Background:Oxidative stress has been a frequent finding in epileptic patients receiving antiepileptic drugs (AEDs). In this study, the influence of Vitamin E on the antiseizure activity and redox state of patients treated with carbamazepine, sodium valproate, and levetiracetam has been investigated.Materials and Methods:This double-blind, placebo-controlled trial was carried out on 65 epileptic patients with chronic antiepileptic intake. The subjects received 400 IU/day of Vitamin E or placebo for 6 months. Seizure frequency, electroencephalogram (EEG), and redox state markers were measured monthly through the study.Results:Total antioxidant capacity, catalase and glutathione were significantly higher in Vitamin E received group compared with controls (P < 0.05) whereas malodialdehyde levels did not differ between two groups (P < 0.07). Vitamin E administration also caused a significant decrease in the frequency of seizures (P < 0.001) and improved EEG findings (P = 0.001). Of 32 patients in case group, the positive EEG decreased in 16 patients (50%) whereas among 33 patients in control group only 4 patients (12.1%) showed decreased positive EEG.Conclusion:The results of this preliminary study indicate that coadministration of antioxidant Vitamin E with AEDs improves seizure control and reduces oxidative stress.

Citation for the original published paper (version of record):Tavakoli, M., Barekatain, M., Doust, H., Molavi, H., Kormi Nouri, R. et al. (2011) Cognitive impairments in patients with intractable temporal lobe epilepsy. Sciences, 16(11): 1466Sciences, 16(11): -1472 Access to the published version may require subscription. N.B. When citing this work, cite the original published paper. Cognitive impairment associated with temporal lobe epilepsy (TLE) has been recognized in multiple studies. We designed this study to find a specific cognitive profile in patients with TLE who were candidates for epilepsy surgery. We also sought to find if neuropsychological assessment could differentiate left TLE, right TLE and normal subjects. Journal of Research in Medical

Background:Catamenial epilepsy is a kind of epilepsy, known in this name, when the periodicity of the exacerbation of the seizure is in association with menstural cycle. The present study examined the progesterone effectiveness as a complementary treatment in women with intractable catamenial epilepsy.Materials and Methods:The present study was conducted as a double-blind randomized controlled trial on 38 women with intractable catamenial epilepsy. Patients were assessed in two groups: The case group received in addition to AEDs, two (Mejestrol) 40 mg progesterone tablets in the second half of the cycle from 15th to 25th day. And the control group received in addition to AEDs, two placebo tablets daily. Age, BMI, epilepsy duration, types of the drugs used, progesterone level, and the number of the seizures in 3 months before and after the study were compared.Results:Based on the results of which there was no statistically significant difference in regard to age, BMI, epilepsy duration, types of the drugs used, progesterone level between the case and the control groups (P-value > 0.05). The number of the seizures after treatment has significantly decreased compared to before-treatment state. The degree of decreasing in the case group receiving the progesterone was higher than in the control group receiving the placebo. The difference, thus, is significant, based on statistical tests (P-value = 0.024).Conclusion:Based on the findings of this study using progesterone in women with intractable catamenial epilepsy has a significant effect on the degree of decreasing in the number of the seizures.

Background:Epilepsy is a rare neurologic disorder during pregnancy. Despite its rarity, it could cause different clinical problems in this natural phenomenon of a woman's life. The aim of this study was to evaluate and compare the course of pregnancy and labor and their outcome in epileptic and healthy women.Materials and Methods:This study was performed during years 2009--2011 in Alzahra and Beheshti hospitals affiliated to Isfahan University of Medical Sciences. A total of 51 pregnant women, who were known cases of epilepsy and were on antiepileptic drugs treatment for at least 3 months, were compared with 47 matched healthy pregnant women without epilepsy. They were followed before and during their pregnancy in several visits and all of their neurologic and obstetric information were collected. For statistical analysis of continuous variables, the t-test was used. The chi-square test was used for dichotomous variables.Results:The rate of monotherapy was more than polytheraphy especially during the pregnancy. The epileptic attacks stopped in majority of patients during the pregnancy. Vaginal bleeding (P=0.020) and abortion (P=0.015) were significantly more frequent among epileptic mothers. The gestational age was lower meaningfully (P= 0.010) in epileptic patients’ neonates and the first minute Apgar score was lower in these babies too (P=0.028).Conclusions:Antiepileptic drugs could have some unsuitable effects on pregnancy course especially by increasing the rate of abortion, preterm labor, and vaginal bleeding. Their adverse effects on neonates’ health could not be neglected.

Ictal asystole is a rare, probably underestimated manifestation of epileptic seizures whose pathophysiology is still debated. This report describes two patients who had cardiac asystole at the end of their seizure. The first patient was a 13-year-old boy with complex partial seizures.. His MRI showed symmetrical signal abnormality in the bilateral parietooccipital lobe accompanied by mild gliosis and volume loss. During a 3-day long-term video-EEG monitoring, he had cardiac arrest at the end of one of his seizures that was secondarily generalized. The second one was a 42-year-old veteran with penetrating head trauma in the left frontal lobe due to shell injury. During long-term video-EEG monitoring, he had one generalized tonic–clonic seizure accompanied by bradycardia and cardiac asystole. Asystoles could have a role in the incidence of sudden unexpected death in epilepsy (SUDEP), meaning that the presence of ictal bradycardia is a risk factor for SUDEP. In cases of epileptic cardiac dysrhythmia, prolonged simultaneous EEG/ECG monitoring may be required. Cardiological investigation should be included in epilepsy management.

Background: Epilepsy is considered as one of the most important disorders in neurology. Temporal lobe epilepsy is a form of epilepsy including two main types of mesial and lateral (neocortex). Objectives: Determination and comparison of electroencephalogram (EEG) pattern in the ictal and interictal phases of mesial and lateral temporal lobe epilepsy. Materials and Methods: This cross-sectional descriptive study included 80 patients with mesial and lateral temporal lobe epilepsy who satisfied the inclusion criteria. The patients were monitored using EEG, and then the EEG results were compared between two groups of temporal epilepsies. Results: There was no significant difference between two groups of patients (mesial and lateral temporal lobe epilepsy) in terms of the type of seizure, history of tumor or trauma or hypoxia, and duration of seizure history (p>0.05). The ictal wave onset in 52.5% of the patients was in the left temporal region, and the ictal wave onset in 58.75% of patients was the slow wave. There was no significant difference between the two groups of patients in terms of ictal wave onset and its location. Conclusions: According to the results, EEG is a good method for detecting temporal lobe epilepsy, but it does not help to differentiate the type of mesial and lateral temporal epilepsy. In order to distinguish between these two types, EEG alone is not helpful, and other diagnostic methods are required.

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