Purpose:To evaluate the effect of antiepileptic drugs (AEDs) on cognition and behavior in adult epileptic males controlled on treatment with conventional antiepileptic medications.Methods:Cognitive, mood, behavior and personality traits were assessed in 45 epileptic patients treated with carbamazepine and/or valproate and free of seizures for ≥1 year. Thirty-four newly diagnosed or untreated patients with epilepsy and 58 matched healthy subjects were also included for comparison. A battery of psychometric tests was utilized including Stanford-Binet (4th edition), Beck Inventory for Depression, Aggressive Scale and Eysenck Personality Questionnaire.Results:Compared to matched control subjects, treated and untreated epileptic patients had poor performance in different cognitive and behavioral functions testing. Treated patients had worse scores in memory for digits forward and backward, total short-term memory, extroversion and psychosis. The duration of AEDs intake was correlated with memory of objects (r = −0.323; P = 0.030), bead memory (r = −0.314; P = 0.036) and total nonverbal short-term memory (r = −0.346; P = 0.020). Treated and untreated epileptic patients had poor performance of similar extent in behavioral functions testing (depression, aggression and neurosis). The dose of AEDs was correlated with testing scores for neurosis (r = 0.307; P = 0.040), verbal aggression (r = 0.483; P = 0.001) and nonverbal aggression (r = 0.526; P = 0.000), and duration of drug intake was correlated with scores for depression (r = 0.384; P = 0.009), psychosis (r = 0.586; P = 0.0001) and nonverbal aggression (r = 0.300; P = 0.045).Conclusions:This study provides support for the notion that AEDs can impair performance in cognition, mood and behavior. Duration of drug intake and the number of the utilized AEDs are the main confounding variables. This study did not provide clues on how to exclude the effect of epilepsy itself and psychosocial variables as additional important confounding variables.

No abstract

ABSTRACT:Background:Basal ganglia (BG) lesions are rarely reported in patients with uremia and may manifest by movement disorders. However, their exact incidence and pathogenesis have not been extensively studied. This study aimed to determine the frequency, types, risk variables (clinical, laboratory, and imaging), and manifestations of BG lesions with uremia and patients’ neurologic outcomes.Methods:This observational study included 70 adults (mean age: 45.87 ± 3.36 years; duration of uremia: 5.5 ± 1.5 years). They underwent extensive evaluations (clinical, laboratory, and neuroimaging) and had prospectively evaluated clinically every 3 months for 2 years. Repeated magnetic resonance imaging (MRI) brains were done to patients with movement disorders and correlated with their neurologic outcomes.Results:BG lesions were found in 15 patients (21.4%) and 6 (8.6%) had movement disorders [Parkinsonism (n = 4), choreo-dystonia (n = 1) and dystonia (n = 1)] after the onset of uremia (mean = 10 months). There were no characteristic risk variables that distinguished patients with movement disorders from those without. Five developed movement disorders prior to the period of the study and one was de novo. The majority was females and had diabetes and higher frequencies of abnormal renal dysfunction, metabolic derangements, and white matter hyperintensities in MRIs. Movement disorders persisted in all patients despite the resolution of neuroimaging in three patients.Conclusions:There is no clear threshold for renal failure to result in movement disorders due to BG lesions. The clinical outcome is variables depending on each patient’s comorbidities and complications. Persistent neuronal damage (due to uremic toxins/metabolic/nutritional and ischemic/microvascular factors) has been suggested as the cause of poor neurologic outcomes.

We describe an unusual clinical and diagnostic feature of a patient with multiple sclerosis (MS). A 25-year-old woman was admitted to the Neurology department (December 2009) with one month history of rapid cognitive deterioration. She had poor cognition, dysphasia, reduction in visual acuity and temporal pallor of the optic discs. She had prolonged latencies of P100 component of visual evoked potentials (VEPs). Magnetic resonance imaging (MRI)-brain showed multifocal large (≥ 3 cm) white-matter hypointense lesions in T1W and hyperintense in T2W and fluid-attenuated inversion recovery images and patchy enhancement. A diagnosis of tumefactive MS was given. She received two consecutive 5-d courses of 1 g daily intravenous methylprednisolone for 2 mo and oral prednisolone in dose of 80 mg twice/daily in between. At the 3(rd) month, Mini Mental State Examination and VEPs returned to normal but not the MRI. Patient continued oral steroids after hospital discharge (March 2010) for 9 mo with significant MRI improvement after which tapering of steroids started for a year. The patient refused immunomodulation therapy due to her low socioeconomic status. Neither clinical relapse nor new MRI lesions were observed throughout the next 4 years. In spite of the aggressive course of tumefactive MS variant, good prognosis may be seen in some patients.

Research Article Recently, the using of stem cells transplantation in clinical purposes is markedly increased (Cantarelli et al. 2015). Stem cells are undifferentiated cells and had the ability to transform into another type of cells, so would be a potential source of pancreatic islet β-cells, the insulin producing cells (Zhu et al. 2012). Regarding stem cells, mesenchymal stem cells (MSCs) are admitted as influential modulators for immune system and have possible therapeutic profits (Portha et al. 2011). There are an increased data showed that there are many therapeutic ABSTRACT Diabetes is a complex chronic endocrinal distinguished with increased blood glucose level and insufficient insulin secretion and function. This disease is leading to many complications and considered as one of the most massive causes of mortality or morbidity around the world. The successful treatment of diabetes is how to regenerate pancreatic islets β-cells. The current study aimed to investigate the effect of mesenchymal stem cells (MSCs) transplantation as a new strategy for treatment of diabetes in Streptozotacin (STZ) induced diabetic male albino rats. To achieve this goal, thirty male albino rats (160-180 grams) were used in this work. Animals were divided into three groups; each of ten rats. Group I, Normal healthy control. Group II, STZ (45 mg/kg) induced diabetic group which left without treatment. Group III, STZ diabetic induced group and treated with MSC.s (2 × 106 cells/rat) via penial vein. After six weeks of treatment, animals were sacrificed; blood samples for biochemical estimations and organs of pancreas, liver, and kidney were removed for histopathological examination. The results revealed that the diabetic group had significant increase in glucose, ALT, AST, ALP, MDA, creatinine, urea, LDL, TGs, and cholesterol levels in addition to significant decrease in insulin and HDL levels. After six weeks of MSCs transplantation, the treated group showed a significant amelioration in these biochemical parameters. Histopathological examination showed an improvement in the histological structure of pancreas, liver and kidney tissues in the MSCs treated group compared with the degeneration observed in the diabetic untreated group which was in accordance with the biochemical finding. In conclusion: treatment with MSC.s transplantation as a cell-therapy could restore pancreatic β-cell function and improved liver and kidney functions in diabetes as a new strategy for diabetes treatment. However, more studies at this field are required.