Farah Ashrafzadeh; Hadi Tohidi; Elnaz Faraji; Alireza Ataei Nakhaei
Abstract
Epilepsy is a major neurological disorder, which may occur in all age groups, including children. Approximately 20% of epileptic children are drug-resistant. Uncontrolled seizures pose variable risks to patients, such as increased mortality rate, trauma, and cognitive and psychiatric disorders. Therefore, ...
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Epilepsy is a major neurological disorder, which may occur in all age groups, including children. Approximately 20% of epileptic children are drug-resistant. Uncontrolled seizures pose variable risks to patients, such as increased mortality rate, trauma, and cognitive and psychiatric disorders. Therefore, effective treatment is essential to controlling seizure attacks. Although many antiepileptic drugs are currently available for clinical treatments, clinicians are concerned with the discovery of safer drugs with enhanced antiepileptic effects and fewer side-effects. Traditional medicine provides strong grounds for modern medicine. Use of some medicinal plants has been shown to reduce or prevent the further progression of epileptic seizures. The present review aimed to discuss the effectiveness of some medicinal plants in the treatment of children with intractable epilepsy. An online literature review was conducted in databases such as IranMedex, Scopus, Medline, and Google Scholar to identify the studies investigating the use of medicinal plants in children with intractable epilepsy. In addition, the files of the authors were reviewed in the reference lists and bibliographies of the retrieved articles. According to the results, herbal therapies could potentially yield new treatment options for children with intractable epilepsy. Using medicinal herbs could be a cost-efficient treatment method in these patients as a culturally acceptable option to their families.
Ali Akbar Momen; Reza Azizi Malamiri
Abstract
Epilepsies and epileptic syndromes are among the most common chronic neurological disorders in neonates, infants, and children. Remission occurs in 70% of epileptic children, while other cases experience frequent seizures and become refractory to various treatment modalities. Refractory seizures have ...
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Epilepsies and epileptic syndromes are among the most common chronic neurological disorders in neonates, infants, and children. Remission occurs in 70% of epileptic children, while other cases experience frequent seizures and become refractory to various treatment modalities. Refractory seizures have a significant adverse impact on the quality of life of epileptic children and their families. Prognosis of epilepsies is determined based on the risk of seizure or convulsion recurrence. Some of the most important risk factors for recurrence are the age at seizure presentation, neurodevelopment of the child, etiology of seizures, seizure frequency before anticonvulsant withdrawal, response to antiepileptic medications, type of epileptic syndromes, and electroencephalography of the patient. Recognition of the risk factors for seizure recurrence results in the optimal management of the treatment protocols, thereby reducing the adverse effects of epileptic seizures on patients and their families. The present study aimed to provide a narrative review of the most important risk factors for the recurrence of epilepsies in children by two child neurologists.
Mahmoud Reza Ashrafi; Morteza Heidari
Abstract
The primary aim of epilepsy treatment is seizure control, and the treatment is principally prophylactic. Although complete seizure control is the most important predictor of improved quality of life, antiepileptic drugs (AEDs) could cause severe side effects in the patients. Therefore, the risk-benefit ...
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The primary aim of epilepsy treatment is seizure control, and the treatment is principally prophylactic. Although complete seizure control is the most important predictor of improved quality of life, antiepileptic drugs (AEDs) could cause severe side effects in the patients. Therefore, the risk-benefit ratio must be considered before the initiation of AED treatment. Accurate recognition and differentiation of epileptic and non-epileptic paroxysmal events and the diagnosis of the seizure type and epilepsy syndrome are essential procedures before AED treatment. It is often recommended that AED treatment start after two seizures, and being seizure-free for a minimum of two years is a prerequisite for treatment withdrawal. The AED treatment process must be initiated with a single drug at a low maintenance dose, along with further upward titration. Overall, the first attempt in AED treatment has been reported to effectively control seizures in 50-70% of the cases. Moreover, there is a consensus that being seizure-free for two years is the most valid approach to discontinue AED treatment. Approximately 50% of the children with epilepsy outgrow their disease. The present study aimed to provide a systematic method for the treatment and management of epilepsy in children.
