Chronotype and sleep disorders in children with epilepsy.

OBJECTIVE: The circadian rhythm can affect the frequency and resistance of epileptic seizures. In this cross-sectional study, we examined the impact of chronobiology and sleep disturbances on children with epilepsy. METHODS: One hundred and twenty-five children and adolescents (55 patients and 70 controls) were included in the study. All participants were asked to complete the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV), Sleep Disturbances Scale for Children (SDSC), Childhood Chronotype Questionnaire (CCQ). RESULTS: According to the CCQ results, controls had longer sleep duration (median 595 vs. 570), lower morningness-eveningness scores (median: 28 vs. 30), and higher rates of the morningness (12.9% vs. 1.8%) and intermediate (74.3% vs. 60%) chronotypes. The children and adolescents with epilepsy scored significantly higher in the Sleep breathing disorders (p = .001), Disorders of arousal nightmares (p = .044), Sleep-wake transition disorders (p = .037), Disorders of excessive somnolence (p = .001), and total SDCS (p = .046) scores. According to the RCADS-CV results, the children with epilepsy scored significantly higher in all subscales in comparison to controls (p < .05). SIGNIFICANCE: Children and adolescents with epilepsy had shorter sleep duration were more likely to be evening-oriented and had more significant sleep disturbance symptoms compared to controls.

Assessment of oxidative/nitrosative stress and antioxidant capacity in children with epilepsy.

Background: The underlying pathophysiological mechanisms in epilepsy, one of the most common neurological diseases, are still unknown. Oxidative/nitrosative stress is considered a possible mechanism involved in epileptogenesis. The production of reactive oxygen species (ROS) and reactive nitrogen species (RNS) is involved in the pathogenesis of signal regulation, cellular damage and central nervous system conditions in living organisms. In this study, we aimed to compare peoxynitrite (ONOO-), a marker of nitrosative stress, total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI) and 8-hydroxy-2-deoxyguanosine (8-OHdG), DNA damage marker, levels in epileptic patients receiving monotherapy and polytherapy with the healthy control group.Methods: The study included 120 patients with diagnosis of epilepsy and 40 healthy volunteers as controls. The TOS, TAS, OSI, ONOO- and 8-OHdG were studied in all groups.Results: The study group included 30 girls (50%) and 30 boys (50%) receiving monotherapy and 31 girls (51.7%) and boys 49.3%) receiving polytherapy while control group included 19 girls (47.5%) and 21 boys (52.5%). The TOS and OSI values were found to be significantly higher in polytherapy group when compared to monotherapy and control groups). The ONOO- values were found to be significantly lower in polytherapy group when compared to monotherapy and control groups. In addition, ONOO- values were found to be higher in monotherapy group than controls. There was no significant difference in 8-OHdG values between the groups.Conclusions: Significant increases were observed in TOS and OSI parameters in polytherapy group when compared to monotherapy and control groups, suggesting that antiepileptic treatment enhances oxidative stress. Lack of significant difference in 8-OHdG suggested that the treatment is effective in patients and that no DNA damage occurred yet.

Kidney Disease Profile of Syrian Refugee Children.

INTRODUCTION: Although preventative nephrology is the effective management of childhood kidney diseases, it is hard to provide it in this undesirable conditions. In this study, we aimed to document the kidney disease profile of Syrian refugee children admitted to our hospital. MATERIALS AND METHODS: One hundred and thirty Syrian refugee children were admitted to the Pediatric Nephrology Department of the University of Gaziantep from September 2012 to January 2015. Demographic data, history, symptoms, physical examination findings, laboratory investigations, diagnosis, disease outcome, and therapeutic procedures such as peritoneal dialysis and hemodialysis were obtained from patient files. RESULTS: Of the 130 admitted children, 74 were girls (59.6%). The average age was 6.97 ± 4.2 years (range, 1 month to 17 years). Congenital abnormalities of the kidney and urinary tract were found in 34 children (26.2%). Other morbidities were chronic kidney disease in 30 (23.1%), nephrotic syndrome in 24 (18.5%), urolithiasis in 9 (6.9%), acute kidney injury in 4 (3.1%), glomerulonephritis in 5 (3.8%), enuresis in 12 (9.2%), and others in 12 (9.2%). CONCLUSIONS: Congenital abnormalities of the kidney and urinary tract and chronic kidney disease were highly prevalent in Syrian refugee children. Although free health care have been provided to all of these children, the continuation of political crisis and instability would increase the number of admissions and affect the quality of life of those children in a different environment from the home country.

The effect of topiramate on body weight and ghrelin, leptin, and neuropeptide-Y levels of prepubertal children with epilepsy.

BACKGROUND: Weight loss is one of the most frequent side effects of topiramate treatment. The aim of our study was to investigate the effect of topiramate on body mass index, serum glucose, insulin, cortisol, leptin, and neuropeptide-Y levels and the role of these variables on the pathogenesis of weight loss in prepubertal children with epilepsy. METHODS: Twenty prepubertal children with epilepsy who were treated with topiramate were enrolled in the study. Topiramate was used at a daily dose of 5 mg/kg. Body mass index and fasting insulin-to-glucose ratio were calculated. Serum glucose, insulin, leptin, neuropeptide-Y, ghrelin, and cortisol levels were measured for all patients before the treatment and at the third and sixth months of the treatment. RESULTS: There were significant decreases in mean body mass index, fasting insulin-to-glucose ratio, and serum cortisol and leptin levels at the third and sixth months of the treatment compared with pretreatment levels. No significant changes were observed in serum glucose, ghrelin, neuropeptide-Y, or insulin levels. CONCLUSIONS: The exact mechanism of topiramate on energy balance regulation is not clearly understood. Topiramate affects body mass index, fasting insulin-to-glucose ratio, and serum leptin and cortisol levels in prepubertal children. These changes may be key factors in weight loss due to topiramate.