Frequency of menstrual abnormalities and their associated neuroimaging findings in women with focal refractory epilepsy.

Patients with refractory epilepsy can suffer from psychological and physical problems. Epilepsy can also be associated with menstruation abnormalities in women. In this paper, we aim to survey women with focal refractory epilepsy who also suffer from menstrual abnormalities. This cross-sectional study was performed in 2018 in Tertiary Epilepsy Center in Kashani Hospital, Isfahan, Iran and Milad hospital, Isfahan, Iran. A total number of 381 patients diagnosed with refractory epilepsy joined the study based on an inclusion and exclusion criteria. Clinical characteristics of epilepsy, menstrual issues and brain MRI findings were assessed. Among 381 women with refractory epilepsy, 250 had refractory focal epilepsy (65.61%), and the others (34.39%) had generalized refractory epilepsy. 132 patients out of 381 had menstrual abnormalities (34.65%). Among 132 women with coexisting refractory epilepsy and menstrual abnormalities, 86 (65.15%) were diagnosed with refractory focal epilepsy, and 46 (34.86%) had generalized refractory epilepsy (p value = 0.041). Oligomenorrhea-hypomenorrhea was the most common type of menstrual abnormality in women with refractory epilepsy seen in 83 (62.87%) (p value = 0.039). The most common brain MRI pathology in women with refractory focal epilepsy was mesial temporal sclerosis (MTS) (39.20%, p = 0.00). We report that almost one-third of women with refractory epilepsy suffer from menstrual disorders, and the most common disorder was Oligomenorrhea-hypomenorrhea, and the most common brain pathology was MTS. It has also been a hypothesis that reproductive dysfunctions are connected to temporal lobe malfunctions, and more specific studies are required in this issue.

The relationship between menstrual disorders and education in women with intractable epilepsy.

OBJECTIVE: The study aimed to investigate the relationship between menstrual disorders and education in women with intractable epilepsy. METHOD: This was a descriptive-analytical study. Statistical population consisted of all female patients with intractable epilepsy in 15-45 age group who visited the third department of epilepsy in Ayatollah Kashani Hospital. The sample size was 380. They were selected using simple random sampling. A questionnaire was distributed among the patients to collect information on education, incidence and type of current menstrual disorder (each type of menstrual disorder was explained to the participants). Then, the relationship between education and prevalence of menstrual disorders in these women was investigated. FINDINGS: Analysis of Spearman correlation coefficient showed a significant and negative correlation between education and menstrual disorder (P≤0.05). Analysis of multivariate logistic regression also showed a significant relationship between education and types of menstrual disorders. There was also a significant relationship between education and regular and irregular menstruation (P≤0.05). CONCLUSION: There is a significant relationship between education and menstrual disorders in women with intractable epilepsy, and the higher education level indicates less prevalent menstrual irregularities.

The correlation between cluster seizures and findings of magnetic resonance imaging in drug refractory epilepsy patients.

BACKGROUND: Epilepsy is a chronic neurologic condition and affects peoples at all ages. Seizure clusters are generally referred to seizures that occur at close intervals with complete recovery between attacks. Various studies have reported a variety of frequencies and risk factors for this condition. METHOD: We designed a study to determine the frequency of seizure cluster and to determine neuroimaging findings in these patients and also to evaluate the Correlation between Cluster Seizures and Findings of Magnetic Resonance Imaging in Drug Refractory Epilepsy patients. RESULTS: After analyzing data from 568 refractory epilepsy patients, we found that the prevalence of cluster seizure variant is 14.43%. 29.26% of patients with a history of cluster seizure had no obvious abnormal MRI findings whereas 14.40 % of patients without history of cluster seizure had no obvious abnormal MRI findings (P-value <0.05). Compared to Drug Refractory Epilepsy patients without history of seizure clusters, patients with a history of seizure clusters had less abnormal MRI findings, less Mesial Temporal Sclerosis, and more Focal Cortical Dysplasia in Magnetic Resonance Imaging (p value <0.05). CONCLUSIONS: Seizure cluster has a significant negative impact on the quality of life of patients. According to results of this study it seems that brain MRI findings of drug refractory epilepsy patients with a history of seizure clusters are different from brain MRI findings of drug refractory epilepsy patients without a history of seizure clusters. mesial temporal sclerosis is less frequent and focal cortical dysplasia is more frequent in brain MRI of drug refractory epilepsy patients with a history of seizure clusters compared to drug refractory epilepsy patients without a history of seizure clusters.

Frequency of Seizure Clusters and Their Associated Risk Factors in Adult Patients with Epilepsy Referred to Epilepsy Center of Kashani Hospital in Isfahan from 2011 to 2016.

BACKGROUND: Epilepsy is a chronic neurologic condition and affects people of all ages. Seizure clusters are generally referred to seizures that occur at close intervals with complete recovery between attacks. Various studies have reported a variety of frequencies and risk factors for this condition. METHODS: We designed a study to determine the frequency of seizure cluster and their associated risk factors in Iranian population for the first time. RESULTS: Among 40 variables analyzed, 18 of them were significantly associated with seizure clustering. Risk factors including educational level, age of onset, number of drugs, seizure types, perinatal complication, developmental delay, other illnesses, parental consanguinity, systemic diseases, number of drugs used, mentation, motor signs, sensory signs, cranial nerves signs, cerebellar signs, seizure duration, existence of magnetic resonance imaging (MRI) lesion, and type of MRI pathology are significantly associated with clustering of seizures. When associated risk factors were analyzed with multivariate analysis, age of onset of seizures, number of antiepileptic drugs currently used, lack of seizure-free periods, seizure frequency, and type of MRI pathology are significantly defining for anticipating clustering of seizures. CONCLUSIONS: Seizure cluster has a significant negative impact on the quality of life of patients. Important risk factors that are found to be associated are age of onset, parental consanguinity, frequency of seizure, lack of have seizure-free period or periods, pathologies in neurological examination, and MRI findings.

Anti-NMDA Receptor Encephalitis Presenting with Status Epilepticus: Brucellosis as a Possible Triggering Factor: A Case Report.

Brucellosis is a common zoonotic infection caused by bacterial genus Brucella, a Gram-negative bacterium, and continued to be a health problem in endemic areas. Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is an autoimmune disease which can lead to status epilepticus. A 19-year-old male patient was referred to our hospital with status epilepticus. The diagnosis of brucellosis was confirmed about 2 weeks before. The brain magnetic resonance imaging was normal. Lumbar puncture was performed, and cerebral spinal fluid (CSF) was in normal limits. The patient was treated with antiepileptic, anti-brucellosis agents. Two weeks after discharge, the patient readmitted to hospital with status epilepticus again. Extensive workup was negative except that NMDAR antibodies were detected in serum and CSF. The diagnosis of anti-NMDAR encephalitis was established. Brucellosis as a triggering factor for NMDAR encephalitis should be considered.