Parvaneh Karimzadeh; Sasan Saket
Abstract
Epilepsy is a common neurological disorder in childhood with prominent neurological manifestations, signs, and symptoms in inherited neurometabolic disorders. Accurate diagnosis of neurometabolic disorders in epileptic patients increases the possibility of a specific treatment to improve epilepsy. Therefore, ...
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Epilepsy is a common neurological disorder in childhood with prominent neurological manifestations, signs, and symptoms in inherited neurometabolic disorders. Accurate diagnosis of neurometabolic disorders in epileptic patients increases the possibility of a specific treatment to improve epilepsy. Therefore, early diagnosis is essential in potentially treatable epileptic disorders. Various seizure types occur in neurometabolic disorders, which are often refractory to antiepileptic drugs (without the treatment of the underlying neurometabolic disorders). Patients with underlying disorders have severe clinical presentations, such as refractory seizures. In addition, they do not respond to antiepileptic drugs in many cases. In the epileptic patients with developmental delay and/or regression, neurometabolic disorders should be considered in the presence of abnormal neurological examination and brain imaging with specific patterns. Some of these disorders are potentially treatable. Therefore, neurologists should determine the etiology of epilepsy, especially in pediatric patients, and the treatment should not be restricted to symptomatic therapy. The present study aimed to introduce some of the treatable causes of epilepsy in pediatric patients.
Mina Erfani; Farah Ashrafzadeh; javad Akhondian; Hamid Reza Rahimi; Mehran Beiraghi-Toosi; Hashem Lashgari-Kalat; Ehsan Alaei; Monica Zeynalzadeh
Abstract
Nearly 70 million people worldwide suffer from epilepsy. Despite administration of routine antiepileptic drugs (AEDs), nearly 30% of seizures are resistant to treatment called drug resistant epilepsy (DRE). Since the epilepsy treatment may result in consequences of multi-drugs administration or sometimes ...
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Nearly 70 million people worldwide suffer from epilepsy. Despite administration of routine antiepileptic drugs (AEDs), nearly 30% of seizures are resistant to treatment called drug resistant epilepsy (DRE). Since the epilepsy treatment may result in consequences of multi-drugs administration or sometimes invasive surgical methods in DRE, herbal treatment can be a good alternative choice due to its easy accessibility, lower cost and fewer side effects. Although turmeric has been one of a very commonly used dietary spices and traditional herbal remedies, its derivation as a newly introduced medicine-curcumin has not been used to a large extent. In this literature, we have reviewed the available trial researches, which studied specifically antiepileptic effect of curcumin. We searched databases of Science direct, PubMed and Google Scholar (2008 to 2016) with key words of turmeric, curcumin, Diferuloylmethane, Epilepsy, and Seizure to find the related references. The major extract of turmeric curcumin has found to have antiepileptic effect according to recent surveys. It not only has no critical adverse effect, but also can protect patients from other AEDs severe side effects. It also makes it possible to gradually decrease the dose of AEDs in long-term combination therapy.
Sona Sepahi; Bamdad Riahi-Zanjani; Adel Ghorani-Azam
Abstract
Introduction: Valproic acid (VPA) is an acidic compound that is commonly used as an anticonvulsant and mood-stabilizing agent in the treatment of epilepsy, mania and bipolar disorders as well as the prevention of migraine headaches. But, it can affect metabolic and endocrine system resulting in hormonal ...
