ABSTRACT
About one third of partial seizures are refractory to treatment. Several anticonvulsant drugs have entered the market in recent decades but concerns about intolerance, drug interactions, and the safety of the drug are notable. One of these new anticonvulsants is pregabalin, a safe drug with almost no interaction with other antiepileptic drugs. In this open label clinical trial study, pregabalin was used for evaluation of its efficacy on reducing seizure frequency in 29 children suffering from refractory partial seizures. Average daily and weekly seizure frequency of the patients was recorded during a 6-week period [baseline period]. Then, during a period of 2 weeks [titration period], pregabalin was started with a dose of 25-75 mg/d, using method of flexible dose, and was brought to maximum dose of drug that was intended in this study [450 mg/d] based on clinical response of the patients and seizure frequency. Then the patients were given the drug for 12 weeks and the average frequency of daily and weekly seizures were recorded again [treatment period]. Reduction in seizure frequency in this study was 36% and the responder rate or number of patients who gained more than 50% reduction in seizure frequency was 51.7%. This study showed that pregabalin can be used with safety and an acceptable efficacy in treatment of childhood refractory partial seizures
ABSTRACT
The suicidal rate among epileptic patients is up to 5 times more than general population and depression is the most common mood disturbance among them while usually under noticed. This study was performed to determine possible symptoms of psychiatric disorders for suicidal behavior in pediatric patients with epilepsy that had attempted suicide. Among medical records of 1169 patients under 17 years of age being admitted to the exclusive university hospital for poisoning in Tehran since April 2006 to Feb 2008 due to attempt to suicide, 31 cases [13 male and 18 female] with mean age 15.8 +/- 1.3 years had concomitant epilepsy. Mental status and epilepsy data sheet of these patients were analyzed. The psychological evaluation of these 31 cases revealed long lasting symptoms of psychological disorder in 21 [91.4%] cases before their attempt to suicide while only 5[16%] cases had been noticed for psychiatric care and merely 3 of them had been under treatment. Despite strong correlation between affective disorders and epilepsy it is unfortunately under-diagnosed or undertreated. Since overdose of antiepileptic drugs used for treatment of epilepsy may be lethal, dismissing suicidal behavior can be life threatening
ABSTRACT
Spastic cerebral palsy [CP] is one of the most difficult and disabling conditions that requires medical attention and treatment. The aim of this study was to assess the efficacy and safety of oral tizanidine in treating spasticity in children with spastic CP. Sixty children with spastic cerebral palsy were enrolled in a double-blind, placebo-controlled, randomized clinical trial. These patients were randomly assigned to receive tizanidine or a matching placebo. Sample normalization was not performed either before or after the study in these two separate groups. Nevertheless, no significant statistical difference was found between the two concerned groups in terms of age, sex, or type of spasticity. Each patient received the treatment for 2 weeks between May 2010 and February 2011. Thirty-one boys and 29 girls with a mean age of 7.3 +/- 3.4 years were evaluated. Our study revealed that spasticity was reduced in 50% of the patients receiving the drug tizanidine compared to only 6.7% of the patients receiving the placebo. Additionally, 66.7% of patients reported less pain on the affected side receiving tizanidine [group A] compared to 13.3% of patients receiving the placebo [group B]. No serious side effects were reported in this study. Tizanidine is effective and safe in decreasing the spastic hypertonia associated with cerebral palsy in children
ABSTRACT
There are few reports about congenital indifference to pain or Hereditary and Sensory Autonomic Neuropathy [HSAN]. Several investigations for pathophysiology of this syndrome have been performed and different classifications about it. In this report we present a case of HSAN type II with general absence of pain and self amputations and leprosy-like damage of extremities which was suspected to be phagocytic immunodeficiency due to past history of repeated ulcer and abscess formation