Exploring psychiatric comorbidities and their effects on quality of life in patients with temporal lobe epilepsy and juvenile myoclonic epilepsy.

AIM: The relation of epilepsy with psychiatric disorders is of great interest to researchers due to its behavioral, social, and cognitive outcomes. In this study, we explored psychiatric comorbidity and its effects on quality of life (QOL) in patients with mesial temporal lobe epilepsy (MTLE) and juvenile myoclonic epilepsy (JME). METHODS: Thirty patients with MTLE, 30 patients with JME, and 30 healthy controls underwent the Structured Clinical Interview for DSM-IV (SCID-I) to diagnose psychiatric disorders. None of the subjects had previously undergone psychiatric examination. The Quality of Life in Epilepsy Inventory-89 (QOLIE-89) was used to assess QOL. We compared psychiatric comorbidity among groups and evaluated its effects on QOL. RESULTS: We detected comorbid psychiatric disorders in 37% of patients with JME and in 57% of patients with MTLE. Comorbid psychiatric disorders were less frequent in healthy controls compared to the patient groups (P = 0.029). Comparing demographic and clinical features of patients with JME and MTLE and their mean QOL scores, there was no statistical difference. Furthermore, we compared QOLIE scores between patients with and without psychiatric comorbidity. JME patients with mood disorders had lower scores on the Attention/Concentration subscale (P = 0.013). MTLE patients with a psychotic disorder had lower scores on the Social Isolation, Energy, and Fatigue subscales (P = 0.045). Patients with somatoform disorders had higher Pain scores (P = 0.04). CONCLUSION: Our study suggests that comorbid psychiatric disorders negatively affect patients' QOL regardless of seizure syndrome. Comorbid psychiatric conditions should be determined to increase QOL in patients with epilepsy.

Chronic manganese toxicity due to substance abuse in Turkish patients.

BACKGROUND: Manganese toxicity may lead to a levodopa-resistant akinetic-rigid syndrome. Pathological changes occur mostly in the pallidium and stratium. MATERIALS AND METHODS: We report seven patients with a new form of chronic manganese toxicity due to long-term intravenous use of a solution consisting of ephedrine, acetylsalicylic acid and potassium permanganate as a psycho-stimulant, popularly known as "Russian Cocktail". RESULTS: The age of the patients ranged between 19 and 31 years, and the duration of substance abuse was between nine and 106 months. The onset of symptoms from first use ranged seven to 35 months. The initial symptom was impaired speech followed by gait disturbance and bradykinesia. In addition to these symptoms, choreic movements, ataxia presenting as backward falls and dystonia were also seen. Serum and urine samples revealed high levels of manganese. Hyperintense lesions on T1-weighted magnetic resonance imaging were seen in bilateral basal ganglia and brainstem, dentate nuclei, features consistent with manganese intoxication. CONCLUSION: Manganese toxicity, which may cause a distinctive irreversible neurodegenerative disorder, can be seen frequently with "Russian Cocktail" abuse, a substance which can be accessed very easily and at a low cost.

Frequency of epilepsies in family members of patients with different epileptic syndromes.

AIM: To determine the frequency of epilepsies in the family members of epileptic patients. METHODS: The records of 4,851 patients with epilepsy were reviewed. The frequency and patterns of different epilepsies and epileptic syndromes in the patients, number of affected relatives and consanguinity were studied. RESULTS: A total of 1,753 patients were excluded due to various reasons. Of the remaining patients, 296 (9.5% of 3,098) had first- or second-degree relatives affected with seizures. The incidence of family history in the localization-related cryptogenic epilepsies group was significantly higher than all other groups (246 patients). Juvenile myoclonic epilepsy was the most frequent epileptic syndrome (34 patients). Consanguinity was detected in 56 patients, and 33 (58.9%) of these subjects were in the localization-related cryptogenic epilepsies group. Of all subjects, 59 (19.9%) had more than 1 epileptic family member. The ratio of affected first- to second-degree relatives was 202/94. CONCLUSIONS: A considerable number of the relatives of epileptic patients have seizures. The risk of relatives being affected depends on their relationship with the proband. Genetic factors may play an almost equal role in the predisposition of relatives to epilepsy in families of probands with cryptogenic and idiopathic epileptic syndromes.