Attitudes toward epilepsy, a systematic review

Surveys about attitudes towards those with epilepsy have been performed since 1949, in order to understand the social stigma toward epilepsy. This review aims to demonstrate the variation in public attitudes towards epilepsy and its associated factors, with a critical review of the methodology used to examine attitudes towards epilepsy. There was marked variation of attitudes between Western and non-Western populations, and these attitudes were positively correlated with the standard of living. Besides the general public, studies were also performed within specifi c groups, particularly teachers and students. However absence of a standardized questionnaire makes direct comparison diffi cult. A few quantitative methods were developed but these were limited by cultural variations and thus lack of global acceptance. Short-term intervention studies demonstrate an improvement of attitude with knowledge. Nonetheless, the cultural and social reasons underlying the attitudes, and how this affects the life of people with epilepsy, are understudied. Therefore, surveys on attitudes should continue to be carried out, particularly in populations prone to have negative attitudes with emphasis on underlying reasons, and such progress should be monitored longitudinally. Attitudes of people such as parents, teachers, school counselors, health care professionals, and employers, which have a direct impact on people with epilepsy, should be more extensively studied.

Wide range of normality in deep tendon reflexes in the normal population

Background and objective: Deep tendon reflexes are important physical signs in neurological examination. Despite being an established technique clinically, there is lack of normality data in the healthy population, especially among the elderly. This study aims to determine the range of normality in deep tendon reflexes among the adults. Methods: The study subjects consisted of 176 healthy volunteers. They were examined by trained assessors using standardized protocol. Results: Among the commonly elicited deep tendon reflexes, isolated absent reflexes were found in up to 34.4% (supinator) in the older group, and 12.5% (triceps) in the young adults, significantly higher in the older group. Symmetrical absent reflexes was seen in up to 26.3% of supinator in the older group. Absent reflexes of the entire limbs both sides were however, much less common particularly among young adults, with 6.3% of the older group having absent reflexes in the entire lower limbs, and 2.5% in the entire upper limbs. Isolated asymmetry in reflex was present in up to 17.0% (triceps). However, only 6.3% had asymmetrical reflexes in the contiguous anatomical region. Conclusion: Isolated absent or asymmetry deep tendon reflexes were common particularly in the elderly.