Effect of interictal epileptiform EEG discharges on cognitive functions in epileptic children

Background: Epilepsy is a chronic disorder of the brain that affects people of all ages Neuropsychological impairment is an important comorbidity of chronic epilepsy in the majority of children with epilepsy. interictal epileptiform EEG discharges may present as a complicating factor in spite of being seizure free. In a group of children with interictal EEG discharges there is sudden and unexpected decline of school performance as the first symptom of epilepsy

Consequently, accumulating cognitive impairment, and even a decline in IQ scores, is reported in epileptic children with frequent episodes with epileptiform EEG discharges

Aim of the Work: To evaluate the possible relationship between interictal EEG discharge and cognitive function in a sample of Egyptian epileptic children

Patients and Methods: The ethical approval was obtained from the Hospital Ethical Research Committee. Each patient and/or parents entering the study signed an informed consent. This study was conducted on 140 children selected from Epilepsy Outpatient Clinic of Al-Azhar University Hospitals during a period of two years starting from June 2016 untill June 2018. A specialized pediatric neurology sheet was taken. EEG and cognitive assessment of epileptic patients with and without epileptiform EEG discharges using Stanford-Binet intelligence scale and P300 by ERP were performed to each patient two times 3 months in between

Results: we found that patients with frequent IEDs had high mean P300 latency and low IQ when compared to patients with infrequent and normal EEG examination. In addition, the mean p300 latency significantly reduced with rising in IQ [more improvement in cognitive function] after disappearance of IED in some patients

Conclusion: Interictal epileptiform EEG discharge had an additional effect on cognitive function especially if generalized and of high frequency. This effect might be often underestimated and might accumulate, and have a severe cognitive impact. So, treatment of epileptic patients should put in concern reduction or even treatment of IEDs as controlling of these IED lead to improvement of cognition

Neurophysiological assessment of peripheral nerve functions in a sample of egyptian patients with liver cirrhosis

Background: peripheral neuropathy is damage to or disease affecting nerves which may impair sensation, movement, gland or organs function or other aspects of health depending on the type of nerve affected. Peripheral neuropathy is a common complication of liver cirrhosis either due to viral [mostly HCV], NASH, Alcoholic or mixed

Objectives: the aim of this study was to define the prevalence of peripheral neuropathy in a sample of Egyptian patients with liver cirrhosis and to determine any etiologic correlation

Patients and Methods: this descriptive study was conducted on 47 Egyptian liver cirrhotic patients. Patients were subjected to history taking, detailed neurological examination and clinical and neurophysiological assessment

Results: viral hepatitis was the commonest cause of liver cirrhosis 59.6% while non viral causes 25.5% e.g. NASH, the main duration of liver cirrhosis was 10 +/+ 3.98 yrs ranging from 3-23 yrs. The majority of patients were asymptomatic, 48.9%, while the most presenting symptoms were sensory symptoms 25.5%, the prevalence of PN among a sample of Egyptian patients with liver cirrhosis according to neurophysiological assessment was 72.3% mostly of mixed sensory and motor polyneuropathic pattern, not related to the cause of liver cirrhosis but affected by the duration and severity of liver cirrhosis determined by Child Pugh classification

Conclusion: peripheral neuropathy is a common complication of liver cirrhosis related mainly to the duration and severity of liver cirrhosis, but not affected by the causes of liver cirrhosis

Early CT diagnosis of brain infarction in normotensive patients

The aim of this work was to evaluate the role of spiral CT in the early diagnosis of brain infarction in normotensive patients. The study included 20 patients clinically suspected to have acute focal central neurological deficit. They were subjected to full clinical examination and non contrast enhanced spiral CT. Initial CT scan was performed within few hours [3: 6] after the onset of the symptoms, followed by second CT scan [24: 30 hours] after the onset of the symptoms. Positive initial CT findings were noted in 18 cases. Spiral CT has proved to have good potential in the early diagnosis of brain infarction