Epidemiology of intractable epilepsy in Al-Kharga district; new valley; [Egypt]

Drug-resistant epilepsy, despite the advancement in epilepsy treatment, continues to be a major clinical problem with devastating consequences. Identification of the prevalence of intractable epilepsy, as well as causes of intractability. Total population of 62,583 persons were screened through door to door survey, including every door. All suspected cases of epilepsy were subjected to complete history taking, meticulous examination, conventional EEG, and Stanford-Binnet intelligence scale. Monitoring of serum level of AEDs was done for those with possible intractable seizures to ensure adequate dose compliance. Patients have an average seizure frequency of one or more per month during the last 6 months despite optimal and suitable use of AED were considered truly intractable Ohtsuka et al [2001]. They were subjected to video monitoring EEG, and brain MRI. In this study, 437 epileptic patients were identified with a life time prevalence rate of epilepsy 6.98/1000, out of whom, 11.4% [n = 50/134] of patients were intractable with a prevalence rate 0.8/1000. Possible aetiology of intractable epilepsy was determined among 46% of cases [Remote symptomatic], while 58% of cases had unknown causes [idiopathic and cryptogenic]. Symptomatic and cryptogenic causes had signicantly lower IQ than idiopathic group Perinatal complications should be better avoided and/or managed to avoid a large sector of intractable epilepsy

Glycemic control effect on diabetic neuropathy and antioxidants in type 2 diabetes mellitus

To assess the relationship between glycemic control, the oxidative stress and antioxidant vitamin status and their influence on diabetic neuropathy. Thirty six type 2 diabetic patients with diabetic neuropathy were included in this study. They were classified into good and poor glycemic controlled groups [12 and 24 patients respectively]. All patients underwent multiple nerve conduction parameters including F wave latencies. Fasting serum glucose and glycosylated hemoglobin [HbAcl%], Lipogram, malondialdehyde [MDA], nitric oxide [NO] and antioxidants vitamin C and E plasma levels were determined. Poor glycemic controlled group recorded significant longer F wave latency of ulnar nerve, slower sensory conduction velocities of median nerve [P<0.05] and segmental motor conduction velocities of ulnar and median nerves [P <0.05; 0.01; 0.001], compared with that of good glycemic controlled group. Poor glycemic controlled group had significant rising oxidative stress markers [MDA] and reducing NO and vitamins [E and C] plasma level compared to that of good glycemic controlled group [P<0.001]. HbAlc% is significantly correlated with plasma MDA, vitamin C and E levels and segmental conduction velocities [P<0.001; 0.05]. Poor glycemic control is associated with high oxidative stress, lipid peroxidation and depletion of vitamins C and E plasma levels, that may be contributing to diabetic neuropathy progress

Short term effect of glycemic and dyslipidemia control on nerve conduction study and antioxidants status in type 2 DM

The importance of glycemic control in patients with diabetes is well known, but neurological studies suggest that dyslipidemia is actually a more significant contributor to diabetic neuropathy. Is to study the relationship between the degree of hyper glycemic and hyperlipidemic control on one hand and the degree of improvement in clinical, neurophysiological parameters, and level of oxidative stress markers and antioxidants in type 2 DM. Twenty four type 2 diabetics with hyperglycemia, dyslipidemia and diabetic neuropathy were included in this study. They received treatment for control of hyperglycemia and dyslipidemia for 3 months. Clinical assessment, nerve conduction, F-wave studies, lipid profile, oxidative stress markers as Plasma malondialdehyde [MDA] and antioxidant status [Nitric Oxide and vitamin C and E] were measured for each patient before, one and 3 months after beginning of treatment. They were classified according to percentage changes [PC] of glucosylated heamoglobin level [HbAlc%] into 2 groups. The first group had low PC of HbAlc% [< 25%] and the second group had high PC of HbAlc%[> 25%][n=11 and 13 respectively]. There were no significant differences in demographic and clinical data between both groups. Higher PC group had significant greater improvement compared to lower PC group in motor conduction velocity of median nerve [p = 0.017], serum triglyceride [p= 0.005], lipidperoxidation [MDA] and antioxidants levels [p= 0.0001 for each]. Efficient glycemic and dyslipidemia control significantly improved peripheral nerves function and antioxidant status