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Introduction: Valproic acid (VPA) is an acidic compound that is commonly used as an anticonvulsant and mood-stabilizing agent in the treatment of epilepsy, mania and bipolar disorders as well as the prevention of migraine headaches. But, it can affect metabolic and endocrine system resulting in hormonal disturbances and incidence of some metabolic disease, especially in pediatric patients. In this study, we aimed to systematically review the literature wherein metabolic and endocrine effect of valproic acid has been studied in pediatric patients with epilepsy.Methods: To evaluate the relationship between VPA consumption and metabolic diseases, a systematic literature search was performed through searching for related documents in the PubMed and Scopus as two known databases using the following key terms “valproic acid”, “metabolic disease” and “pediatrics” in the title, keywords, and abstract of literatures. Data were then extracted and described.Result: Nearly 934 documents were collected and reviewed based on the main purpose of this study. Of the collected articles, 918 documents were excluded in several step by step processes of article selection, and only 16 relevant documents were included for further data assessment. The results showed that VPA can cause significant increase in plasma concentration of thyroid hormones and therefore increase the risk of metabolic disease in patients with epilepsy.Conclusion:The results of included documents in this review showed that VPA may induce metabolic and hormonal disturbances in pediatric patients, who were on treatment with VPA.
Masoud Pezeshki Rad; Mina Taghavi; Jahanbakhsh Hashemi; Farzaneh Sharifipour; Abbasali Zeraati
Abstract
Glomerulonephritis (GN) is responsible for 25-30% of end-stage renal disease (ESRD) among all causes. Renal biopsy is important to determine the GN treatment method and its prognosis. In some cases, renal biopsy is required for definitive diagnosis. Biopsies were used as a diagnostic method in different ...
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Glomerulonephritis (GN) is responsible for 25-30% of end-stage renal disease (ESRD) among all causes. Renal biopsy is important to determine the GN treatment method and its prognosis. In some cases, renal biopsy is required for definitive diagnosis. Biopsies were used as a diagnostic method in different disease from 1930. They were performed blindly and at bedside. Complication rate varies from 2 to 20% in different reports. Percutaneous renal biopsy is a routine diagnostic procedure in nephrology nowadays, and it should be individualized for each patient depending on their age, BMI, coagulation status and the availability of skilled radiologist. In this paper, we review image-guided renal biopsy in glomerulonephritis.
Abolfazl Mahmoudzadeh; Yasamin Davoudi; Hossein Haghir; Maryam Salehi; Farah Ashrafzadeh; Behzad Aminzadeh; Sara Mehrnoosh; Mohammadreza Mehrnoosh
Abstract
Many children with hippocampal sclerosis underwent surgery for treatment. Early childhood convulsion occurs in 2 to 4% of population and its prognosis is good in majority of cases. It seems that hippocampal anomalies are common in patients with neocortical epilepsies. The theory of hippocampal sclerosis ...
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Many children with hippocampal sclerosis underwent surgery for treatment. Early childhood convulsion occurs in 2 to 4% of population and its prognosis is good in majority of cases. It seems that hippocampal anomalies are common in patients with neocortical epilepsies. The theory of hippocampal sclerosis association with temporal lobe epilepsy has been proposed 100 years ago. Recent studies demonstrated that there was a correlation between memory impairments and prolonged febrile convulsion (PFC), which might be a result of hippocampal injury. Transient hippocampus swelling might happen in complicated early childhood epilepsy or status epilepticus and result in hippocampal sclerosis.
Seyed Ebrahim Mansoorinejad; Farah Ashrafzadeh; Javad Akhondian; Mehran Beiraghi Toosi
Abstract
Epilepsy is described as a heterogeneous clinical syndrome results from various cerebral destructions. It is categorized to partial and generalized forms. Degree of neural system impairment and affected area determine the severity and pattern of symptoms. Patients might experience sensory, motor, or ...
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Epilepsy is described as a heterogeneous clinical syndrome results from various cerebral destructions. It is categorized to partial and generalized forms. Degree of neural system impairment and affected area determine the severity and pattern of symptoms. Patients might experience sensory, motor, or both signs and symptoms. About 60% of epileptic patients suffer from partial type. It is estimated that up to 30% of epilepsy cases would not be controlled adequately despite sufficient and proper management. Anacyclus pyrethrum, Citrus aurantium var. amara, Paeonia officinalis, Rosa Damascena and Nigella Sativa are some of herbal drugs which have antiepileptic effect. Natural agents are valuable sources to treat chronic diseases and a huge number of world`s population believe herbs are effective and safe for daily primary health care needs. There is not enough evidence about their efficacy and safety obtained from randomized control trials.