Knowledge and attitude towards epilepsy among biology teachers in fars province, Iran

This study investigates the awareness and perception on "epilepsy" amongst biology teachers in Fars province, Iran. A sample of high school biology teachers in Fars province, Iran, filled out an investigator designed questionnaire including questions about their knowledge and attitude concerning "epilepsy". There were 17 questions in the questionnaire. Nine questions addressed the knowledge and the rest were about attitude and perception. Forty two teachers completed the questionnaires. More than two-thirds of the participants had a fairly desirable awareness about the definition; whereas, only approximately 40% knew something about the etiology and treatment of epilepsy. More than two-thirds of the participants had a positive attitude towards epilepsy; however, misconceptions and negative attitudes were observed. Educational programs for biology teachers and also other teachers are necessary to improve their knowledge, attitude and perception about epilepsy

Effects of antiepileptic drugs on electroencephalographic findings in patients with idiopathic generalized epilepsy

Several antiepileptic drugs [AEDs] such as henobarbital [Pb], carbamazepine [CBZ], and valproate [VPA] may suppress interictal epileptiform activity. We investigated the effects of AEDs on electroencephalography [EEG] data from patients with idiopathic generalized epilepsy [IGE]. In this cross-sectional study, all patients electroclinically diagnosed with IGE were recruited in the outpatient epilepsy clinic at Shiraz University of Medical Sciences from September 2008 through August 2010. A routine EEG was requested at the time of referral for all patients. Statistical analyses were performed using Chi square and Fisher's exact test. This study comprised of 336 patients. For about 20.8% [70 patients] of them, the initial EEG appeared normal. The first EEG was normal in 14.2% of the patients who had newly diagnosed IGE [19 patients]. Normal EEG was also detected for 27.6% of the patients who received VPA monotherapy [16 patients], 31% of the patients who received CBZ monotherapy [9 patients], 29.4% of the patients who received Pb monotherapy [5 patients], and 11.1% of the patients who received lamotrigine [LTG] [1 patient]. This study shows that compared to LTG, VPA suppresses generalized interictal epileptiform activity in patients with IGE more effectively. Theoretically, if a drug can frequently induce normalization of EEG, then it may be a better drug for treating IGEs

neurological manifestations of H1N1 influenza infection; diagnostic challenges and recommendations

World Health Organization declared pandemic phase of human infection with novel influenza A [H1N1] in April 2009. There are very few reports about the neurological complications of H1N1 virus infection in the literature. Occasionally, these complications are severe and even fatal in some individuals. The aims of this study were to report neurological complaints and/or complications associated with H1N1 virus infection. The medical files of all patients with H1N1 influenza infection admitted to a specified hospital in the city of Shiraz, Iran from October through November 2009 were reviewed. More information about the patients were obtained by phone calls to the patients or their care givers. All patients had confirmed H1N1 virus infection with real-time PCR assay. Fifty-five patients with H1N1 infection were studied. Twenty-three patients had neurological signs and/or symptoms. Mild neurological complaints may be reported in up to 42% of patients infected by H1N1 virus. Severe neurological complications occurred in 9% of the patients. The most common neurological manifestations were headache, numbness and paresthesia, drowsiness and coma. One patient had a Guillan-Barre syndrome-like illness, and died in a few days. Another patient had focal status epilepticus and encephalopathy. The H1N1 infection seems to have been quite mild with a self-limited course in much of the world, yet there appears to be a subset, which is severely affected. We recommend performing diagnostic tests for H1N1 influenza virus in all patients with respiratory illness and neurological signs/symptoms. We also recommend initiating treatment with appropriate antiviral drugs as soon as possible in those with any significant neurological presentation accompanied with respiratory illness and flu-like symptoms

Vasovagal syncope treated as epilepsy for 16 years

The differentiation of vasovagal syncope and epileptic seizure is sometimes problematic, since vasovagal syncope may mimic epileptic seizures in many ways. The present report describes a patient who had been diagnosed and treated as having epilepsy with medically-refractory seizures for 16 years. Often, unlike epileptic seizures, tonic-clonic convulsions and postical confusion are uncommon features of vasovagal syncope, but these may occur. Our patient was subjected to subcutaneous injection of one ml normal saline, which caused asystole leading to hypoxia and consequently a typical tonic-clonic convulsion. This patient was proved to have vasovagal syncope. The findings in the present case suggest that the possibility of vasovagal syncope should always be taken into consideration when evaluating patients with medically-refractory or unusual pattern of seizures. In such a circumstance, simultaneous video-electroencephalogram/electrocardiogram monitoring may help achieve the correct diagnosis