة: لدراسة تاثير الافرازات الصرعية اللاسريرية على المستوى الذهني لمرضى الصرع واذا كان العلاج يحسن من مستوى ذهنية وتركيز هؤلاء المرضى. طريقة اجراء البحث: أجريت الدراسة في مستشفى الصدر التعليمي في البصرة للفترة من كانون الثاني 2009 ولغاية شباط 2011 وشملت (224) مريضا بالصرع تم فحصهم بجهاز تخطيط الدماغ وبقياس كمون الموجة(p300) والذي يقيم مستوى ذهنية المرضى.تمت إعادة هذه الفحوصات لكلك مريض اربع مرات خلال فترة الدراسة التي استمرت سنة كاملة. كما تم اختيار 91 شخصا من الأصحاء كمجموعة قياس وتم فحصهم بجهاز تخطيط الدماغ وجهاز قياس كمون الموجة (p300) لمرة واحدة . النتائج: لقد وجدنا ان المرضى اللذين لديهم إفرازات صرعية متكررة كان معدل قياس كمون الموجة(p300) عندهم اطول من المرضى الذين لديهم هذه الإفرازات قليلة وغير متكررة في تخطيط الدماغ او المرضى الذين كان تخطيط الدماغ عندهم طبيعيا . كما ان معدل كمون الموجة (p300) بدء يتحسن بعد فترة العلاج. الاستنتاج: معالجة المرضى الذين لديهم إفرازات دماغية صرعية متكررة يؤدي إلى تحسن مستوى ذهنية وتركيز هؤلاء المرضى ويطور قابليتهم الفكرية والذهنية.

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